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

囊状棘球蚴病（CE）是一种常见的、具有重要经济意义的人畜共患病，对偏远地区的贫困牧民社区具有特殊影响。世卫组织将其列为一种被忽视的热带疾病，缺乏研究和资金，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有代表性的国家建立研究基础设施和获得流行病数据，决策者可以利用这些数据来决定控制和预防战略。总体研究目的是了解棘球绦虫属遗传多样性的流行病学和临床意义。在非洲CE是由一个高度多样化的复杂的物种，以前分配到细粒棘球绦虫。在非洲至少有五种物种，它们的生命周期模式和对人类健康的影响差异很大。关于这种多样性对公共卫生、畜牧业生产或控制的影响，几乎没有数据。在整个项目期间（第1-3阶段），已经/将在8个经济和生态多样化的国家进行研究：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。研究分三步进行：（1）进行调查，以获得关于人类、牲畜和野生动物中各种棘球绦虫物种的频率和分布的基本数据，（2）证明通过狗或野生食肉动物向牲畜和人类传播的途径，（3）关于寄生虫传播和引入的假设，系统发育特征以及临床特征与寄生虫物种和基因型的相关性，估计公共卫生和经济影响，以及传播模型。由于实际原因，并非所有这些方面都可以在所有国家进行研究，因此该项目分为广泛和纵向覆盖的核心国家（苏丹、肯尼亚、赞比亚）和研究有限方面的外围国家。在这项研究的背景下，新的moleuclar工具已经/正在开发的现场应用。建立实验室能力和包括德国和非洲机构在内的培训/支助网络将向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病。该项目在苏丹和肯尼亚建立的两个中心已经成为参考实验室，并为其他非洲联盟成员提供支持，从而为非洲和德国申请人之间的合作关系提供了长期前景。值得注意的是，在该项目中获得的专业知识不仅限于CE，而且还积极应用于其他寄生虫病（例如血吸虫病，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).