Worldwide literature on epidemiology of human alveolar echinococcosis: a systematic review of research published in the twenty-first century

Abstract

Purpose: Human alveolar echinococcosis (AE) is a potentially lethal zoonosis caused by the cestode Echinococcus multilocularis. The aim of this systematic review is to establish a comprehensive global AE literature overview taking into account the epidemiologically relevant AE research of the twenty-first century.

Methods: We systematically searched the global literature published from 2001 through 2018 via MEDLINE, EMBASE, the Russian databases eLIBRARY.RU, CyberLeninka, the Chinese databases CNKI, VIP, Journals.

Research: ac.ir (Farsi language-based), Jordan E-Library (Arab language-based) and supplementary Google Scholar, in accordance with the PRISMA guidelines. QGIS software was used for the mapping of the affected countries.

Results: We have listed 154 relevant publications in the final literature synopsis in consideration of our quality assessment. Including non-autochthonous cases, human AE was reported in 36 countries within the northern hemisphere from 2001 to 2018. The first publication of AE in Tajikistan, Pakistan, South Korea, Belgium, the Netherlands, Slovakia, Hungary, Lithuania, Latvia, Slovenia and Morocco occurred in this century; further first cases in Taiwan, Thailand, and Denmark were considered to be non-autochthonous by the authors. The highest total case numbers (n ≥ 100 in a single article) were reported in France, Germany, Switzerland, Poland, and Lithuania, including China and Kyrgyzstan with by far the highest prevalence figures.

Conclusions: Our paper emphasises the increasing spread of reported cases and the rise in its numbers in the literature of the twenty-first century, especially in western, northern and eastern Europe, as well as in central Asia. Epidemiological studies on human infections are lacking in many parts of the world.

Keywords: Alveolar echinococcosis; Echinococcus multilocularis; Geographical distribution; Maps; Prevalence; Worldwide epidemiology.

Fig. 1

Following the PRISMA guidelines, the flowchart represents the algorithm for article selection

Fig. 2

Worldwide distribution of alveolar echinococcosis in humans according to the published literature 2001–2018. Each country in which cases of AE had been reported in the literature between 2001 and 2018 was mapped. For the topographical colour shading of a country, the highest total number of cases in one reference within this period was the deciding factor

Fig. 3

Current distribution of alveolar echinococcosis in humans according to the published literature 2001–2018 in China. Each province in which cases of AE had been reported in the literature between 2001 and 2018 was mapped. For the topographical colour shading of a province, the highest total number of cases in one reference within this period was the deciding factor

Fig. 4

The twelve most frequently listed countries on which epidemiologically relevant papers on AE were published, according to the inclusion and exclusion criteria (data of publication 2001–2018). Redundancy possible