Populations at Risk for Alveolar Echinococcosis, France

Martine Piarroux,Jérôme Dumortier,Jenny Knapp,Alain Gerard,Jérôme Watelet,For The Francechino Surveillance Network ,Renaud Piarroux,Armand Abergel,Karine Bardonnet,Solange Bresson-Hadni,Jean Gaudart,Jean Beytout

doi:10.3201/eid1905.120867

Abstract

During 1982–2007, alveolar echinococcosis (AE) was diagnosed in 407 patients in France, a country previously known to register half of all European patients. To better define high-risk groups in France, we conducted a national registry-based study to identify areas where persons were at risk and spatial clusters of cases. We interviewed 180 AE patients about their way of life and compared responses to those of 517 controls. We found that almost all AE patients lived in 22 départements in eastern and central France (relative risk 78.63, 95% CI 52.84–117.02). Classification and regression tree analysis showed that the main risk factor was living in AE-endemic areas. There, most at-risk populations lived in rural settings (odds ratio [OR] 66.67, 95% CI 6.21–464.51 for farmers and OR 6.98, 95% CI 2.88–18.25 for other persons) or gardened in nonrural settings (OR 4.30, 95% CI 1.82–10.91). These findings can help sensitization campaigns focus on specific groups.

Highlights

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not
Because many patients who received a diagnosis of alveolar echinococcosis (AE) during the 1980s and the 1990s were lost to follow-up or had died, only part of the cohort could be interviewed
A heterogeneous geographic distribution of AE has been reported in numerous foci, such as in Hokkaido, Japan, where humans cases spread from the various areas where infected foxes were introduced in the 1920s [23]; in the People’s Republic of China, where the disease is endemic to only the western and northern provinces and the autonomous regions [24]; and in other European countries such as Poland, Germany, Austria, and Switzerland [7]

Summary

Introduction

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. There, most at-risk populations lived in rural settings (odds ratio [OR] 66.67, 95% CI 6.21–464.51 for farmers and OR 6.98, 95% CI 2.88–18.25 for other persons) or gardened in nonrural settings (OR 4.30, 95% CI 1.82–10.91). These findings can help sensitization campaigns focus on specific groups. Dumortier); and University Hospital Nancy, Nancy, France

Objectives

Methods

Results

Conclusion