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Background: 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. Methods: 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. Results: 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. Conclusion: 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. Author summary: 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. This study covered all endemic counties in China and studied the main environmental factors affecting the epidemic of echinococcosis. 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. 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. Prevalence of human echinococcosis was negatively correlated with annual LST and summer NDVI, and positively correlated with average elevation and dog infection rate. 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. [ABSTRACT FROM AUTHOR]

The prevention and control of the spread of Cystic Echinococcosis is an important public health issue. Health education has been supported by many governments because it can increase public awareness of echinococcosis, promote the development of personal hygiene habits, and subsequently reduce the transmission of echinococcosis. In this paper, a dynamic model of echinococcosis is used to integrate all aspects of health education. Theoretical analysis and numerical model fitting were used to quantitatively analysed by the impact of health education on the spread of echinococcosis. Theoretical findings indicate that the basic reproduction number is crucial in determining the prevalence of echinococcosis within a given geographical area. The parameters of the model were estimated and fitted by using data from the Ningxia Hui Autonomous Region in China, and the sensitivity of the basic reproduction number was analysed by using the partial rank correlation coefficient method. These findings illustrate that all aspects of health education demonstrate a negative correlation with the basic reproduction number, suggesting the effectiveness of health education in reducing the basic reproduction number and mitigating the transmission of echinococcosis, which is consistent with reality. Particularly, the basic reproduction number showed a strong negative correlation with the burial rate of infected livestock (b) and the incidence of infected livestock viscera that is not fed to dogs (q). This paper further analyzes the implementation plan for canine deworming rates and sheep immunity rates, as well as the transmission of infected hosts over time under different parameters b and q. According to the findings, emphasizing the management of infected livestock in health education has the potential to significantly reduce the risk of echinococcosis transmission. This study will provide scientific support for the creation of higher quality health education initiatives. [ABSTRACT FROM AUTHOR]

[Display omitted] • Genotyping of Echinococcus multilocularis based on the whole mitochondrial (mt) genome was performed. • Information on genetic diversity was obtained for 30 visceral samples from alveolar echinococcosis (AE) patients. • Full mtDNA was compared with three mt genes and nuclear EmsB microsatellite genotyping. • We found 14 haplotypes based on full-mtDNA, six with cob - cox1 - nad2 genes and five with EmsB. • It was possible to trace the geographical origin of AE infections in patients. Alveolar echinococcosis (AE) is a parasitosis that is expanding worldwide, including in Europe. The development of genotypic markers is essential to follow its spatiotemporal evolution. Sequencing of the commonly used mitochondrial genes cob , cox1 , and nad2 shows low discriminatory power, and analysis of the microsatellite marker EmsB does not allow nucleotide sequence analysis. We aimed to develop a new method for the genotyping of Echinococcus multilocularis based on whole mitochondrial genome (mitogenome) sequencing, to determine the genetic diversity among 30 human visceral samples from French patients, and compare this method with those currently in use. Sequencing of the whole mitochondrial genome was carried out after amplification by PCR, using one uniplex and two multiplex reactions to cover the 13,738 bp of the mitogenome, combined with Illumina technology. Thirty complete mitogenome sequences were obtained from AE lesions. One showed strong identity with Asian genotypes (99.98% identity) in a patient who had travelled to China. The other 29 mitogenomes could be differentiated into 13 haplotypes, showing higher haplotype and nucleotide diversity than when using the cob , cox1 , and nad2 gene sequences alone. The mitochondrial genotyping data and EmsB profiles did not overlap, probably because one method uses the mitochondrial genome and the other the nuclear genome. The pairwise fixation index (F st) value between individuals living inside and those living outside the endemic area was high (F st = 0.222, P = 0.002). This is consistent with the hypothesis of an expansion from historical endemic areas to peripheral regions. [ABSTRACT FROM AUTHOR]

Background: Human cystic and alveolar echinococcosis are neglected tropical diseases that WHO has prioritized for control in recent years. Both diseases impose substantial burdens on public health and the socio-economy in China. In this study, which is based on the national echinococcosis survey from 2012 to 2016, we aim to describe the spatial prevalence and demographic characteristics of cystic and alveolar echinococcosis infections in humans and assess the impact of environmental, biological and social factors on both types of the disease. Methods: We computed the sex-, age group-, occupation- and education level-specific prevalences of cystic and alveolar echinococcosis at national and sub-national levels. We mapped the geographical distribution of echinococcosis prevalence at the province, city and county levels. Finally, by analyzing the county-level echinococcosis cases combined with a range of associated environmental, biological and social factors, we identified and quantified the potential risk factors for echinococcosis using a generalized linear model. Results: A total of 1,150,723 residents were selected and included in the national echinococcosis survey between 2012 and 2016, of whom 4161 and 1055 tested positive for cystic and alveolar echinococcosis, respectively. Female gender, older age, occupation at herdsman, occupation as religious worker and illiteracy were identified as risk factors for both types of echinococcosis. The prevalence of echinococcosis was found to vary geographically, with areas of high endemicity observed in the Tibetan Plateau region. Cystic echinococcosis prevalence was positively correlated with cattle density, cattle prevalence, dog density, dog prevalence, number of livestock slaughtered, elevation and grass area, and negatively associated with temperature and gross domestic product (GDP). Alveolar echinococcosis prevalence was positively correlated with precipitation, level of awareness, elevation, rodent density and rodent prevalence, and negatively correlated with forest area, temperature and GDP. Our results also implied that drinking water sources are significantly associated with both diseases. Conclusions: The results of this study provide a comprehensive understanding of geographical patterns, demographic characteristics and risk factors of cystic and alveolar echinococcosis in China. This important information will contribute towards developing targeted prevention measures and controlling diseases from the public health perspective. [ABSTRACT FROM AUTHOR]

Human cystic echinococcosis (CE) is a parasitic disease caused by tapeworms from the Echinococcus granulosus genus, potentially affected by the environment and host animals. West China is one of the most endemic areas of human CE nation and worldwide. The current study identifies the crucial environmental and host factors of human CE prevalence in the Qinghai‐Tibet Plateau and non‐Qinghai‐Tibet Plateau regions. An optimal county‐level model was used to analyze the association between key factors and human CE prevalence within the Qinghai‐Tibet Plateau. Geodetector analysis and multicollinearity tests identify key factors, and an optimal model is developed through generalized additive models. In the Qinghai‐Tibet Plateau, four key factors were identified from the 88 variables, such as maximum annual precipitation (Pre), maximum summer normalized difference vegetation index (NDVI), Tibetan population rate (TibetanR), and positive rates of Echinococcus coproantigen in dogs (DogR). Based on the optimal model, a significant positive linear relationship was observed between maximum annual Pre and human CE prevalence. A probable U‐shaped curve depicts the non‐linear relationship between maximum summer NDVI and the human CE prevalence. Human CE prevalence possesses significant positive non‐linear relationships with TibetanR and DogR. Human CE transmission is integrally affected by environmental and host factors. This explains the mechanism of human CE transmission based on the pathogen, host, and transmission framework. Therefore, the current study provides references and innovative ideas for preventing and controlling human CE in western China. Plain Language Summary: Western China is one of the most prevalent epidemic areas of human cystic echinococcosis (CE) worldwide. This region is closely associated with the natural environment, human society, and host animals. The relative contribution of the natural and human environments and host factors to human CE prevalence has been tremendously neglected. Here it was presented that natural, human, and host factors interactively affect human CE prevalence by impacting pathogens, hosts, and transmission. Thus climate, geographical landscape, demographic characteristics, and host infection status significantly affect human CE prevalence. This explains the mechanism of nature, humans, and the host on CE transmission and is instructive for monitoring, preventing, and controlling CE in the future. Key Points: Climate, geographical landscape, demographic characteristics, and host infection integrally affect cystic echinococcosis (CE)The driving factors for CE in Qinghai‐Tibet Plateau and other regions are distinguishedThe optimal generalized additive model model fits well with the correlation between CE and key risk factors [ABSTRACT FROM AUTHOR]

Purpose: Echinococcosis remains a major economic and severe public health problem in endemic areas. Bone echinococcosis is rare, and the vertebra and pelvis are the most common sites of echinococcosis involving the skeletal. Because of the clinical severe symptoms and high recurrence rate, it brings excellent trouble to patients. Methods: This study retrospectively analyzed the clinical manifestations, laboratory tests, radiological findings, and treatment of 44 patients with vertebral and pelvic echinococcosis during a period of 16 years (2005–2020). Results: The mean age was 43 years (25 males, 19 females; 19–68 years). The most common symptom was pain, followed by numbness, weakness, activity limitation, and progressive paraparesis. Enzyme-linked immunosorbent assay test (ELISA) results were positive in 18 cases (75%). There are 24 cases of hydatid infection of the spine, 14 hydatid infection of the pelvis, and six hydatid infection of both vertebra and pelvis. The site of infection was 13 (29.5%) thoracic, five (11.4%) lumbar, four (9.1%) lumbosacral, seven (15.9%) sacral, 19 (43.2%) ilium, seven (15.9%) hip, six (13.6%) ischium, five (11.4%) pubis, and two (4.5%) femur, respectively. The imaging findings were cystic dilatancy, septal, and irregular bone destruction. MRI has a special value in showing the relationship between the surrounding tissues and organs of cystic bone echinococcosis. All patients were followed up for at least one year. The mean follow-up time was 3.6 years. Conclusions: Even in epidemic areas, the incidence of bone echinococcosis is relatively rare. However, when encountering the vertebral and pelvic destruction, consider bone echinococcosis's possibility, especially for the herdsmen in endemic regions. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

