Factors affecting human alveolar echinococcosis in Baqing County, Xizang Autonomous Region: a case control study

doi:10.12140/j.issn.1000-7423.2026.02.020

Abstract

Abstract:

Objective To identify the main influencing factors of human alveolar echinococcosis (AE) in Baqing County, Xizang Autonomous Region, so as to provide insights into echinococcosis control in pastoral areas. Methods AE patients that were definitively diagnosed with abdominal B-mode ultrasonography and based on WS 257-2006 Diagnostic Criteria for Echinococcosis in the Human Echinococcosis Screening Programme in Baqing County, Xizang Autonomous Region from January 2023 to October 2024 were selected as the case group, and residents that were free of echinococcosis as revealed by abdominal B-mode ultrasonography during the same time served as controls. Matching was performed based on the same gender, similar age (± 5 years), and residence in the same or geographically adjacent administrative villages, with one case matched to two controls. A face to face questionnaire survey was conducted by uniformly trained investigators, and the questionnaire covered general demographics, dog breeding and management, environmental exposure factors, and personal behavioral habits. All statistical analyses were performed using the software R, with chi square test used for between group comparisons, and a conditional logistic regression model for identifying factors affecting the risk of AE. Results A total of 258 residents from Baqing County were enrolled, including 86 cases in the case groups and 172 matched controls, and all subjects were Tibetan residents. The mean age was (44.6 ± 14.2) years in the case group and (44.1 ± 14.1) years in the control group, with no statistically significant difference （t = 0.26, P > 0.05）, and no significant differences were observed in gender, occupation, educational level, body mass index, marital status, or household size (χ² = 0.00, 1.53, 0.83, 4.09, 0.71 and 0.53, all P > 0.05). Univariate conditional logistic regression analysis identified significant associations of dog breeding (OR = 2.82, 95% CI: 1.45-5.48), never deworming for dogs (OR = 3.22, 95% CI: 1.09-9.48), improper disposal of dog feces (OR = 4.86, 95% CI: 2.09-11.30), frequent contact with dogs (OR = 2.98, 95% CI: 1.42-6.24), presence of foxes around the residence (OR = 2.42, 95% CI: 1.37-4.27), use of river/stream water as the main drinking water source (OR = 2.55, 95% CI: 1.26-5.16), drinking unboiled water (OR = 2.02, 95% CI: 1.17-3.48), and frequent consumption of unwashed fresh Cordyceps (OR = 3.87, 95% CI: 1.55-9.67) with the risk of AE (all P < 0.05), and multivariate analysis identified dog breeding duration for > 5 years (OR = 4.68, 95% CI: 1.09-20.17), non disposal of dog feces (OR = 9.35, 95% CI: 2.39-36.64), frequent contact with dogs (OR = 6.92, 95% CI: 1.21-39.51), and drinking water sourced from rivers, lakes, ditches, or ponds (OR = 4.97, 95% CI: 1.07-23.20) as main risk factors for AE. Conclusion The development of human AE is closely associated with dog management and drinking water safety in Baqing County. It is recommended to reinforce dog management and standardized disposal of dog feces, improve drinking water sanitation, and enhance health education among herders.

Key words: Alveolar echinococcosis, Influencing factor, Case-control study, Baqing County

CLC Number:

Danzeng Quzhen, Bianba Zhuoma, Ci Duojie, Suolang Lamu, Suolang Wangjie, Kangzhu Yixi, Laba Sangzhu, Gongsang Quzhen. Factors affecting human alveolar echinococcosis in Baqing County, Xizang Autonomous Region: a case control study[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2026, 44(2): 284-289.

Figures/Tables 3

Table 1

Table 2

Univariate conditional logistic regression analysis of factors affecting the development of alveolar echinococcosis in Baqing County from January 2023 to October 2024

