title: Epidemiology and control of echinococcosis in central Asia, with particular reference to the People's Republic of China.
abstract: 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. Echinococcus transmission in the region is largely associated with social factors including limited community knowledge of echinococcosis, small-scale household animal production, home killing of livestock, and the feeding of dogs with uncooked offal. 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 population are seropositive against E. granulosus antigens, indicating that a large number of individuals have been exposed to the parasite. Although echinococcosis control programs have been initiated in some countries in Central Asia, control efforts are generally fragmented and uncoordinated. Monthly deworming of dogs with praziquantel (PZQ), as a key measure to control the Echinococcus parasites, has been used in western China. However, the approach has proven difficult in local semi-nomadic communities. Additional control measures including health education, domestic livestock animal treatment/vaccination and dog vaccination are needed in CE-endemic areas to accelerate progress.
authors.affiliation: State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, Xinjiang Key Laboratory of Echinococcosis, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China; Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, QLD, Australia. Electronic address: wenbao.zhang88@gmail.com.
authors.forename: Wenbao
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Xinjiang Veterinary Research Institute, Xinjiang Academy of Animal Science, Urumqi, Xinjiang, China.
authors.forename: Zhuangzhi
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: National Institute of Parasitic Diseases, China CDC, Shanghai 200025, China.
authors.forename: Weiping
authors.initials: W
authors.lastname: Wu
authors.affiliation: Xinjiang Veterinary Research Institute, Xinjiang Academy of Animal Science, Urumqi, Xinjiang, China.
authors.forename: Baoxin
authors.initials: B
authors.lastname: Shi
authors.affiliation: State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, Xinjiang Key Laboratory of Echinococcosis, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China; Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, QLD, Australia.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: National Institute of Parasitic Diseases, China CDC, Shanghai 200025, China.
authors.forename: Xiaonong
authors.initials: X
authors.lastname: Zhou
authors.affiliation: State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, Xinjiang Key Laboratory of Echinococcosis, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wen
authors.affiliation: Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, QLD, Australia. Electronic address: donM@qimr.edu.au.
authors.forename: Donald P
authors.initials: DP
authors.lastname: McManus
mesh_terms: D000818:Animals; D000829:Animals, Domestic / Q000469:parasitology; D000871:Anthelmintics / Q000627:therapeutic use; D001209:Asia, Central / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D004285:Dogs / Q000469:parasitology*; D004443:Echinococcosis / Q000453:epidemiology* / Q000517:prevention & control; D004444:Echinococcosis, Hepatic / Q000453:epidemiology / Q000517:prevention & control; D004446:Echinococcus; D006801:Humans; D007492:Iran / Q000453:epidemiology; D007623:Kazakhstan / Q000453:epidemiology; D007707:Kyrgyzstan / Q000453:epidemiology; D058751:Livestock / Q000469:parasitology*; D010154:Pakistan / Q000453:epidemiology; D011223:Praziquantel / Q000627:therapeutic use; D015995:Prevalence; D013620:Tajikistan / Q000453:epidemiology; D014611:Vaccination
chemical_list: D000871:Anthelmintics; D011223:Praziquantel
keywords: Alveolar echinococcosis; Central Asia; Control of echinococcosis; Cystic echinococcosis; Echinococcus granulosus; Echinococcus multilocularis; Epidemiology