RNA-sequencing (RNA-seq) is a versatile, high-throughput technology that is being widely employed for screening differentially expressed genes (DEGs) in various diseases. Echinococcosis, a globally distributed zoonosis, has been reported to impose a heavy disease burden in pastoral areas of China. Herein we aimed to explore the molecular mechanisms underlying echinococcosis. In this study, peripheral blood samples were collected from six patients with alveolar echinococcosis (AE), six patients with cystic echinococcosis (CE), and six healthy controls. RNA-Seq (mRNA) was performed to detect gene transcript and expression levels, and DEGs were subjected to bioinformatic analyses. In comparison with healthy controls, 492 DEGs (270 upregulated, 222 downregulated) were found in the AE group and 424 DEGs (170 upregulated, 254 downregulated) were found in the CE group (|log2 (fold change)| > 1 and P < 0.05). Further, 60 genes were upregulated and 39 were downregulated in both the AE and CE groups. Gene ontology enrichment analysis indicated that DEGs were mainly involved in molecular functions, including extracellular space, extracellular region, organ and system development, and anatomical structure development. Protein–protein interaction (PPI) networks were constructed to depict the complex relationship between DEGs and interacting proteins. [ABSTRACT FROM AUTHOR]

Background: In China the highest prevalence of echinococcosis is in Tibet Autonomous Region (TAR). The government has issued documents and implemented comprehensive prevention and control measures focusing on controlling the source of infection of echinococcosis. It was very important to understand the implementation and effect of infectious source control measures. The purpose of this study was to examine the implementation of measures to control infectious source (domestic and stray dogs) in TAR and to assess their effectiveness. Methods: We collected data on domestic dog registration and deworming and stray dog sheltering in 74 counties/districts in the TAR from 2017 to 2019. Fecal samples from domestic dogs were collected from randomly selected towns to determine Echinococcus infection in dogs using coproantigen ELISA. We analyzed the data to compare the canine rate of infection between 2016 and 2019. The data analysis was performed by SPSS statistical to compare dog infection rate in 2016 and 2019 by chi-square test, and ArcGIS was used for mapping. Results: From 2017 to 2019, 84 stray dog shelters were built in TAR, and accumulatively 446,660 stray or infected dogs were arrested, sheltered, or disposed of. The number of domestic dogs went downward, with an increased registration management rate of 78.4% (2017), 88.8% (2018), and 99.0% (2019). Dogs were dewormed 5 times in 2017, 12 times in 2018, and 12 times in 2019. The dog infection rate was 1.7% (252/14,584) in 2019, significantly lower than 7.3% (552/7564) from the survey of echinococcosis prevalence in Tibet in 2016 (P < 0.05). Conclusion: Between 2017 and 2019, the number of stray dogs and infection rate of Echinococcus spp. in domestic dogs decreased significantly, indicating that dogs were effectively controlled as a source of infection in TAR and reflecting a significant decrease in the risk of echinococcosis transmission. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

There are two main types of echinococcosis, namely alveolar echinococcosis (AE) and cystic echinococcosis (CE). They are zoonotic parasitic diseases caused by the metacestodes of Echinococcus multilocularis and Echinococcus granulosus. In order to explore the gut microbiome composition of patients with echinococcosis, we analyzed fecal samples of seven patients with AE, six patients with CE, and 13 healthy individuals from the Qinghai-Tibetan Plateau, China. Using metagenomic next-generation sequencing, we identified fecal bacteria in the patients with AE and CE. The gut microbiota was analyzed by next-generation metagenomic sequencing (mNGS) to compare patients with either AE or CE against healthy individuals. We found there were some differences between them in abundant bacteria. Our results led to five findings: (1) Between patients with echinococcosis and healthy individuals, the differential bacteria were from four phyla: Firmicutes, Proteobacteria, Bacteroidetes, Actinobacteria. (2) Rothia mucilaginosa , Veillonella dispar , Veillonella atypica , Streptococcus parasanguinis, Streptococcus salivarius , and Alistipes finegoldii were abundant in the feces of patients with AE. (3) Bacteroides dorei, Parabacteroides distasonis, Escherichia sp_E4742, and Methanobrevibacter smithii were abundant in the feces of the patients with CE. (4) At the phylum and class level, compared to the AE group, the healthy group was characterized by higher numbers of Actinobacteria. (5) At the family level, Lachnospiraceae and Eubacteriaceae were more abundant in the feces of healthy individuals than in AE patients. The genera Coprococcus , Eubacterium , and Bilophia were more abundant in the healthy group, while the genus Rothia was more abundant in the AE group. The results of this study enrich our understanding of the gut microbiome composition of patients with AE and CE in the Qinghai-Tibetan Plateau. [ABSTRACT FROM AUTHOR]

Simple Summary: Blastocystis is a neglected enteric pathogen that is highly prevalent in humans and animals worldwide. Studies have reported that Blastocystis infection frequently coexists with other infectious pathogens in humans. However, dual infection by Blastocystis and Echinococcus multilocularis, which causes the severe parasitic disease echinococcosis has not been reported. In this study, the authors investigated the clinical prevalence, risk factors, and genotypes of Blastocystis in Tibetan patients with liver echinococcosis and Tibetan healthy controls from the Qinghai province in China, and also tested whether E. multilocularis infection increases host susceptibility to Blastocystis using a mouse model. The results found a significantly higher prevalence of genetically divergent Blastocystis in Tibetans with liver echinococcosis. E. multilocularis infection in Balb/c mice increased the host susceptibility to Blastocystis and aggravated intestinal pathology with higher disease severity and higher mortality. Taken together, these findings provide new insights into dual infections by Blastocystis and helminths in humans. Blastocystis is a common human intestinal protozoan parasite. Little is known about its prevalence in echinococcosis. This study tested whether Echinococcus multilocularis infection would increase host susceptibility to Blastocystis. A total of 114 fecal samples (68 hydatid disease patients and 46 healthy people) were collected from Tibetans in the Qinghai province in China. The presence of Blastocystis was identified by sequencing of the small subunit (SSU) rRNA gene. Balb/c mice were co-infected with Blastocystis and E. multilocularis and tested for host susceptibility to Blastocystis. The overall Blastocystis prevalence was 12.3%; 16.2% in the patients and 4.4% in healthy people (p < 0.05). Sequence analysis identified three known Blastocystis genotypes, including ST1, ST2, and ST3, and one unknown genotype. Experimental dual infection significantly reduced mouse survival rate (20%), induced more severe signs, and increased intestinal damages with a higher intestinal colonization level of Blastocystis. The mouse model showed that E. multilocularis infection increases host susceptibility to Blastocystis. Our study shows a significantly higher prevalence of Blastocystis in patients with liver echinococcosis and reveals that non-intestinal E. multilocularis infection increases host susceptibility to the Blastocystis. Our results highlight that E. multilocularis infection is associated with Blastocystis. These findings remind us that more attention should be paid to the gut health of the patients with a helminth infection during clinical patient care. [ABSTRACT FROM AUTHOR]

Exosomes are small and single-membrane secreted organelles, up to 200 nm in diameter that have the same topology as the cell, but are enriched in proteins, nucleic acids, lipids, and glycoconjugates. It can be found in any type of body fluids such as plasma, urine, saliva, sperm, bile, etc. On the other hand, cystic Echinococcosis (CE) has been studied from different points of view, among others, from genomics and proteomics, and the presence of CE exosomes in humans and other intermediate hosts has been reported in very few articles. The aim of this review was to report the evidence available regarding exosomes and CE. Systematic review. Data sources: Trip Database, SciELO, WoS, MEDLINE, EMBASE and SCOPUS. Eligibility criteria: Studies related to CEin any type of host and state of the parasite, without language restriction, published between 1966-2021. Variables: Year of publication, geographical origin, species isolated, location of exosomes. Forty-two studies were initially identified. After scrutinizing titles and abstracts, checking duplications and in-depth analysis of the studies selected, 12 articles including human, bovine, sheep, dog samples were also included. All were case reports or case series. The highest proportion of articles was published between 2019 and 2021 (58.3 %). Publications were predominantly from China (58.3 %). Evidence about exosomes and CE is scarce and reduced range of articles and cases. [ABSTRACT FROM AUTHOR]

Background: Echinococcosis, 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. Methods: Data 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. Results: In 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. Conclusions: This 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. [ABSTRACT FROM AUTHOR]

