Epidemiology and control of Echinococcosis in the Northwestern of China and Central Asia
Résumé
Human cystic echinococcosis (CE) and human alveolar echinococcosis(AE) are known to be endemic in the Northwestern of China and central Asia; At least 270 million people (58% of the total population) are at risk of cystic echinococcosis (CE) in Central Asia including areas of Mongolia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, Afghanistan, Iran, Pakistan and western China. The annual surgical incidence rate in Uzbekistan and Tadjikistan has been estimated to be as high as 25-27 cases/100,000 with the highest prevalence reaching 10% (range from 0.8 to 11.9%) in some Tibetan communities in western China. Alveolar echinococcosis (AE) is also endemic in Central Asia and is recognized as a major problem in some Tibetan communities with up to 6% of villagers infected in some villages. In western China, 5-30% of the populations are seropositive against E. granulosus antigens, indicating that a large number of individuals have been exposed to the parasite. Echinococcus transmission in the region is largely associated with CE risk factors including human behavior, dog-livestock cycle, the environmental factors such as cold climate and grassland landscape, owned dogs and livestock, Poor hygienic habits, Uncooked or even unwashed vegetables, drinking water-Streams contaminated by dog feces. Human behavior-fox hunter, fox skin business, playing with dog and poor hygiene habits were AE risk factors. Although echinococcosis control programs have been initiated in some countries in Central Asia, control efforts are generally fragmented and uncoordinated. In China, additional control measures including health education, domestic livestock animal treatment/vaccination and dog vaccination are needed and we got some achievements which was including created of hepatic alveolar echinococcosis diagnosis and treatment system of autologous liver transplantation, establishment of clinical pathway for hepatic cystic echinococcosis, telemedicine platform for remote consultation, guiding operation in Xinjiang, Demonstration and promotion of appropriate technology and clinical pathway to the whole country and we were the third WHO Collaborating Centre for Prevention and Management of Echinococcosis.