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Spatiotemporal patterns and environmental drivers of human echinococcoses over a twenty-year period in Ningxia Hui Autonomous Region, China


Angela M. Cadavid Restrepo

Yu Rong Yang

Donald P. McManus

Darren J. Gray

Tamsin S. Barnes

Gail M. Williams

Ricardo J.

Nicholas A.S Hamm

Archie C.A. Clements



Human cystic (CE) and alveolar (AE) echinococcoses are zoonotic parasitic diseases that can be influenced by environmental variability and change through effects on the parasites, animal intermediate and definitive hosts, and human populations. We aimed to assess and quantify the spatiotemporal patterns of human echinococcoses in Ningxia Hui Autonomous Region (NHAR), China between January 1994 and December 2013, and examine associations between these infections and indicators of environmental variability and change, including large-scale landscape regeneration undertaken by the Chinese authorities.


Data on the number of human echinococcosis cases were obtained from a hospital-based retrospective survey conducted in NHAR for the period 1 January 1994 through 31 December 2013. High-resolution imagery from Landsat 4/5-TM and 8-OLI was used to create single date land cover maps. Meteorological data were also collected for the period January 1980 to December 2013 to derive time series of bioclimatic variables. A Bayesian spatio-temporal conditional autoregressive model was used to quantify the relationship between annual cases of CE and AE and environmental variables.


Annual CE incidence demonstrated a negative temporal trend and was positively associated with winter mean temperature at a 10-year lag. There was also a significant, nonlinear effect of annual mean temperature at 13-year lag. The findings also revealed a negative association between AE incidence with temporal moving averages of bareland/artificial surface coverage and annual mean temperature calculated for the period 11–15 years before diagnosis and winter mean temperature for the period 0–4 years. Unlike CE risk, the selected environmental covariates accounted for some of the spatial variation in the risk of AE.


The present study contributes towards efforts to understand the role of environmental factors in determining the spatial heterogeneity of human echinococcoses. The identification of areas with high incidence of CE and AE may assist in the development and refinement of interventions for these diseases, and enhanced environmental change risk assessment.


Cadavid Restrepo, A. M., Yang, Y. R., McManus, D. P., Gray, D. J., Barnes, T. S., Williams, G. M., …Clements, A. C. (2018). Spatiotemporal patterns and environmental drivers of human echinococcoses over a twenty-year period in Ningxia Hui Autonomous Region, China. Parasites and Vectors, 11, Article 108.

Journal Article Type Article
Acceptance Date Feb 2, 2018
Publication Date Feb 22, 2018
Deposit Date Jul 19, 2018
Publicly Available Date Jul 19, 2018
Journal Parasites and Vectors
Electronic ISSN 1756-3305
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 11
Article Number 108
Keywords Echinococcosis; Cystic echinococcosis; Alveolar echinococcosis; Spatial analysis; Environmental change;
Remote sensing
Public URL
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