Background: According to the latest data, the detection rate of echinococcus in Hoboksar Mongol Autonomous County was 3.7%. The objective of this study is to further investigate the epidemiology of echinococcosis in Hoboksar Mongol Autonomous County of Xinjiang Uygur Autonomous Region, People's Republic of China and provide the scientific evidence for preventive and control measures. Methods: We performed ultrasound examination of 521 people in Hoboksar Mongol Autonomous County of Xinjiang Autonomous Region, and collected 508 serum samples, which were analyzed with enzyme-linked immunosorbent assay. Data were analyzed by t-test and multinomial logistic regression for risk factor analysis. We collected 126 pieces of herder's dog feces and used double antibody sandwich method to detect the positive rate of fecal antigen. Results: The prevalence rate of human echinococcosis in this region was 4.4% (23/521), including 4.0% (21/521) for cystic echinococcosis (CE), 0.38% (2/521) for alveolar echinococcosis (AE). It was found that CE seropositivity was significantly different from gender, age, ethnic group, occupation, culture, area, income and awareness of this disease. The seroprevalence rate of people aged 41 - 65 (3.74%) was higher than of age 0 - 17 (0.197%) (p > 0.05); Female serological positive (4.921%) was higher than male (1.772%) (p > 0.005); Mongolian serological positive (5%) was higher than Han (0.197%) and Kazakhs (1.181%) (p > 0.05); The herdsmen serological positive (2.756% was higher than students (0.197%) (p > 0.05); The primary school students serological positive (2.559%) was higher than children before school 0% (p > 0.05); Chagankule serological positive (9.211%) was higher than Bayinaow (8.497%) (p > 0.05); The seroprevalence rate of people with income < 2,000 (3.74%) was higher than people with income over 5,000 (0.197%) (p > 0.05); The seroprevalence rate of people who had no disease awareness (4.724%) was higher than those who had awareness of Hydatid disease (1.969%) (p < 0.05). Multivariate logistic regression show age, ethic group and awareness of station are the influence factors of epidemiology of echinococcosis. Canine fecal antigen positive rate was 50% (p > 0.05). Narenhebuke (48.78%) was higher than chahet (20.00%), but there is no statistical difference (p > 0.05). Conclusions: The surveillance data and our study results tend to be consistent that echinococcosis has an increasing trend in Hoboksar Mongol Autonomous County. Efforts should be continued, in both animals and humans by increasing training campaigns and public awareness. [ABSTRACT FROM AUTHOR]

Background: Echinococcosis is a zoonotic parasitic disease caused by larval stages of cestodes belonging to the genus Echinococcus. The infection affects people's health and safety as well as agropastoral sector. In China, human echinococcosis is a major public health burden, especially in western China. Echinococcosis affects people health as well as agricultural and pastoral economy. Therefore, it is important to understand the prevalence status and spatial distribution of human echinococcosis in order to advance our knowledge of basic information for prevention and control measures reinforcement. Methods: Report data on echinococcosis were collected in 370 counties in China in 2018 and were used to assess prevalence and spatial distribution. SPSS 21.0 was used to obtain the prevalence rate for CE and AE. For statistical analyses and mapping, all data were processed using SPSS 21.0 and ArcGIS 10.4, respectively. Chi-square test and Exact probability method were used to assess spatial autocorrelation and spatial clustering. Results: A total of 47,278 cases of echinococcosis were recorded in 2018 in 370 endemic counties in China. The prevalence rate of human echinococcosis was 10.57 per 10,000. Analysis of the disease prevalence showed obvious spatial positive autocorrelation in globle spatial autocorrelation with two aggregation modes in local spatial autocorrelation, namely high-high and low-high aggregation areas. The high-high gathering areas were mainly concentrated in northern Tibet, western Qinghai, and Ganzi in the Tibetan Autonomous Region and in Sichuan. The low-high clusters were concentrated in Gamba, Kangma and Yadong counties of Tibet. In addition, spatial scanning analysis revealed two spatial clusters. One type of spatial clusters included 71 counties in Tibet Autonomous Region, 22 counties in Qinghai, 11 counties in Sichuan, three counties in Xinjiang Uygur Autonomous Region, two counties in Yunnan, and one county in Gansu. In the second category, six types of spatial clusters were observed in the counties of Xinjiang Uygur Autonomous Region, and the Qinghai, Gansu, and Sichuan Provinces. Conclusion: This study showed a serious prevalence of human echinococcosis with obvious spatial aggregation of the disease prevalence in China. The Qinghai-Tibet Plateau is the "hot spot" area of human echinococcosis in China. Findings from this study indicate that there is an urgent need of joint strategies to strengthen efforts for the prevention and control of echinococcosis in China, especially in the Qinghai-Tibet Plateau. Author summary: Echinococcosis is a zoonotic parasitic disease caused by larval stages of cestodes belonging to the genus Echinococcus. In China, human echinococcosis is a major public health burden, especially in western China. Therefore, it is important to understand the prevalence status and spatial distribution of human echinococcosis in order to provide basic information for prevention and control measures reinforcement. To describe the distribution and analyze the prevalence and spatial distribution characteristics of human echinococcosis in China, report data of echinococcosis were collected in 370 counties in 2018. For the year 2018, there were 47,278 cases of echinococcosis recorded in 370 endemic counties in China. Analysis of the disease prevalence showed obvious spatial positive autocorrelation in global spatial autocorrelation with two aggregation modes in local spatial autocorrelation, namely high-high and low-high aggregation areas. The high-high gathering areas were mainly concentrated in northern Tibet, western Qinghai, and Ganzi in the Tibetan Autonomous Region and in Sichuan. This study showed obvious spatial aggregation of human echinococcosis prevalence in China. The Qinghai-Tibet Plateau is the "hot spot" area of human echinococcosis in China. Such findings indicate that here is an urgent need of joint strategies to strengthen efforts for the prevention and control of echinococcosis in China, especially in the Qinghai-Tibet Plateau. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE), caused by the larval stage of the complex Echinococcus granulosus sensu lato (s.l.), is a zoonotic parasitic disease with a high social burden in China. E. ortleppi is a species (formerly genotype 5 of E. granulosus s.l.) with unique epidemic areas (tropical areas), transmission patterns (mainly cattle origin), and pathological characteristics (large and small hook lengths) compared to other species that cause CE. A 19-year-old female patient in an area with no history of echinococcosis in Guizhou Province, China, was diagnosed with E. ortleppi infection in 2019. This study is to understand the source of this human E.ortleppi infection. Methods: We performed computer tomography (CT) scans, surgical operation, morphological sectioning, molecular diagnosis, phylogenetic analyses, and epidemiological investigation in Anshun City, Guizhou Province, China in 2019. Results: The patient presented with intermittent distension and pain in the upper abdomen without other abnormal symptoms. Routine blood examination results were normal. However, abdominal CT revealed a fertile cyst with a diameter of approximately 8 cm, uniform density, and a clear boundary, but without an evident cyst wall in the right lobe of the liver. The cyst was fertile, and phylogenetic analyses revealed that the isolates represented a new E. ortleppi genus haplotype. A result of 10‒14 years incubation period with indigenous infection was considered available for the case through the epidemiological survey. Conclusions: CE due to E. ortleppi infection can be confused with other diseases causing liver cysts, resulting in misdiagnosis. A transmission chain of E. ortleppi may exist or existed in the past in the previously considered non-endemic areas of echinococcosis in southwestern China. [ABSTRACT FROM AUTHOR]

In this paper, based on the transmission mechanism of echinococcosis in China, we propose a discrete-time dynamical model for the transmission of echinococcosis. The research results indicate that transmission dynamics of this discrete-time model are determined by basic reproduction number R0. It is shown that when R0 ≤ 1 then the disease-free equilibrium is globally asymptotically stable and when R0 > 1 then the model is permanent while the disease-free equilibrium is unstable. Finally, on the basis of the theoretical results established in this paper, we come up with some specific measures to control the transmission of echinococcosis. [ABSTRACT FROM AUTHOR]

Background: Lymph node metastasis is a specific type of metastasis in hepatic alveolar echinococcosis (AE). Currently, there is a scarcity of describing the clinical characteristics and lymph node metastasis rules of patients with hepatic AE combined with lymph node metastasis and its mechanism and management are still controversial. Radical hepatectomy combined with regional lymph node dissection is a better treatment., Aim: To analyse the clinical features of hepatic AE combined with lymph node metastasis to explore its treatment and efficacy., Methods: A total of 623 patients with hepatic AE admitted to the First Affiliated Hospital of Xinjiang Medical University from 1 January 2012 to 1 January 2022 were retrospectively analysed. Fifty-five patients with combined lymph node metastasis were analysed for their clinical data, diagnosis and treatment methods, follow-up efficacy, and characteristics of lymph node metastasis. Finally, we comparatively analysed the lymph node metastasis rates at different sites. Categorical variables are expressed as frequencies and percentages, and the analysis of difference was performed using the χ 2 test. The Bonferroni method was used for pairwise comparisons when statistical differences existed between multiple categorical variables., Results: A lymph node metastasis rate of 8.8% (55/623) was reported in patients with hepatic AE, with a female predilection (69.1%) and a statistically significant sex difference ( χ 2 = 8.018, P = 0.005). Of the 55 patients with lymph node metastasis, 72.7% had a parasite lesion, neighbouring organ invasion, and metastasis stage of P3N1M0 and above, of which 67.3%, 78.2%, and 34.5% of hepatic AE lesions invaded the bile ducts, blood vessels, and distant metastases, respectively. Detection rates of lymph node metastasis of 16.4%, 21.7%, and 34.2% were reported for a preoperative abdominal ultrasound, magnetic resonance imaging, and computed tomography examinations. All patients were intraoperatively suspected with enlarged lymph nodes and underwent radical hepatectomy combined with regional lymph node dissection. After surgery, a routine pathological examination was conducted on the resected lymph nodes. A total of 106 positive lymph nodes were detected in six groups at various sites, including 51 single-group metastasis cases and four multi-group metastasis cases. When the metastasis rates at different sites were statistically analysed, we observed that the metastasis rate in the para-hepatoduodenal ligament lymph nodes was significantly higher than that of the other sites ( χ 2 = 128.089, P = 0.000 < 0.05). No statistical difference was observed in the metastasis rate between the five other groups. Clavien-Dindo grade IIIa complication occurred in 14 cases, which improved after administering symptomatic treatment. Additionally, lymph node dissection-related complications were not observed. Recurrence after 2 years was observed in one patient., Conclusion: Lymph node metastasis is a rare form of metastasis in hepatic AE, which is more frequent in women. Para-hepatoduodenal ligament lymph nodes are commonly observed. Radical hepatectomy combined with regional lymph node dissection is a safe, effective, and feasible treatment for liver AE combined with lymph node metastasis., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: 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., Methods: 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., Results: 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 (χ 2 = 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 (χ 2 = 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)., Conclusions: 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.

