Prevention Of Echinococcosis Research Articles

Construction and application of a risk index of Echinococcus infection based on the classification of echinococcosis lesions

To investigate the feasibility of constructing the risk index of Echinococcus infection based on the classification of echinococcosis lesions, so as to provide insights into the management of echinococcosis. The imaging data of echinococcosis cases were collected from epidemiological surveys of echinococcosis in China from 2012 to 2016, and the detection of incident echinococcosis cases was captured from the annual echinococcosis prevention and control reports across provinces (autonomous regions) and Xinjiang Production and Construction Corps in China from 2017 to 2022. After echinococcosis lesions were classified, a risk index of Echinococcus infection was constructed based on the principle of discrete distribution marginal probability and multi-group classification data tests. The correlation between the risk index of Echinococcus infection and the detection of incident echinococcosis cases was evaluated in the provinces (autonomous regions and corps) from 2017 to 2022, and the correlations between the short and medium-term risk indices and between the medium and long-term risk indices of Echinococcus infection were examined using a univariate linear regression model. A total of 4 014 echinococcosis cases in China from 2012 to 2016 were included in this study. The short-, medium- and long-term risk indices of E. granulosus infection varied in echinococcosis-endemic provinces (autonomous regions and corps) of China (χ2 = 4.12 to 708.65, all P values < 0.05), with high short- (0.058), medium- (0.137) and long-term risk indices (0.104) in Tibet Autonomous Region, and the short-, medium- and long-term risk indices of E. multilocularis infection varied in echinococcosis-endemic provinces (autonomous regions and corps) of China (χ2 = 6.74 to 122.60, all P values < 0.05), with a high short-term risk index in Sichuan Province (0.016) and high medium- (0.009) and long-term risk indices in Qinghai Province (0.018). There were no significant correlations between the risk index of E. granulosus infection and the detection of incident cystic echinococcosis cases during the study period (t = -0.518 to 2.265, all P values > 0.05), and strong correlations were found between the risk indices of E. multilocularis infection and the detection of incident alveolar echinococcosis cases (including mixed type) in 2018, 2020, 2021, 2022, during the period from 2017 through 2020, from 2017 through 2021, from 2017 through 2022 (all r values > 0.7, t = 2.521 to 3.692, all P values < 0.05). Linear regression models were established between the risk index of E. multilocular infection and the detection of alveolar echinococcosis cases (including mixed type), and the models were all statistically significant (b = 0.214 to 2.168, t = 2.458 to 3.692, F = 6.044 to 13.629, all P values < 0.05). The regression coefficients for the correlations between the medium- and short-term, and between the long- and medium-term risk indices of E. granulosus infection were 2.339 and 0.765, and the regression coefficients for the correlations between the medium- and short-term, and between the long- and medium-term risk indices of E. multilocular infection were 0.280 and 1.842, with statistical significance seen in both the regression coefficients and regression models (t = 16.479 to 197.304, F = 271.570 to 38 928.860, all P values < 0.05). The risk index of Echinococcus infection has been successfully established based on the classification of echinococcosis lesions, which may provide insights into the prevention and control, prediction, diagnosis and treatment, and classified management of echinococcosis.

A regressive analysis of the main environmental risk factors of human echinococcosis in 370 counties in China.

Echinococcosis is a natural focal, highly prevalent disease in China. Factors influencing the spread of echinococcosis are not only related to personal exposure but also closely related to the environment itself. The purpose of this study was to explore the influence of environmental factors on the prevalence of human echinococcosis and to provide a reference for prevention and control of echinococcosis in the future. Data were collected from 370 endemic counties in China in 2018. By downloading Modis, DEM and other remote-sensing images in 2018. Data on environmental factors, i.e., elevation, land surface temperature (LST) and normalized difference vegetation index (NDVI) were collected. Rank correlation analysis was conducted between each environmental factor and the prevalence of echinococcosis at the county level. Negative binomial regression was used to analyze the impact of environmental factors on the prevalence of human echinococcosis at the county level. According to rank correlation analysis, the prevalence of human echinococcosis in each county was positively correlated with elevation, negatively correlated with LST, and negatively correlated with NDVI in May, June and July. Negative binomial regression showed that the prevalence of human echinococcosis was negatively correlated with annual LST and summer NDVI, and positively correlated with average elevation and dog infection rate. The prevalence of human cystic echinococcosis was inversely correlated with the annual average LST, and positively correlated with both the average elevation and the prevalence rate of domestic animals. The prevalence of human alveolar echinococcosis was positively correlated with both NDVI in autumn and average elevation, and negatively correlated with NDVI in winter. The prevalence of echinococcosis in the population is affected by environmental factors. Environmental risk assessment and prediction can be conducted in order to rationally allocate health resources and improve both prevention and control efficiency of echinococcosis.

