부산대학교 도서관

Background: Cystic echinococcosis (CE) is a neglected zoonotic disease that is caused by Echinococcus granulosus sensu lato (s.l.), the life cycle of which involves multiple hosts. We conducted a systematic review (SR) on E. granulosus s.l. in the Greater Horn of Africa (GHA), to provide a picture of its recent epidemiology across all hosts. Methods: For this SR, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, five electronic databases, as well experts in the region were consulted to retrieve records published between 2000 and 2022, reporting the presence of E. granulosus s.l. infections in any natural host in the GHA (Djibouti, Eritrea, Ethiopia, Kenya, Sudan, Somalia, South Sudan, Tanzania and Uganda). Principal findings: A total of 247 records were retained, describing the presence of E. granulosus s.l. throughout the GHA, except for Djibouti. Only few population surveys on human CE were conducted in the area, with the prevalence ranging between 0.3 and 11.3%. In animals, the reported prevalence ranged up to 61.6% in camels, 88.4% in cattle; 65.2% in goats, 9.9% in pigs, 67.8% in sheep and 94.5% in dogs. In addition, E. granulosus s.l. was also reported in wildlife. A total of five species were reported in the different hosts, namely E. granulosus sensu stricto (G1, G3, GOmo), E. canadensis (G6/7), E. ortleppi (G5), E. felidis, and E. equinus (G4). Conclusions: We confirm that E. granulosus s.l. is prevalent throughout the GHA. Nevertheless, despite our efforts to screen grey literature, an accurate assessment of the epidemiology in GHA remains challenging, due to the lack of combined host, in-depth risk factor and behavioural studies, as well as the wide diversity in subpopulations studied and diagnostic tools used. Interdisciplinary and transboundary partnerships would be essential for the design of effective control strategies, tuned to the GHA setting. Author summary: Cystic echinococcosis (CE) is a disease caused by the tapeworm Echinococcus granulosus that affects both humans and animals. In the Greater Horn of Africa (GHA), the livelihoods of millions of people depend on livestock and herding dogs. At the same time, poor animal slaughter practices still exist in the area. Therefore, the GHA is considered a textbook example for the transmission of E. granulosus. Nevertheless, although the World Health Organization (WHO) prioritized CE as one of the seven neglected zoonotic tropical diseases, a recent summary on the true extent to which the tapeworm occurs across the different host species in the GHA, and the factors that contribute to its transmission is missing. Our systematic review of the literature on the topic confirms that the tapeworm is widely spread in the GHA. At the same time, it remains difficult to accurately assess the occurrence of the worm and how exactly it spreads between the hosts, in absence of well-designed surveys. Based on the nature of the disease (involving both animals and humans) and the disease being highly prevalent in pastoralist communities that move across national borders, a firm response to control CE will require both interdisciplinary and transboundary partnerships. [ABSTRACT FROM AUTHOR]