Countries across the globe are currently experiencing a third or fourth wave of SARS-CoV-2 infect... more Countries across the globe are currently experiencing a third or fourth wave of SARS-CoV-2 infections; therefore, the need for effective vaccination campaigns is higher than ever. However, effectiveness of these campaigns in disease reduction is highly dependent on vaccination uptake and coverage in susceptible populations. Therefore, this systematic review and meta-analysis estimated the vaccination intention and identified determinants of willingness and hesitancy. This study updates the existing body of literature on vaccination willingness, and was conducted according to the PRISMA guidelines. PubMed was searched for publications, selecting only studies published between 20 October 2020 and 1 March 2021, in English, with participants aged >16 years of age. The search identified 411 articles, of which 63 surveys were included that accounted for more than 30 countries worldwide. The global COVID-19 vaccination willingness was estimated at 66.01% [95% CI: 60.76–70.89% I2 = 99.4%...
Dirk Berkvens for the opportunity to conduct this master thesis and for all the support, educatio... more Dirk Berkvens for the opportunity to conduct this master thesis and for all the support, education and useful feedback throughout its construction. Under the very helpful guidance of Dirk Berkvens the whole process was one of "learning by doing", which triggered my intellectual capabilities. For me it was a great experience; it gave me the opportunity to combine my veterinary background with new epidemiological-and mathematical skills. I have always had an interest in epidemiology, but the Veterinary Epidemiology course and subsequent Master Thesis even further increased this sincere interest. I like the fact that it has a great balance between its theoretical part and its practical side with impact on a great scale. Special recognition is given to Dr. Anisur Rahman for the supply of information about the study area, the field-and laboratory work, which resulted in the data used in this study, and the valuable feedback. In addition, my sincere thanks go my parents for the trust and support they have given me to successfully complete this Master of Science. In my struggle, during the last few years, to get myself back on track they have helped me enormously. Without their love and care i could never have reached where i am now. Thank you mum and dad for everything. I would also like to thank my brother, Gerben, for being such a good friend and for insisting on fun times during the hard work. New years evening was the start of a new beginning.. Further more, thanks to all my friends for making my life "as awesome as it can be" and for always being there for me.
Background: In Vietnam, few studies have determined the epidemiological status of toxoplasmosis i... more Background: In Vietnam, few studies have determined the epidemiological status of toxoplasmosis in pregnant women and no routine prenatal screening is in place. This study was conducted to evaluate the seroprevalence of this zoonotic parasitic infection in pregnant women in Northern Vietnam and to assess the association with awareness, risk factors and congenital toxoplasmosis. Methods: Approximately 800 pregnant women were included in the study from two hospitals, one in Hanoi and one in Thai Binh province, which is known to have a dense cat population. Serological immunoglobulin G (IgG) and immunoglobulin M (IgM) detection was performed to estimate the seroprevalence of toxoplasmosis and sero-incidence of maternal and congenital toxoplasmosis. In addition, a survey was conducted about awareness, clinical history, presentation of signs and symptoms relating to toxoplasmosis and to detect biologically plausible and sociodemographic risk factors associated with toxoplasmosis. Associations with seroprevalence were assessed using univariable and multivariable analysis. Results: The mean IgG seroprevalence after the full diagnostic process was 4.5% (95% confidence interval(CI): 2.7-7.0) and 5.8% (95% CI: 3.7-8.6) in Hanoi and Thai Binh hospital, respectively, and included one seroconversion diagnosed in Thai Binh hospital. Only 2.0% of the pregnant women in Hanoi hospital and 3. 3% in Thai Binh hospital had heard about toxoplasmosis before this study. Conclusion: Since the percentage of seronegative, and thus susceptible, pregnant women was high and the awareness was low, we suggest to distribute information about toxoplasmosis and its prevention among women of child bearing age. Furthermore, future studies are recommended to investigate why such a low seroprevalence was seen in pregnant women in Northern Vietnam compared to other countries in South East Asia and globally.
In Vietnam, no systematic prenatal toxoplasmosis screening is in place, and only few studies have... more In Vietnam, no systematic prenatal toxoplasmosis screening is in place, and only few studies have assessed the prevalence and importance of this zoonotic parasite infection. In addition, no studies have been conducted to assess the risk factors associated with toxoplasmosis. This study protocol was developed to determine the seroprevalence of toxoplasmosis in pregnant women in Hanoi and Thai Binh, Northern Vietnam, and to evaluate the association with risk factors and congenital toxoplasmosis. The protocol was developed in a way that it could potentially evolve into a countrywide prenatal diagnosis and prevention program, with the main focus on primary prevention. The collaborating gynaecologists will invite eligible pregnant women attending antenatal care for the first time to participate in the study. At first consult, information about toxoplasmosis and its prevention will be provided. All participants will be asked to fill in a questionnaire, which is designed to analyse socio-d...
