Past, present and future epidemiology of echinococcosis in China based on nationwide surveillance data 2004–2022 - 05/03/25

Doi : 10.1016/j.jinf.2025.106445

Xu Wang ^a,^b,^c,^d,^{^{1
Contributed equally.}}, Yan Kui ^a,^b,^c,^d,^{^{1
Contributed equally.}}, Chui-Zhao Xue ^a,^b,^c,^d, Qian Wang ^e, Can-Jun Zheng ^f, Jiang-Shan Zhao ^g, Ya-Ming Yang ^h, Xiao-Feng Jiang ⁱ, Qu-Zhen Gong-Sang ^j, Xiao Ma ^k, Yu Feng ^l, Xiang-Lin Wu ^m, Sa Chen ⁿ, Fan-Ka Li ^o, Wen-Jie Yu ^e, Ben-Fu Li ^h, Bai-Xue Liu ^a,^b,^c,^d, Ying Wang ^a,^b,^c,^d, Li-Ying Wang ^a,^b,^c,^d, Shi-Jie Yang ^a,^b,^c,^d, Zheng-Huan Wang ^p, Wei Hu ^q, Yu-Juan Shen ^a,^b,^c,^d, Wen-Bao Zhang ^r, Philip S. Craig ^s, Wei-Ping Wu ^a,^b,^c,^d, Ning Xiao ^a,^b,^c,^d, Shuai Han ^a,^b,^c,^d,^q,^⁎ , Xiao-Nong Zhou ^a,^b,^c,^d,^⁎ , Shi-Zhu Li ^a,^b,^c,^d,^⁎ , Jian-Ping Cao ^a,^b,^c,^d,^⁎
^a National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
^b Key Laboratory on Parasite and Vector Biology, Ministry of Health, Shanghai, China
^c World Health Organization Collaborating Centre for Tropical Diseases, Shanghai, China
^d National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
^e Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
^f Chinese Center for Disease Control and Prevention, Beijing, China
^g Xinjiang Uygur Autonomous Regional Center for Disease Control and Prevention, Urumqi, China
^h Yunnan Institute of Parasitic Diseases, Pu’er, China
ⁱ Inner Mongolia Autonomous Regional Center for Disease Control and Prevention, Hohhot, China
^j Xizang Autonomous Regional Center for Disease Control and Prevention, Lhasa, China
^k Qinghai Provincial Institute for Endemic Diseases Prevention and Control, Xining, China
^l Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
^m Ningxia Hui Autonomous Regional Center for Disease Control and Prevention, Yinchuan, China
ⁿ Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
^o Center for Disease Control and Prevention of Xinjiang Production and Construction Corps, Urumqi, China
^p School of Life Sciences, East China Normal University, Shanghai, China
^q School of Life Science, Fudan University, Shanghai, China
^r Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
^s School of Environment and Life Sciences, University of Salford, Greater Manchester, United Kingdom

^⁎Correspondence to: No. 207 Ruijin'er Road, Huangpu District, Shanghai 200025, China.No. 207 Ruijin'er Road, Huangpu DistrictShanghai200025China

Summary

Objectives

We evaluated the epidemiological characteristics of echinococcosis, a global public health threat, in China to inform global control efforts.

Methods

Descriptive, statistical, cluster, spatial, and trend analyses were used to evaluate the epidemiology at national, provincial, and county levels based on 2004–2022 nationwide surveillance data from China.

Results

Between 2004 and 2022, China recorded 72,676 cystic echinococcosis (CE) cases, 11,465 alveolar echinococcosis (AE) cases, and 5703 others, with an average annual cases per million (ANpM) of 3.45. Females had a higher incidence (ANpM = 3.87) than males (3.05), with most cases (41.15%) in the 30–49 age group, mainly among herders (38.76%) and farmers (37.82%). Seven provinces (Xizang, Qinghai, Xinjiang, Ningxia, Gansu, Sichuan, and Inner Mongolia) accounted for 98.12% of cases, with the Tibetan Plateau showing the highest rates (ANpMs = 155.51 for CE, 46.95 for AE). Surgery and case fatality rates were 39.45% and 5.23% in key surveillance regions (KSRs). Prevalence among residents (0.20%), livestock (1.33%), rodents (1.30%), and dogs (1.26%) declined with increased control funding in KSRs. Between 2023 and 2030, there will be an estimated 20,096 new cases and 45,323 cases requiring treatment.

Conclusion

The prevalence of echinococcosis has been alleviated in China, but significant control challenges remain, requiring sustained and targeted control measures.

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Graphical abstract

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Highlights

•	A total of 89,844 cases in China (2004–2022), with a 3.45/1,000,000 annual incidence.
•	Prevalence is higher among groups of females, ages 30–49, and farmers/herders.
•	KSRs show a 4.05/1,000,000 mortality rate per year and a 5.23% case fatality rate.
•	The Tibetan Plateau has the highest annual incidence for both CE and AE.
•	There will be an estimated 20,096 new echinococcosis cases in 2023–2030.

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Abbreviations : AE, ANpM, BS-PSRs, CDCs, CE, China CDC, IE, KSRs, ME, NEESP, NHIS, NPES, OT-KSRs, OT-PSRs, PSRs, Pop 6, Pop 7, TP-KSRs, WHO

Keywords : Echinococcosis, Epidemiology, Disease surveillance, Public health, China

Plan

Incidence from NHIS at the national level

Prevalence in KSRs based on NEPS at the national level

Past incidence at the provincial level

Future incidence at the provincial level

Distribution of echinococcosis at the county level

Echinococcosis incidence at the county level

Discussion

Epidemiology in the past

Issues at the present

Challenges for the future

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Vol 90 - N° 3

Article 106445- mars 2025 Retour au numéro

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Past, present and future epidemiology of echinococcosis in China based on nationwide surveillance data 2004–2022 - 05/03/25

Summary

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Methods

Results

Conclusion

Graphical abstract

Highlights

Plan

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