Dataset Information

Geographic distribution of echinococcosis in Tibetan region of Sichuan Province, China.

ABSTRACT:

Background

Echinococcosis is a parasitic zoonosis caused by Echinococcus larvae parasitism causing high mortality. The Tibetan Region of Sichuan Province is a high prevalence area for echinococcosis in China. Understanding the geographic distribution pattern is necessary for precise control and prevention. In this study, a spatial analysis was conducted to explore the town-level epidemiology of echinococcosis in the Sichuan Tibetan Region and to provide guidance for formulating regional prevention and control strategies.

Methods

The study was based on reported echinococcosis cases by the end of 2017, and each case was geo-coded at the town level. Spatial empirical Bayes smoothing and global spatial autocorrelation were used to detect the spatial distribution pattern. Spatial scan statistics were applied to examine local clusters.

Results

The spatial distribution of echinococcosis in the Sichuan Tibetan Region was mapped at the town level in terms of the crude prevalence rate, excess hazard and spatial smoothed prevalence rate. The spatial distribution of echinococcosis was non-random and clustered with the significant global spatial autocorrelation (I =?0.7301, P =?0.001). Additionally, five significant spatial clusters were detected through the spatial scan statistic.

Conclusions

There was evidence for the existence of significant echinococcosis clusters in the Tibetan Region of Sichuan Province, China. The results of this study may assist local health departments with developing better prevention strategies and prompt more efficient public health interventions.

SUBMITTER: Liu L

PROVIDER: S-EPMC6214160 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

Geographic distribution of echinococcosis in Tibetan region of Sichuan Province, China.

Liu Lei L Guo Bing B Li Wei W Zhong Bo B Yang Wen W Li Shu-Cheng SC Wang Qian Q Zhao Xing X Xu Ke-Jun KJ Qin Sheng-Chao SC Huang Yan Y Yu Wen-Jie WJ He Wei W Liao Sha S Wang Qi Q

Infectious diseases of poverty 20181102 1

<h4>Background</h4>Echinococcosis is a parasitic zoonosis caused by Echinococcus larvae parasitism causing high mortality. The Tibetan Region of Sichuan Province is a high prevalence area for echinococcosis in China. Understanding the geographic distribution pattern is necessary for precise control and prevention. In this study, a spatial analysis was conducted to explore the town-level epidemiology of echinococcosis in the Sichuan Tibetan Region and to provide guidance for formulating regional ...[more]

PMID: 30384860

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Project description:BackgroundHuman cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, with the liver as the most frequently affected organ, is known to be highly endemic in Tibetan communities of northwest Sichuan Province. Antiparasitic treatment with albendazole remains the primary choice for the great majority of patients in this resource-poor remote area, though surgery is the most common approach for CE therapy that has the potential to remove cysts and lead to complete cure. The current prospective study aimed to assess the effectiveness of community based use of cyclic albendazole treatment in Tibetan CE cases, and concurrently monitor the changes of serum specific antibody levels during treatment.Methodology/principal findingsUltrasonography was applied for diagnosis and follow-up of CE cases after cyclic albendazole treatment in Tibetan communities of Sichuan Province during 2006 to 2008, and serum specific IgG antibody levels against Echinococcus granulosus recombinant antigen B in ELISA was concurrently monitored in these cases. A total of 196 CE cases were identified by ultrasound, of which 37 (18.9%) showed evidence of spontaneous healing/involution of hepatic cyst(s) with CE4 or CE5 presentations. Of 49 enrolled CE cases for treatment follow-up, 32.7% (16) were considered to be cured based on B-ultrasound after 6 months to 30 months regular albendazole treatment, 49.0% (24) were improved, 14.3% (7) remained unchanged, and 4.1% (2) became aggravated. In general, patients with CE2 type cysts (daughter cysts present) needed a longer treatment course for cure (26.4 months), compared to cases with CE1 (univesicular cysts) (20.4 months) or CE3 type (detached cyst membrane or partial degeneration of daughter cysts) (9 months). In addition, the curative duration was longer in patients with large (>10 cm) cysts (22.3 months), compared to cases with medium (5-10 cm) cysts (17.3 months) or patients with small (<5 cm) cysts (6 months). At diagnosis, seven (53.8%) of 13 cases with CE1 type cysts without any previous intervention showed negative specific IgG antibody response to E. granulosus recombinant antigen B (rAgB). However, following 3 months to 18 months albendazole therapy, six of these 7 initially seronegative CE1 cases sero-converted to be specific IgG antibody positive, and concurrently ultrasound scan showed that cysts changed to CE3a from CE1 type in all the six CE cases. Two major profiles of serum specific IgG antibody dynamics during albendazole treatment were apparent in CE cases: (i) presenting as initial elevation followed by subsequent decline, or (ii) a persistent decline. Despite a decline, however, specific antibody levels remained positive in most improved or cured CE cases.ConclusionsThis was the first attempt to follow up community-screened cystic echinococcosis patients after albendazole therapy using ultrasonography and serology in an endemic Tibetan region. Cyclic albendazole treatment proved to be effective in the great majority of CE cases in this resource-poor area, but periodic abdominal ultrasound examination was necessary to guide appropriate treatment. Oral albendazole for over 18 months was more likely to result in CE cure. Poor drug compliance resulted in less good outcomes. Serology with recombinant antigen B could provide additional limited information about the effectiveness of albendazole in CE cases. Post-treatment positive specific IgG antibody seroconversion, in initially seronegative, CE1 patients was considered a good indication for positive therapeutic efficacy of albendazole.

