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Abstract：
BACKGROUND: Echinococcosis is prevalent in 9 provinces in Western and Northern China. An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province.
OBJECTIVE: To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province.
METHODS: Based on the China Information System for Disease Control and Prevention (CISDCP), echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022. The exclusion criteria included suspected cases, same case only counted once and cases not from Yunnan. A total of 705 cases were investigated, of which 397 cases were suitable for statistical analysis. In these 397 cases, epidemiological investigation was tracked in 187 cases. All data were inputted using double entry in the Excel database, with error correction by double-entry comparison. The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution. All statistical analyses were conducted using SPSS 17.0, including the chi-square test, linear regression test and logistic univariate and multivariate regression analyses.
RESULTS: A total of 397 cases were found in 89 counties in Yunnan Province. The number of cases in the top three prefectures were Dali (38.1%), Diqing (10.1%), and Kunming (8.3%), and the top five counties were Jianchuan (9.1%), Shangri La (8.3%), Eryuan (7. 6%), Heqing (6.9%), and Dali Districts (5.0%). There were significant differences between the different areas. The case reporting rate by CISDCP (33.8%) was low; the first case was reported by CISDCP in 2002, and the highest number of cases was 50 (2017). Confirmed and clinical cases accounted for 62.5% and 37.5%, respectively. However, 90.9% of the cases of hydatid disease were reported by the hospital system, and only 9.1% of the cases of hydatid disease were found in the community through active screening. The difference between the two methods of case detection was statistically significant. Most of the cases of echinococcosis were found in farmers/herdsmen (75.1%) and students (9.1%). In addition, Han (43.6%) and Bai (26.2%) had a higher incidence of infection than other nationalities, and the liver (87.7%) and lung (6.8%) were the most common sites of cyst formation. Among the analyzed cases, 187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1% of cases. The results of logistic regression analysis showed that the age group, education level, presence of dogs in the family (either previously or currently), and handwashing (occasionally or not) were factors related to echinococcosis infection. 55.6% of cases were in endemic areas, and 44.4% of cases were in non-endemic areas. Among 83 cases in non-endemic areas, only 4 cases had been to endemic areas and had a history of living, working, travelling, or hunting in echinococcosis epidemic areas.
CONCLUSIONS: Cases of echinococcosis were reported throughout the entire Yunnan province, with the majority distributed in Western Yunnan, suggesting that echinococcosis control should be strengthened in this area. We suggest that an epidemiological investigation should be carried out in the future, based on the clues from newly discovered cases in hospitals or from the CISDCP. The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.
OBJECTIVE: To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province.
METHODS: Based on the China Information System for Disease Control and Prevention (CISDCP), echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022. The exclusion criteria included suspected cases, same case only counted once and cases not from Yunnan. A total of 705 cases were investigated, of which 397 cases were suitable for statistical analysis. In these 397 cases, epidemiological investigation was tracked in 187 cases. All data were inputted using double entry in the Excel database, with error correction by double-entry comparison. The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution. All statistical analyses were conducted using SPSS 17.0, including the chi-square test, linear regression test and logistic univariate and multivariate regression analyses.
RESULTS: A total of 397 cases were found in 89 counties in Yunnan Province. The number of cases in the top three prefectures were Dali (38.1%), Diqing (10.1%), and Kunming (8.3%), and the top five counties were Jianchuan (9.1%), Shangri La (8.3%), Eryuan (7. 6%), Heqing (6.9%), and Dali Districts (5.0%). There were significant differences between the different areas. The case reporting rate by CISDCP (33.8%) was low; the first case was reported by CISDCP in 2002, and the highest number of cases was 50 (2017). Confirmed and clinical cases accounted for 62.5% and 37.5%, respectively. However, 90.9% of the cases of hydatid disease were reported by the hospital system, and only 9.1% of the cases of hydatid disease were found in the community through active screening. The difference between the two methods of case detection was statistically significant. Most of the cases of echinococcosis were found in farmers/herdsmen (75.1%) and students (9.1%). In addition, Han (43.6%) and Bai (26.2%) had a higher incidence of infection than other nationalities, and the liver (87.7%) and lung (6.8%) were the most common sites of cyst formation. Among the analyzed cases, 187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1% of cases. The results of logistic regression analysis showed that the age group, education level, presence of dogs in the family (either previously or currently), and handwashing (occasionally or not) were factors related to echinococcosis infection. 55.6% of cases were in endemic areas, and 44.4% of cases were in non-endemic areas. Among 83 cases in non-endemic areas, only 4 cases had been to endemic areas and had a history of living, working, travelling, or hunting in echinococcosis epidemic areas.
CONCLUSIONS: Cases of echinococcosis were reported throughout the entire Yunnan province, with the majority distributed in Western Yunnan, suggesting that echinococcosis control should be strengthened in this area. We suggest that an epidemiological investigation should be carried out in the future, based on the clues from newly discovered cases in hospitals or from the CISDCP. The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.
