Elsevier

Acta Tropica

Volume 86, Issue 1, April 2003, Pages 3-17
Acta Tropica

Review article
Control of echinococcosis and cysticercosis: a public health challenge to international cooperation in China☆

https://doi.org/10.1016/S0001-706X(02)00269-3Get rights and content

Abstract

Echinococcosis, both cystic and alveolar, and Taenia solium cysticercosis are the most serious zoonotic cestodoses worldwide. Because of the emerging importance of these diseases in China, several international workshops and meetings were held in this country from 1998 to 2001. Based on round table discussions in Chengdu 2000, the proposal of a strategy to control echinococcosis and cysticercosis has been prepared in China. It includes a comprehensive approach based on a careful analysis of the local situations (particularly concerning the particularities of the cycle, ecology, and ethology of the animal hosts, and behavioral characteristics of the population at risk), the use of newly developed tools both in animals and human (immunology, molecular biology, and imaging), and the association of the traditional control measures (control of slaughtering, antiparasitic treatment and control of the definitive hosts, and health education) with more recent developments such as vaccination of the intermediate hosts. Plans on for the control of echinococcosis and cysticercosis in China are summarized.

Section snippets

Introduction: Urumqi, June and July 1999, Chengdu, July 2000, and Dunghuang, October 2000

The recent emergence of infectious diseases, most of which have involved zoonotic parasitic disease agents of public health importance, represents a growing global concern. Parasitic zoonoses of international importance include echinococcosis and cysticercosis. Although these infections are not among the leading causes of parasite-induced mortality worldwide, they represent a significant hazard in most developing countries, where they cause considerable losses in human health and agricultural

Echinococcosis/hydatidosis in the world

Cystic echinococcosis (CE) (caused by the cestode Echinococcus granulosus) causes serious morbidity and is a problem of worldwide importance. Echinococcosis has been listed by the Scientific Committee on Veterinary measures relating to Public Health of the European Commission DG SANCO among the zoonotic diseases causing major concern to public health in European countries (European Commission, 2000a). In North African countries, the cost and losses due to CE and cysticercosis in the human and

Echinococcosis/hydatidosis in China

Data presented at the meeting in Urumqi 1999 indicated that 500,000 was probably a conservative estimate of the number of existing cases of echinococcosis in China that require treatment since the disease had emerged as a public health problem in this country (at the end of the 1960s). This figure has been increased to 600,000 to 1.3 million people at the meeting at Dunghuang in 2000, among those one-third are children. The population at risk of echinococcosis is believed to include more than

Taeniosis/cysticercosis in the world

Millions of people are affected by Taenia solium taeniosis/cysticercosis in Latin America, Asia and Africa, where the disease is a factor in the relatively high prevalence rate of epilepsy. According to the Commission on Tropical Diseases of the International League against Epilepsy (1994), the age-adjusted prevalence of active epilepsy in tropical countries ranges from 10 to 15 per 100,000 inhabitants, almost twice the level in Europe. More recent data show from 30 to 77 and from 29 to 53 per

Taeniosis/cysticercosis in China

Recent national investigation in China has revealed that T. solium cysticercosis has been reported from 671 counties in 29 Provinces in China. Five zones of high endemicity are as follows. First zone: Northeast China including Helongjiang, Jilin, Liaoning Provinces; second zone: North China including Hebei, Neimonggol, and Shanxi; third zone: Northwest China including Gansu, Ningxia, Qinghai; fourth zone comprising of Shandong, Henan, Anhui, Hubei, Shaanxi, and fifth zone comprising of

New opportunities for control

Because of their impacts on public health and the economy, it is necessary to implement national plans aimed at controlling echinococcosis and T. solium taeniosis/cysticercosis and technologic advances have improved the possibilities of success of such efforts. However, despite increased awareness and improvements in technology, these infections have not yet been successfully controlled in most countries where their impacts on health and agricultural productivity are significant. Reasons for

The treatment of echinococcosis in human

Surgery had long been the only effective therapeutic choice in human echinococcosis. Introduction of benzimidazoles, mebendazole, and then albendazole, in clinical practice, at the beginning of the 1980s increased the therapeutic options and has markedly changed the prognosis of AE (Bresson-Hadni et al., 2000). Interventional imaging has provided other options, and the puncture–aspiration–injection–reaspiration (PAIR) technique, that consists of injecting a protoscolicidal agent after puncture

Conclusion: current state of international cooperation for echinococcosis and cysticercosis control in China

In industrialized countries, improvements in the economy, education, and availability of public services have generally contributed to decreased transmission of both CE (E. granulosus) and cysticercosis (T. solium). Both WHO and FAO are committed to collaborate with the national governments in developing national or regional control programs. Support of NATO has also allowed a now well-established network of scientists and public health specialists to meet in Poznan, Poland, September 2000 (

Acknowledgements

The workshop held in Chengdu 2000 was organized by the Sichuan Institute of Parasitic Diseases (the Director, Cheng Yawei) under the initiative of A. Ito, Asahikawa Medical College, Japan, and in collaboration with the Sichuan Provincial Health Bureau in Chengdu. WHO Western Pacific Regional Office supported the participation of C. Urbani and D.A. Vuitton. Financial supports from the Ministry of Health of China, the Asahikawa Medical Fund, and a grant-in-aid for International Scientific

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    ☆

    Akira Ito, Carlo Urbani, Dominique A. Vuitton, David D. Heath, Philip S. Craig, Feng Zheng and Peter M. Schantz equally contributed to this work.

    †

    This review is dedicated to our bestfriend, Dr. Carlo Urbani, an outstanding expert on communicable diseases and a great challenger for control of parasitic diseases in Aisa, who died of SARS on 29 March 2003 in Bangkok.

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