Objective: To investigate the prevalence of Echinococcus infections in small rodents around human residential areas in Yushu City, Qinghai Province in 2023, so as to provide insights into precision echinococcosis control., Methods: One or two quadrats, each measuring 50 m × 50 m, were randomly assigned in Shanglaxiu Township and Longbao Township, Yushu City, Qinghai Province on June 2023, respectively, and 300 plate-type mouse traps, each measuring 12.0 cm × 6.5 cm, were assigned in each quadrat. Small rodents were captured during the period between 10 : 00 and 18 : 00 each day for 4 days. Then, all captured small rodents were identified and dissected, and liver specimens with suspected Echinococcus infections were subjected to pathological examinations. The Echinococcus cytochrome c oxidase 1 ( cox1 ) gene was amplified using PCR assay, and the sequence of the amplified product was aligned to that was recorded in the GenBank to characterize the parasite species. In addition, a phylogenetic tree of Echinococcus was generated based on the cox1 gene sequence using the neighbor-joining method., Results: A total of 236 small rodents were captured in Shanglaxiu and Longbao townships, Yushu City, including 65 Qinghai voles and 51 plateau pikas in Shanglaxiu Township, and 62 Qinghai voles and 58 plateau pikas in Longbao Township, and there was no significant difference in the constituent ratio of small rodents between the two townships (χ 2 = 0.294, P > 0.05). Seven plateau pikas and 12 Qinghai voles were suspected to be infected with Echinococcus by dissection, and pathological examinations showed unclear structure of hepatic lobules and disordered hepatocyte arrangement in livers of small rodents suspected of Echinococcus infections. PCR assay identified E. shiquicus DNA in 7 Qinghai voles, which were all captured from Shanglaxiu Township. Phylogenetic analysis showed that the cox1 gene sequence of Echinococcus in small rodents was highly homologous to the E. shiquicus cox1 gene sequence reported previously., Conclusions: Plateau pika and Qinghai vole were predominant small rodents around human residential areas in Yushu City, Qinghai Province in 2023, and E. shiquicus infection was detected in Qinghai voles.

Background: The main endemic areas of alveolar echinococcosis (AE) are in central Europe and western China. The infiltration of intrahepatic vascular and bile ducts as well as extrahepatic disease can lead to complications and may increase morbidity in AE. Purpose: To evaluate the vascular/biliary involvement of hepatic alveolar echinococcosis (HAE) and distant extrahepatic disease at each of four locations in Germany, France, and China. Material and Methods: Contrast-enhanced abdominal magnetic resonance imaging (MRI) scans of patients with HAE, 200 in total, were evaluated by five examiners. AE liver lesions were classified according to Kodama's classification. Furthermore, distant extrahepatic manifestations were documented with additionally performed imaging modalities. Vascular/biliary involvement of hepatic manifestations as well as the presence of extrahepatic manifestations were correlated with the respective Kodama type of the liver lesion. Results: Distant extrahepatic AE manifestations were significantly more frequent in China than in Europe (12/100 vs. 3/100; Fisher's exact test: P =0.0286). A significant relationship exists between presence of distant extrahepatic disease manifestation and size of the AE liver lesion (132.53 ± 48.65 vs. 92.49 ± 50.06; P = 0.0030). Vascular/biliary involvement is significantly more frequent in China than in Europe (86/100 vs. 65/100; χ2 = 11.92; P = 0.0006). Vascular/biliary involvement depends on lesion size (111.10 ± 47.44 vs. 47.36 ± 24.36; P <0.0001). Different types of AE liver lesions are associated with differences in vascular/biliary involvement and extrahepatic manifestations. Conclusion: Vascular/biliary involvement and presence of distant extrahepatic manifestations depend on size of the HAE lesions and are more frequently detected in China. Different MRI morphological patterns influence vascular/biliary involvement and the occurrence of distant extrahepatic manifestations. [ABSTRACT FROM AUTHOR]

Echinococcosis is a zoonosis caused by the larval stage of cestode species that belong to the genus Echinococcus. The infection of hydatid in sheep is very common in China, especially in the northwestern China. Here, we conducted the first systematic review and meta-analysis of echinococcosis in sheep in China. Six databases (PubMed, ScienceDirect, Baidu Library, CNKI, Wanfang, and VIP Chinese Journal Database) were used to retrieve the literatures on echinococcosis in sheep in China from 1983 to 2020, and 74 studies. The random effects model was used in the "meta" package of the R software and the PFT was chosen for rate conversion. The research data were analyzed through subgroup analysis and univariate meta-regression analysis to reveal the factors that lead to research heterogeneity. The combined prevalence of Echinococcus in the selected period was estimated to be 30.9% (192,094/826,406). In the analysis of sampling year, the lowest positive rate was 13.9% (10,296/177,318) after 2011. The highest prevalence of Echinococcus was 51.1% (278/531) in the southwestern China. The highest infection rate in sheep was 20.1% (58,344/597,815) in the liver. The analysis based on age showed that the infection rate of elderly sheep was significantly higher than that in younger animals (P < 0.05). We also evaluated the effects of different geographic and climatic factors on the prevalence of Echinococcus in sheep. The results showed that the prevalence of Echinococcus was higher in high altitude, cold, humid, and high rainfall areas. It is necessary to carry out long-term monitoring and control of echinococcosis, cut off the infection route, and reduce the risk of infection in the high risk areas. [ABSTRACT FROM AUTHOR]

Background: As a neglected cross-species parasitic disease transmitted between canines and livestock, echinococcosis remains a global public health concern with a heavy disease burden. In China, especially in the epidemic pastoral communities on the Qinghai-Tibet Plateau, the harsh climate, low socio-economic status, poor overall hygiene, and remote and insufficient access to all owned dogs exacerbate the difficulty in implementing the ambitious control programme for echinococcosis. We aimed to design and implement a remote management system (RMS) based on internet of things (IoT) for control and surveillance of echinococcosis by combining deworming devices to realise long-distance smart deworming control, smooth statistical analysis and result display. New methods and tools are urgently needed to increase the deworming coverage and frequency, promote real-time scientific surveillance, and prevent transmission of echinococcosis in remoted transmission areas. Methods: From 2016 to 2019, we had cooperated and developed the smart collar and smart feeder with the Central Research Institute of Shanghai Electric Group Co., Ltd. (Shanghai, China) and Shenzhen Jizhi Future Technology Co., Ltd. (Shenzhen, China). From September 2019 to March 2020, We had proposed the RMS based on IoT as a novel tool to control smart deworming devices to deliver efficient praziquantel (PZQ) baits to dogs regularly and automatically and also as a smart digital management platform to monitor, analyse, and display the epidemic trends of echinococcosis dynamically, in real time in Hezuo City, Gannan Tibetan Autonomous Prefecture, Gansu Province, China. Starting from January 2018, The RMS has been maintained and upgraded by Shanghai Yier Information Technology Co., Ltd (Shanghai, China). The database was based on MySQL tools and the Chi-square test was used to probe the difference and changes of variables in different groups. Results: The smart collars are fully capable of anti-collision, waterproof, and cold-proof performance, and the battery's energy is sufficient, the anti-collision rate, water-proof rate, cold-proof rate and voltage normal rate is 99.6% (521/523), 100.0% (523/523), 100.0% (523/523) and 100.0% (523/523), respectively. The RMS can accurately analyse the monitoring data and parameters including positive rates of canine faeces, and the prevalence of echinococcosis in the general population livestock, and children. The data of dogs deworming and surveillance for echinococcosis is able to be controlled using RMS and has expanded gradually in townships to the whole Hezuo region. The automatic delivering PZQ rate, collar positioning rate, deliver PZQ reminding rate, and fault report rate is 91.1% (1914/2102), 92.1% (13 580/14 745), 92.1% (1936/2102) and 84.7% (1287/1519), respectively. After using the RMS from 2019, the missing rate of monitoring data decreased from 32.1% (9/28) to 0 (0/16). A total of 48 administrators (3, 3, 8, 11, 23 at the provincial, municipal, county, township, village levels, respectively) participated in the questionnaire survey, with 93.8% of its overall satisfaction rate. Conclusions: The existing difficulties and challenges in the way of prevention and control for echinococcosis can partially be resolved using the innovative, IoT-based technologies and tools. The proposed RMS advance the upgrade of existing manual prevention and control models for echinococcosis, especially in the current ongoing COVID-19 pandemic, as social distance and community blockade continue. [ABSTRACT FROM AUTHOR]