摘要：
背景：棘球蚴病流行于中国西部和北部的9个省。2012年和2016年云南省包虫病流行病学调查显示包虫病病例。
目的：了解云南省包虫病的空间分布和流行病学特征，为云南省包虫病的预防和控制提供依据。
方法：基于中国疾病预防控制信息系统（CISDCP），从2021年到2022年，对36家医院和34个疾病控制中心报告的包虫病病例进行了调查和流行病学分析。排除标准包括疑似病例,同样的病例只统计了一次，而不是云南的病例。共调查了705例,其中397例适用于统计学分析。在这397个案例中，对187例病例进行流行病学追踪调查。所有数据均使用Excel数据库中的双重条目输入，通过双输入比较进行纠错。利用ArcGIS10.1软件对云南省包虫病病例资料进行分析,生成包虫病分布密度图。所有统计分析均使用SPSS17.0进行，包括卡方检验，线性回归检验和Logistic单变量和多元回归分析。
结果：云南省89个县共发现397例。病例数前三的州为大理(38.1%),迪庆（10.1%），和昆明(8.3%)，排名前五位的县是剑川(9.1%)，香格里拉（8.3%），洱源（7。6%),鹤庆(6.9%),和大理地区(5.0%)。不同地区之间存在显著差异。CISDCP的病例报告率（33.8％）较低；2002年CISDCP报告了第一例病例，最高病例数为50例（2017年）。确诊和临床病例分别占62.5%和37.5%,分别。然而,90.9%的包虫病病例由医院系统报告,社区中只有9.1%的包虫病病例是通过积极筛查发现的。两种病例检测方法差异有统计学意义。包虫病的大多数病例发生在农牧民（75.1％）和学生（9.1％）中。此外,汉族(43.6%)和白族(26.2%)的感染率高于其他民族,肝(87.7%)和肺(6.8%)是最常见的囊肿形成部位。在分析的案例中，对187例进行流行病学分析，47.1％的病例早期临床症状不明显。Logistic回归分析结果显示,教育水平,狗在家庭中的存在（以前或现在），洗手（偶尔或不洗手）是与包虫病感染有关的因素。55.6%的病例发生在流行地区,44.4%的病例在非流行地区。在非流行地区的83例病例中，只有4个病例去过流行区，有生活史，工作,旅行,或者在包虫病流行地区狩猎。
结论：在整个云南省报告了包虫病病例，大部分分布在云南西部，建议在该地区加强包虫病的控制。我们建议今后开展流行病学调查,根据医院或CISDCP新发现病例的线索。医院新发现的病例提供了线索,全面确定了病例发生的地点和应该在哪里进行疫点调查。
目的：了解云南省包虫病的空间分布和流行病学特征，为云南省包虫病的预防和控制提供依据。
方法：基于中国疾病预防控制信息系统（CISDCP），从2021年到2022年，对36家医院和34个疾病控制中心报告的包虫病病例进行了调查和流行病学分析。排除标准包括疑似病例,同样的病例只统计了一次，而不是云南的病例。共调查了705例,其中397例适用于统计学分析。在这397个案例中，对187例病例进行流行病学追踪调查。所有数据均使用Excel数据库中的双重条目输入，通过双输入比较进行纠错。利用ArcGIS10.1软件对云南省包虫病病例资料进行分析,生成包虫病分布密度图。所有统计分析均使用SPSS17.0进行，包括卡方检验，线性回归检验和Logistic单变量和多元回归分析。
结果：云南省89个县共发现397例。病例数前三的州为大理(38.1%),迪庆（10.1%），和昆明(8.3%)，排名前五位的县是剑川(9.1%)，香格里拉（8.3%），洱源（7。6%),鹤庆(6.9%),和大理地区(5.0%)。不同地区之间存在显著差异。CISDCP的病例报告率（33.8％）较低；2002年CISDCP报告了第一例病例，最高病例数为50例（2017年）。确诊和临床病例分别占62.5%和37.5%,分别。然而,90.9%的包虫病病例由医院系统报告,社区中只有9.1%的包虫病病例是通过积极筛查发现的。两种病例检测方法差异有统计学意义。包虫病的大多数病例发生在农牧民（75.1％）和学生（9.1％）中。此外,汉族(43.6%)和白族(26.2%)的感染率高于其他民族,肝(87.7%)和肺(6.8%)是最常见的囊肿形成部位。在分析的案例中，对187例进行流行病学分析，47.1％的病例早期临床症状不明显。Logistic回归分析结果显示,教育水平,狗在家庭中的存在（以前或现在），洗手（偶尔或不洗手）是与包虫病感染有关的因素。55.6%的病例发生在流行地区,44.4%的病例在非流行地区。在非流行地区的83例病例中，只有4个病例去过流行区，有生活史，工作,旅行,或者在包虫病流行地区狩猎。
结论：在整个云南省报告了包虫病病例，大部分分布在云南西部，建议在该地区加强包虫病的控制。我们建议今后开展流行病学调查,根据医院或CISDCP新发现病例的线索。医院新发现的病例提供了线索,全面确定了病例发生的地点和应该在哪里进行疫点调查。