The pork tapeworm Taenia solium causes an important economic and health burden, mainly in rural o... more The pork tapeworm Taenia solium causes an important economic and health burden, mainly in rural or marginalized communities of sub-Saharan Africa, Asia and Latin-America. Although improved pig rearing conditions seem to have eliminated the parasite in most Western European countries, little is known about the true endemicity status of T. solium throughout Europe. Three recent reviews indicate that autochthonous human T. solium taeniosis/cysticercosis may be possible in Europe, but that current peer-reviewed literature is biased towards Western Europe. Officially reported data on porcine cysticercosis are highly insufficient. Favourable conditions for local T. solium transmission still exist in eastern parts of Europe, although the ongoing integration of the European Union is speeding up modernisation and intensification of the pig sector. Further evidence is urgently needed to fill the gaps on the European T. solium endemicity map. We urge to make human cysticercosis notifiable and to improve the reporting of porcine cysticercosis.
Background: To support public health policy, information on the burden of disease is essential. I... more Background: To support public health policy, information on the burden of disease is essential. In recent years, the Disability-Adjusted Life Year (DALY) has emerged as the most important summary measure of public health. DALYs quantify the number of healthy life years lost due to morbidity and mortality, and thereby facilitate the comparison of the relative impact of diseases and risk factors and the monitoring of public health over time. Discussion: Evidence on the disease burden in Belgium, expressed as DALYs, is available from international and national efforts. Non-communicable diseases and injuries dominate the overall disease burden, while dietary risks, tobacco smoking, and high body-mass index are the major risk factors for ill health. Notwithstanding these efforts, if DALYs were to be used for guiding health policy, a more systematic approach is required. By integrating DALYs in the current data generating systems, comparable estimates, rooted in recent local data, can be produced. This might however be hampered by several restrictions, such as limited harmonization, timeliness, inclusiveness and accessibility of current databases. Summary: Routine quantification of disease burden in terms of DALYs would provide a significant added value to evidence-based public health policy in Belgium, although some hurdles need to be cleared.
Congenital toxoplasmosis (CT) and cytomegalovirus infection (cCMV) may cause significant morbidit... more Congenital toxoplasmosis (CT) and cytomegalovirus infection (cCMV) may cause significant morbidity and even fetal or neonatal mortality. We aimed to quantify the disease burden of CT and cCMV in Belgium in terms of disability-adjusted life years (DALYs) and identify data gaps. The public health impact of CT and cCMV in Belgium in 2013 was 188 (95% uncertainty interval [UI], 43-419) and 1976 (95% UI, 757-4067) DALYs, respectively. The major data gaps identified were representative Belgian studies; information on important sequelae, intrauterine mortality, and termination of pregnancy; and late onset sequelae. A scenario analysis showed important increases in years of life lost when the burden due to fetal losses was included and decreases in DALYs when comprehensive CT prevention measures were conducted. Addressing the key data gaps identified may allow generation of the data needed to break the vicious circle of underrecognition.
