1. Hospital and community surveys reveal the severe public health problem and socio-economic impact of human echinococcosis in Ningxia Hui Autonomous Region, China
- Author
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Donald P. McManus, X. Pan, S. K. Yang, Yu Rong Yang, Tao Sun, S. Hu, Patrick Giraudoux, Gail M. Williams, X. P. Li, Philip S. Craig, Dominique-Angèle Vuitton, L. Cheng, X. Liu, Ningxia Medical College, Biomedical Sciences Research Institute, University of Salford, WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Université de Franche-Comté (UFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Brain imaging (LIAMA), Laboratoire Franco-Chinois d'Informatique, d'Automatique et de Mathématiques Appliquées (LIAMA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique (CNRS)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique (CNRS), Molecular Parasitology, University of Queensland [Brisbane]-Queensland Institute of Medical Research-Australian Centre for International and Tropical Health and Nutrition (ACITH), Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ), Brain imaging ( LIAMA ), Laboratoire Franco-Chinois d'Informatique, d'Automatique et de Mathématiques Appliquées ( LIAMA ), Centre de Coopération Internationale en Recherche Agronomique pour le Développement ( CIRAD ) -Institut National de la Recherche Agronomique ( INRA ) -Chinese Academy of Sciences [Changchun Branch] ( CAS ) -Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique ( CNRS ) -Centre de Coopération Internationale en Recherche Agronomique pour le Développement ( CIRAD ) -Institut National de la Recherche Agronomique ( INRA ) -Chinese Academy of Sciences [Changchun Branch] ( CAS ) -Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique ( CNRS ), Queensland Institute of Medical Research-University of Queensland [Brisbane]-Australian Centre for International and Tropical Health and Nutrition ( ACITH ), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Institute of Automation - Chinese Academy of Sciences-Institut National de Recherche en Informatique et en Automatique (Inria)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de la Recherche Agronomique (INRA)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre National de la Recherche Scientifique (CNRS)-Institute of Automation - Chinese Academy of Sciences-Institut National de Recherche en Informatique et en Automatique (Inria)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de la Recherche Agronomique (INRA)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre National de la Recherche Scientifique (CNRS), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement (UMR 6249) (LCE), and Queensland Institute of Medical Research-University of Queensland [Brisbane]-Australian Centre for International and Tropical Health and Nutrition (ACITH)
- Subjects
Male ,Cost effectiveness ,MESH : Aged ,MESH: Hospitalization ,MESH : Child, Preschool ,MESH : Echinococcosis ,MESH: Epidemiologic Methods ,MESH: Length of Stay ,030308 mycology & parasitology ,0302 clinical medicine ,MESH: Aged, 80 and over ,MESH : Child ,MESH: Child ,Epidemiology ,80 and over ,MESH : Population Surveillance ,MESH : Socioeconomic Factors ,MESH : Female ,Child ,Echinococcus granulosus ,MESH: Echinococcosis, Pulmonary ,MESH: Treatment Outcome ,Aged, 80 and over ,MESH: Aged ,0303 health sciences ,MESH: Middle Aged ,biology ,Mortality rate ,MESH : Infant ,[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie ,Pulmonary ,Health Care Costs ,Middle Aged ,MESH : Adult ,Echinococcosis ,MESH: Infant ,MESH: China ,3. Good health ,Hospitalization ,MESH : Length of Stay ,Treatment Outcome ,Infectious Diseases ,Child, Preschool ,Population Surveillance ,MESH : Hospitalization ,Female ,Public Health ,MESH: Public Health ,MESH : Health Care Costs ,Adult ,MESH : Echinococcosis, Pulmonary ,China ,medicine.medical_specialty ,MESH: Socioeconomic Factors ,Echinococcosis, Pulmonary ,Adolescent ,MESH : Male ,030231 tropical medicine ,MESH : Public Health ,MESH: Health Care Costs ,MESH : Treatment Outcome ,Echinococcus multilocularis ,MESH : Epidemiologic Methods ,MESH: Population Surveillance ,03 medical and health sciences ,MESH: Echinococcosis ,MESH : Adolescent ,medicine ,Humans ,MESH : China ,MESH : Middle Aged ,Preschool ,MESH : Aged, 80 and over ,Disease burden ,Aged ,MESH: Adolescent ,MESH: Humans ,business.industry ,Public health ,MESH : Humans ,MESH: Child, Preschool ,Public Health, Environmental and Occupational Health ,Infant ,MESH: Adult ,Length of Stay ,biology.organism_classification ,medicine.disease ,MESH: Male ,Surgery ,Socioeconomic Factors ,Parasitology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Epidemiologic Methods ,business ,MESH: Female ,Demography - Abstract
International audience; A comprehensive study of human echinococcosis (caused by Echinococcus granulosus or E. multilocularis), including assessment of hospital records, community surveys and patient follow-up, was conducted in Ningxia Hui Autonomous Region (NHAR), China. In contrast to hospital records that showed 96% of echinococcosis cases were caused by cystic echinococcosis (CE), 56% of cases detected in active community surveys were caused by alveolar echinococcosis (AE). The AE and CE cases co-existed frequently in the same village, even occurring in the same patient. A serious public health problem caused by echinococcosis was evident in southern NHAR, typified by: a long diagnostic history for both AE and CE (7.5 years) compared with a shorter treatment history (4.7 years); a significant mortality rate (39%) caused by AE in one surveyed village, where patients had no previous access to treatment; family aggregation of CE and AE cases; a high proportion of both AE (62.5%) and CE (58%) in females; a high rate of recurrent surgery (30%) for CE demonstrated by surgical records; and frequent symptomatic recurrences (51%) because of discontinuous or sporadic access to chemotherapy for AE. The disease burden for both human AE and CE is thus very severe among these rural communities in NHAR, and this study provides the first attempt to determine the costs of morbidity and surgical intervention of human CE and AE cases both at the hospital and community level in this setting. This information may be useful for assessing the cost effectiveness of designing effective public health programs to control echinococcosis in this and other endemic areas in China and elsewhere.
- Published
- 2006