Human echinococcosis is present worldwide but it is in China that disease prevalence is the highest. In western China, especially in the Tibetan Plateau, the burden of echinococcosis is the most important. Dogs are a major definitive host of Echinococcus and monitoring the presence of Echinococcus worms in dogs is therefore essential to efficiently control the disease. Detection kits based on three different technologies including sandwich ELISA, (indirect) ELISA, and gold immunodiffusion, are currently marketed and used in China. The objective of this work was to assess the efficacy of these kits, in particular with respect to sensitivity and specificity. Four fecal antigen detection kits for canine infection reflecting the three technologies were obtained from companies and tested in parallel on 220 fecal samples. The results indicate that the performance is lower than expected, in particular in terms of sensitivity. The best results were obtained with the sandwich ELISA technology. The gold immunofiltration yielded the poorest results. In all cases, further development is needed to improve the performance of these kits which are key components for the control of echinococcosis. Author summary: Although present worldwide, human echinococcosis is at its highest prevalence in western China and particularly in the Tibetan Plateau. Controlling echinococcosis is a national priority and routine monitoring must be established. Dogs are the main infection source in China and surveying Echinococcus worms in dogs is therefore a research priority. Commercial detection kits are currently in use in China to monitor the presence of Echinococcus in dogs. The kits are based on three different technologies including sandwich ELISA with two monoclonal antibodies, (indirect) ELISA, and gold immunodiffusion. National survey programmes are essential for the control of echinococcosis and it is thus very important to assess the efficacy of these kits for the programmes. This work was therefore undertaken to assess efficacy of the kits, in particular with respect to sensitivity and specificity. Four fecal antigen detection kits for canine infection reflecting the three technologies were obtained from companies and tested in parallel on 220 fecal samples. The performance was lower than expected, in particular for their sensitivity which ranged between 51.5% and 83.9% with only two samples displaying a worm burden lower than 100. Three out of four kits showed non-specific cross-reactions with other parasites. The best results were obtained with the sandwich ELISA technology, whereas gold immunofiltration yielded the poorest results. However, in all cases, further development is strongly needed to improve the performance of these kits which are key components for the control of echinococcosis. [ABSTRACT FROM AUTHOR]

Background: Echinococcosis is highly endemic in western and northern China. Tibet Autonomous Region (TAR) is the most serious prevalent area. Linzhi is located in southeastern part of TAR. Dogs are the primary infection source for the transmission of echinococcosis to humans. A control and prevention campaign based on dog management has been implemented in the past three years. This study aims to evaluate the effects of dog management on the infection rate of dogs. Methods: Data of dog population, registration and de-worming of seven counties/district in Linzhi between 2017 and 2019 were obtained from the annual prevention and control report. Domestic dog fecal samples were collected from each endemic town of seven counties/district in Linzhi in 2019 to determine the infection of domestic dogs using coproantigen enzyme-linked immunosorbent assay (ELISA). Data analysis was processed using SPSS statistics to compare dog infection rate between 2016 and 2019 by chi-square test, and maps were mapped using ArcGIS. Results: In Linzhi, domestic dog population has decreased from 17 407 in 2017 to 12 663 in 2019, while the registration rate has increased from 75.9% in 2017 to 98.6% in 2019. Similarly, stray dog population has decreased from 14 336 in 2017 to 11 837 in 2019, while sheltered rate has increased from 84.6% in 2017 to 96.6% in 2019. Dog de-worming frequency has increased from 4 times per annum in 2017 to 12 times in 2019, indicating that approximately every dog was dewormed monthly. A total of 2715 dog fecal samples were collected for coproantigen ELISA assay. The dog infection rate was 2.8% (77/2715) in 2019, which was significantly lower than 7.3% (45/618) in 2016 (P < 0.05). Conclusions: Increased dog registration, decreased dog population, and increased dog de-worming frequency contributed to significantly decrease the dog infection rate in Linzhi. Control and prevention campaign based on dog management could significantly decrease dog infection with Echinococcus spp. in echinococcosis endemic areas. [ABSTRACT FROM AUTHOR]

The unique geographical and ecological conditions of the Qinghai-Tibetan Plateau (QTP) constitute the environmental conditions of the natural foci of cystic echinococcosis (CE). It is a rare and highly endemic area in the world. The main host of the pathogen, Tibetan sheep, is widely distributed, and the population density is on the rise in recent years, which increases the pressure on the transmission and risk of the natural epidemic source. Currently, the developments of serological diagnosis test for Echinococcus granulosus infection on the QTP Tibetan sheep are scanty, which seriously restricts the epidemiological investigation of CE in Tibetan sheep on the QTP. EgAgB8/2 is one of the most important targets of host antibody response in CE and has better diagnostic performance in livestock. This study expressed the recombinant EgAgB8/2 antigen of E. granulosus from Tibetan sheep in prokaryotic expression vector, and also preliminarily evaluated its potential value for diagnosing CE in Tibetan sheep using indirect ELISA. Our preliminary results shown that the recombinant EgAgB8/2 antigen had good immunogenicity and exhibited high sensitivity (95%) and high specificity (100%) and no cross-reacted with both Taenia multiceps and Taenia hydatigena. Further studies are needed to collect more Tibetan sheep sera from E. granulosus and other parasitic infections, which may evaluate further sensitivity, specificity and cross-reactive of recombinant EgAgB8/2 antigen in Tibetan sheep positive for CE of the QTP, China. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis (AE) is a life-threatening disease in humans caused by the larval stage of Echinococcus multilocularis. The tapeworm is transmitted between small mammals and dogs/foxes in the Northern Hemisphere. In this study 286 AE cases were reported from eight counties and one city in Yili Prefecture, Xinjiang Autonomous Region, the People's Republic of China from 1989 to 2015 with an annual incidence (AI) of 0.41/100,000. Among the patients, 73.08% were diagnosed in the last 11 years. Four counties in the high mountainous areas showed higher AI (0.51–1.22 cases//100,000 residents) than the four counties in low level areas (0.19–0.29/100,000 residents). The AI of AE in Mongolian (2.06/100,000 residents) and Kazak (0.93/100,000 residents) ethnic groups was higher than the incidence in other ethnic groups indicating sheep-farming is a risk for infection given this activity is mainly practiced by these two groups in the prefecture. A total of 1411 small mammals were captured with 9.14% infected with E. multilocularis metacestodes. Microtus obscurus was the dominant species in the mountain pasture areas with 15.01% of the voles infected, whereas Mus musculus and Apodemus sylvaticus were the dominant small mammals in the low altitude areas. Only 0.40% of A. sylvaticus were infected with E. multilocularis. PCR amplification and sequencing analysis of the mitochondrial cox1 gene showed that E. multilocularis DNA sequences from the small mammals were identical to isolates of local human AE cases. The overall results show that Yili Prefecture is a highly endemic area for AE and that the high-altitude pasture areas favorable for M. obscurus may play an important role in its transmission in this region. Author summary: Alveolar echinococcosis (AE) is a neglected zoonosis caused by the larval stage of the fox/dog tapeworm Echinococcus multilocularis. In this study, we collected data on 286 AE cases reported from Yili Prefecture, Xinjiang Autonomous Region, the People's Republic of China from 1989 to 2015 with an annual incidence (AI) of 0.41/100,000. Among the patients, 73.08% were diagnosed in the last 11 years. The incidence (0.51–1.22 cases/100,000 residents) was higher in the high-altitude mountainous areas than those in low level areas (0.19–0.29/100,000 residents). In term of ethnic group, the AI of AE in Mongolian (2.06/100,000 residents) and Kazak (0.93/100,000) groups had higher incidence than the other ethnic groups, indicating sheep-farming activity is a risk for infection given that sheep farming is mainly practiced by these two groups in the prefecture. A total of 1411 small mammals were captured with 9.14% infected with E. multilocularis metacestodes. Microtus obscurus was the dominant species captured in the mountainous pasture areas with 15.01% infection rate, whereas Mus musculus and Apodemus sylvaticus were the dominant small mammals in the low altitude areas. Only 0.40% of A. sylvaticus were infected with E. multilocularis. These findings show that Yili Prefecture is a highly endemic area for AE and that the high-altitude pasture areas favorable for M. obscurus may play an important role in its transmission in this region. [ABSTRACT FROM AUTHOR]

Objectives: Intracranial alveolar echinococcosis (IAE), a zoonotic disease, is a critical health problem in the Tibetan region. We aimed to describe the clinical and radiological characteristics and outcomes among patients with IAE. Methods: We screened patients diagnosed with IAE between March 2015 and May 2019 at the Ganzi Tibetan Autonomous Prefecture People's Hospital. Detailed demographics, clinical characteristics, neuroimaging features, and outcomes were recorded. Results: A total of 21 patients with an average age of 44.1 ± 12.7 years were included. Thirteen (61.9%) patients were male. The most common chief neurological complaint was headache (n = 17, 81.0%), followed by dizziness, seizure, visual disturbances, hemiparesis, disturbed consciousness, and dysphasia. All the patients had coexisting liver localizations. The typical neuroimaging features of IAE on cerebral magnetic resonance imaging scans showed obvious low-signal shadow with multiple small vesicles inside the lesions on T2-weighted images and FLAIR images. The pathological HE staining demonstrates vesicular lesions with several internal sacs. For hepatic alveolar echinococcosis (AE), the hepatic portal was invaded in six (28.6%) patients, and the portal vein (n = 5, 23.8%) was the mostly commonly involved vessel. As for treatment, 11 patients (52.4%) had poor compliance with albendazole. The duration of patients taken albendazole ranged from 2 months to 3 years. Cerebral AE surgery was performed in 11 patients, five of them underwent partial resection of AE lesions, and six patients received total resection. One patient with primary IAE underwent radical surgery. Ten patients (47.6%) died during the follow-up for a mean of 21.7 ± 11.9 (3–46) months. In total, 28.9% of the patients died within 5 years, and 71.6% died within 10 years. The median interval between the date of diagnosis as AE and death was 84 (19–144) months. Conclusion: Despite substantial advances in diagnostic and therapeutic methods, the treatment of IAE remains difficult and results in unsatisfactory outcomes. The major critical issue is surgical treatment of IAE although the disease is disseminated. Besides, lifelong albendazole would be indicated, but most patients had poor medication compliance. It is important to educate patients about the necessity of medical treatment. [ABSTRACT FROM AUTHOR]