List of Figures ix List of Tables xi List of Abbreviations xiii 1 Introduction 1 2 Objectives 37 ... more List of Figures ix List of Tables xi List of Abbreviations xiii 1 Introduction 1 2 Objectives 37 3 The public health impact of congenital cytomegalovirus infection in Belgium, 2013: A systematic review and data synthesis 41 4 The disease burden of congenital cytomegalovirus infection in the European Union, 2013: A systematic review and data synthesis 53 5 The seroprevalence of cytomegalovirus infection in Belgium anno 2002 and 2006: A comparative analysis with hepatitis A virus seroprevalence 69 6 The public health impact of congenital toxoplasmosis in Belgium, 2013: A systematic review and data synthesis 89 7 Sero-epidemiological status and risk factors of toxoplasmosis in pregnant women in Northern Vietnam 8 General discussion 123 Bibliography Summary Résumé 169 Samenvatting 175 Curriculum Vitae Acknowledgements viii ix List of Figures 1.1. Estimated mean global cytomegalovirus seroprevalences in women of reproductive age. 1.2. Food-borne and environmental contamination sources of Toxoplasma gondii infection in cats, humans and other warm blooded animals. Adapted from Robert-Gangneux and Dardé (2012). 3.1. Flowchart showing study selection for the systematic review on the seroprevalence and incidence of toxoplasmosis and cytomegalovirus infections in women of childbearing age and the incidence of both congenital infections in Belgium. 3.2. Variable importance analysis indicating which parameters influence the DALY estimate for congenital cytomegalovirus infection in Belgium. 3.3. Bar plot of the results of three scenarios examining the public health impact of congenital cytomegalovirus infection. 4.1. Flowchart showing study selection for the systematic review on the incidence of congenital cytomegalovirus infection in the European Union. 4.2. Estimated incidence of congenital cytomegalovirus infection per 10 000 live births in the European Union. 4.3. Bar plots of the congenital cytomegalovirus infection burden in terms of DALYs per 10 000 live births in the different countries of the European Union. 5.1. Cytomegalovirus seroprevalence in function of age in 2002 and 2006 estimated by using splines and fixed cutoffs and by the mixture model. 5.2. Cytomegalovirus seroprevalence by birth cohort in 2002 and 2006 estimated by splines and fixed cutoffs and by the mixture models (rows) for the total population, males and females (columns). 5.3. Cytomegalovirus seroincidence by birth cohort in 2006 compared to 2002 estimated using splines and fixed cutoffs and by the mixture models (rows) for the total population, males and females (columns). x 5.4. Age-specific cytomegalovirus seroprevalence by Belgian region in 2002 and 2006 estimated using splines and the fixed cutoffs. 5.5. Seroprevalence of hepatitis A virus antibodies as a function of age and birth cohorts in 1993, 2002 and 2006 resulting from primary infection or vaccination using splines and the fixed cutoffs .
We evaluated the performance of three serological tests – an immunoglobulin G indirect enzyme lin... more We evaluated the performance of three serological tests – an immunoglobulin G indirect enzyme linked immunosorbent assay (iELISA), a Rose Bengal test and a slow agglutination test (SAT) – for the diagnosis of bovine brucellosis in Bangladesh. Cattle sera (n = 1360) sourced from Mymensingh district (MD) and a Government owned dairy farm (GF) were tested in parallel. We used a Bayesian latent class model that adjusted for the conditional dependence among the three tests and assumed constant diagnostic accuracy of the three tests in both populations. The sensitivity and specificity of the three tests varied from 84.6% to 93.7%, respectively. The true prevalences of bovine brucellosis in MD and the GF were 0.6% and 20.4%, respectively. Parallel interpretation of iELISA and SAT yielded the highest negative predictive values: 99.9% in MD and 99.6% in the GF; whereas serial interpretation of both iELISA and SAT produced the highest positive predictive value (PPV): 99.9% in the GF and also ...
Following the first report of Opisthorchis viverrini infection in a domestic duck in Phu My Distr... more Following the first report of Opisthorchis viverrini infection in a domestic duck in Phu My District of Binh Dinh Province, Central Vietnam, many other cases were observed in the province. We determined the infection rate and intensity of O. viverrini infection in ducks in 4 districts of the province. A total of 178 ducks were randomly selected from 34 farms for examination of flukes in the liver and gall bladder. An infection rate of 34.3% (range 20.7-40.4% among districts) was found; the intensity of infection was 13.8 worms per infected duck (range 1-100). These findings show the role of ducks as a host for O. viverrini, duck genotype, which is sympatric with the human O. viverrini genotype in this province. It also stresses the need for investigations on the zoonotic potential and the life cycle of this parasite.
Taenia solium taeniasis/cysticercosis is a neglected zoonotic disease complex occurring primarily... more Taenia solium taeniasis/cysticercosis is a neglected zoonotic disease complex occurring primarily in developing countries. Though claimed eradicated from the European Union (EU), an increasing number of human neurocysticercosis cases is being detected. Risk factors such as human migration and movement of pigs/pork, as well as the increasing trend in pig rearing with outside access are discussed in this review. The entry of a tapeworm carrier into the EU seems a lot more plausible than the import of infected pork. The establishment of local transmission in the EU is presently very unlikely. However, considering the potential changes in risk factors, such as the increasing trend in pig farming with outdoor access, the increasing human migration from endemic areas into the EU, this situation might change, warranting the establishment of an early warning system, which should include disease notification of taeniasis/cysticercosis both in human and animal hosts. As currently human-to-hum...
