Effectiveness of comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023

doi:10.12140/j.issn.1000-7423.2025.01.004

Abstract

Abstract:

Objective To evaluate the effectiveness of comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023, so as to provide insights into formulation of the echinococcosis control strategy in the province in the future. Methods The central government fiscal transfer payment program for echinococcosis prevention and control was implemented across 24 counties (cities, districts) in 9 prefectures (cities) of Yunnan Province in 2017, and establishment of the echinococcosis surveillance and laboratory testing system, standardized management of echinococcosis patients, case investigation, investigation and disposal of foci, management of dogs and intermediate host animals and health education were performed in echinococcosis-endemic areas. The comprehensive echinococcosis control measures, echinococcosis control reports and echinococcosis surveillance reports were collected in Yunnan Province from 2016 to 2023, and the prevalence of human echinococcosis, positive rate of Echinococcus coproantigen in dogs, prevalence of echinococcosis in livestock, and awareness of echinococcosis control knowledge among residents were estimated. All analyses were performed with the statistical software SPSS 21.0, and the trends were tested with chi-square test. In addition, the relative risk was calculated from 2017 to 2023 based on the 2016 data, in order to evaluate the effectiveness of comprehensive echinococcosis control measures in Yunnan Province. Results An echinococcosis control workstation and 2 province-level echinococcosis testing reference laboratories were built in Yunnan Province during the period between 2017 and 2023, when B-mode ultrasonography screening for human echinococcosis among 1.83 million person-times, 365 times of follow-up of echinococcosis patients, 254 case investigations, a 100% proportion of standardized case management and investigation and disposal of 5 foci were conducted. The prevalence of human echinococcosis reduced from 38.17/105 (24/62 874) at baseline to 1.42/105 (11/774 609) in 2023, with a reduction of 96.28% (χ² = 187.881, P < 0.05). The awareness of echinococcosis control knowledge increased from 43.50% (5 075/11 668) among residents at baseline to 89.20% (6 680/7 489) in 2023 (χ² = 922.835，P < 0.05), while the awareness of echinococcosis control knowledge increased from 77.86% (2 687/3 451) among primary school students in 2019 to 95.21% (7 097/7 454) in 2023 (χ² = 44.170，P < 0.05). The positive rate of Echinococcus coproantigen reduced from 4.38% (186/4 246) in dogs in 2017 to 1.68% (141/8 392) in 2023 (χ² = 367.928，P < 0.05), and the prevalence of echinococcosis reduced from 0.23% (8/3 472) in livestock at baseline to 0.12% (7/5 663) in 2023 (χ² = 1.492，P > 0.05). In addition, the risk of human echinococcosis reduced by 97.99% in 2023 relative to in 2017, and the risk of dog-associated transmission of echinococcosis reduced by 90.76% in 2023 relative to in 2018. Nevertheless, there was no significant difference in the risk ratio of the prevalence of echinococcosis in livestock among years (P > 0.05). Conclusion Remarkable achievements had been obtained in the comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023; however, transmission of echinococcosis remained among animal sources of infections. Intensified management of animal sources of infections is required to effective block the transmission chain of echinococcosis.

Key words: Echinococcosis, Comprehensive control, Measure, Effectiveness, Yunnan Province

CLC Number:

R523.32

LI Benfu, WU Fangwei, ZI Jinrong, YAN Xinliu, PENG Jia, WANG Zhengqing, LI Jianxiong, XU Qian, LI Yongfei, YANG Yaming. Effectiveness of comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2025, 43(1): 20-25.