Morbidity of mixed cystic and alveolar echinococcosis (CE and AE) is exceptionally rare. Less literature retrieved from a database on the internet detailed the content, including radiography, pathology, and therapeutics data. Such a case of cooccurrence of the different Echinococcus species was diagnosed and treated at our hospital center from Nov 2019 to Feb 2020. A 30 yr old female from the pastoral area in Qinghai Province, China, was diagnosed with a case of echinococcosis and diagnosis was confirmed after image studies, immunoassaying of hydatid enzymes, life history and pathology result. The patient underwent hepatectomy along with excision of the internal capsule. Post-operative pathology was done, and it confirmed a mixed infection of both CE and AE. The patient recovered well without complications after liver-protecting and tissue repair treatment for 15 days. Knowing about infective mode and immune method of the case might be vital for research on variation for Echinococcus infection. [ABSTRACT FROM AUTHOR]

Objective: To analyze the echinococcosis surveillance results in Bayingolin Mongol Autonomous Prefecture, Xinjiang Uygur Autonomous Region from 2017 to 2022, so as to provide insights into formulation of echinococcosis control measures in the prefecture., Methods: Villagers were randomly sampled using a multistage sampling method from class I and II echinococcosis endemic counties in Bayingolin Mongolian Autonomous Prefecture from 2017 to 2022 for detection of human echinococcosis, while all patients undergoing ultrasound examinations in medical institutions in class III endemic counties received active echinococcosis screening. In addition, livestock in centralized slaughterhouses or slaughtering sites were screened for echinococcosis using the palpation and necropsy method, and fresh domestic dog feces samples were collected from randomly selected dog owners in each administrative village for detection of Echinococcus copro-antigen in domestic dogs. The trends in detection of human and livestock echinococcosis, detection of newly diagnosed human echinococcosis cases and detection of Echinococcus coproantigen in domestic dogs were analyzed in Bayingolin Mongol Autonomous Prefecture from 2017 to 2022., Results: The mean detection rate of human echinococcosis was 0.13% (540/407 803) in Bayingolin Mongol Autonomous Prefecture from 2017 to 2022, which appeared a tendency towards a decline over years (χ 2 trend < 0.001), and the highest detection of newly diagnosed echinococcosis cases was seen in Hejing County (0.28%, 191/67 865). The detection of livestock echinococcosis appeared a tendency towards a decline over years from 2017 to 2022 (χ P < 0.001), and the highest detection of newly diagnosed echinococcosis cases was seen in Hejing County (0.28%, 191/67 865). The detection of livestock echinococcosis appeared a tendency towards a decline over years from 2017 to 2022 (χ 2 trend = 147.02, P < 0.001), with the highest detection rate seen in Hejing County (3.44%, 86/2 500), and the detection of Echinococcus copro-antigen in domestic dogs appeared a tendency towards a decline over years from 2017 to 2022 (χ 2 trend = 302.46, P < 0.001), with the highest detection rate in Qiemo County (2.74%, 118/4 313)., Conclusions: The detection of human and livestock echinococcosis and dog feces antigens Echinococcus copro-antigen in domestic dogs all appeared a tendency towards a decline in Bayingolin Mongol Autonomous Prefecture, Xinjiang Uygur Autonomous Region from 2017 to 2022; however, there is still a high echinococcosis transmission risk in local areas. Sustainable integrated echinococcosis control is required in Bayingolin Mongol Autonomous Prefecture.

Objective: To evaluate the effectiveness of comprehensive echinococcosis control measures with emphasis on management of infectious source in Sichuan Province from 2010 to 2022, so as to provide insights into formulation of future control interventions., Methods: Data pertaining to comprehensive echinococcosis control measures with emphasis on management of infectious source and echinococcosis surveillance in Sichuan Province from 2010 to 2022 were collected. The effectiveness of comprehensive echinococcosis control measures with emphasis on management of infectious source was evaluated with prevalence of human echinococcosis, detection of newly diagnosed echinococcosis patients, prevalence of Echinococcus infection in domestic dogs, prevalence of cystic echinococcosis in livestock, prevalence of alveolar echinococcosis in small mammals and awareness of echinococcosis control knowledge, and Spearman's rank correlation analysis., Results: The prevalence of human echinococcosis reduced from 1.08% in 2010 to 0.40% in 2022 in Sichuan Province (χ 2 = 1 482.97, P < 0.05), with a reduction from 0.30% to 0.02% in the detection of newly diagnosed echinococcosis cases (χ 2 = 2 776.41, P < 0.05), a reduction from 15.87% to 0.46% in the prevalence of Echinococcus infection in domestic dogs (χ 2 = 20 823.96, P < 0.05), a reduction from 8.05% to 1.07% in the prevalence of cystic echinococcosis in livestock (χ 2 = 1 296.02, P < 0.05), and the awareness of echinococcosis control knowledge increased from 50.65% to 95.24% (χ 2 = 34 938.63, P < 0.05); in addition, there was a year-specific prevalence rate of alveolar echinococcosis in small mammals (χ 2 = 164.07, P < 0.05). Spearman's rank correlation analysis revealed that the detection of newly diagnosed echinococcosis cases correlated positively with the prevalence of Echinococcus infections in domestic dogs ( r s < 0.05) and the prevalence of cystic echinococcosis in livestock ( P < 0.05) and the prevalence of cystic echinococcosis in livestock ( r < 0.05), and correlated negatively with the awareness of echinococcosis control knowledge ( s = 0.795, P < 0.05), and correlated negatively with the awareness of echinococcosis control knowledge ( r infection in domestic dogs correlated positively with the prevalence of cystic echinococcosis in livestock ( s = - 0.918, P < 0.05) and negatively with the awareness of echinococcosis control knowledge ( Echinococcus infection in domestic dogs correlated positively with the prevalence of cystic echinococcosis in livestock ( r s infections in domestic dogs and the prevalence of alveolar echinococcosis in small mammals ( P < 0.05) and negatively with the awareness of echinococcosis control knowledge ( r s = -0.747, P < 0.05); however, there was no correlation between the prevalence of Echinococcus infections in domestic dogs and the prevalence of alveolar echinococcosis in small mammals ( r s = -0.750, P > 0.05)., Conclusions: The comprehensive echinococcosis control measures with emphasis on management of infectious source had achieved remarkable effectiveness in Sichuan Province; however, the transmission chain of echinococcosis has not been interrupted. Reinforced comprehensive echinococcosis control measures with emphasis on management of infectious source and sustained tracking evaluation of the effectiveness are recommended in Sichuan Province.

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.

Objective: To evaluate the effectiveness of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, so as to provide insights into echinococcosis control., Methods: Administrative villages were sampled using a multi-stage cluster random sampling method from Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, and all residents at ages of 12 years and older in the sampled villages were screened for echinococcosis, and schools were sampled using a cluster sampling method, and all children at ages of 12 years and older in the sampled schools were screened for echinococcosis. Domestic dogs were sampled using a systematic random sampling method, and one domestic dog stool sample was collected from each household. Stray dog stool samples were collected outside the villages, and Echinococcus coproantigens were detected using enzyme-linked immunosorbent assay in domestic and stray dogs. In addition, echinococcosis was screened in sheep and cattle in designated slaughterhouses in Tianzhu Tibetan Autonomous County. The trends in the prevalence of echinococcosis in humans and livestock and the positive rate of Echinococcus coproantigens in dogs were examined with the Cochran-Armitage trend test. In addition, individuals screened for echinococcosis were randomly sampled from 2007 to 2022 for survey on the awareness of echinococcosis control knowledge., Results: A total of 290 356 person-times were screened for echinococcosis among residents at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 094 residents detected with cystic echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ 2 = 358.602, P < 0.001). A total of 32 931 person-times were screened for echinococcosis among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 296 children detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ 2 = 267.673, P < 0.001). A total of 33 230 domestic dog stool samples were tested for Echinococcus coproantigens in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 777 Echinococcus coproantigens-positive samples tested, and the positive rate of Echinococcus coproantigens appeared a tendency towards a decline in domestic dogs over years (χ 2 = 2 210.428, P < 0.001), while the positive rate of Echinococcus coproantigens showed a tendency towards a rise in domestic animals from 2016 to 2022 (χ 2 = 37.745, P < 0.001). The positive rate of Echinococcus coproantigens remained relatively stable in stray dogs in Tianzhu Tibetan Autonomous County, Gansu Province from 2019 to 2022 (χ 2 = 0.315, P = 0.575). A total of 10 973 sheep were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2007 to 2022, with 334 sheep detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a decline in sheep over years (χ 2 = 53.579, P < 0.001); however, there was no significant change in the detection of echinococcosis during the period from 2015 through 2022 (χ 2 = 1.520, P = 0.218). A total of 2 400 cattle were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2017 to 2022, with 231 cattle detected with echinococcosis, and the detection of echinococcosis showed a tendency towards a decline over years (χ 2 = 5.579, P < 0.05). The awareness of echinococcosis control knowledge increased from 44.37% in 2007 to 94.00% in 2022 among residents at ages of 12 years and older and from 52.50% in 2007 to 92.50% in 2022 among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, respectively., Conclusions: There has been a reduction in the detection of echinococcosis in humans and domestic animals and the positive rate of Echinococcus coproantigens in dogs and a rise in the awareness of the echinococcosis control knowledge following the implementation of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province; however, integrated echinococcosis control measures are still required for further control of the prevalence of echinococcosis.