The effect of cystic echinococcosis (hydatid disease) on carcase weight in cattle in eastern Australia

Cystic echinococcosis is caused by the zoonotic tapeworm Echinococcus granulosus. There has been ongoing controversy over whether it causes weight loss in cattle. Recently implemented recording of comorbidities at processors has provided opportunity to investigate this effect. Using prevalence-based observational data from 1,648,049 adult cattle processed in seven states and territories in Australia (2019–2022), we explored associations between carcase weight, hydatid cysts, comorbidities, sex, age, and region. Linear mixed-effect regression models estimated the effect of cystic echinococcosis on carcase weight, guided by directed acyclic graphs to reduce bias. The highest, previously unreported, prevalence was in the southeast Queensland region. The estimated effect of cystic echinococcosis cysts on carcase weight ranged from a gain of 0.32 kg/carcase (standard error [se] 0.58 kg; two-tooth 2022) to a loss of −5.45 kg/carcase (se 0.63 kg; six-tooth 2019) with most point estimates (11/16) between 0 and −2.5 kg across all cattle grouped by year and dentition. This effect size would be practically undetectable in live cattle which is an important finding; cattle producers are unlikely to observe increased productivity through weight gain from cystic echinococcosis prevention in cattle, and awareness to strengthen prevention in domestic dogs around cattle properties to reduce human risk remains a public health focus.

Epidemiological survey of cystic echinococcosis in southwest China: From the Qinghai-Tibet plateau to the area of Yunnan.

Echinococcosis is prevalent in 9 provinces in Western and Northern China. An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province. To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province. Based on the China Information System for Disease Control and Prevention (CISDCP), echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022. The exclusion criteria included suspected cases, same case only counted once and cases not from Yunnan. A total of 705 cases were investigated, of which 397 cases were suitable for statistical analysis. In these 397 cases, epidemiological investigation was tracked in 187 cases. All data were inputted using double entry in the Excel database, with error correction by double-entry comparison. The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution. All statistical analyses were conducted using SPSS 17.0, including the chi-square test, linear regression test and logistic univariate and multivariate regression analyses. A total of 397 cases were found in 89 counties in Yunnan Province. The number of cases in the top three prefectures were Dali (38.1%), Diqing (10.1%), and Kunming (8.3%), and the top five counties were Jianchuan (9.1%), Shangri La (8.3%), Eryuan (7. 6%), Heqing (6.9%), and Dali Districts (5.0%). There were significant differences between the different areas. The case reporting rate by CISDCP (33.8%) was low; the first case was reported by CISDCP in 2002, and the highest number of cases was 50 (2017). Confirmed and clinical cases accounted for 62.5% and 37.5%, respectively. However, 90.9% of the cases of hydatid disease were reported by the hospital system, and only 9.1% of the cases of hydatid disease were found in the community through active screening. The difference between the two methods of case detection was statistically significant. Most of the cases of echinococcosis were found in farmers/herdsmen (75.1%) and students (9.1%). In addition, Han (43.6%) and Bai (26.2%) had a higher incidence of infection than other nationalities, and the liver (87.7%) and lung (6.8%) were the most common sites of cyst formation. Among the analyzed cases, 187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1% of cases. The results of logistic regression analysis showed that the age group, education level, presence of dogs in the family (either previously or currently), and handwashing (occasionally or not) were factors related to echinococcosis infection. 55.6% of cases were in endemic areas, and 44.4% of cases were in non-endemic areas. Among 83 cases in non-endemic areas, only 4 cases had been to endemic areas and had a history of living, working, travelling, or hunting in echinococcosis epidemic areas. Cases of echinococcosis were reported throughout the entire Yunnan province, with the majority distributed in Western Yunnan, suggesting that echinococcosis control should be strengthened in this area. We suggest that an epidemiological investigation should be carried out in the future, based on the clues from newly discovered cases in hospitals or from the CISDCP. The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.

