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Meta-Analysis
. 2022 May 17:10:821265.
doi: 10.3389/fpubh.2022.821265. eCollection 2022.

Risk Factors Associated With Echinococcosis in the General Chinese Population: A Meta-Analysis and Systematic Review

Tiantian Zhang  1 , Bin Li  1 , Yuying Liu  1 , Shou Liu  1
Affiliations
Meta-Analysis

Risk Factors Associated With Echinococcosis in the General Chinese Population: A Meta-Analysis and Systematic Review

Tiantian Zhang et al. Front Public Health. .

Abstract

Background: Echinococcosis is a severe zoonotic disease that imposes a substantial burden on human life. This meta-analysis aimed to summarize available data on the prevalence of human echinococcosis and identify the key risk factors for echinococcosis in the Chinese general population.

Methods: Relevant studies were comprehensively searched in the PubMed, EMBASE, Web of Science, Cochrane, Chinese National Knowledge Infrastructure (CNKI), Chongqing VIP Information (VIP), Wanfang and SinoMed databases until August 22, 2020. A random-effects model was used to estimate the pooled odds ratio (OR) and 95% confidence interval (95% CI). The I2 and Q statistics were calculated to evaluate the heterogeneity, and potential sources of heterogeneity were identified using sensitivity analysis and subgroup analysis. Publication bias was estimated by funnel plots and Egger's test.

Results: A total of 1026 studies were identified through the database search, of which 26 were eligible for this meta-analysis. The pooled prevalence of AE and CE were 2.88% and 5.66%, respectively. Ethnicity (OR = 2.93, 95% CI: 1.81-4.75; I2 = 0), herdsman occupation (OR = 2.66, 95% CI: 2.25-3.14; I2 = 8.0%), not washing hands before meals (OR = 2.40, 95% CI: 1.34-4.28; I2 = 82.8%) and being female (OR = 1.45, 95% CI: 1.26-1.66; I2 = 33.9%) were risk factors for AE. The top five risk factors for CE were ethnicity (OR = 3.18, 95% CI: 1.55-6.52; I2 = 79.2%), nomadism (OR = 2.71, 95% CI: 1.65-4.47; I2 = 55.8%), drinking nonboiled water (OR = 2.47, 95% CI: 1.36-4.47; I2 = 85.7), feeding viscera to dogs (OR = 2.35, 95% CI: 1.89-2.91; I2 = 21.5%), and herdsman occupation (OR = 2.19, 95% CI: 1.67-2.86; I2 = 85.1%).

Conclusions: This study generalized articles that have contributed to our current understanding of the epidemic of human echinococcosis (AE and CE) in China over the years. The results support that the ethnicity and dog-related factors are major risk factors for both CE and AE. The identification of echinococcosis risk factors may aid researchers and policymakers in improving surveillance and preventive measures aimed at reducing Echinococcus granulosus and Echinococcus multilocularis infection in humans.

Keywords: China; echinococcosis; human; meta-analysis; risk factor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Summary of the literature search and study selection.
Figure 2
Figure 2
Concept map of risk factors for AE and CE.
Figure 3
Figure 3
The forest chart of AE factors. (A) Sex (female/male); (B) Ethnicity (Tibetan/Han); (C) Dog ownership; (D) Playing with dogs; (E) Contanct with fox hides; (F) Not washing hands before meals; (G) Herdsman occupation.
Figure 4
Figure 4
The forest chart of CE factors. (A) Sex (female/male); (B) Ethnicity (Tibetan/Han); (C) Dog ownership; (D) Not washing hands before meals; (E) Herdsman occupation; (F) Feeding viscera to dogs; (G) Drinking nonboiled water; (H) Presence of stray dogs; (I) Number of household dog (with each addition); (J) Nomadism; (K) Eating raw vegetables.
Figure 5
Figure 5
Funnel chart of AE risk factor sex.
Figure 6
Figure 6
Funnel chart of CE risk factor sex before and after study design subgroup analysis.
See this image and copyright information in PMC

References

    1. Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. (2010) 114:1-16. 10.1016/j.actatropica.2009.11.001 - DOI - PubMed
    1. Khan A, Ahmed H, Simsek S, Afzal MS, Cao J. Spread of cystic echinococcosis in pakistan due to stray dogs and livestock slaughtering habits: research priorities and public health importance. Front Public Health. (2019) 7:e412. 10.3389/fpubh.2019.00412 - DOI - PMC - PubMed
    1. Wang X, Dai G, Li M, Jia W, Guo Z, Lu J. Prevalence of human alveolar echinococcosis in China: a systematic review and meta-analysis. BMC Public Health. (2020) 20:1105. 10.1186/s12889-020-08989-8 - DOI - PMC - PubMed
    1. Torgerson PR, Devleesschauwer B, Praet N, Speybroeck N, Willingham AL, Kasuga F, et al. . World health organization estimates of the global and regional disease burden of 11 foodborne parasitic diseases, 2010: a data synthesis. PLoS Med. (2015) 12:e1001920. 10.1371/journal.pmed.1001920 - DOI - PMC - PubMed
    1. Deplazes P, Rinaldi L, Alvarez Rojas CA, Torgerson PR, Harandi MF, Romig T, et al. . Global distribution of alveolar and cystic echinococcosis. Adv Parasitol. (2017) 95:315-493. 10.1016/bs.apar.2016.11.001 - DOI - PubMed

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