PDF(Pubmed)
Abstract：
Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management. This study aimed to provide a more accurate estimate of CE in Mongolia by comparing data from surgical (reported) and diagnosed (unreported) cases and assessing the challenges faced by rural doctors in disease management and surveillance. We collected data on surgical cases hospitalized between 2006 and 2016 and newly diagnosed CE cases in 2016 from eight provinces. Using a quasi-Poisson regression model, we extrapolated the collected data to estimate the number of diagnosed cases for the entire country. Additionally, forty health professionals from all 21 provinces rated local clinical management for CE through a questionnaire. The results reveal that surgical cases (2.2 per year) represent only one-eighth of diagnosed cases (15.9 per year). The laboratory facilities, disease reporting, and cyst classification usage scored below 2. These results highlight the significant underreporting of CE in Mongolia and urge human and animal health experts, along with policymakers, to invest in combating CE, particularly in remote provincial areas. This study also emphasizes the need for standard clinical management involving cyst classification according to the WHO-IWGE and seamless integration of CE reporting and monitoring mechanisms, which can significantly contribute to the national and global burden estimation of CE.
摘要：
囊性包虫病（CE），由细粒棘球蚴幼虫期引起，由于地理偏远，蒙古的报告严重不足，缺乏早期诊断，和不良的临床管理。本研究旨在通过比较手术（报告）和诊断（未报告）病例的数据，并评估乡村医生在疾病管理和监测方面面临的挑战，从而更准确地估计蒙古的CE。我们收集了8个省2006年至2016年住院的手术病例和2016年新诊断的CE病例的数据。使用准泊松回归模型，我们对收集的数据进行外推,以估计整个国家的确诊病例数.此外,来自所有21个省的40名卫生专业人员通过问卷调查对当地的CE临床管理进行了评估。结果显示，手术病例（每年2.2例）仅占诊断病例的八分之一（每年15.9例）。实验室设施,疾病报告,囊肿分类使用率低于2分。这些结果突出了蒙古CE的严重漏报，并敦促人类和动物卫生专家，连同政策制定者，为了投资打击CE，特别是在偏远地区。本研究还强调需要根据WHO-IWGE进行囊肿分类的标准临床管理，以及CE报告和监测机制的无缝整合。这可以为CE的国家和全球负担估计做出重大贡献。
