Abstract

BackgroundA national control program for echinococcosis has been in effect since 2005 in China. This program has applied a comprehensive strategy, and good control results have been achieved. Human echinococcosis prevalence rate decrease from 1.08% in 2004 to 0.24% in 2012. The objective of this study is focusing on assessment of the programme with two indices, including patient treatment and registered dogs deworming, in endemic areas of echincoccosis control over the period of 10 years (2004–2014) in China.MethodsWe established the database including demography at county and township levels with coverage for ten provinces and autonomous regions of China in this study. We using methods of epidemiological descriptive, instead the expectation-maximization for missing value filling for grouping available patients into those subjected to surgery and those receiving drug treatment after population screening and the dogs population after registered by deworming. We performed Microsoft Excel software and SPSS software on the results as percentages with the corresponding 95% confidence intervals (95% CIs). We also statistically analyzed the economics data on patient treatment and dogs deworming after the corresponding discount with annual bank interest rates (USD 1 = CNY 6.5, bank discount average changes of 2.3–3.3%).ResultsDuring 2004–2014, the grant total average rate of surgical patient (after surgical operation) treatment had increased with 32.4% and with 81.3% for medical treatment with albendazole. Meanwhile, it increased by 58.6% for the deworming of registered dog since 2007. The accumulated costs amounted to USD 27.03 million after discount for patients and registered dog treatment, which is 1/4 of the total accumulated financial inputs (USD 110.67 million from the Chinese Government). Since the implementation of the national program, it has increased 57 times with respect to the annual financial inputs (costs) and 368 times with respect to all accumulated financial inputs (costs).ConclusionsThis study showed that in endemic areas, patient diagnosis and management, dog management and treatment over this period helped reduce the parasite load to control the disease. More attention should be paid to controlling wild canines during the ongoing program period and sustainable follow-up evaluations are crucial for success and continued implementation of the national program.

Highlights

  • A national control program for echinococcosis has been in effect since 2005 in China

  • Humans intervention During the period 2004–2014, the total number of human echinococcosis cases reported in the endemic areas ranged from 1749 to 31 507 among 56.7–79.7 million inhabitants at the county level and 19.3–39.1 million inhabitants at the township level

  • Because disease surveillance was not performed in the endemic regions due to the uneven development of disease control, the actual and accurate data of the dogs in which infection was not reported until 2012, with the exception of large-scale treatment schemes of the dog population using praziquantel tablets, whereas unpublished data based on Echioncoccus coproantigen ELISA tests for Population Available Proportion of patients subjected to surgical interventions (%)

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Summary

Introduction

A national control program for echinococcosis has been in effect since 2005 in China. This program has applied a comprehensive strategy, and good control results have been achieved. Human echinococcosis prevalence rate decrease from 1.08% in 2004 to 0.24% in 2012. The objective of this study is focusing on assessment of the programme with two indices, including patient treatment and registered dogs deworming, in endemic areas of echincoccosis control over the period of 10 years (2004–2014) in China. Infection in humans/livestock/small mammals is caused by the larval stage of the parasite. Canines (i.e. dogs, foxes, and wolves) are the definitive hosts and play a key role in the transmission and dissemination of the adult stage of this tapeworms belonging to genus Echinococcus. Expressed in global disability-adjusted life years (DALYs), losses of 0.3–1 million DALYs for CE and 0.65 million DALYs for AE, respectively, have been reported [2,3,4,5]

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