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Abstract

BACKGROUND

is a parasite causing alveolar echinococcosis (AE), a severe disease affecting primarily the liver. Surveillance of this non-notifiable disease in France is performed by the National Reference Center for Echinococcoses (NRC-E).

AIM

We aimed to analyse changes in epidemiological, clinical and survival data of patients with AE over time.

METHODS

We described and analysed data from 906 AE patients reported to the NRC-E over three periods: 1982–1999, 2000–2010 and 2011–2021, using regression methods and survival analysis methods.

RESULTS

At diagnosis, the median age of the patients was 60.0 years, most (770; 85.0%) resided in an endemic region and 483 (53.3%) in a rural area. The percentage of asymptomatic patients increased significantly from 19.1% (48/251) in 1982–1999 to 56.2% (209/372) in 2011–2021 (p < 0.001). The number of patients with weakened immune systems increased significantly in 2000–2021 (p < 0.001). Most (761/836; 91.0%) patients were treated with antiparasitic drugs and 402 (44.4%) underwent surgery. The number of surgical interventions decreased significantly during the study period (p = 0.007). Palliative surgery decreased, curative hepatic resection became more commonly performed (p < 0.001). Multivariate analysis showed a lower risk of death in the first 10-year follow-up in patients diagnosed after 2000 and those receiving benzimidazoles (sub-distribution hazard ratio (SHR) = 0.43; 95% confidence interval (CI): 0.28–0.66; p < 0.001).

CONCLUSION

International recommendations for treating all patients with benzimidazoles and favouring curative hepatic resection, whenever possible, were generally followed and associated with better survival. We recommend national and European-wide registries to ensure effective surveillance of AE.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2025-08-14
2025-08-15
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Epidemiological and clinical characteristics of patients in the alveolar echinococcosis registry, France, 1982 to 2021
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Jenny+Knapp&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Knapp Jenny</a>, <a href="/search?value1=Florent+Demonmerot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Demonmerot Florent</a>, <a href="/search?value1=Houssein+Gbaguidi-Haore&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gbaguidi-Haore Houssein</a>, <a href="/search?value1=Carine+Richou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Richou Carine</a>, <a href="/search?value1=Dominique+Ang%C3%A8le+Vuitton&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vuitton Dominique Angèle</a>, <a href="/search?value1=Anne-Pauline+Bellanger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bellanger Anne-Pauline</a>, <a href="/search?value1=Solange+Bresson-Hadni&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bresson-Hadni Solange</a>, <a href="/search?value1=Laurence+Millon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Millon Laurence</a>, <a href="/search?value1=on+behalf+of+the+FrancEchino+network&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the FrancEchino network</a></span>. Epidemiological and clinical characteristics of patients in the alveolar echinococcosis registry, France, 1982 to 2021. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(32):pii=2500041. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.32.2500041" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.32.2500041</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 10 Jan 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 08 Apr 2025 </span> </p>
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