Countries across the globe are currently experiencing a third or fourth wave of SARS-CoV-2 infect... more Countries across the globe are currently experiencing a third or fourth wave of SARS-CoV-2 infections; therefore, the need for effective vaccination campaigns is higher than ever. However, effectiveness of these campaigns in disease reduction is highly dependent on vaccination uptake and coverage in susceptible populations. Therefore, this systematic review and meta-analysis estimated the vaccination intention and identified determinants of willingness and hesitancy. This study updates the existing body of literature on vaccination willingness, and was conducted according to the PRISMA guidelines. PubMed was searched for publications, selecting only studies published between 20 October 2020 and 1 March 2021, in English, with participants aged >16 years of age. The search identified 411 articles, of which 63 surveys were included that accounted for more than 30 countries worldwide. The global COVID-19 vaccination willingness was estimated at 66.01% [95% CI: 60.76–70.89% I2 = 99.4%...
Dirk Berkvens for the opportunity to conduct this master thesis and for all the support, educatio... more Dirk Berkvens for the opportunity to conduct this master thesis and for all the support, education and useful feedback throughout its construction. Under the very helpful guidance of Dirk Berkvens the whole process was one of "learning by doing", which triggered my intellectual capabilities. For me it was a great experience; it gave me the opportunity to combine my veterinary background with new epidemiological-and mathematical skills. I have always had an interest in epidemiology, but the Veterinary Epidemiology course and subsequent Master Thesis even further increased this sincere interest. I like the fact that it has a great balance between its theoretical part and its practical side with impact on a great scale. Special recognition is given to Dr. Anisur Rahman for the supply of information about the study area, the field-and laboratory work, which resulted in the data used in this study, and the valuable feedback. In addition, my sincere thanks go my parents for the trust and support they have given me to successfully complete this Master of Science. In my struggle, during the last few years, to get myself back on track they have helped me enormously. Without their love and care i could never have reached where i am now. Thank you mum and dad for everything. I would also like to thank my brother, Gerben, for being such a good friend and for insisting on fun times during the hard work. New years evening was the start of a new beginning.. Further more, thanks to all my friends for making my life "as awesome as it can be" and for always being there for me.
Background: In Vietnam, few studies have determined the epidemiological status of toxoplasmosis i... more Background: In Vietnam, few studies have determined the epidemiological status of toxoplasmosis in pregnant women and no routine prenatal screening is in place. This study was conducted to evaluate the seroprevalence of this zoonotic parasitic infection in pregnant women in Northern Vietnam and to assess the association with awareness, risk factors and congenital toxoplasmosis. Methods: Approximately 800 pregnant women were included in the study from two hospitals, one in Hanoi and one in Thai Binh province, which is known to have a dense cat population. Serological immunoglobulin G (IgG) and immunoglobulin M (IgM) detection was performed to estimate the seroprevalence of toxoplasmosis and sero-incidence of maternal and congenital toxoplasmosis. In addition, a survey was conducted about awareness, clinical history, presentation of signs and symptoms relating to toxoplasmosis and to detect biologically plausible and sociodemographic risk factors associated with toxoplasmosis. Associations with seroprevalence were assessed using univariable and multivariable analysis. Results: The mean IgG seroprevalence after the full diagnostic process was 4.5% (95% confidence interval(CI): 2.7-7.0) and 5.8% (95% CI: 3.7-8.6) in Hanoi and Thai Binh hospital, respectively, and included one seroconversion diagnosed in Thai Binh hospital. Only 2.0% of the pregnant women in Hanoi hospital and 3. 3% in Thai Binh hospital had heard about toxoplasmosis before this study. Conclusion: Since the percentage of seronegative, and thus susceptible, pregnant women was high and the awareness was low, we suggest to distribute information about toxoplasmosis and its prevention among women of child bearing age. Furthermore, future studies are recommended to investigate why such a low seroprevalence was seen in pregnant women in Northern Vietnam compared to other countries in South East Asia and globally.
In Vietnam, no systematic prenatal toxoplasmosis screening is in place, and only few studies have... more In Vietnam, no systematic prenatal toxoplasmosis screening is in place, and only few studies have assessed the prevalence and importance of this zoonotic parasite infection. In addition, no studies have been conducted to assess the risk factors associated with toxoplasmosis. This study protocol was developed to determine the seroprevalence of toxoplasmosis in pregnant women in Hanoi and Thai Binh, Northern Vietnam, and to evaluate the association with risk factors and congenital toxoplasmosis. The protocol was developed in a way that it could potentially evolve into a countrywide prenatal diagnosis and prevention program, with the main focus on primary prevention. The collaborating gynaecologists will invite eligible pregnant women attending antenatal care for the first time to participate in the study. At first consult, information about toxoplasmosis and its prevention will be provided. All participants will be asked to fill in a questionnaire, which is designed to analyse socio-d...
