title: Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China.
abstract: 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ningxia Medical College, Yinchuan, Ningxia Hui Autonomous Region, China.
authors.forename: Yu Rong
authors.initials: YR
authors.lastname: Yang
authors.forename: Tao
authors.initials: T
authors.lastname: Sun
authors.forename: Zhengzhi
authors.initials: Z
authors.lastname: Li
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Teng
authors.forename: Xongzhou
authors.initials: X
authors.lastname: Liu
authors.forename: Ruiqi
authors.initials: R
authors.lastname: Liu
authors.forename: Rui
authors.initials: R
authors.lastname: Zhao
authors.forename: Malcolm K
authors.initials: MK
authors.lastname: Jones
authors.forename: Yunhai
authors.initials: Y
authors.lastname: Wang
authors.forename: Hao
authors.initials: H
authors.lastname: Wen
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Feng
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhao
authors.forename: Yumin
authors.initials: Y
authors.lastname: Zhao
authors.forename: Dazhong
authors.initials: D
authors.lastname: Shi
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bartholomot
authors.forename: Dominique A
authors.initials: DA
authors.lastname: Vuitton
authors.forename: David
authors.initials: D
authors.lastname: Pleydell
authors.forename: Patrick
authors.initials: P
authors.lastname: Giraudoux
authors.forename: Akira
authors.initials: A
authors.lastname: Ito
authors.forename: Mark F
authors.initials: MF
authors.lastname: Danson
authors.forename: Belchis
authors.initials: B
authors.lastname: Boufana
authors.forename: Philip S
authors.initials: PS
authors.lastname: Craig
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.forename: Donald P
authors.initials: DP
authors.lastname: McManus
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004445:Echinococcosis, Pulmonary / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control; D048209:Echinococcus granulosus / Q000302:isolation & purification; D048210:Echinococcus multilocularis / Q000302:isolation & purification; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires