ORIGINAL RESEARCH article
Front. Trop. Dis.
Sec. Tropical Disease Epidemiology and Ecology
Volume 6 - 2025 | doi: 10.3389/fitd.2025.1627873
Global Burden and Trends of Cystic Echinococcosis from 1990 to 2021: Age, Gender, and Socioeconomic Disparities in a Persistent Zoonosis
Provisionally accepted
- 1Medical Health Service Department, General Hospital of Northern Theater Command of PLA, Shenyang, China
- 2969th Hospital of PLA Joint Logistics Support Forces, Hohhot, China
- 3Nuclear and Chemical Protection Department, Center for Disease Control and Prevention of Northern Theater Command of PLA, Shenyang, China
- 4Military Patients Management Department, General Hospital of Northern Theater Command of PLA, Shenyang, Shenyang, China
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Background Cystic echinococcosis (CE), a zoonotic parasitic disease, remains a major public health challenge in pastoral regions worldwide. Despite substantial mortality reductions through international control efforts, paradoxical rises in incidence and prevalence in some regions reveal traditional strategies' limitations. This study employs a multidimensional framework integrating gender, age, and sociodemographic index (SDI) to analyze evolving CE burden patterns, providing scientific evidence for precision control. Methods Based on Global Burden of Disease (GBD) data from 1990 to 2021, the study uses age-standardized mortality rates (ASMR), disability-adjusted life years (ASDR), and related indicators to evaluate the spatiotemporal distribution of CE. Estimated annual percentage changes (EAPC) were calculated to quantify long-term trends, Joinpoint regression identified turning points in disease burden, and a Bayesian age-period-cohort (BAPC) model was applied to predict future trajectories through 2035. Results In 2021, the global ASMR of CE declined to 0.02 per 100,000 (95% UI: 0.01-0.02), a 71.4% reduction from 1990 (EAPC = -4.85%). However, gender disparities were pronounced: male ASMR was 26.7% higher than that of females (0.019 vs. 0.015 per 100,000). The burden exhibited a bimodal age distribution, with the highest mortality risk in children under five (88 male deaths, 95% UI: 25-199) and a marked increase in prevalence among adults over 80 (female ASPR up to 3.81 per 100,000). SDI stratification showed that low-SDI countries achieved the fastest mortality reduction through basic interventions (EAPC = -5.06%), whereas high-SDI countries had relatively inefficient chronic disability management (ASDR decline only -1.73%). The BAPC model predicts that by 2035, global ASMR may approach zero, yet incidence and prevalence will persist with notable gender and regional heterogeneity (female ASPR 32.2% higher than males).This study identifies a "risk transition" in CE from acute fatal disease to chronic health issue. The paradox of declining mortality but rising incidence highlights the need to shift from treatment-centered strategies to multidimensional interventions. Recommendations include: prioritizing female health education, child exposure prevention, and dog deworming in low-SDI regions; implementing gender-sensitive screening and tiered diagnosis in middle-to-high SDI regions; and establishing chronic disease management systems stratified by SDI.
Keywords: Cystic echinococcosis, Global disease burden, gender disparities, Age-specific risk, socio-demographic index, Risk transition
Received: 14 May 2025; Accepted: 07 Aug 2025.
Copyright: © 2025 Boyang, Liu, Wang, Zhang, Zhao and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shuang Zhang, Military Patients Management Department, General Hospital of Northern Theater Command of PLA, Shenyang, Shenyang, China
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