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References 21

[1]	吐尔洪江•吐逊, 邵英梅, 吐尔干艾力•阿吉, 等. 棘球蚴病临床领域相关中文专业术语专家共识[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(1): 76-84. doi: 10.12140/j.issn.1000-7423.2021.01.011
	Tuerhongjiang TX, Shao YM, Tuerganaili AJ, et al. Consensus on Chinese terminology in the clinical field of echinococcosis[J]. Chin J Parasitol Parasit Dis, 2021, 39(1): 76-84. (in Chinese)
[2]	Wen H, Vuitton L, Tuxun T, et al. Echinococcosis: Advances in the 21st century[J]. Clin Microbiol Rev, 2019, 32(2): e00075-e00093.
[3]	中国医师协会外科医师分会包虫病外科专业委员会. 肝两型包虫病诊断与治疗专家共识(2019版)[J]. 中华消化外科杂志, 2019, 18(8): 711-721.
	Chinese Doctor Association, Chinese College of Surgeons (CCS). Expert consensus on diagnosis and treatment of hepatic cystic and alveolar echinococcosis (2019 edition)[J]. Chin J Dig Surg, 2019, 18(8): 711-721. (in Chinese)
[4]	四川省包虫病临床医学研究中心, 四川省医师协会包虫病专业委员会. 复杂肝多房棘球蚴病诊疗专家共识(2020版)[J]. 中国普外基础与临床杂志, 2020, 27(1): 18-23.
	Sichuan Provincial Hydatid Disease Clinical Medical Research Center, Sichuan Provincial Medical Doctors Association Hydatid Disease Professional Committee. Expert consensus on the diagnosis and treatment of complex hepatic multilocular echinococcosis (2020 edition)[J]. Chin J Bases Clin Gen Surg, 2020, 27(1): 18-23. (in Chinese)
[5]	Cadavid Restrepo AM, Yang YR, McManus DP, et al. The landscape epidemiology of echinococcoses[J]. Infect Dis Poverty, 2016, 5: 13. doi: 10.1186/s40249-016-0109-x pmid: 26895758
[6]	Budke CM, Deplazes P, Torgerson PR. Global socioeconomic impact of cystic echinococcosis[J]. Emerg Infect Dis, 2006, 12(2): 296-303. doi: 10.3201/eid1202.050499 pmid: 16494758
[7]	张梦媛, 伍卫平. 国内外包虫病疾病负担研究进展[J]. 中国病原生物学杂志, 2017, 12(5): 473-475.
	Zhang MY, Wu WP. Advances in study the burden of echinococcosis in China and elsewhere around the world[J]. J Pathog Biol, 2017, 12(5): 473-475. (in Chinese)
[8]	McManus DP, Zhang WB, Li J, et al. Echinococcosis[J]. Lancet, 2003, 362(9392): 1295-1304. doi: 10.1016/S0140-6736(03)14573-4 pmid: 14575976
[9]	Moro P, Schantz PM. Echinococcosis: A review[J]. Int J Infect Dis, 2009, 13(2): 125-133. doi: 10.1016/j.ijid.2008.03.037 pmid: 18938096
[10]	李奔福, 吴方伟, 严信留, 等. 2012—2017年云南省棘球蚴病流行病学分析[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(5): 576-582. doi: 10.12140/j.issn.1000-7423.2019.05.012
	Li BF, Wu FW, Yan XL, et al. Epidemiological analysis of echinococcosis in Yunnan Province from 2012 to 2017[J]. Chin J Parasitol Parasit Dis, 2019, 37(5): 576-582. (in Chinese)
[11]	Zi JR, Xiao D, Peng J, et al. Epidemiological survey of cystic echinococcosis in southwest China: From the Qinghai-Tibet plateau to the area of Yunnan[J]. World J Hepatol, 2024, 16(2): 229-240.
[12]	李奔福, 史帅, 和文胜, 等. 2016—2020年云南省迪庆藏族自治州棘球蚴病流行病学分析[J]. 中国病原生物学杂志, 2023, 18(7): 812-815.
	Li BF, Shi S, He WS, et al. Epidemiological analysis of echinococcosis in Diqing Tibetan Autonomous Prefecture of Yunnan Province from 2016 to 2020[J]. J Pathog Biol, 2023, 18(7): 812-815. (in Chinese)
[13]	李奔福, 杨敬, 杨金玉, 等. 云南省大理州棘球蚴病流行病学调查和病例回顾性分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(5): 573-578. doi: 10.12140/j.issn.1000-7423.2023.05.008
	Li BF, Yang J, Yang JY, et al. Epidemiological investigation and case retrospective analysis of echinococcosis in Dali Prefecture, Yunnan Province[J]. Chin J Parasitiol Parasit Dis, 2023, 41(5): 573-578. (in Chinese)
[14]	李奔福, 王正青, 徐倩, 等. 云南省细粒棘球绦虫线粒体co1和nd1基因序列分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(3): 306-311. doi: 10.12140/j.issn.1000-7423.2023.03.007
	Li BF, Wang ZQ, Xu Q, et al. Sequence analysis of mitochondrial co1 and nd1 genes in Echinococcus granulosus in Yunnan Province[J]. Chin J Parasitol Parasit Dis, 2023, 41(3): 306-311. (in Chinese)
[15]	韩帅, 蒉嫣, 薛垂召, 等. 2004—2020年全国棘球蚴病疫情分析[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(4): 475-480. doi: 10.12140/j.issn.1000-7423.2022.04.009
	Han S, Kui Y, Xue CZ, et al. The endemic status of echinococcosis in China from 2004 to 2020[J]. Chin J Parasitol Parasit Dis, 2022, 40(4): 475-480. (in Chinese)
[16]	严俊, 胡桃, 雷正龙. 全国重点寄生虫病的防控形势与挑战[J]. 中国寄生虫学与寄生虫病杂志, 2015, 33(6): 412-417.
	Yan J, Hu T, Lei ZL. The endemic situation and challenges of major parasitic diseases in China[J]. Chin J Parasitol Parasit Dis, 2015, 33(6): 412-417. (in Chinese)
[17]	郑灿军, 杨柳, 张光葭, 等. 《棘球蚴病防治技(案(版2019年)》解读[J]. 热带病与寄生虫学, 2020, 18(4): 193-196, 201.
	Zheng CJ, Yang L, Zhang GJ, et al. Interpretation of technical scheme for echinococcosis control (edition 2019)[J]. J Trop Dis Parasitol, 2020, 18(4): 193-196, 201. (in Chinese)
[18]	李奔福, 和文胜, 字金荣, 等. 云南省香格里拉市棘球蚴病流行状况调查及防控措施分析[J]. 中国病原生物学杂志, 2020, 15(12): 1436-1441.
	Li BF, He WS, Zi JR, et al. Analysis of the prevalence of and control measures for echinococcosis in Shangrila, Yunnan Province[J]. J Pathog Biol, 2020, 15(12): 1436-1441.
[19]	肖宁. 理念与机制创新为我国棘球蚴病防治提供持续动力[J]. 中国血吸虫病防治杂志, 2021, 33(4): 329-333.
	Xiao N. Concept and mechanism innovations provide a sustainable driver for echinococcosis control in China[J]. Chin J Schisto Control, 2021, 33(4): 329-333. (in Chinese)
[20]	喻文杰, 王谦, 杨毅, 等. 2019年四川省色达县棘球蚴病流行病学调查[J]. 中国血吸虫病防治杂志, 2021, 33(6): 623-625, 642.
	Yu WJ, Wang Q, Yang Y, et al. Epidemiology of echinococcosis in Serthar County of Sichuan Province in 2019[J]. Chin J Schisto Control, 2021, 33(6): 623-625, 642. (in Chinese)
[21]	吴向林, 段红菊, 齐蓉婷, 等. 2011—2018年宁夏回族自治区棘球蚴病综合防治效果[J]. 中国血吸虫病防治杂志, 2020, 32(6): 598-604.
	Wu XL, Duan HJ, Qi RT, et al. Evaluation of the effect of the integrated echinococcosis control program in Ningxia Hui Autonomous Region from 2011 to 2018[J]. Chin J Schisto Control, 2020, 32(6): 598-604. (in Chinese)

