SOCIOECONOMIC AND BEHAVIOR RISK FACTORS OF HUMAN ALVEOLAR ECHINOCOCCOSIS IN TIBETAN COMMUNITIES IN SICHUAN, PEOPLE’S REPUBLIC OF CHINA

QIAN WANG World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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JIAMIN QIU World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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WEN YANG World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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PETER M. SCHANTZ World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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FRANCIS RAOUL World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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PHILIP S. CRAIG World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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PATRICK GIRAUDOUX World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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DOMINIQUE A. VUITTON World Health Organization Collaborating Centre on Prevention and Treatment of Human Echinococcosis, Santé et Environnement Rural-Université de Franche-Comté (SERF) and Laboratoire de Biologie Environnementale (LBE) Unité sous contrat avec l’Institut National de la Recherche Agronomique (Usc INRA) Research Units, Université de Franche-Comté, Besançon, France; Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers For Disease Control and Prevention, Atlanta, Georgia; Cestode Zoonoses Research Group, Bioscience Research Institute and School of Environment and Life Sciences, University of Salford, Salford, United Kingdom

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Data from two cross-sectional investigations on 7,138 subjects were used to explore risk factors of human alveolar echinococcosis (AE) in Tibetan communities. The overall human AE prevalence was 3.1% (223 of 7,138), females had a higher prevalence (3.6%, 132 of 3,713) than males (2.7%, 91 of 3,425; P = 0.011), and herdsmen had a higher prevalence (5.2%, 154 of 2,955) than farmers (1.8%, 12 of 661; P < 0.001) and urban populations (2.1%, 49 of 2,360; P < 0.001). Age in all populations, number of dogs kept, fox skin ownership in farmers, not preventing flies from landing on food in herdsmen, using open streams as drinking water sources, and playing with dogs in urban populations were statistically significant risk factors. The results suggest that AE is highly endemic in the eastern Tibetan plateau, in Sichuan Province, the role of the dog is important for human infection, and other factors associated with environmental contamination may vary according to structure and practices of communities.

Author Notes

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