Study on the genotypes of Echinococcus granulosus in yaks and sheep from Langkazi County in Tibet Autonomous Region of China based on mitochondrial cox1 and nad1.

To determine the genotypes of the epidemic strains of Echinococcus granulosus in livestock in Tibet, samples of E. granulosus cysts were collected from 11 yaks and 62 sheep. Genomic DNA was extracted from these samples, and gene fragments of mitochondrial cytochrome c oxidase subunit I (cox1) and NADH dehydrogenase subunit I (nad1) were amplified by PCR and sequenced. DNASTAR and MAGA7.0 were employed for homology analysis and phylogenetic tree construction. Echinococcus granulosus cysts were detected in 56.2% (41/73) of the samples screened. Of these, 63.4% (26/41) were identified as E. granulosus G1 genotype (common sheep strain), 24.4% (10 /41) as G3 genotype (buffalo strain), and 12.2% (5/41) were G6 genotype (camel strain). The study concludes that yaks and sheep in Langkazi county, Tibet, carry three E. granulosus genotypes (G1, G3, and G6), with the G1 genotype the predominant genotype in the region. This study clarifies the distribution of E. granulosus genotypes, providing genetic data and insight for the surveillance and prevention of echinococcosis.

China's prevention and control experience of echinococcosis: A 19-year retrospective.

Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People's Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.

The impact of echinococcosis interventions on economic outcomes in Qinghai Province of China: Evidence from county-level panel data.

Echinococcosis can incur substantial economic losses for the livestock industry by causing organ condemnation, delayed growth, and reduced meat and wool output and quality in sheep and cattle, as well as increased surgery costs, hospital care, and decreased productivity in humans. Yet echinococcosis could be prevented and controlled by interventions, such as dog management and deworming, lamb vaccination, slaughter management, and training and public education. Exploiting temporal and spatial variations in the number of intervention measures implemented in 39 counties in Qinghai province of China in 2015-2020, this study assesses the economic impact of echinococcosis interventions using a dynamic difference-in-differences model. The results suggest that echinococcosis interventions brought about substantial economic gains measured by per capita net income of rural residents and per capita gross output of animal husbandry. These economic gains are greater in non-pastoral counties (with a gain in per capita net income of rural residents of 3,308 yuan and a gain per capita gross output of animal husbandry of 1,035 yuan) than in pastoral counties (with a gain in per capita net income of rural residents of 1,372 yuan and a gain per capita gross output of animal husbandry of 913 yuan). They are also greater in counties with echinococcosis infection level-2 (with a human infection rate of 0.1-1% or a dog infection rate of 1-5%) than infection level-1 counties (with a human prevalence rate ≥1% or a dog infection rate ≥5%). Not only will these economic gains encourage livestock farmers to strengthen their echinococcosis prevention and control practices, but they will also inform public policy on zoonotic disease prevention and control in China and other countries alike.

Molecular Epidemiology and the Control and Prevention of Cystic Echinococcosis in China: What is Known from Current Research

As a zoonotic parasitic disease, echinococcosis is a severe global public health issue caused by the larvae of Echinococcus spp. Not only does echinococcosis threaten human health, but echinococcosis also causes enormous economic losses. China ranks first in the range of echinococcosis endemic areas, the number of infected patients, and the number of threatened populations worldwide, hence the most severe echinococcosis epidemic currently exists in China. Cystic echinococcosis (CE) is the most important form of echinococcosis. Accounting for nearly 80% of all echinococcosis cases, CE is the most important cause of the echinococcosis disease burden. Echinococcus granulosus sensu lato (s.l.) is the causative agent of CE and is considered a multi-genotype complex. The different genotypes of E. granulosus s.l. exhibit differences in morphology, transmission route, and epidemic characteristics. The corresponding clinical characteristics, clinical treatment, and vaccine responses also differ between the genotypes of E. granulosus s.l. During the past two decades, China has implemented echinococcosis control and prevention programs in endemic areas with impressive results. Specifically, the prevalence of echinococcosis has decreased. With such extraordinary achievements, precise control and prevention of the genotypes of E. granulosus s.l. have never been more important. Nevertheless, insufficient attention has been devoted to molecular epidemiology in the current control programs, and the lack of genotype data from humans and animal hosts exacerbates the situation. Hence, based on the ongoing control and surveillance programs, collecting additional molecular epidemiologic data and geographic information from humans and animals, as well as monitoring the clinical manifestations and drug and vaccine responses of the different genotypes, are invaluable for establishing a molecular epidemiologic database, which in turn can enhance the precise control and prevention of echinococcosis.

