Clinical characteristics and prognosis of echinococcosis in Tibet: An analysis of 1 172 cases

  Background  Echinococcosis is a worldwide endemic zoonotic disease with a high prevalence in Tibet, while the local awareness of this disease is still low.

  Objective  To analyze the clinical characteristics of hospitalized patients with echinococcosis in Tibet in recent years and the factors affecting their disease prognosis.

  Methods  Clinical data about 1 172 hospitalized patients diagnosed with echinococcosis in the People's Hospital of Tibet Autonomous Region from August 1, 2013 to August 1, 2018 were retrospectively analyzed. The patients were followed up regularly. We analyzed the clinical characteristics and disease outcomes.

  Results   Of the 1 172 patients, 484 (41.3%) cases were male, with an average age of (39.3±19.5) years, and 688 (58.7%) were female, with an average age of (41.3±17.7) years; 48.0% of the patients were from Naqu city. Farmers and herdsmen accounted for 71.5%. Clinical symptoms were associated with the site of hydatid parasitism, and some patients might not have any associated symptoms or signs. The liver is the most frequent location of parasitic cysts, and some rare locations, such as septum, thyroid gland, uterus, and muscle, were also found; 83.7% of the patients had single-organ involvement. Except for 220 cases lost for follow-up, 489 cases (41.7%) were completely cured, 256 cases (21.8%) were improved, 205 cases (17.5%) were not healed (including no change or deterioration of symptoms), and 2 cases died. Age were associated with the prognosis of the patients with echinococcosis, and the odds ratio (OR) was 0.992 (95% CI: 0.984-1.000, P=0.048), indicating that advanced age was associated with poor prognosis. When compared to no treatment, surgery combined with medication significantly improved the prognosis of patients (OR: 216.618, 95% CI: 124.650-376.441, P＜0.001).

  Conclusion  Health education to public and prevention of echinococcosis in Tibet need to be strengthened. Age has an effect on the prognosis of patients with echinococcosis. Surgery combined with medical treatment can significantly improve the prognosis .