The pork tapeworm Taenia solium causes an important economic and health burden, mainly in rural o... more The pork tapeworm Taenia solium causes an important economic and health burden, mainly in rural or marginalized communities of sub-Saharan Africa, Asia and Latin-America. Although improved pig rearing conditions seem to have eliminated the parasite in most Western European countries, little is known about the true endemicity status of T. solium throughout Europe. Three recent reviews indicate that autochthonous human T. solium taeniosis/cysticercosis may be possible in Europe, but that current peer-reviewed literature is biased towards Western Europe. Officially reported data on porcine cysticercosis are highly insufficient. Favourable conditions for local T. solium transmission still exist in eastern parts of Europe, although the ongoing integration of the European Union is speeding up modernisation and intensification of the pig sector. Further evidence is urgently needed to fill the gaps on the European T. solium endemicity map. We urge to make human cysticercosis notifiable and to improve the reporting of porcine cysticercosis.
Background: To support public health policy, information on the burden of disease is essential. I... more Background: To support public health policy, information on the burden of disease is essential. In recent years, the Disability-Adjusted Life Year (DALY) has emerged as the most important summary measure of public health. DALYs quantify the number of healthy life years lost due to morbidity and mortality, and thereby facilitate the comparison of the relative impact of diseases and risk factors and the monitoring of public health over time. Discussion: Evidence on the disease burden in Belgium, expressed as DALYs, is available from international and national efforts. Non-communicable diseases and injuries dominate the overall disease burden, while dietary risks, tobacco smoking, and high body-mass index are the major risk factors for ill health. Notwithstanding these efforts, if DALYs were to be used for guiding health policy, a more systematic approach is required. By integrating DALYs in the current data generating systems, comparable estimates, rooted in recent local data, can be produced. This might however be hampered by several restrictions, such as limited harmonization, timeliness, inclusiveness and accessibility of current databases. Summary: Routine quantification of disease burden in terms of DALYs would provide a significant added value to evidence-based public health policy in Belgium, although some hurdles need to be cleared.
Congenital toxoplasmosis (CT) and cytomegalovirus infection (cCMV) may cause significant morbidit... more Congenital toxoplasmosis (CT) and cytomegalovirus infection (cCMV) may cause significant morbidity and even fetal or neonatal mortality. We aimed to quantify the disease burden of CT and cCMV in Belgium in terms of disability-adjusted life years (DALYs) and identify data gaps. The public health impact of CT and cCMV in Belgium in 2013 was 188 (95% uncertainty interval [UI], 43-419) and 1976 (95% UI, 757-4067) DALYs, respectively. The major data gaps identified were representative Belgian studies; information on important sequelae, intrauterine mortality, and termination of pregnancy; and late onset sequelae. A scenario analysis showed important increases in years of life lost when the burden due to fetal losses was included and decreases in DALYs when comprehensive CT prevention measures were conducted. Addressing the key data gaps identified may allow generation of the data needed to break the vicious circle of underrecognition.
