Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China.
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.
Yang
Yu Rong
YR
Ningxia Medical College, Yinchuan, Ningxia Hui Autonomous Region, China.
Sun
Tao
T
Li
Zhengzhi
Z
Zhang
Jianzhong
J
Teng
Jing
J
Liu
Xongzhou
X
Liu
Ruiqi
R
Zhao
Rui
R
Jones
Malcolm K
MK
Wang
Yunhai
Y
Wen
Hao
H
Feng
Xiaohui
X
Zhao
Qin
Q
Zhao
Yumin
Y
Shi
Dazhong
D
Bartholomot
Brigitte
B
Vuitton
Dominique A
DA
Pleydell
David
D
Giraudoux
Patrick
P
Ito
Akira
A
Danson
Mark F
MF
Boufana
Belchis
B
Craig
Philip S
PS
Williams
Gail M
GM
McManus
Donald P
DP
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