Cystic echinococcosis in sub-Saharan Africa Research Initiative (Epidemiology and clinical implications of the genetic diversity of Echinococcus spp. in eastern and southern Africa)

囊性棘球蚴病（CE）是一种常见且经济上重要的人畜共患病，对偏远地区的弱势牧民社区有特殊影响。它被世卫组织列为一种被忽视的热带病（NTD），研究和资金不足，撒哈拉以南非洲尤其如此。我们的网络继续在东部和南部非洲的代表性国家建立研究基础设施和获取流行病学数据，供决策者决定控制和预防战略时使用。总体研究目的是了解非洲棘球绦虫遗传多样性的流行病学和临床意义。CE是由高度多样化的物种引起的，以前被认为是细粒棘球绦虫。非洲至少有五种，它们的生命周期模式和对人类健康的影响各不相同。关于这种多样性对公共卫生、牲畜生产或控制的影响的数据很少。在整个项目期间（第1-3阶段），研究已经/将在8个经济和生态多样化的国家进行：苏丹、南苏丹、埃塞俄比亚、肯尼亚、乌干达、赞比亚、纳米比亚和南非。研究分三个步骤进行：(1)调查获取各种棘球蚴在人类、牲畜和野生动物中的频率和分布的基本数据；(2)论证通过狗或野生食肉动物传播给牲畜和人类的途径；(3)关于寄生虫扩散和引入的假设、系统发育特征和临床特征与寄生虫种类和基因型的相关性、公共卫生和经济影响的估计，以及传播模型。由于实际原因，并非所有国家都可以研究所有这些方面，因此该项目被分为广泛和纵向覆盖的核心国家（苏丹，肯尼亚，赞比亚）和研究方面有限的外围国家。在这项研究的背景下，新的分子工具已经/正在开发用于现场应用。建立实验室能力和包括德国和非洲机构在内的培训/支助网络将为非洲科学家提供分子、临床和流行病学专门知识，使他们能够独立研究人畜共患疾病。这个项目已经在苏丹和肯尼亚建立了两个中心，作为参考实验室，并为其他非洲财团成员提供支持，从而为非洲之间以及与德国申请者之间的合作关系提供了一个长期的前景。值得注意的是，在这个项目中获得的专门知识不仅限于CE，而且还被积极应用于其他寄生虫病（如血吸虫病、囊虫病）的研究。

Cystic echinococcosis (CE) is a frequent and economically important zoonosis with a specific impact on disadvantaged pastoralist communities in remote areas. It is rated by WHO as a neglected tropical disease (NTD) with deficits in research and funding, which is particularly true for sub-Saharan Africa. Our network continues to establish research infrastructure and to obtain epidemiological data in representative countries of eastern and southern Africa, which can be used by policy makers to decide on strategies for control and prevention. General research objective is to understand the epidemiological and clinical implications of the genetic diversity of Echinococcus spp. in Africa. CE is caused by a highly diverse complex of species, previously assigned to Echinococcus granulosus. In Africa at least five species exist, with highly different life cycle patterns and impact on human health. Few data exist on the consequences of this diversity for public health, livestock production, or control. During the entire project period (phase 1-3), studies have been / will be conducted in 8 economically and ecologically diverse countries: Sudan, South Sudan, Ethiopia, Kenya, Uganda, Zambia, Namibia and South Africa. Studies are conducted in three steps: (1) surveys to obtain basic data on frequency and distribution of the various Echinococcus species in humans, livestock and wildlife, (2) demonstration of transmission routes to livestock and humans via dogs or wild carnivores, (3) hypotheses on parasite dispersion and introductions, phylogenetic characterization and correlation of clinical features with species and genotypes of the parasite, estimation of public health and economic impact, and transmission modelling. For practical reasons, not all these aspects could / can be studied in all the countries, so the project is structured into core countries which are extensively and longitudinally covered (Sudan, Kenya, Zambia) and peripheral countries with a limited number of aspects studied. In the context of this research, new moleuclar tools have been / are being developed for on-site application. The establishment of laboratory capacities and of a training/support network including the German and African institutions will provide African scientists with molecular, clinical and epidemiological expertise that will enable them for independent studies on zoonotic diseases. Already, two centers in Sudan and Kenya, established by this project, act as reference laboratories and provide support for other African consortium members, thereby providing a long-term perspective for cooperative ties between the African, but also with the German applicants. Notably, the expertise obtain in this project is not limited to CE, but is also being actively applied to the study of other parasitic diseases (e.g. schistosomiasis, cysticercosis).