Epidemic cystic and alveolar echinococcosis in Kyrgyzstan: an analysis of national surveillance data.,The Lancet Global Health

当前位置： X-MOL 学术 › Lancet Global Health › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Epidemic cystic and alveolar echinococcosis in Kyrgyzstan: an analysis of national surveillance data.
The Lancet Global Health ( IF 19.9 ) Pub Date : 2020-03-18 , DOI: 10.1016/s2214-109x(20)30038-3
Giulia Paternoster ₁ , Gianluca Boo ₂ , Craig Wang ₃ , Gulnara Minbaeva ₄ , Jumagul Usubalieva ₄ , Kursanbek Mamasalievich Raimkulov ₅ , Abdykadyr Zhoroev ₄ , Kubanychbek Kudaibergenovich Abdykerimov ₆ , Philipp Andreas Kronenberg ₇ , Beat Müllhaupt ₈ , Reinhard Furrer ₉ , Peter Deplazes ₁₀ , Paul Robert Torgerson ₁₁

Affiliation

Section of Epidemiology, University of Zurich, Zurich, Switzerland; Life Science Zurich Graduate School, ETH Zurich and University of Zurich, Zurich, Switzerland.
WorldPop, Department of Geography and Environment, University of Southampton, Southampton, UK.
Vetsuisse Faculty, Department of Mathematics, University of Zurich, Zurich, Switzerland; Life Science Zurich Graduate School, ETH Zurich and University of Zurich, Zurich, Switzerland.
Government Sanito-Epidemiology Unit, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
Center for Disease Prevention and Sanitary Epidemiological Surveillance of Osh region, Ministry of Health of the Kyrgyz Republic, Osh, Kyrgyzstan.
Section of Epidemiology, University of Zurich, Zurich, Switzerland; Institute of Parasitology, University of Zurich, Zurich, Switzerland; Kyrgyz Research Institute of Veterinary Science named after A Duisheev, Ministry of Education and Science of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
Institute of Parasitology, University of Zurich, Zurich, Switzerland; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Vetsuisse Faculty, Department of Mathematics, University of Zurich, Zurich, Switzerland; Department of Computational Science, University of Zurich, Zurich, Switzerland.
Institute of Parasitology, University of Zurich, Zurich, Switzerland.
Section of Epidemiology, University of Zurich, Zurich, Switzerland.

Background

Human cystic and alveolar echinococcosis are among the priority neglected zoonotic diseases for which WHO advocates control. The incidence of both cystic echinococcosis and alveolar echinococcosis has increased substantially in the past 30 years in Kyrgyzstan. Given the scarcity of adequate data on the local geographical variation of these focal diseases, we aimed to investigate within-country incidence and geographical variation of cystic echinococcosis and alveolar echinococcosis at a high spatial resolution in Kyrgyzstan.

Methods

We mapped all confirmed surgical cases of cystic echinococcosis and alveolar echinococcosis reported through the national echinococcosis surveillance system in Kyrgyzstan between Jan 1, 2014, and Dec 31, 2016, from nine regional databases. We then estimated crude surgical incidence, standardised incidence, and standardised incidence ratios (SIRs) of primary cases (ie, excluding relapses) based on age and sex at country, region, district, and local community levels. Finally, we tested the SIRs for global and local spatial autocorrelation to identify disease hotspots at the local community level. All incidence estimates were calculated per 100 000 population and averaged across the 3-year study period to obtain annual estimates.

Findings

The surveillance system reported 2359 primary surgical cases of cystic echinococcosis and 546 primary surgical cases of alveolar echinococcosis. Country-level crude surgical incidence was 13·1 per 100 000 population per year for cystic echinococcosis and 3·02 per 100 000 population per year for alveolar echinococcosis. At the local community level, we found annual crude surgical incidences up to 176 per 100 000 population in Sary-Kamysh (Jalal-Abad region) for cystic echinococcosis and 246 per 100 000 population in Uch-Dobo (Alay district, Osh region) for alveolar echinococcosis. Significant hotspots of cystic echinococcosis were found in four regions: Osh (five local communities in Uzgen district and four in Alay district), Naryn (three local communities in Jumgal district and one in Naryn district), Talas (three local communities in Talas district), and Chuy (one local community in Jayyl district). Significant alveolar echinococcosis hotspots were detected in the Osh region (11 communities in Alay district, including the local community of Sary Mogol, and one in Chong-Alay district) and in the Naryn region (five communities in Jumgal district and three in At-Bashy district), in the southwest and centre of the country.

Interpretation

Our analyses reveal remarkable within-country variation in the surgical incidence of cystic echinococcosis and alveolar echinococcosis in Kyrgyzstan. These high-resolution maps identify precise locations where interventions and epidemiological research should be targeted to reduce the burden of human cystic echinococcosis and alveolar echinococcosis.

Funding

Swiss National Science Foundation.

中文翻译：

吉尔吉斯斯坦流行的囊性和肺泡棘球co病：国家监测数据分析。

背景

人的囊性和肺泡棘球菌病是世卫组织提倡控制的优先被忽视的人畜共患病。在过去的30年中，吉尔吉斯斯坦的囊性包虫病和肺泡包虫病的发病率都大大增加了。鉴于缺乏关于这些局灶性疾病的本地地理变异的足够数据，我们旨在研究吉尔吉斯斯坦在高空间分辨率下的囊性棘球cc虫病和肺泡棘球ech虫病的国内发生率和地理变异。

方法

我们绘制了2014年1月1日至2016年12月31日期间在吉尔吉斯斯坦通过国家埃奇球菌病监测系统报告的所有确诊的囊性埃奇球菌病和肺泡埃奇球菌病的手术病例，来自9个地区数据库。然后，我们根据国家，地区，地区和当地社区级别的年龄和性别，估算了主要病例的粗手术率，标准化发病率和标准化发病率（SIR）（即，不包括复发）。最后，我们针对全局和局部空间自相关性对SIR进行了测试，以识别本地社区一级的疾病热点。所有发病率估算值均按每10万人口计算，并在3年研究期内取平均值，以获得年度估算值。

发现

监测系统报告了2359例囊性棘球co虫病的原发手术病例和546例肺泡棘球co虫病的原发手术病例。囊性棘球co虫病的国家一级粗略外科手术发生率为每年每十万人口13·1，而肺泡棘球菌病为每年每十万人口3·02。在当地社区一级，我们发现囊性棘球co虫病的Sary-Kamysh（贾拉勒-阿巴德地区）的年粗手术发生率高达176/100 000，Uch-Dobo（奥什州阿拉伊地区）的Uch-Dobo每年发生的粗手术发生率高达100,000 / 10万。肺泡棘球co病。在四个地区发现了严重的囊性棘球ech病热点：奥什（乌兹根地区有五个当地社区，阿莱地区有四个社区），纳林（Jumgal地区有三个当地社区，纳伦地区有一个社区），塔拉斯（塔拉斯区的三个当地社区）和丘伊（杰伊尔区的一个本地社区）。在奥什地区（奥莱州地区（包括Sary Mogol的当地社区，在阿莱地区有11个社区，在崇阿莱地区有一个），在纳林地区（贾穆加尔地区有5个社区，在阿巴什州有3个社区），发现了明显的肺泡棘球cc病热点地区），位于该国的西南和中部。