TY - JOUR
T1 - The burden of parasitic zoonoses in Nepal
T2 - a systematic review
AU - Devleesschauwer, Brecht
AU - Ale, Anita
AU - Torgerson, Paul
AU - Praet, Nicolas
AU - Maertens de Noordhout, Charline
AU - Pandey, Basu Dev
AU - Pun, Sher Bahadur
AU - Lake, Rob
AU - Vercruysse, Jozef
AU - Joshi, Durga Datt
AU - Havelaar, Arie H
AU - Duchateau, Luc
AU - Dorny, Pierre
AU - Speybroeck, Niko
N1 - FTX
PY - 2014
Y1 - 2014
N2 - BACKGROUND: Parasitic zoonoses (PZs) pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY). However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding.METHODOLOGY: We examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs.PRINCIPAL FINDINGS: Between 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI): 5450-27,694] and 9255 DALYs [95% CrI: 6135-13,292], respectively), followed by cystic echinococcosis (251 DALYs [95% CrI: 105-458]). Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur.CONCLUSIONS/SIGNIFICANCE: In settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this study would enable additional burden estimates, and a more complete picture of the impact of these diseases.
AB - BACKGROUND: Parasitic zoonoses (PZs) pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY). However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding.METHODOLOGY: We examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs.PRINCIPAL FINDINGS: Between 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI): 5450-27,694] and 9255 DALYs [95% CrI: 6135-13,292], respectively), followed by cystic echinococcosis (251 DALYs [95% CrI: 105-458]). Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur.CONCLUSIONS/SIGNIFICANCE: In settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this study would enable additional burden estimates, and a more complete picture of the impact of these diseases.
KW - Animals
KW - Endemic Diseases
KW - Humans
KW - Nepal
KW - Parasitic Diseases
KW - Prevalence
KW - Zoonoses
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
KW - Review
U2 - 10.1371/journal.pntd.0002634
DO - 10.1371/journal.pntd.0002634
M3 - A1: Web of Science-article
C2 - 24392178
SN - 1935-2727
VL - 8
SP - e2634
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
IS - 1
ER -