Alveolar and neotropical echinococcosis

The urgency of the problem of human alveolar and neotropic echinococcosis is due to polymorphism and the severity of clinical manifestations. The purpose and result of the work is to summarize the data available in the literature on the etiology, epidemiology, clinic, diagnosis, treatment, prevention of alveolar and neotropic echinococcosis in humans. Conclusion. The causative agent of human alveolar echinococcosis is E. multilocularis, neotropic – E. vogeli, E. oligarthra. The liver and lungs are most often affected, less often other organs of the abdominal cavity, bones, brain, spinal cord, eyes, etc. Diagnostics is carried out on the basis of a complex of clinical, instrumental, serological, molecular genetic studies. Treatment includes surgical removal of parasitic cysts and drug therapy.

Prediction of the potential suitable habitat of Echinococcus granulosus, the pathogen of echinococcosis, in the Tibetan Plateau under future climate scenarios.

Echinococcosis is a zoonotic parasitic infectious disease caused by human or domestic animals infected with Echinococcus granulosus. China is the country with the heaviest disease burden caused by Echinococcosis in the world. Therefore, it is feasible to evaluate the prevalence and distribution of echinococcosis using relevant ecological methods, combined with environmental factors and human activities. In this study, MaxEnt was used to predict the distribution range of E. granulosus in China under current and future climate scenarios and explain the impact of environmental variables on its distribution. The results showed that elevation (El), annual mean temperature (bio1), human footprint (Hf), annual precipitation (bio12), mean temperature of warmest quarter (bio10), and mean temperature of wettest quarter (bio8) were identified as the dominant environmental variables. In Tibet, the most suitable habitats (25.9 × 104 km2) of E. granulosus were distributed in Nyingchi and Qamdo in the east, Shigatse and Shannan in the south, and Ali in the west. In Sichuan, the most suitable habitat (18.83 × 104 km2) was located in Aba, Ganzi, and Liangshan. In Qinghai, the most suitable habitat (13.05 × 104 km2) mainly included Yushu in the southwest; Guoluo in the southeast; Haidong, Huangnan, Xining, and Hainan in the east; and Haixi in the west. In Gansu, the most suitable habitat (7.36 × 104 km2) was located in Gannan and Linxia in the southwest and Wuwei and Dingxi in the middle. In Yunnan, the most suitable habitat (1.53 × 104 km2) was distributed in Diqing in the northwest. Under future climate scenarios, the area of the most suitable habitat of E. granulosus showed an obvious expansion trend, with an increase of 44.64-70.76%. Trajectory trend of centroids showed that the most suitable habitat would move to the west in the future, and the increased areas were mainly located in the west of the current most suitable habitat. AUC values of the training data and test data were 0.936 ± 0.001 ~ 0.97 ± 0.006 and 0.912 ± 0.006 ~ 0.956 ± 0.015, respectively. The result can provide a theoretical basis for the prevention, monitoring, and early warning of echinococcosis in China.

Echinococcus granulosus Protoscoleces-Derived Exosome-like Vesicles and Egr-miR-277a-3p Promote Dendritic Cell Maturation and Differentiation.