变量 Variable	病例组人数（构成比/%）Number of case group (percentage/%)	对照组人数（构成比/%）Number of control group (percentage/%)	条件优势比OR(95% CI)	P值 P value
养犬 Dog ownership
否 No	14（16.3）	61（35.5）	1
是 Yes	72（83.7）	111（64.5）	2.82（1.45~5.48）	< 0.01
养犬时间/年 Duration of dog ownership/years
< 3	10（13.9）	19（17.1）	1
3~5	17（23.6）	55（49.5）	0.55（0.23~1.51）	> 0.05
> 5	45（62.5）	37（33.3）	2.20（0.85~5.68）	> 0.05
养犬方式 Dog restraint practice
完全拴养 Always restrained	12（16.7）	31（27.9）	1
白天拴养晚上放养 Restrained in daytime, free-roaming at night	60（83.3）	80（72.1）	1.95（0.84~4.53）	> 0.05
给犬驱虫 Dog deworming practice
定期 Regularly	30（41.7）	50（45.0）	1
偶尔 Occasionally	24（33.3）	54（48.6）	0.69（0.32~1.48）	> 0.05
从不 Never	18（25.0）	7（6.3）	3.22（1.09~9.48）	< 0.01
犬粪处理 Disposal of dog feces
规范处理 Proper disposal	30（41.7）	84（75.7）	1
不做处理 No disposal	42（58.3）	27（24.3）	4.86（2.09~11.30）	< 0.01
与犬接触 Touch with dogs
从不 Never	18（20.9）	52（30.2）	1
偶尔 Occasionally	35（40.7）	88（51.2）	1.17（0.60~2.27）	> 0.05
经常 Frequently	33（38.4）	32（18.6）	2.98（1.42~6.24）	< 0.01
家周围有无狐狸 Presence of foxes around the home
无 No	40（46.5）	113（65.7）	1
有 Yes	46（53.5）	59（34.3）	2.42（1.37~4.27）	< 0.01
饮用水来源 Source of drinking water
受保护的井水或泉水＋净化自来水 Protected well/spring water＋purified tap water	33（38.4）	92（53.5）	1
不受保护的井水或泉水 Unprotected well or spring water	31（36.0）	56（32.6）	1.63（0.89~3.01）	> 0.05
江河湖泊沟塘水 River/lake/pond/ditch water	22（25.6）	24（14.0）	2.55（1.26~5.16）	< 0.01
饮用生水 Drinking untreated water
从不 Never	45（52.3）	118（68.6）	1
饮用 Ever	41（47.7）	54（31.4）	2.02（1.17~3.48）	< 0.05
食用新鲜未清洗虫草 Consumption of fresh, unwashed caterpillar fungus
从不 Never	21（25.9）	56（33.9）	1
偶尔 Occasionally	41（50.6）	97（58.8）	1.07（0.55~2.08）	> 0.05
经常 Frequently	19（23.5）	12（7.3）	3.87（1.55~9.67）	< 0.01

Table 2

Table 3

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变量 Variable	病例组人数（构成比/%） Number of case group (percentage/%)	对照组人数（构成比/%） Number of control group (percentage/%)	χ²	P
性别 Sex
男 Male	35（40.7）	70（40.7）	0	> 0.05
女 Female	51（59.3）	102（59.3）
职业 Occupation
牧民 Herder	81（94.2）	154（89.5）	1.53	> 0.05
非牧民 Non-herder	5（5.8）	18（10.5）
教育水平 Educational level
文盲 Illiterate	73（84.9）	138（80.2）	0.83	> 0.05
非文盲 Literate	13（15.1）	34（19.8）
身体质量指数/kg·m^-2 BMI/kg·m^-2
偏低 Underweight	4（5.9）	7（4.5）	4.09	> 0.05
正常 Normal weight	27（39.7）	82（52.2）
超重 Overweight	28（41.2）	45（28.7）
肥胖 Obese	9（13.2）	23（14.6）
婚姻状况 Marital status
已婚 Married	70（81.4）	147（85.5）	0.71	> 0.05
其他 Other	16（18.6）	25（14.5）
家庭常住人口 Household size
1~3	5（6）	12（7.4）	0.53	> 0.05
4~6	37（44）	77（47.2）
≥ 7	42（50）	74（45.4）

变量 Variable	β值 β value	标准误 SE value	Wald χ²值 Wald χ² value	OR值（95% CI） OR value (95% CI)	P值 P value
养犬时间/年 Duration of dog ownership/year
< 3	1
3~5	-0.66	0.80	0.68	0.52（0.11~2.47）	> 0.05
> 5	1.54	0.75	4.28	4.68（1.09~20.17）	< 0.05
犬粪处理 Disposal of dog feces
规范处理 Proper disposal	1
不做处理 No disposal	2.24	0.70	10.3	9.35（2.39~36.64）	< 0.01
与犬接触 Contact with dogs
从不 Never	1
偶尔 Occasionally	0.20	0.73	0.08	1.22（0.30~5.06）	> 0.05
经常 Frequently	1.93	0.89	4.73	6.92（1.21~39.51）	< 0.05
饮用水来源 Source of drinking water
受保护的井水或泉水＋净化自来水 Protected well/spring water＋purified tap water	1
不受保护的井水或泉水 Unprotected well or spring water	-0.50	0.72	0.49	0.61（0.15~2.48）	> 0.05
江河湖泊沟塘水 River/lake/pond/ditch water	1.60	0.79	4.17	4.97（1.07~23.20）	< 0.05