Past, present and future epidemiology of echinococcosis in China based on nationwide surveillance data 2004–2022

Wang, Xu; Kui, Yan; Xue, Chui-Zhao; Wang, Qian; Zheng, Can-Jun; Zhao, Jiang-Shan; Yang, Ya-Ming; Jiang, Xiao-Feng; Gong-Sang, Qu-Zhen; Ma, Xiao; Feng, Yu; Wu, Xiang-Lin; Chen, Sa; Li, Fan-Ka; Yu, Wen-Jie; Li, Ben-Fu; Liu, Bai-Xue; Wang, Ying; Wang, Li-Ying; Yang, Shi-Jie; Wang, Zheng-Huan; Hu, Wei; Shen, Yu-Juan; Zhang, Wen-Bao; Craig, Philip S; Wu, Wei-Ping; Xiao, Ning; Han, Shuai; Zhou, Xiao-Nong; Li, Shi-Zhu; Cao, Jian-Ping

Abstract

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.

• Journal Article Type: Article
• Acceptance Date: Feb 12, 2025
• Online Publication Date: Feb 14, 2025
• Publication Date: Feb 14, 2025
• Deposit Date: Mar 20, 2025
• Publicly Available Date: Mar 20, 2025
• Journal: Journal of Infection
• Print ISSN: 0163-4453
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 90
• Issue: 3
• Article Number: 106445
• DOI: https://doi.org/10.1016/j.jinf.2025.106445