Cystic echinococcosis, a major parasitic disease caused by Echinococcus granulosus, seriously threatens human health. The excretory–secretory (ES) products of E. granulosus can induce immune tolerance in dendritic cells (DCs) to downregulate the host’s immune response; however, the effect of exosomes in the ES products on the DCs has remained unclear. This study showed that E. granulosus protoscoleces-derived exosome-like vesicles (PSC-ELVs) could be internalized by bone marrow-derived dendritic cells (BMDCs), allowing for the delivery of the parasite microRNAs to the BMDCs. Moreover, PSC-ELVs induced BMDCs to produce the proinflammatory cytokinesinterleukin (IL)-6, IL-12, IL-β, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ). PSC-ELVs also upregulated the BMDCs surface marker major histocompatibility complex class II (MHC II), as well as costimulatory molecules CD40, CD80, and CD86. PSC-ELV-derived egr-miR-277a-3p upregulated the IL-6, IL-12, and TNF-α mRNA levels in BMDCs. Moreover, egr-miR-277a-3p directly targeted Nfkb1 (encoding nuclear factor kappa B 1) to significantly suppress the mRNA and protein levels of NF-κB1 in BMDCs, while the expression of NF-κB p65 significantly increased, suggesting that egr-miR-277a-3p induces the production of proinflammatory cytokines by the modification of the NF-kB p65/p50 ratio in BMDCs. These results demonstrated that PSC-ELVs and egr-miR-277a-3p might enhance DCs maturation and differentiation in a cross-species manner, which in turn may modulate the host immune responses and offer a new approach to echinococcosis prevention and treatment.

Reasons for late diagnosis of pulmonary echinococcosis in a non-endemic area

Background. Diagnosis, treatment, prevention of echinococcosis remain relevant tasks for most Russian regions. One of the key problems is the diagnosis of this disease in non-endemic regions.Objective. To describe a clinical case of cystic echinococcosis of the lungs.Materials and methods. A multislice computed tomography of the chest with contrast enhancement, serological diagnosis and histological examination and subsequent surgical treatment of a 6-year-old patient were performed.Results. A case of cystic echinococcosis of the lungs in a 6-year-old boy is presented. Echinococcosis was diagnosed at the stage of a large diameter cyst during chest X-ray to exclude pneumonia. Surgical treatment was performed. The decrease in titers of antiparasitic antibodies in dynamics after the operation allowed to conclude that the patient had recovered. The presented clinical case demonstrates a typical error in the diagnosis of pulmonary echinococcosis. Cystic echinococcosis is a rare pathology in the Arkhangelsk region (up to 4 per year). This situation leads to late diagnosis of this helminthiasis. The main mistake in the diagnosis was the lack of alertness in relation to echinococcosis and, as a result, the establishment of an incorrect diagnosis — pneumonia.Conclusions. The use of multislice computed tomography of the chest with contrast enhancement, serological diagnosis and histological examination in combination allows you to accurately establish the diagnosis of echinococcosis of the lungs.

Improvement of Treatment and Prevention of Liver Echinococcosis

The purpose of the study was to determine optimal pathogenetically justified methods and means to improve the results of diagnosis and treatment of liver echinococcosis. Materials and methods. During treatment, on the 1st, 3rd, 5th, and 10th day of the postoperative period, patients were examined for the functional state of the liver by blood analysis for the amount of proinflammatory cytokines TNF-α, IL-6, IL-4 and IL-10, IL-1. The activity of humoral immunity was assessed based on the level of immunoglobulins IgA, IgG and IgM. Results and discussion. On the 1st day after the operation, the level of IgA increased and amounted to 5.56 ± 0.1 q/L. The improvement in the dynamics of indicators was observed on the 5th day of observations, and this trend persisted up to 10 days after surgical treatment. On day 5, a significant decrease in the concentration of the main proinflammatory cytokines TNF-α, IL-6 and IL-4 was revealed, compared with the indicators before treatment and on the first day after treatment – 12.5 ± 0.6 pg/ml; 11.7 ± 0.3 pg/ml and 4.0 ± 0.2 pg/ml, respectively. This treatment regimen resulted in a marked decrease in TNF-α, IL-6 and IL-10 levels on day 10. The initial level of cytokines and immunoglobulins indicates a pronounced immunosuppressive effect on the body of a parasitic disease. A significant decrease in cytokines IL-1, IL-6 and IL-10 in patients after surgery and a decrease in indicators after maintenance therapy can serve as a potential immunological marker for evaluating its effectiveness. When studying the cytokine profile in the patients we examined, there was a significant increase in the level of TNF-α and IL-6 in blood serum relative to the control values, which is directly dependent on the severity of the pathological process and the functional state of the liver and suppresses the secretion of anti-inflammatory cytokines, which was confirmed by data from foreign authors. As well as the works published earlier, the data of our studies show that Echinococcus granulosus cysts induce a strong antibody response in most patients, causing, at the same time, a reaction of antigen-specific antibodies of various classes with different intensity and specificity against the background of their synthesis and increased secretion. It is necessary to note an increase in quantitative and qualitative indicators of IgG, IgM and IgA levels in the blood serum of patients with liver echinococcosis, with IgG predominance. Conclusion. A comprehensive study of inflammatory mediators and the dynamics of cytokine levels makes it possible to diagnose complications in time and prevent possible relapses of the disease. The data obtained made it possible to justify the further use of imunofan and to develop recommendations for the management of patients with liver echinococcosis in the postoperative period

