Evidence-Based Semiquantitative Methodology for Prioritization of Foodborne Zoonoses
Evidence-Based Semiquantitative Methodology for Prioritization of Foodborne Zoonoses
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DOI：
10.1089/fpd.2009.0291
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发表时间：
2009-11-01
影响因子：
2.8
通讯作者：
Dierick, Katelijne
中科院分区：
文献类型：
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作者：
Cardoen, Sabine;Van Huffel, Xavier;Dierick, Katelijne
目标：优先考虑食品和水传播人畜共患病的扩展清单，使食品安全当局能够将重点放在食品链中最相关的危害上。方法：采用循证半定量方法。由动物和公共卫生、食品、临床微生物学和流行病学领域的35名科学专家根据与公共卫生（严重程度和在人类中发生）、动物卫生（疾病严重程度与经济后果和在动物中发生）和食品（在食品中发生）相关的5个标准对51种人畜共患病原体进行评分。评分程序是标准化的，并以证据为基础，为每个人畜共患病原体提供了一套与五个标准相关的相同的最新帮助信息数据。独立地，这五个标准的相对重要性由七个食品链风险管理人员加权。人畜共患病原体根据总体加权得分进行排名，并按四个统计上不同的重要程度分组。结果：最重要的食源性人畜共患致病菌为沙门氏菌、弯曲杆菌、单核细胞增生李斯特菌和产毒大肠杆菌。第二组“意义重大”的包括刚地弓形虫（牛海绵状脑病的病原体）、肉毒梭菌、金黄色葡萄球菌、细小隐孢子虫、牛分枝杆菌、细粒棘球球菌、链球菌、多房棘球球菌、小肠结肠炎耶尔森菌、鸟分枝杆菌、肝片吸虫、肠贾第鞭毛虫和轮状病毒。结论：该方法可以客观地对51种人畜共患病原体进行排名，并考虑到风险评估者和风险管理者的综合输入。应用：这些结果支持食品安全决策者建立食源性人畜共患病的多年监测计划。它们还能够确定关于特定人畜共患病原体的知识差距，并制定关键的研究问题。基本上，这种确定优先次序的方法是普遍感兴趣的，因为它可以应用于任何其他排名工作和在任何国家。
Objectives: To prioritize an extended list of food- and water-borne zoonoses to allow food safety authorities to focus on the most relevant hazards in the food chain.Methods: An evidence-based semiquantitative methodology was developed. Scores were given by 35 scientific experts in the field of animal and public health, food, and clinical microbiology and epidemiology to 51 zoonotic agents according to five criteria related to public health (severity and occurrence in humans), animal health (severity of disease coupled with economic consequences and occurrence in animals), and food (occurrence in food). The scoring procedure was standardized and evidence-based as experts were provided, for each zoonotic agent, a same set of up-to-date help information data related to the five criteria. Independently, the relative importance of the five criteria was weighted by seven food chain risk managers. The zoonotic agents were ranked based on overall weighted scores and were grouped in four statistically different levels of importance.Results: The following foodborne zoonotic pathogens were classified as "most important'': Salmonella spp., Campylobacter spp., Listeria monocytogenes, and verocytotoxigenic Escherichia coli. A second group of "significant importance'' included Toxoplasma gondii, the agent of bovine spongiform encephalopathy, Clostridium botulinum, Staphylococcus aureus, Cryptosporidium parvum, Mycobacterium bovis, Echinococcus granulosus, Streptococcus spp., Echinococcus multilocularis, Yersinia enterocolitica, Mycobacterium avium, Fasciola hepatica, Giardia intestinalis, and Rotavirus.Conclusions: This methodology allowed to rank 51 zoonotic agents with objectivity and taking account of a combined input from risk assessors and risk managers.Applications: These results support food safety policy makers to establish the multiannual monitoring program of foodborne zoonoses. They also enable to identify knowledge gaps on specific zoonotic agents and to formulate key research questions. Principally, this method of prioritization is of general interest as it can be applied for any other ranking exercise and in any country.