Unveiling the incidences and trends of the neglected zoonosis cystic echinococcosis in Europe: a systematic review from the MEmE project
Adriano Casulli, Bernadette Abela-Ridder, Daniele Petrone, Massimo Fabiani, Branko Bobić, David Carmena, Barbara Šoba, Enver Zerem, Maria João Gargaté, Gordana Kuzmanovska, Cristian Calomfirescu, Iskra Rainova, Smaragda Sotiraki, В. Лунгу, Balázs Dezsényi, Zaida Herrador, Jacek Karamon, Pavlo Maksimov, Antti Oksanen, Laurence Millon, Mario Sviben, Renata Shkjezi, Valbona Gjoni, Ilir Akshija, Urmas Saarma, Paul R. Torgerson, Viliam Šnábel, Daniela Antolová, D Muhović, Hasan Besim, Fanny Chéreau, Moncef Belhassen‐García, François Chappuis, Severin Gloor, Marcel Stoeckle, Beat Müllhaupt, Valerio Manno, Azzurra Santoro, Federica Santolamazza
Abstract
The neglected zoonosis cystic echinococcosis affects mainly pastoral and rural communities in both low-income and upper-middle-income countries. In Europe, it should be regarded as an orphan and rare disease. Although human cystic echinococcosis is a notifiable parasitic infectious disease in most European countries, in practice it is largely under-reported by national health systems. To fill this gap, we extracted data on the number, incidence, and trend of human cases in Europe through a systematic review approach, using both the scientific and grey literature and accounting for the period of publication from 1997 to 2021. The highest number of possible human cases at the national level was calculated from various data sources to generate a descriptive model of human cystic echinococcosis in Europe. We identified 64 745 human cystic echinococcosis cases from 40 European countries. The mean annual incidence from 1997 to 2020 throughout Europe was 0·64 cases per 100 000 people and in EU member states was 0·50 cases per 100 000 people. Based on incidence rates and trends detected in this study, the current epicentre of cystic echinococcosis in Europe is in the southeastern European countries, whereas historical endemic European Mediterranean countries have recorded a decrease in the number of cases over the time.