Project description:Venerable trees are important natural resources and cultural heritage, offering historical, ecological, social and economic value. However, global warming and anthropogenic activities have threatened their welfare and survival. A comprehensive understanding of their current and future spatial patterns, vis-á-vis environmental conditions, can inform the co-management of sustainable resource use and conservation. We employed the existing spatial occurrence data and environmental variables (bioclimate and elevation) to simulate the optimal habitats for venerable trees in China’s Sichuan Province. We evaluated the current and future climate scenarios of 2100 with double CO2 concentration. The BIOCLIM and QGIS spatial analyses assessed the primary factors of geographical distribution. The results identified 10,720 venerable trees from 123 species, 81 genera and 42 families. Cupressus funebris dominated, with the maximum importance value, followed by Ginkgo biloba, Ficus virens var. sublanceolata, and Phoebe zhennan. The elevation distribution of tree abundance and species richness demonstrated a unimodal pattern, skewing to the low-elevation end, with a concentration in the 600–1500 m low-medium altitude. The majority of trees and excellent habitats were found in eastern Sichuan with a less harsh terrain and climate. The bio3 (isothermality) and bio7 (temperature annual range) factors significantly influenced tree occurrence. Temperature imposed a greater effect on distribution than moisture under the current climate scenario. For the future climate-change scenario, the suitable habitats were predicted to maintain an overall stable pattern, with largely contiguous expansions of better habitats. However, climate warming would shrink the excellent habitats on the plains. The findings can inform strategies and guidelines for venerable-tree conservation in Sichuan. Furthermore, vulnerable areas could be identified. The future range expansion sites could be enlisted to cultivate new trees to replenish the venerable-tree pool. Habitat patches that remain sustainable could provide refugia with the potential for protected-area designation.

Project description:BackgroundAs part of an ongoing program that aims to use early detection and timely treatment to improve the control of echinococcosis, especially in younger age groups, we undertook a series of active surveys among Qinghai-Tibetan children in the Qinghai Province of Northwestern China in 2011 and 2012. The significant outcomes that resulted from this study emphasize the need to draw attention to echinococcosis, both alveolar echinococcosis (AE) and cystic echinococcosis (CE), so that policy development is promoted and suitable avenues for control are identified in the highly endemic areas on the Tibetan Plateau.MethodsA total of 19 629 primary school students, aged 6-18 years, with a dominant Tibetan background underwent abdominal ultrasound examination, and 86.4% of the compliant students donated 2-5 ml of venous blood for serological tests. All the abnormal ultrasound results were recorded. If identified as echinococcosis, the disease lesion was assessed according to the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) classification for AE and CE. Among the surveyed students, the prevalence by school was compared among geo-locations, sex and age groups. The clinical image presentations were analyzed according to lesion number, size, the location in the liver and the classification stage. Statistical significance was set at P-value <?0.05 for comparisons among groups.ResultsA total of 341 students (1.7%) were identified by ultrasound as having either CE (119, 0.6%) or AE (222, 1.1%). The highest prevalence rates of childhood AE cases occurred in the Tehetu (12.1%) and Moba (11.8%) townships in Dari County. There was a high seropositive rate (37.0%) and a heterogeneous distribution of cases, with a prevalence ranged from 0 to 12.1% for AE and 0-2.9% for CE. Moreover, the seropositive rate ranged from 0.7-45.1% across different schools.ConclusionsThe high prevalence of echinococcosis in Qinghai-Tibetan primary school students reflects a lack of knowledge about Echinococcus spp. transmission. The combination of systematic education for children and regularly performed anthelmintic treatment for dogs could achieve the goal of sustainable hydatidosis control.

Dataset Information

Geographic distribution of echinococcosis in Tibetan region of Sichuan Province, China.

Background

Methods

Results

Conclusions

Publications

Geographic distribution of echinococcosis in Tibetan region of Sichuan Province, China.

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