Hospital and community surveys reveal the severe public health problem and socio-economic impact of human echinococcosis in Ningxia Hui Autonomous Region, China
Hospital and community surveys reveal the severe public health problem and socio-economic impact of human echinococcosis in Ningxia Hui Autonomous Region, China
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DOI：
10.1111/j.1365-3156.2006.01633.x
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发表时间：
2006-06-01
影响因子：
3.3
通讯作者：
McManus, D. P.
中科院分区：
文献类型：
--
作者：
Yang, Y. R.;Williams, G. M.;McManus, D. P.
中国在宁夏回族自治区对细粒棘球绦虫或多房棘球绦虫引起的人体包虫病进行了全面的研究，包括病历评估、社区调查和患者随访。医院记录显示96%的包虫病病例是由囊型包虫病(CE)引起的，而在活跃的社区调查中发现的56%的病例是由泡状包虫病(AE)引起的。AE和CT病例经常共存于同一村庄，甚至发生在同一患者身上。包虫病引起的严重公共卫生问题在NHAR南部是显而易见的，其典型特征是：AE和CE的主要诊断史(7.5年)与较短的治疗史(4.7年)相比；在一个被调查的村庄，患者以前没有获得治疗的机会，由AE引起的显著死亡率(39%)；CE和AE病例的家庭聚集性，女性中AE和CE的比例很高(62.5%)和CE(58%)；手术记录表明，CE的再手术率(30%)很高；因不连续或零星接受化疗而经常出现症状复发(51%)。因此，在NHAR的这些农村社区中，人类CE和CE的疾病负担非常严重，这项研究首次尝试确定在这种情况下，在医院和社区层面上人类CE和CE病例的发病率和手术干预成本。这些信息可能有助于评估设计有效的公共卫生计划来控制中国和其他地方的包虫病流行地区的成本效益。
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 echinococco.sis (CE), 56% of cases detected in active community surveys were caused by alveolar echinococcosis (AE). The AE and CT 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 king 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.