He Wei, Liu Yang, Zhong Bo, Yu Wenjie, Liao Sha, Zhang Guangjia, Wang Qi, Li Ruirui, Yang Liu, Yao Renxin, Zhang Zhongshuang, Huang Yan, Wang Liying, Wang Qian
Institute of Parasitic Diseases Prevention and Control, Sichuan Center for Disease Control and Prevention, Chengdu, China.
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China.
PLoS Negl Trop Dis. 2025 Aug 4;19(8):e0013358. doi: 10.1371/journal.pntd.0013358. eCollection 2025 Aug.
Echinococcosis is a zoonotic parasitic disease that significantly endangers public health and hinders socioeconomic development. Sichuan Province is a mixed endemic area of cystic echinococcosis (CE) and alveolar echinococcosis (AE), and it has one of the most severe epidemics of echinococcosis in China. In 2012, the national epidemiological sampling survey of echinococcosis revealed that the prevalence rate of echinococcosis among the population in Sichuan Province was 1.08%, significantly higher than the national average (0.24%). In this study, the spatiotemporal distribution characteristics of newly diagnosed patients with echinococcosis in Sichuan Province from 2013 to 2024 were analyzed, providing a reference for identifying key areas of echinococcosis and developing targeted prevention and control strategies.
Data on the number of individuals screened for echinococcosis and the number of newly diagnosed patients in endemic counties were obtained from the annual reports of the Sichuan Provincial Echinococcosis Control Program between 2013 and 2024. The detection rate of newly diagnosed echinococcosis patients was calculated for each year. County-level electronic maps of Sichuan Province were downloaded from the National Geographic Information Public Service Platform. The spatial distribution map of the detection rate of newly diagnosed patients with echinococcosis in Sichuan Province was created using ArcGIS software, and global and local spatial autocorrelation analyses were conducted. Spatiotemporal scanning analysis of the detection rate of newly diagnosed echinococcosis patients in Sichuan Province was conducted using SaTScan software.
From 2013 to 2024, the total detection rate of newly diagnosed patients with echinococcosis in the endemic areas of Sichuan Province was 55.77/100,000, with the detection rates of CE and AE being 36.71/100,000 and 19.88/100,000, respectively. The total detection rate of newly diagnosed patients with echinococcosis, as well as that of CE and AE, demonstrated a decreasing trend year by year (χ2 = 1,054.785, 925.936, 196.018; P < 0.001). The detection rate of CE was higher than that of AE between 2013 and 2021; however, this trend was reversed between 2022 and 2024. In terms of spatial distribution, areas with higher detection rates were primarily concentrated in the northwestern part of Sichuan Province, whereas areas with lower detection rates were mainly distributed in the southeastern part of the province. The global spatial autocorrelation analysis results revealed that the total detection rate of newly diagnosed echinococcosis patients exhibited spatial clustering in 2013-2016, 2018, 2020, and 2024. The detection rate of newly diagnosed CE patients exhibited spatial clustering in 2013, 2014, and 2022. The detection rate of newly diagnosed patients with AE exhibited spatial clustering in 2013-2018, 2020, and 2023. Local spatial autocorrelation analyses revealed that the "high-high" clustering areas of the total detection rates, CE and AE detection rates were concentrated in the northwestern and northern parts of the endemic areas, while the "low-low" clustering areas were concentrated in the southeastern parts of the endemic areas. Spatiotemporal scanning analysis revealed that the most important clusters of newly total diagnosed echinococcosis and CE patients in Sichuan Province were mainly located in Shiqu, Seda, Baiyu, Ganzi, Dege, Xinlong, Luhuo, Aba, and Rangtang counties. The most important clusters of patients with AE were mainly in Shiqu, Seda, Baiyu, Ganzi, Dege, and Rangtang counties.
The results demonstrated that the detection rate of newly diagnosed patients with echinococcosis in Sichuan Province decreased annually between 2013 and 2024, exhibiting significant spatial clustering. The western Sichuan Qinghai Tibet Plateau region is a "hot spot" for echinococcosis in the Sichuan Province population. It is recommended that relevant departments develop precise prevention and control strategies for the current areas of clustering.
棘球蚴病是一种人畜共患寄生虫病，严重危害公众健康，阻碍社会经济发展。四川省是囊型棘球蚴病（CE）和泡型棘球蚴病（AE）的混合流行区，是我国棘球蚴病疫情最为严重的地区之一。2012年全国棘球蚴病流行病学抽样调查显示，四川省人群棘球蚴病患病率为1.08%，显著高于全国平均水平（0.24%）。本研究分析了2013年至2024年四川省新诊断棘球蚴病患者的时空分布特征，为确定棘球蚴病重点区域及制定针对性防控策略提供参考。
从2013年至2024年四川省棘球蚴病防治项目年度报告中获取流行县棘球蚴病筛查人数及新诊断患者人数数据。计算每年新诊断棘球蚴病患者的检出率。从国家地理信息公共服务平台下载四川省县级电子地图。利用ArcGIS软件绘制四川省新诊断棘球蚴病患者检出率空间分布图，并进行全局和局部空间自相关分析。使用SaTScan软件对四川省新诊断棘球蚴病患者检出率进行时空扫描分析。
2013年至2024年，四川省流行区新诊断棘球蚴病患者总检出率为55.77/10万，其中CE和AE的检出率分别为36.71/10万和19.88/10万。新诊断棘球蚴病患者总检出率以及CE和AE的检出率均呈逐年下降趋势（χ2 = 1054.785、925.936、196.018；P < 0.001）。2013年至2021年CE的检出率高于AE；然而，2022年至2024年这一趋势发生逆转。在空间分布方面，检出率较高的地区主要集中在四川省西北部，而检出率较低的地区主要分布在该省东南部。全局空间自相关分析结果显示，2013 - 2016年、晚2018年、2020年和2024年新诊断棘球蚴病患者总检出率呈现空间聚集性。新诊断CE患者的检出率在2013年、2014年和2022年呈现空间聚集性。新诊断AE患者的检出率在2013 - 2018年、2020年和2023年呈现空间聚集性。局部空间自相关分析显示，总检出率、CE和AE检出率的“高高”聚集区集中在流行区的西北部和北部，而“低低”聚集区集中在流行区的东南部。时空扫描分析显示，四川省新诊断棘球蚴病和CE患者最重要的聚集区主要位于石渠、色达、白玉、甘孜、德格、新龙、炉霍、阿坝和壤塘县。AE患者最重要的聚集区主要在石渠、色达、白玉、甘孜、德格和壤塘县。
结果表明，2013年至2024年四川省新诊断棘球蚴病患者检出率逐年下降，呈现明显的空间聚集性。川西青藏高原地区是四川省人群棘球蚴病的“热点”地区。建议相关部门针对当前的聚集区域制定精准防控策略。
