Unveiling the incidences and trends of the neglected zoonosis cystic echinococcosis in Europe: a systematic review from the MEmE project

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 center dot 64 cases per 100 000 people and in EU member states was 0 center dot 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.

Automated summary

Cystic echinococcosis, a neglected zoonosis, is prevalent in pastoral and rural communities in low-income and upper-middle-income countries. In Europe, it is considered an orphan and rare disease, but its under-reporting by national health systems is a practical issue. This study extracted data on human cystic echinococcosis cases in Europe from 1997 to 2021, revealing a total of 64,745 cases from 40 European countries. The highest incidence rates were found in southeastern European countries, while historical endemic Mediterranean countries showed a decrease in cases over time.