Imported cystic echinococcosis in Spain: a systematic review.

BACKGROUND Cystic echinococcosis (CE) is a zoonosis caused by Echinococcus granulosus (sensu lato). It is a neglected tropical disease with a global distribution, affecting an estimated 2-3 million people globally. Official reporting systems in Spain lack information concerning imported cases and their country of origin. METHODS This is a systematic review of the literature that was performed to obtain published cases of immigrant patients diagnosed with CE in Spain. RESULTS From the 21 included articles, a total of 84 cases of CE imported into Spain were documented from 1995 to 2018, with an average age of 33.2 years. The main countries of origin of the patients were Morocco with 30 cases (35.7%), Romania with 12 cases (14.3%) and Peru with 8 cases (9.5%). The most involved organ was the liver (28 cases [33.3%]). We found discrepancies between the published cases of imported CE in Spain and those reported by official authorities. CONCLUSIONS This review of the literature shows the lack of information and clarity in the mechanisms of CE notification in Spain. The disparity between these systems and the cases documented in the literature highlights a failure or shortcoming of the current reporting system.