Epidemiological factors associated with human cystic echinococcosis: a semi-structured questionnaire from a large population-based ultrasound cross-sectional study in eastern Europe and Turkey.
Abdomen
/ diagnostic imaging
Animals
Cross-Sectional Studies
Echinococcosis
/ diagnostic imaging
Europe, Eastern
/ epidemiology
Female
Humans
Logistic Models
Male
Odds Ratio
Prevalence
Risk Factors
Rural Population
/ statistics & numerical data
Surveys and Questionnaires
Turkey
/ epidemiology
Ultrasonography
Zoonoses
/ epidemiology
Bulgaria
Cystic echinococcosis
Eastern Europe
Epidemiology of human infection
Potential risk factors
Romania
Semi-structured questionnaires
Turkey
Journal
Parasites & vectors
ISSN: 1756-3305
Titre abrégé: Parasit Vectors
Pays: England
ID NLM: 101462774
Informations de publication
Date de publication:
29 Jul 2019
29 Jul 2019
Historique:
received:
13
05
2019
accepted:
23
07
2019
entrez:
31
7
2019
pubmed:
31
7
2019
medline:
4
12
2019
Statut:
epublish
Résumé
Cystic echinococcosis (CE) is a neglected parasitic zoonosis prioritized by the WHO for control. Several studies have investigated potential risk factors for CE through questionnaires, mostly carried out on small samples, providing contrasting results. We present the analysis of risk factor questionnaires administered to participants to a large CE prevalence study conducted in Bulgaria, Romania and Turkey. A semi-structured questionnaire was administered to 24,687 people from rural Bulgaria, Romania and Turkey. CE cases were defined as individuals with abdominal CE cysts detected by ultrasound. Variables associated with CE at P < 0.20 in bivariate analysis were included into a multivariable logistic model, with a random effect to account for clustering at village level. Adjusted odds ratios (AOR) with 95% CI were used to describe the strength of associations. Data were weighted to reflect the relative distribution of the rural population in the study area by country, age group and sex. Valid records from 22,027 people were analyzed. According to the main occupation in the past 20 years, "housewife" (AOR: 3.11; 95% CI: 1.51-6.41) and "retired" (AOR: 2.88; 95% CI: 1.09-7.65) showed significantly higher odds of being infected compared to non-agricultural workers. "Having relatives with CE" (AOR: 4.18; 95% CI: 1.77-9.88) was also associated with higher odds of infection. Interestingly, dog-related and food/water-related factors were not associated with infection. Our results point toward infection being acquired in a "domestic" rural environment and support the view that CE should be considered more a "soil-transmitted" than a "food-borne" infection. This result helps delineating the dynamics of infection transmission and has practical implications in the design of specific studies to shed light on actual sources of infection and inform control campaigns.
Sections du résumé
BACKGROUND
BACKGROUND
Cystic echinococcosis (CE) is a neglected parasitic zoonosis prioritized by the WHO for control. Several studies have investigated potential risk factors for CE through questionnaires, mostly carried out on small samples, providing contrasting results. We present the analysis of risk factor questionnaires administered to participants to a large CE prevalence study conducted in Bulgaria, Romania and Turkey.
METHODS
METHODS
A semi-structured questionnaire was administered to 24,687 people from rural Bulgaria, Romania and Turkey. CE cases were defined as individuals with abdominal CE cysts detected by ultrasound. Variables associated with CE at P < 0.20 in bivariate analysis were included into a multivariable logistic model, with a random effect to account for clustering at village level. Adjusted odds ratios (AOR) with 95% CI were used to describe the strength of associations. Data were weighted to reflect the relative distribution of the rural population in the study area by country, age group and sex.
RESULTS
RESULTS
Valid records from 22,027 people were analyzed. According to the main occupation in the past 20 years, "housewife" (AOR: 3.11; 95% CI: 1.51-6.41) and "retired" (AOR: 2.88; 95% CI: 1.09-7.65) showed significantly higher odds of being infected compared to non-agricultural workers. "Having relatives with CE" (AOR: 4.18; 95% CI: 1.77-9.88) was also associated with higher odds of infection. Interestingly, dog-related and food/water-related factors were not associated with infection.
CONCLUSIONS
CONCLUSIONS
Our results point toward infection being acquired in a "domestic" rural environment and support the view that CE should be considered more a "soil-transmitted" than a "food-borne" infection. This result helps delineating the dynamics of infection transmission and has practical implications in the design of specific studies to shed light on actual sources of infection and inform control campaigns.
Identifiants
pubmed: 31358039
doi: 10.1186/s13071-019-3634-1
pii: 10.1186/s13071-019-3634-1
pmc: PMC6664724
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
371Subventions
Organisme : European Commission, Seventh Framework Programme
ID : 602051
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