Echinococcosis in China: Epidemiology, Burden of Disease, and Economic Impacts

Echinococcosis, also known as hydatidosis or hydatid disease, is a neglected, tropical, zoonotic parasitic disease caused by infection with larvae of the genus Echinococcus. China is one of the countries with the highest disease burden of echinococcosis in the world, and the disease is particularly prevalent in western and northwestern pastoral areas of China where the highest prevalence of both alveolar echinococcosis (AE) and cystic echinococcosis (CE) is detected in the world. Results from the nationwide epidemiological survey on echinococcosis in China from 2012 to 2016 showed that the overall detection of echinococcosis was 0.51% among the study participants, and the prevalence of human echinococcosis was estimated to be 0.28% in endemic foci, with more than 50 million people at risk of infections. The disease burden due to CE in China accounts for 40% of global burden of CE, and the economic loss to human patients with CE consists of 30% of global economic losses; in addition, 91% of global new cases diagnosed with AE occur in China, which is responsible for 95% of total DALYs worldwide. Since the national echinococcosis control program was launched in 2006, an integrated strategy based on control of the source of echinococcus infections has been implemented, including health education, chemotherapy of infected patients, periodical deworming of dogs, and improved hygiene in the slaughtering of livestock, and great strides have been achieved for echinococcosis control in China (Xiao 2021). In this chapter, we describe the evolution of the national echinococcosis control program, and summarize the advances in the epidemiology, disease burden, and economic impacts of CE and AE in China. In addition, we recommend the implementation of One Health approach to eliminate echinococcosis in China, and collaboration with other disease-affected countries to walk together for joint control of echinococcosis, thereby contributing to achievement of the target set in the WHO new roadmap.