Belchis Boufana, Donald P. McManus, Dominique A. Vuitton, Gail M. Williams, Hao Wen, Tao Sun, Yumin Zhao, Xongzhou Liu, Ruiqi Liu, Jing Teng, Malcolm K. Jones, Patrick Giraudoux, Dazhong Shi, Brigitte Bartholomot, Jianzhong Zhang, Mark F. Danson, Xiaohui Feng, Yu Rong Yang, Akira Ito, Zhengzhi Li, Philip S. Craig, Qin Zhao, David Pleydell, Yunhai Wang, Rui Zhao, Ningxia Medical College, Molecular Parasitology Unit, Queensland Institute of Medical Research-University of Queensland [Brisbane]-Australian Centre for International and Tropical Health and Nutrition (ACITH), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Department of Parasitology, Asahikawa Medical College, Biomedical Sciences Research Institute, University of Salford, University of Queensland [Brisbane]-The Queensland Institute of Medical Research-Australian Centre for International and Tropical Health and Nutrition ( ACITH ), Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Ningxia Medical University, Medical College, Queensland Institute of Medical Research, Xinjiang Medical University, Lanzhou Medical University, Université Bourgogne Franche-Comté [COMUE] (UBFC), Unité sous contrat biologie environnementale, and Institut National de la Recherche Agronomique (INRA)-Université de Franche-Comté (UFC)
International audience; OBJECTIVE: To determine the true community prevalence of human cystic (CE) and alveolar (AE) echinococcosis (hydatid disease) in a highly endemic region in Ningxia Hui, China, by detecting asymptomatic cases. METHODS: Using hospital records and "AE-risk" landscape patterns we selected study communities predicted to be at risk of human echinococcosis in Guyuan, Longde and Xiji counties. We conducted community surveys of 4773 individuals from 26 villages in 2002 and 2003 using questionnaire analysis, ultrasound examination and serology. FINDINGS: Ultrasound and serology showed a range of prevalences for AE (0-8.1%; mean 2%) and CE (0-7.4%; mean 1.6%), with the highest prevalence in Xiji (2% for CE, 2.5% for AE). There were significant differences in the prevalence of CE, AE and total echinococcosis between the three counties and villages (with multiple degrees of freedom). While hospital records showed 96% of echinococcosis cases attributable to CE, our survey showed a higher prevalence of human AE (56%) compared to CE (44%). Questionnaire analysis revealed that key risk factors for infection were age and dog ownership for both CE and AE, and Hui ethnicity and being female for AE. Drinking well-water decreased the risk for both AE and CE. CONCLUSION: Echinococcosis continues to be a severe public health problem in this part of China because of unhygienic practices/habits and poor knowledge among the communities regarding this disease.