As a zoonotic parasitosis caused by the parasitism of Echinococcus larvae, echinococcosis imposes serious disease and economic burdens on human beings and society, and is thus a global public health issue. Its complex life history, wide distribution, the combined influence of various epidemic factors, coupled with the unique natural environment, customs, and religious beliefs in endemic areas, pose a huge challenge to the national echinococcosis control programme in China. Accurate early detection and confirmation of diagnosis of echinococcosis, the use of effective drugs, real-time surveillance of the infection status of populations and various hosts, controlling the source of infection, and blocking the route of transmission are of enormous significance for control. In this paper, the work by NIPD-CTDR on the prevention and control of echinococcosis in China is reviewed, with a view to providing reference for the further promotion of the national echinococcosis control programme. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis is a zoonotic infection caused by Echinococcus granulosus. This case report shows the difficulty in differential diagnosis in a patient with highly suspected hydatid disease.Case Presentation: A 29-year-old Chinese woman presented with progressive abdominal distension. Imaging results revealed a large multicystic tumor with typical features of hydatid disease. There was no clear relationship between the cystic tumor and the liver, which led to the assumption of primary extrahepatic cystic echinococcosis. After albendazole therapy was initiated, a laparotomy was performed and a huge ovarian cystadenoma was diagnosed.Conclusions: This case highlights the possible challenges of differential diagnosis in patients with suspicion of hydatid cysts. [ABSTRACT FROM AUTHOR]

Purpose: Echinococcosis is a chronic neglected zoonotic disease with high endemic in western China. The aim of the study was to evaluate the Health-related Quality of Life (HRQoL) in patients with echinococcosis in Tibetan communities for investigating the physical and mental health challenges faced by the echinococcosis patients and meeting community health needs.Methods: The HRQoL was measured with 36-Item Short Form Health Survey (SF-36) questionnaire in the case-control study. Analysis of variance (ANOVA) method was used to analyze the data.Results: 50 echinococcosis patients were collected in study group and divided into three subgroups by the duration of staying on albendazole tablets. 52 healthy individuals were collected in control group. In physical quality of life, the duration of staying on albendazole tables influenced the PF (F = 6.661, P < 0.001), RP (F = 3.130, P = 0.029), and GH (F = 4.105, P = 0.008). In mental quality of life, the duration of staying on albendazole tables influenced the SF (F = 10.764, P < 0.001) and RE (F = 5.573, P = 0.001). The income level was the important confounder in PF (F = 11.515, P = 0.001), GH (F = 10.315, P = 0.002), VT (F = 5.984, P = 0.016), and MH (F = 5.565, P = 0.020).Conclusions: The HRQoL in people with echinococcosis is reduced in comparison with the healthy individuals. It is necessary to shorten the duration of treatment and adopt the special methods adapting the local culture to improve the health-related quality of life in Tibetan communities. Meanwhile, the economic improvement is the foundation. [ABSTRACT FROM AUTHOR]

Background Hydatid disease is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. As the imaging characteristics of pancreatic echinococcosis (PE) are similar to those of cystic diseases, such as cysts, tuberculosis, and tumors, PE is often misdiagnosed and mistreated. Methods The clinical manifestations, laboratory tests, radiological findings, and treatment of 19 patients with PE between January 2006 and December 2018 in 2 hospitals were retrospectively analyzed. Results The mean age of the patients was 38 years, and the ratio of women to men was 2. All patients came from rural areas. Clinical manifestations included cholestatic jaundice, mass, nausea, pain, and swelling. Hemagglutination inhibition test results were positive for all patients. Enzyme-linked immunosorbent assay test results were positive in 17 cases (89.5%). Foci in the pancreas were head in 52.6%, body in 26.3%, body and tail in 15.8%, tail in 5.3%. The size of lesions' diameter ranged from 1 to 12 cm (mean, 6.5 cm). The imaging features of PE included the presence of (a) daughter cysts on abdominal computed tomography (CT) and/or magnetic resonance imaging (MRI); (b) internal cyst wall dissection and ribbon sign on abdominal CT and/or MRI; (c) typical eggshell cyst wall calcification on abdominal CT. Conclusions For patients with cystic lesions on CT and/or MRI combined with epidemiological history and positive echinococcosis serology, doctors can correctly diagnose PE earlier. Surgical treatment combined with drugs can reduce the mortality of PE, leading to a better prognosis. [ABSTRACT FROM AUTHOR]

Background: Echinococcosis is a neglected zoonotic parasitic disease caused echinococcus parasitizes, poseing a significant economic burden on both humans and animals. There are limited studies on echinococcosis in China, especially Xizang Autonomous Region, although the area is endemic area for echinococcosis. The study aimed to provide information for strategic prevention against this disease.Methods: A cross-sectional survey was conducted among the residents in Xizang Autonomous Region, China to evaluate their knowledge, attitudes and practices on endemicity of echinococcosis. A face-to-face survey was conducted to collect the data using a well-designed questionnaire. The contents included basic personal information, knowledge, attitudes and practices about echinococcosis, personal hygiene and behavior habits, dog feeding and whether they had received the information on echinococcosis, and so on. We surveyed 840 persons in practice. All data analysis was performed using Epi Info 7.2.Results: Of the total particpants, 86.8% had a primary education level or below (including primary and illiterate), and even 45.0% were illiterate. Farmers and herdsmen represent the main occupations in this study. People who know all the echinococcosis-related knowledge in the questionnaire only accounted for 8.7% of the participants. However, none of the participants was aware of routes of echinococcosis infection in human or dogs. The data showed participants with higher educational background had the high awareness rate of echinococcosis-related knowledge or attitudes (chi-square for trend, χ2 = 21.23, p<0.05 & χ2 = 48.43, p<0.05). In addition, The percentage of the participant with awareness of echinococcosis-related practices was associated with their age and principle occupation (χ2 = 52.72, p<0.05 & χ2 = 20.63, p<0.05).Conclusions: Xizang Autonomous Region is an epidemic area of Echinococcosis. The prevalence of the disease has been largely due to the lack of knowledge, awareness, and poor hygiene practice in local residences. Therefore, effective disease prevention education and awareness campaigns in community will be significantly helpful in prevention and control of echinococcosis. [ABSTRACT FROM AUTHOR]

Background: Human cystic echinococcosis (CE) is one of the commonest zoonoses, and it is endemic in many parts of the world including China. Complications and recurrences after the surgical treatment of hepatic CE (HCE) incur a large personal, healthcare, and societal burden. There has been some progress in HCE prevention, diagnosis, and treatment, but there is no "one size fits all" approach, and surgery still remains the cornerstone of treatment for some cyst stages and locations or in areas with little knowledge or access to other treatment modalities. In 2009 we designed and implemented a program to improve surgical outcomes from HCE in Xinjiang province, China. Methodology/Principal findings: A multimodal HCE training program was implemented in eleven primary hospitals in Xinjiang province, China, which provided education and training on HCE clinical knowledge and practice, the application of diagnostic and treatment options, and optimal surgery. The management of HCE cases was analyzed before and after program implementation. Contrast enhanced CT use, application of scoloicidal agents, removal of necrotic cyst wall remnants, appropriate perioperative drug use, and the use of optimal surgical approach increased after program implementation. Further, postoperative recurrences and residual cavity complications creased from 7.4% to 1.3% and 15.2% to 9.0% after program implementation, respectively. Conclusions/Significance: Tis integrated surgical training program is useful for improving outcomes of patients with HCE and can be used in institutions in other endemic areas. Author summary: Hepatic cystic echinococcosis (HCE) is an endemic and neglected global disease. Many deprived areas in China still lack the knowledge and expertise to successfully treat HCE surgically, which results in high postoperative complication and recurrence rates that further decrease postoperative quality of life. In this study, we aimed to transfer our extensive experience in the development and implementation of effective surgery for HCE to eleven hospitals in the Echinococcus granulosus endemic province of Xinjiang to improve the surgical treatment of HCE. Our results indicate that our training program effectively reduces recurrence and complication rates and will be of use in other endemic areas. [ABSTRACT FROM AUTHOR]

