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The burden of parasitic zoonoses in Nepal: a systematic review.
[congenital toxoplasmosis]
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
.
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
.
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
.
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
.
Diseases
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"complete picture of the impact of these diseases"
symptom
congenital toxoplasmosis
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