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Background  Human echinococcoses are parasitic helminth infections that constitute a serious public health concern in several regions across the world. Cystic (CE) and alveolar echinococcosis (AE) in China represent a high proportion of the total global burden of these infections. This study was conducted to predict the spatial distribution of human seropositivity for  Echinococcus  species in Xiji County, Ningxia Hui Autonomous Region (NHAR), with the aim of identifying communities where targeted prevention and control efforts are required.    Methods  Bayesian geostatistical models with environmental and demographic covariates were developed to predict spatial variation in the risk of human seropositivity for  Echinococcus granulosus  (the cause of CE) and  E. multilocularis  (the cause of AE). Data were collected from three cross-sectional surveys of school children conducted in Xiji County in 2002–2003, 2006–2007 and 2012–2013. Environmental data were derived from high-resolution satellite images and meteorological data.    Results  The overall seroprevalence of  E. granulosus  and  E. multilocularis  was 33.4 and 12.2%, respectively, across the three surveys. Seropositivity for  E. granulosus  was significantly associated with summer and winter precipitation, landscape fragmentation variables and the extent of areas covered by forest, shrubland, water and bareland/artificial surfaces. Seropositivity for  E. multilocularis  was significantly associated with summer and winter precipitations, landscape fragmentation variables and the extent of shrubland and water bodies. Spatial correlation occurred over greater distances for  E. granulosus  than for  E. multilocularis.  The predictive maps showed that the risk of seropositivity for  E. granulosus  expanded across Xiji during the three surveys, while the risk of seropositivity for  E. multilocularis  became more confined in communities located in the south.    Conclusions  The identification of high-risk areas for seropositivity for these parasites, and a better understanding of the role of the environment in determining the transmission dynamics of  Echinococcus  spp. may help to guide and monitor improvements in human echinococcosis control strategies by allowing targeted allocation of resources.

parasites and vectors

Environmental risk factors and changing spatial patterns of human seropositivity for Echinococcus spp. in Xiji County, Ningxia Hui Autonomous Region, China