Abstract
Human cystic echinococcosis (CE) is known to be endemic in the Tibet Autonomous Region (TAR), China; however, there is relatively little data from hospital records or community prevalence studies, and the situation regarding occurrence of human alveolar echinococcosis (AE) is unclear. Here we review the available reports about human echinococcosis in the seven prefectures of TAR. In addition, two pilot studies by mass screening using ultrasound (with serology) were undertaken (2006/7) in Dangxiong County of Lhasa Prefecture (north central TAR) and Dingqing County of Changdu Prefecture (eastern TAR). In Dangxiong County a prevalence of 9.9% (55/557) for human CE was obtained but no human AE cases were detected. By contrast, in Dingqing County (N= 232 persons screened), 11 CE cases (4.7%) and 12 AE cases (5.2%) (including one mixed CE and AE case) were diagnosed by ultrasound. Hospital records and published reports indicated that CE cases were recorded in all of seven prefectures in Tibet Autonomous Region, and AE cases in four prefectures. Incidence rates of human CE were estimated to range from 1.9 to 155 per 100,000 across the seven prefectures of TAR, with a regional incidence of 45.1 per 100,000. Incidence of AE was estimated to be between 0.6 and 2.8 cases per 100,000. Overall for TAR, human AE prevalence appeared relatively low; however, the pilot mass screening in Dingqing in eastern TAR indicated that human AE disease is a potential public health problem, possibly similar to that already well described in Tibetan communities bordering TAR in north-west Sichuan and south-west Qinghai provinces.
Highlights
Human cystic echinococcosis (CE) and alveolar echinococcosis (AE) are helminthic zoonotic diseases caused by infection with the metacestode stages of Downloaded from https://www.cambridge.org/core
In order to investigate the status of human echinococcosis in Tibet Autonomous Region (TAR), we reviewed published reports on echinococcosis in the TAR up to 2006/7, and patient records from the People’s Hospital of Changdu Prefecture in eastern TAR
In addition to serum samples collected in association with the active ultrasound-based screening in Dangxiong and Dingqing counties, a panel of archived sera was available from an earlier ultrasound survey (2003, N 1⁄4 722) carried out in Qusong County (Shannan Prefecture) in south-central TAR
Summary
Human cystic echinococcosis (CE) and alveolar echinococcosis (AE) are helminthic zoonotic diseases caused by infection with the metacestode stages of Downloaded from https://www.cambridge.org/core. A national echinococcosis control programme was implemented from 2006/7 in western China with emphasis on dog deworming, but has not yet been rolled out effectively in the more remote communities in western China, including north-west Xinjiang and much of the Tibet Autonomous Region (TAR) (Craig et al, 2007, 2008; van Kesteren et al, 2015) The burden of both human CE and AE disease is known to be high in Tibetan communities located in north-west Sichuan and south-west Qinghai provinces on the eastern Tibetan plateau (Budke et al, 2005; Li et al, 2005, 2010). We carried out pilot community studies based on mass ultrasound screening in Dangxiong County of Lhasa Prefecture and Dingqing County of Changdu Prefecture (eastern TAR)
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