年份 Year	居民 Resident			小学生 Primary school students
年份 Year	调查人数 No. surveyed	合格人数 No. qualified	知晓率/% Awareness rate/%	调查人数 No. surveyed	合格人数 No. qualified	知晓率/% Awareness rate/%
2016	11 668	5 075	43.5	-	-	-
2017	2 675	2 182	81.57	-	-	-
2018	5 372	4 310	80.23	-	-	-
2019	3 699	3 191	86.27	3 451	2 687	77.86
2020	6 458	5 511	85.34	8 096	6 811	84.13
2021	7 721	6 924	89.68	7 418	6 791	91.55
2022	7 236	6 479	89.54	7 246	6 681	92.20
2023	7 489	6 680	89.2	7 454	7 097	95.21

年份Year	家犬Domestic dog			家畜Livestock
年份Year	调查数 No. examined	阳性数 No. positive	阳性率% Prevalence/%	调查数 No. examined	患病数 No. positive	患病率% Prevalence/%
2016	6 587	105	1.59	3 472	8	0.23
2017	4 246	186	4.38	21 054	21	0.10
2018	5 347	299	5.59	21 725	55	0.25
2019	6 986	152	2.18	11 419	20	0.18
2020	8 022	107	1.33	6 758	9	0.13
2021	6 969	146	2.10	4 991	4	0.08
2022	7 936	157	1.98	5 077	13	0.26
2023	8 392	141	1.68	5 663	7	0.12
合计Total	54 485	1 293	2.37	80 159	137	0.17

年份Year	人群^a Human population^a		犬^b Domestic dog^b		家畜^c Livestock^c
年份Year	风险比/% Risk ratio/%	95% CI	风险比/% Risk ratio/%	95% CI	风险比/% Risk ratio/%	95% CI
2017	1.844	1.064~3.195	2.267	2.112~3.387	0.433	0.192~0.978
2018	1.538	0.891~2.652	3.375	2.710~4.204	1.098	0.524~2.307
2019	0.402	0.332~0.487	1.357	1.061~1.736	0.761	0.335~1.725
2020	0.353	0.206~0.603	0.244	0.200~0.309	0.579	0.233~1.498
2021	0.197	0.105~0.371	0.387	0.319~0.471	0.348	0.105~1.156
2022	0.295	0.125~0.404	0.366	0.303~0.443	0.111	0.461~2.678
2023	0.037	0.018~0.076	0.312	0.256~0.380	0.537	0.195~1.480