There is no direct evidence to support the existence of regional lymph node metastatic routes in hepatic alveolar echinococcosis, and only a few literature have been reported. There was a case of hepatic alveolar echinococcosis suspected of metastasis of regional lymph node in Clinical Center for Hydatidosis, Qinghai Province, China. The patient was a 24-yr-old male from pastoral area of Seda County, Sichuan Province, China in 2018. He was admitted to the hospital for physical examination and had no special discomfort. Preoperative examination showed liver occupancy and regional lymph node enlargement in the space between liver and stomach. Hepatectomy and lymph node resections were performed. Postoperative pathological results showed that both primary and metastatic lesion were of alveolar echinococcosis. Recovery of patient was good without complications and recurrence. In this case, metastasis was considered because the liver lesion was not directly connected to the lymph node. However, the case was still suspected due to the lack of pathological examination of other lymph nodes in the lymphatic return pathway. Regional lymph node metastasis may be one of the metastatic ways of alveolar echinococcosis. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) in humans and livestock is caused by Echinococcus granulosus (sensu lato). In China where CE is endemic, a number of studies have shown that Echinococcus granulosus (sensu stricto) is majorly responsible for CE. However, E. canadensis (G6) which is the second leading cause of CE is now being detected in most parts of the country. In this study, the species diversity and genetic variation of Echinococcus granulosus (s.l.) in four counties in Tibet Autonomous Region of China were investigated. Methods: Infection with Echinococcus granulosus (s.s.) in yaks and sheep was identified using NADH dehydrogenase subunit 1 and 5 (nad1 and nad5) mitochondrial genes while the genotype G6 of E. canadensis initially diagnosed with NADH dehydrogenase subunit 1 (nad1) was further confirmed by analysis of the complete mitochondrial genome and a phylogenetic network constructed based on the nad2 and nad5 genes. Results: Out of 85 hydatid cyst samples collected from slaughtered sheep (n = 54) and yaks (n = 31), 83 were identified as E. granulosus (s.s.) G1 (n = 77), G3 (n = 6) and 2 were identified as E. canadensis G6. Analysis of the nad1/nad5 genes revealed 16/17 mutations with 9/14 parsimony informative sites resulting in 15/14 haplotypes, respectively. Haplotype diversity (Hd) and nucleotide diversity (π) of E. granulosus (s.s.) population were 0.650 and 0.00127 for nad1 and 0.782 and 0.00306 for nad5, respectively, with an overall negative Tajima's D and Fu's Fs. A low FST indicated no genetic difference between isolates from sheep and yaks. Conclusion: Pockets of infection with E. canadensis (G6, G7, G8 and G10) have been previously reported in sheep, goats, yaks and/or humans in different parts of China. While the G6 genotype has been previously reported in sheep in the Tibet Autonomous Region, the detection in a yak in the present study represents the first to the best of our knowledge. Therefore, we recommend future surveys and control efforts to comprehensively investigate other potential intermediate hosts for the prevalence and genetic diversity of the E. canadensis group (G6, G7, G8 and G10) across the country and their inclusion into the existing CE control programme. [ABSTRACT FROM AUTHOR]

Hydatid disease, also known as echinococcosis, is an endemic zoonotic parasitic disease caused by larvae of the Echinococcus tapeworm.Humans as accidental intermediate hosts in the parasite life cycle, echinococcus usually parasitizes the liver, solitary cystic echinococcosis in the gallbladder is very rare. Here we report a rare case of cystic echinococcosis in the gallbladder without liver involvement. A female patient was admitted to the hospital primarily for "right upper abdominal pain with radiating pain in the back of the shoulder for 20 days", initially suspected to be gallbladder stones, and underwent laparoscopic cholecystectomy after completing the relevant investigations, and was diagnosed with primary cystic echinococcosis of the gallbladder based on the pathologic findings in the postoperative period. The patient recovered well after surgery and remained well without complications during the 6-month follow-up period. This case illustrates that echinococcus granulosus can also parasitize in the gallbladder only, although it is quite uncommon. In addition, it is difficult to distinguish it from gallbladder stones by conventional imaging. The diagnosis of some cases of gallbladder cystic echinococcosis is completed during surgery and confirmed by postoperative pathological results. [Display omitted] • Echinococcus granulosus parasitizes only the gallbladder without involving the liver. • The clinical presentation of the patient in this case was similar to that of gallbladder stones. • Echinococcus granulosus of the gallbladder was confirmed by postoperative pathology. [ABSTRACT FROM AUTHOR]

Background: Human alveolar echinococcosis caused by infection with Echinococcus multilocularis is one of the most potentially pathogenic helminthic zoonoses. Transmission occurs involving wildlife cycles typically between fox and small mammal intermediate hosts. In the late 1980s/early 1990s a large focus of human AE was identified in poor upland agricultural communities in south Gansu Province, China. More detailed investigations in 1994–97 expanded community screening and identified key risk factors of dog ownership and landscape type around villages that could support susceptible rodent populations. A crash of the dog population (susceptible domestic definitive host) in the early 1990s appeared to stop transmission. Methodology/Findings: We subsequently undertook follow-up eco-epidemiological studies based on human population screening and dog survey, in 2005/6 and in 2014/15. Our observations show a decrease in human AE prevalence, especially marked in the 11–30 year old age category. In 2015, although the dog population had recovered and in addition, forest protection and the reforestation of some areas may have favoured red fox (wild definitive host) population growth, there was no evidence of infection in owned dogs. Conclusions/Significance: Those observations suggest that over decades socio-ecological changes resulted in a cascade of factors that exacerbated and then interrupted parasite emergence, with probable elimination of peri-domestic transmission of E. multilocularis in this area, despite the relative proximity of large active transmission foci on the eastern Tibetan Plateau. This study case exemplifies how anthropogenic land use and behavioural changes can modify emergence events and the transmission of endemic zoonotic parasite infections, and subsequently the importance of considering processes over the long-term in a systems approach in order to understand pathogen and disease distribution. [ABSTRACT FROM AUTHOR]

Health is the core of development. Health cooperation between countries plays a pivotal role under the Belt and Road Initiative (B&R). In 2013, China launched its B&R to improve the international cooperation of which health was an important component. As one of the neglected zoonotic diseases, echinococcosis has become a public health concern and is on top of the government agenda among neglected zoonosis in Mongolia. The transmission of the disease involves animal husbandry, and its characteristics determine the prevention and control of such diseases which requires cross-sector collaboration and comprehensive prevention and control strategies. Taking echinococcosis as an entry point and adopting a 'Mongolia-led, China-supported, and results-sharing' approach to public health cooperation will not only contribute to the advancement of Mongolia's national health coverage, but also promoting China's capacity to engage in global health. In this way, it contributes to meeting the sustainable development goals, especially goal 3, target 3.3: by 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases. This paper provides an overview on how the cooperation between China and Mongolia under the context of B&R was initiated, planned and moved forward to implementation. The experience may provide a good model and inform policy and practice for other bilateral cooperations. [ABSTRACT FROM AUTHOR]

Echinococcus granulosus is an important zoonotic parasite globally causing cystic echinococcosis (CE) in humans and animals. In this study, prevalence of CE and variation of cox1 gene sequence were analyzed with isolates E. granulosus collected from different areas in northern Xinjiang, China. The survey showed that 3.5% of sheep and 4.1% of cattle were infected with CE. Fragment of cox1 was amplified from all the positive sheep and cattle samples by PCR. In addition, 26 positive samples across the 4 areas were included. The isolates were all E. granulosus sensu stricto (s.s.) containing 15 haplotypes (Hap1-15), and clustered into 2 genotypes, G1 (90.1%, 91/101) and G3 (9.9%, 10/101). Hap1 was the most common haplotype (48.5%, 49/101). Hap9 were found in humans samples, indicating that sheep and cattle reservoir human CE. It is indicate that E. granulosus may impact on control of CE in livestock and humans in the region. [ABSTRACT FROM AUTHOR]

Background: From January 2020 to December 2022, China implemented "First-level-response", "Normalized-control" and "Dynamic-COVID-zero" to block the COVID-19 epidemic; however, the immediate and long-term impact of three strategies on other infectious diseases and the difference in their impact is currently unknown. We aim to provide a more comprehensive understanding of the impact of non-pharmacological interventions (NPIs) on infectious diseases in China., Methods: We collected data on the monthly case count of infectious diseases in China from January 2015 to July 2022. After considering long-term trends using the Cox-Stuart test, we performed the two ratio Z tests to preliminary analyze the impact of three strategies on infectious diseases. Next, we used a multistage interrupted-time-series analysis fitted by the Poisson regression to evaluate and compare the immediate and long-term impact of three strategies on infectious diseases in China., Results: Compared to before COVID-19, the incidence of almost all infectious diseases decreased immediately at stages 1, 2, and 3; meanwhile, the slope in the incidence of many infectious diseases also decreased at the three stages. However, the slope in the incidence of all sexually transmitted diseases increased at stage 1, the slope in the incidence of all gastrointestinal infectious diseases increased at stage 2, and the slope in the incidence of some diseases such as pertussis, influenza, and brucellosis increased at stage 3. The immediate and long-term limiting effects of "Normalized-control" on respiratory-transmitted diseases were weaker than "First-level-response" and the long-term limiting effects of "Dynamic-COVID-zero" on pertussis, influenza, and hydatid disease were weaker than "Normalized-control"., Conclusions: Three COVID-19 control strategies in China have immediate and long-term limiting effects on many infectious diseases, but there are differences in their limiting effects. Evidence from this study shows that pertussis, influenza, brucellosis, and hydatid disease began to recover at stage 3, and relaxation of NPIs may lead to the resurgence of respiratory-transmitted diseases and vector-borne diseases., (© 2023. The Author(s).)