Yang Y R, Williams G M, Craig P S, Sun T, Yang S K, Cheng L, Vuitton D A, Giraudoux P, Li X, Hu S, Liu X, Pan X, McManus D P
Molecular Parasitology Laboratory, Queensland Institute of Medical Research and School of Population Health, Brisbane, Australia.
Trop Med Int Health. 2006 Jun;11(6):880-8. doi: 10.1111/j.1365-3156.2006.01633.x.
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.
在中国宁夏回族自治区开展了一项关于人体包虫病（由细粒棘球绦虫或多房棘球绦虫引起）的综合研究，包括对医院记录、社区调查和患者随访的评估。与医院记录显示96%的包虫病病例由囊性包虫病（CE）引起不同，在积极的社区调查中检测到的病例有56%由泡型包虫病（AE）引起。AE和CE病例在同一个村庄经常共存，甚至出现在同一名患者身上。宁夏南部由包虫病导致的严重公共卫生问题明显，其特点是：AE和CE的诊断病史都很长（7.5年），而治疗病史较短（4.7年）；在一个被调查村庄，AE导致的死亡率很高（39%），那里的患者此前无法获得治疗；CE和AE病例存在家庭聚集性；女性中AE（62.5%）和CE（58%）的比例都很高；手术记录显示CE的再次手术率很高（30%）；由于AE患者间断或零星接受化疗，症状复发频繁（51%）。因此，在宁夏回族自治区的这些农村社区中，人体AE和CE的疾病负担都非常严重，本研究首次尝试确定在该地区医院和社区层面人体CE和AE病例的发病成本及手术干预成本。这些信息可能有助于评估设计有效的公共卫生项目以控制中国及其他地方此流行区包虫病的成本效益。
