Objective To systematically evaluate the economic burden of echinococcosis patients in western China using meta-analysis, so as to provide insights into formulation of effective echinococcosis control strategies and optimization of medical resource allocation. Methods Articles pertaining to the economic burden of echinococcosis patients in western China were retrieved in international and Chinese databases, including PubMed, Web of Science, CNKI, Wanfang Data, and VIP Chinese Science and Technology Periodicals Full-Text Database. Studies were screened according to inclusion and exclusion criteria, and the basic characteristics of included articles, characteristics of included studies, and echinococcosis patients’ economic burden were extracted. A meta-analysis was performed using the software R package. The pooled effect size and heterogeneity were examined using a random effects model, and subgroup analyses were conducted. Results A total of 13 articles were enrolled, including 12 Chinese publications and one English publication, and all were retrospective studies. Included studies covered 4 western provinces (autonomous regions) of China, including Ningxia Hui Autonomous Region, Xinjiang Uygur Autonomous Region, Sichuan Province, and Qinghai Province, which involved 11 282 echinococcosis patients, and the study period spanned from 2006 to 2023. Meta-analysis showed that the pooled direct medical costs of echinococcosis patients were 24 730 [95% confidence interval (CI): (13 040, 36 430)] Yuan in endemic areas of western China, appearing a significant heterogeneity (I² = 79.95%, P < 0.01). Subgroup analyses showed the pooled direct medical costs of 9 090 [95% CI: (-4 970, 23 150)] Yuan for echinococcosis patients in Ningxia Hui Autonomous Region and 18 140 [95% CI: (8 440, 27 840)] Yuan in Xinjiang Uygur Autonomous Region, and pooled direct medical costs of 9 470 [95% CI: (-1 850, 20 790)] Yuan for cystic echinococcosis patients prior to 2007 and 15 270 [95% CI: (560, 24 030)] Yuan after 2007, respectively. There were high heterogeneities in the pooled direct medical costs for echinococcosis patients in terms of date of publication (I² = 82.05%, P < 0.001), treatment modality (I² = 83.28%, P < 0.001) and type of echinococcosis (I² = 72.63%, P < 0.001). In addition, the pooled indirect medical costs and direct non-medical costs were 5 670 Yuan and 4 000 Yuan for echinococcosis patients in western regions of China, respectively. Conclusions Echinococcosis patients suffer from a high economic burden in endemic areas of western China, and there are disparities in the direct medical costs for echinococcosis patients depending on disease type, study areas and study period.

Abstract: Objective　To understand the current epidemic status of echinococcosis in non-endemic areas of Xinjiang and provide a scientific basis for the local prevention and control of echinococcosis. Methods A cross-sectional study was conducted to investigate the prevalence of echinococcosis in non-epidemic areas of Xinjiang: Tianshan District, Shayibake District, Shule County in Kashgar Prefecture, and Hotan City in Hotan Prefecture of Urumqi City. From each surveyed county (city/district), three townships with higher numbers of reported echinococcosis cases from 2016 to 2020 were selected. Subsequently, three administrative villages with the highest number of reported echinococcosis cases were chosen as survey points from each township. A total of 9 administrative villages were investigated in each county (city/district). In the surveyed village, abdominal B-ultrasound screening was carried out for permanent residents aged three years and older, with suspected cases further tested for echinococcosis antibodies in blood using ELISA. In each survey village, at least 20 fecal samples from domestic dogs and, if present, at least 10 fecal samples from stray dogs were collected and tested for Echinococcus antigens. In the designated slaughterhouse of the surveyed townships, a random sample of 100 sheep or cattle raised in the township was selected on the spot, and their organs were examined by naked eyes, and the suspected diseased organs were detected by PCR. Results Among the four survey counties (cities/districts), 6 020 people underwent ultrasound screening for echinococcosis, with 7 positive cases detected, resulting in a detection rate of 0.12% (7/6 020). The detection rates of Tianshan District, Shayibake District, Shule County, and Hotan City were 0.26 % (4/1 512), 0.14 % (2/1 475), 0 (0/1 499), and 0.07% (1/1 534), respectively, all of which were cystic echinococcosis patients. A total of 1 474 dog fecal samples were detected, with an infection rate of 0.68% (10/1 474). The infection rates for domestic dogs and stray dogs were 0.84% (9/1 076) and 0.25% (1/398) respectively; there was no statistically significant difference between the two (χ2=0.74, P>0.05). A total of 2 095 livestock were surveyed, with an overall infection rate of 2.67% (56/2 095). The infection rates for sheep and cattle were 2.94% (46/1 564) and 1.88% (10/531) respectively, with a statistically significant difference between the two (χ2=6.99, P<0.01). Conclusions No human or dog infections were found in Shule County, which needs to be confirmed by in-depth epidemiological investigation and analysis of previously reported cases. Echinococcosis was found among humans, dogs, and livestock in Tianshan District, Shayibake District, and Hotan City, providing preliminary evidence of circulation history and transmission conditions of echinococcosis. It should be comprehensively considered to determine whether or not to incorporate into the epidemiologic area of echinococcosis to carry out systematic prevention and control.

Objective To analyze the echinococcosis surveillance results in Bayingolin Mongol Autonomous Prefecture, Xinjiang Uygur Autonomous Region from 2017 to 2022, so as to provide insights into formulation of echinococcosis control measures in the prefecture. Methods Villagers were randomly sampled using a multistage sampling method from class I and II echinococcosis endemic counties in Bayingolin Mongolian Autonomous Prefecture from 2017 to 2022 for detection of human echinococcosis, while all patients undergoing ultrasound examinations in medical institutions in class III endemic counties received active echinococcosis screening. In addition, livestock in centralized slaughterhouses or slaughtering sites were screened for echinococcosis using the palpation and necropsy method, and fresh domestic dog feces samples were collected from randomly selected dog owners in each administrative village for detection of Echinococcus copro-antigen in domestic dogs. The trends in detection of human and livestock echinococcosis, detection of newly diagnosed human echinococcosis cases and detection of Echinococcus coproantigen in domestic dogs were analyzed in Bayingolin Mongol Autonomous Prefecture from 2017 to 2022. Results The mean detection rate of human echinococcosis was 0.13% (540/407 803) in Bayingolin Mongol Autonomous Prefecture from 2017 to 2022, which appeared a tendency towards a decline over years (χ²_trend = 1 217.21, P < 0.001), and the highest detection of newly diagnosed echinococcosis cases was seen in Hejing County (0.28%, 191/67 865). The detection of livestock echinococcosis appeared a tendency towards a decline over years from 2017 to 2022 (χ²_trend = 147.02, P < 0.001), with the highest detection rate seen in Hejing County (3.44%, 86/2 500), and the detection of Echinococcus copro-antigen in domestic dogs appeared a tendency towards a decline over years from 2017 to 2022 (χ²_trend = 302.46, P < 0.001), with the highest detection rate in Qiemo County (2.74%, 118/4 313). Conclusions The detection of human and livestock echinococcosis and dog feces antigens Echinococcus copro-antigen in domestic dogs all appeared a tendency towards a decline in Bayingolin Mongol Autonomous Prefecture, Xinjiang Uygur Autonomous Region from 2017 to 2022; however, there is still a high echinococcosis transmission risk in local areas. Sustainable integrated echinococcosis control is required in Bayingolin Mongol Autonomous Prefecture.