Modern Approaches in the Treatment of the Prevention of Liver Echinococcosis

Modern Approaches in the Treatment of the Prevention of Liver Echinococcosis

Stability Analysis and Optimal Control Strategies of an Echinococcosis Transmission Model

This paper presents a deterministic compartmental model for echinococcosis transmission dynamics. The basic reproduction number of the model determines the existence and stability of the disease-free and disease-endemic equilibrium points. We further formulate the optimal control problem and obtain the necessary conditions to minimize the number of infected individuals and the associated costs. Numerical simulations show that optimal control strategies can significantly reduce the number of infected individuals to lower levels. Environmental disinfection may be essential for the elimination of infections. The results of this study will be beneficial for the prevention and control of echinococcosis in the Ganzi Tibetan Autonomous Prefecture and other areas of China.

Spatial analysis of echinococcosis in pastoral area of Qinghai province, 2019

Objective: To understand the spatial characteristics of echinococcosis and associated factors in the pastoral area of Qinghai province, and provide evidence for the effective prevention and control of echinococcosis. Methods: The number of echinococcosis cases in the pastoral areas of Qinghai in 2019 was collected to perform spatial epidemiological analysis. The thematic map of the distribution of echinococcosis cases was generated with software ArcGIS 10.8 for visual analysis and spatial autocorrelation analysis. The spatial autocorrelation and spatial scanning analysis were performed to estimate the clustering of echinococcosis with software SaTScan 9.5. Software GeoDa 1.14 and ArcGIS 10.8 were used to establish spatial lag model and geographical weighted regression model to analyze the related factors of echinococcosis epidemic. Results: In 2019, the echinococcosis surveillance covered 64 741 people in the pastoral area of Qinghai, and 829 echinococcosis cases were found, with a prevalence rate of 1.28%. The distribution of the cases had spatial correlation (Moran's I=0.41, P<0.001). The most possible clustering areas indicated by spatial scanning analysis included Banma, Jiuzhi, Dari and Gande counties of Guoluo Tibetan Autonomous Prefecture (LLR=460.77, RR=9.20, P<0.001). The prevalence of echinococcosis in the pastoral areas was positively associated with the total annual precipitation (β=0.13, P=0.036), and negatively associated with population density (β=-1.36, P=0.019) and doctors/nurse ratio (β=-25.60, P=0.026). Conclusions: The distribution of echinococcosis cases in the pastoral areas of Qinghai in 2019 had spatial correlation, and the prevalence was affected by total annual precipitation, population density, and doctors/nurse ratio.

A novel architecture of Web-GIS for mapping and analysis of echinococcosis in Poland

Echinococcosis is an infectious disease transferred through ingestion of food or water which has been contaminated with eggs of the Echinococcus tapeworm, which are spread by intermediate parasite hosts. Because the latter are primarily territorial, research related to diagnosis and prevention of echinococcosis requires investigation of environmental factors, which can be supported with the use of a Geographical Information System (GIS). In particular, since this type of research is usually performed by a team of medical researchers working individually with many patients, it can greatly benefit from the use of a Web-GIS, which provides remote access to data integration, storage and analysis tools. However, most existing Web-GIS solutions dedicated for disease mapping either exhibit limited functionality and interactivity (often due to the use of a thin-client approach) or are tied to a particular technological platform through a thick client based on a browser plugin. Moreover, few of the existing solutions provide user-friendly tools for data input, and none is directly integrated into the workflow of clinicians. This paper proposes a novel system architecture for Web-GIS dedicated to disease mapping, which attempts to optimize the use of client and server hardware resources while providing the user with a variety of analytic functionalities. The proposed architecture has been implemented in the form of a system for remote mapping and analysis of echinococcosis cases in Poland, which has been designed in cooperation with a major Polish hospital centre.

