The prevalence, exposure and transmission patterns of human cystic and alveolar echinococcosis will be investigated respectively in two rural communities in Xinjiang and Gansu Provinces, where each disease is a major public health problem.
Between 1500-2000 people in each community will be registered and screened by combination of portable ultrasound scanning with serology (dot-ELISA) for anti-cyst antibodies.
Ultrasound positive and seropositive (image neqative) individuals will be followed-up by conventional ELISA with purified native E-granulosus or E.multllocularis antigens.
Confirmed cases will be treated by albendazole chemotherapy and/or surgery where appropriate.
Treatment efficacy, post-treatment surveillance and prognosis will be assessed using serologic parameters including assays for specific antibody, immune complex and cytokines, together with the normal clinical follow-up. The group of sero-positive 'asymptomatics' will also be regularly followed-up serologically and ultrasonographically.
All sera will also be screened for oncosphere 'exposure' antibodies. Thus the course and outcome of human disease may be defined by prospective epidemiologic surveys.
The exposure and prevalence rates in domestic dogs will also be investigated using serum antibody and coproantigen immunoassays respectively in conjunction with coproparasitological data.
A longitudinal study in dogs will enable determination of the natural rate of re-infection in both communities.
The transmission patterns will be elucidated including the rodent cycle for E.multilocularis (in Gansu).
Parasitologic and immunologic data for humans and definitive hosts will also be used to identify risk factors for human cystic and alveolar echinococcosis in the study communities.
Funding SchemeCSC - Cost-sharing contracts
730000 Lanzhou City
830054 Xinjiang - Urumqi