List of Figures ix List of Tables xi List of Abbreviations xiii 1 Introduction 1 2 Objectives 37 ... more List of Figures ix List of Tables xi List of Abbreviations xiii 1 Introduction 1 2 Objectives 37 3 The public health impact of congenital cytomegalovirus infection in Belgium, 2013: A systematic review and data synthesis 41 4 The disease burden of congenital cytomegalovirus infection in the European Union, 2013: A systematic review and data synthesis 53 5 The seroprevalence of cytomegalovirus infection in Belgium anno 2002 and 2006: A comparative analysis with hepatitis A virus seroprevalence 69 6 The public health impact of congenital toxoplasmosis in Belgium, 2013: A systematic review and data synthesis 89 7 Sero-epidemiological status and risk factors of toxoplasmosis in pregnant women in Northern Vietnam 8 General discussion 123 Bibliography Summary Résumé 169 Samenvatting 175 Curriculum Vitae Acknowledgements viii ix List of Figures 1.1. Estimated mean global cytomegalovirus seroprevalences in women of reproductive age. 1.2. Food-borne and environmental contamination sources of Toxoplasma gondii infection in cats, humans and other warm blooded animals. Adapted from Robert-Gangneux and Dardé (2012). 3.1. Flowchart showing study selection for the systematic review on the seroprevalence and incidence of toxoplasmosis and cytomegalovirus infections in women of childbearing age and the incidence of both congenital infections in Belgium. 3.2. Variable importance analysis indicating which parameters influence the DALY estimate for congenital cytomegalovirus infection in Belgium. 3.3. Bar plot of the results of three scenarios examining the public health impact of congenital cytomegalovirus infection. 4.1. Flowchart showing study selection for the systematic review on the incidence of congenital cytomegalovirus infection in the European Union. 4.2. Estimated incidence of congenital cytomegalovirus infection per 10 000 live births in the European Union. 4.3. Bar plots of the congenital cytomegalovirus infection burden in terms of DALYs per 10 000 live births in the different countries of the European Union. 5.1. Cytomegalovirus seroprevalence in function of age in 2002 and 2006 estimated by using splines and fixed cutoffs and by the mixture model. 5.2. Cytomegalovirus seroprevalence by birth cohort in 2002 and 2006 estimated by splines and fixed cutoffs and by the mixture models (rows) for the total population, males and females (columns). 5.3. Cytomegalovirus seroincidence by birth cohort in 2006 compared to 2002 estimated using splines and fixed cutoffs and by the mixture models (rows) for the total population, males and females (columns). x 5.4. Age-specific cytomegalovirus seroprevalence by Belgian region in 2002 and 2006 estimated using splines and the fixed cutoffs. 5.5. Seroprevalence of hepatitis A virus antibodies as a function of age and birth cohorts in 1993, 2002 and 2006 resulting from primary infection or vaccination using splines and the fixed cutoffs .
We evaluated the performance of three serological tests – an immunoglobulin G indirect enzyme lin... more We evaluated the performance of three serological tests – an immunoglobulin G indirect enzyme linked immunosorbent assay (iELISA), a Rose Bengal test and a slow agglutination test (SAT) – for the diagnosis of bovine brucellosis in Bangladesh. Cattle sera (n = 1360) sourced from Mymensingh district (MD) and a Government owned dairy farm (GF) were tested in parallel. We used a Bayesian latent class model that adjusted for the conditional dependence among the three tests and assumed constant diagnostic accuracy of the three tests in both populations. The sensitivity and specificity of the three tests varied from 84.6% to 93.7%, respectively. The true prevalences of bovine brucellosis in MD and the GF were 0.6% and 20.4%, respectively. Parallel interpretation of iELISA and SAT yielded the highest negative predictive values: 99.9% in MD and 99.6% in the GF; whereas serial interpretation of both iELISA and SAT produced the highest positive predictive value (PPV): 99.9% in the GF and also ...
Following the first report of Opisthorchis viverrini infection in a domestic duck in Phu My Distr... more Following the first report of Opisthorchis viverrini infection in a domestic duck in Phu My District of Binh Dinh Province, Central Vietnam, many other cases were observed in the province. We determined the infection rate and intensity of O. viverrini infection in ducks in 4 districts of the province. A total of 178 ducks were randomly selected from 34 farms for examination of flukes in the liver and gall bladder. An infection rate of 34.3% (range 20.7-40.4% among districts) was found; the intensity of infection was 13.8 worms per infected duck (range 1-100). These findings show the role of ducks as a host for O. viverrini, duck genotype, which is sympatric with the human O. viverrini genotype in this province. It also stresses the need for investigations on the zoonotic potential and the life cycle of this parasite.
Taenia solium taeniasis/cysticercosis is a neglected zoonotic disease complex occurring primarily... more Taenia solium taeniasis/cysticercosis is a neglected zoonotic disease complex occurring primarily in developing countries. Though claimed eradicated from the European Union (EU), an increasing number of human neurocysticercosis cases is being detected. Risk factors such as human migration and movement of pigs/pork, as well as the increasing trend in pig rearing with outside access are discussed in this review. The entry of a tapeworm carrier into the EU seems a lot more plausible than the import of infected pork. The establishment of local transmission in the EU is presently very unlikely. However, considering the potential changes in risk factors, such as the increasing trend in pig farming with outdoor access, the increasing human migration from endemic areas into the EU, this situation might change, warranting the establishment of an early warning system, which should include disease notification of taeniasis/cysticercosis both in human and animal hosts. As currently human-to-hum...
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