Population-based ultrasound prevalence and risk factors for cystic echinococcosis in endemic Kazakhstan.

Abstract

BACKGROUND: Cystic echinococcosis (CE), caused by Echinococcus granulosus sensu lato, remains a significant public health concern in endemic areas of Kazakhstan. Despite global control efforts, CE persists due to insufficient deworming of dogs, the absence of control programs, and low public awareness. METHODS: A cross-sectional study was conducted between September 2023 and June 2024 in 51 remote villages across two endemic regions of Kazakhstan. Participants underwent abdominal ultrasound screening and completed a structured questionnaire to assess potential risk factors. Cyst staging was performed according to the WHO - Informal Working Group on Echinococcosis guidelines. Statistical analyses included both univariate and multivariate models to identify significant predictors of infection. RESULTS: The prevalence of CE was 0.34%, with higher rates observed in young people (82.1%) than in adults (17.9%), particularly among those aged 9-14 years. Major potential risk factors included dog ownership (OR = 3.17, p = 0.012), failure to deworm dogs (OR = 11.12, p = 0.018), feeding raw offal to dogs (OR = 3.06, p = 0.012), and consumption of unwashed vegetables and fruits among women (OR = 5.25, p = 0.005). All identified CE cases were newly diagnosed. Of these, 92.85% were active cysts, predominantly found in young individuals, while inactive cysts accounted for 7.14%, distributed equally between adults and youths. CONCLUSIONS: These findings underscore the urgent need for regular deworming programs for dogs, public education on hygiene practices, and stricter management of livestock offal. Further research is needed to investigate transmission through water and environmental contamination.