Abstract
Cystic echinococcosis is a chronic, complex and neglected zoonotic disease with considerable socio-economic impact on the affected population. Even though Mongolia is included in the list of high cystic echinococcosis risk countries, there has been very limited research and evidence on the prevalence or prevention of cystic echinococcosis. This field-based cross-sectional study to investigate the prevalence of cystic echinococcosis and its potential risk factors in Mongolia was conducted from April 2016 to March 2018. A total of 1,993 people were examined by ultrasound in five provinces of Mongolia. All cystic echinococcosis positive cases were classified according to the WHO-IWGE expert recommendations. The logistic regression model was used to detect the association between the presence of echinococcus infection and each potential risk factor. This was the first community survey based on ultrasound screening in Mongolia. We found 98 cystic echinococcosis cases (prevalence = 4.9%), including 85 abdominal ultrasound cystic echinococcosis positive cases and 13 abdominal ultrasound cystic echinococcosis negative cases (surgically treated cystic echinococcosis cases 11, and 2 confirmed cases of lung cystic echinococcosis by chestcomputed tomography in hospital of Ulaanbaatar). The prevalence of cystic echinococcosis varied greatly among different provinces, ranging from 2.0% to 13.1%. Children, elderly people and those with lower education had higher chances of getting cystic echinococcosis. Rather than dog ownership itself, daily practice for cleaning dog feces was associated with increased odds of cystic echinococcosis. The results of the present study show very high endemicity of cystic echinococcosis in Umnugovi province. Evaluation of potential risk factors associated with cystic echinococcosisshow high significance for following factors: demographics (age), social condition (education level) and hygiene practices (cleaning dog feces and use of gloves). Children under 18 and elderly people are considered as the most risk age groups in Mongolia.
Highlights
Cystic echinococcosis (CE) is well-known as one of the most frequent zoonotic diseases in the world, and has considerable social and economic impacts on the affected human population [1,2,3]
The results of the present study revealed very high endemicity of CE in Umnugovi province
Evaluation of potential risk factors associated with CE shows high significance for following factors: demographics, social condition and hygiene practices
Summary
Cystic echinococcosis (CE) is well-known as one of the most frequent zoonotic diseases in the world, and has considerable social and economic impacts on the affected human population [1,2,3]. The socio-economic consequences caused by CE are related with direct and indirect expenses including diagnostic procedures, hospitalization and treatment costs, and quality of human life. It has been reported as an endemic disease in many areas in the world such as Peru, Chile, Central Asia and western China. Intermediate hosts are infected by Echinococcus eggs via ingesting contaminated food or water. The oncospheral embryos released from the eggs penetrate the small intestine of the intermediate hosts, enter the bloodstream and migrates into various organs, especially liver (80%) and lungs [6]. The oncosphere further develops into an echinococcal cyst (metacestode) which is a spherical, unilocular and fluidfilled cyst that grows gradually and contains many thousands of protoscolices
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