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Meta-Analysis
. 2016 Nov 7;10(11):e0005114.
doi: 10.1371/journal.pntd.0005114. eCollection 2016 Nov.

Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis

Alessia Possenti  1   2 , Raúl Manzano-Román  3 , Carlos Sánchez-Ovejero  3 , Belgees Boufana  1   2   4 , Giuseppe La Torre  5 , Mar Siles-Lucas  3 , Adriano Casulli  1   2   4
Affiliations
Meta-Analysis

Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis

Alessia Possenti et al. PLoS Negl Trop Dis. .

Abstract

Background: Scientific literature on cystic echinococcosis (CE) reporting data on risk factors is limited and to the best of our knowledge, no global evaluation of human CE risk factors has to date been performed. This systematic review (SR) summarizes available data on statistically relevant potential risk factors (PRFs) associated with human CE.

Methodology/principal findings: Database searches identified 1,367 papers, of which thirty-seven were eligible for inclusion. Of these, eight and twenty-nine were case-control and cross-sectional studies, respectively. Among the eligible papers, twenty-one were included in the meta-analyses. Pooled odds ratio (OR) were used as a measure of effect and separately analysed for the two study designs. PRFs derived from case-control studies that were significantly associated with higher odds of outcome were "dog free to roam" (OR 5.23; 95% CI 2.45-11.14), "feeding dogs with viscera" (OR 4.69; 95% CI 3.02-7.29), "slaughter at home" (OR 4.67; 95% CI 2.02-10.78) or at "slaughterhouses" (OR 2.7; 95% CI 1.15-6.3), "dog ownership" (OR 3.54; 95% CI 1.27-9.85), "living in rural areas" (OR 1.83; 95% CI 1.16-2.9) and "low income" (OR 1.68; 95% CI 1.02-2.76). Statistically significant PRFs from cross-sectional studies with higher odds of outcome were "age >16 years" (OR 6.08; 95% CI 4.05-9.13), "living in rural areas" (OR 2.26; 95% CI 1.41-3.61), "being female" (OR 1.38; 95% CI 1.06-1.8) and "dog ownership" (OR 1.37; 95% CI 1.01-1.86).

Conclusions/significance: Living in endemic rural areas, in which free roaming dogs have access to offal and being a dog-owner, seem to be among the most significant PRFs for acquiring this parasitic infection. Results of data analysed here may contribute to our understanding of the PRFs for CE and may potentially be useful in planning community interventions aimed at controlling CE in endemic areas.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Searches performed and the number of articles returned and examined at each stage of the research on potential risk factors associated with human cystic echinococcosis (CE).
Fig 2
Fig 2. Key findings on the highly statistically significant (p<0.01) potential risk factors associated with human cystic echinococcosis (CE) derived from the meta-analysis of case-control (C-c) and cross-sectional (C-s) studies.
In blue: possible vertical and horizontal interventions aimed at decreasing or interrupting the transmission of CE to humans.
See this image and copyright information in PMC

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