The impact of environmental factors on human echinococcosis epidemics: spatial modelling and risk prediction

BackgroundHuman echinococcosis is affected by natural environmental factors, and its prevalence shows a distinct geographical distribution. Western China has the highest endemicity of human echinococcosis worldwide, but the spatial pattern and environmental determinants of echinococcosis are still unclear.MethodsHot/cold spot analysis was used to investigate the spatial distribution of human echinococcosis prevalence. Geodetector was used to identify key natural factors, and a structured additive regression model was used to analyse the relationship between natural factors and human echinococcosis prevalence and spatially predict echinococcosis epidemics.ResultsHot spots for human echinococcosis prevalence include western and southeastern parts of Tibet Autonomous Region (henceforth Tibet) and the border areas between Tibet and the provinces of Qinghai and Sichuan. Spatial effects are crucial when modelling epidemics, and relative humidity, altitude and grassland area ratio were found to have the most evident effects on echinococcosis epidemics. The relationship between these three factors and echinococcosis prevalence was non-linear, and echinococcosis risk was higher in areas with high relative humidity, high altitude, and a high ratio of grassland to other land use types. The prevalence that was predicted from the investigated environmental factors was generally higher than the actual prevalence, and more epidemic hot spots were predicted for the Qinghai-Tibet Plateau, Inner Mongolia Autonomous Region, and the provinces of Yunnan and Sichuan than the rest of western China. These results indicate that prevention and control measures may effectively reduce echinococcosis prevalence.ConclusionsWe suggest that the prevention and control of human echinococcosis should be prioritized in the hot spots identified here, through the rational allocation of limited medical resources to where they are most needed. Furthermore, the spatial epidemiological modelling methods used in this study can be employed in future studies on echinococcosis and similar diseases.Graphical abstract

Geographic distribution and prevalence of human echinococcosis at the township level in the Tibet Autonomous Region

BackgroundEchinococcosis, a zoonotic parasitic disease, is caused by larval stages of cestodes in the Echinococcus genus. Echinococcosis is highly prevalent in ten provinces/autonomous regions of western and northern China. In 2016, an epidemiological survey of Tibet Autonomous Region (TAR) revealed that the prevalence of human echinococcosis was 1.66%, which was much higher than the average prevalence in China (0.24%). Therefore, to improve on the current prevention and control measures, it is important to understand the prevalence and spatial distribution characteristics of human echinococcosis at the township level in TAR.MethodsData for echinococcosis cases in 2018 were obtained from the annual report system of echinococcosis of Tibet Center for Disease Control and Prevention. Diagnosis had been performed via B-ultrasonography. The epidemic status of echinococcosis in all townships in TAR was classified according to the relevant standards of population prevalence indices as defined in the national technical plan for echinococcosis control. Spatial scan statistics were performed to establish the geographical townships that were most at risk of echinococcosis.ResultsIn 2018, a total of 16,009 echinococcosis cases, whose prevalence was 0.53%, were recorded in 74 endemic counties in TAR. Based on the order of the epidemic degree, all the 692 townships were classified from high to low degrees. Among them, 127 townships had prevalence rates ≥ 1%. The high prevalence of human echinococcosis in TAR, which is associated with a wide geographic distribution, is a medical concern. Approximately 94.65% of the villages and towns reported echinococcosis cases. According to spatial distribution analysis, the prevalence of human echinococcosis was found to be clustered, with the specific clustering areas being identified. The cystic echinococcosis primary cluster covered 88 townships, while that of alveolar echinococcosis’s covered 38 townships.ConclusionsThis study shows spatial distributions of echinococcosis with different epidemic degrees in 692 townships of TAR and high-risk cluster areas at the township level. Our findings indicate that strengthening the echinococcosis prevention and control strategies in TAR should directed at townships with a high prevalence and high-risk clustering areas.Graphical

Demand Analysis of Health Education Materials Diversification for Echinococcosis Prevention and Control

Demand Analysis of Health Education Materials Diversification for Echinococcosis Prevention and Control