Integrated Serological And Ultrasonographic Screening Reveals The Burden Of Human Cystic Echinococcosis In Southern Kyrgyzstan: A Population-Based Cross-Sectional Study

Abstract

Background: Cystic echinococcosis (CE) is a neglected zoonotic disease caused by the larval stage of Echinococcus granulosus sensu lato and remains a major public health problem in many pastoral regions of the world. The Kyrgyz Republic is among the countries hyperendemic for echinococcosis and has one of the highest reported incidences of human echinococcosis worldwide; however, community-based epidemiological studies integrating serological screening, abdominal ultrasonography, and assessment of potential risk factors remain limited. This study aimed to determine the seroprevalence of human cystic echinococcosis and describe the epidemiological characteristics of a rural population in southern Kyrgyzstan.

Methods: A population-based cross-sectional study was conducted in Nookat District, Osh Region, Kyrgyzstan. A total of 1,444 participants underwent standardized epidemiological interviews, abdominal ultrasonography, and serological testing for anti-Echinococcus granulosus IgG antibodies using an enzyme-linked immunosorbent assay (ELISA). Demographic, environmental, and behavioral information was collected through a structured questionnaire. Descriptive statistical analyses were performed to summarize participant characteristics, serological findings, and ultrasonographic abnormalities.

Results: Among the 1,444 participants, the mean age was 32.3± 19.9 years, and 66.4% were female. ELISA detected 114 seropositive individuals, corresponding to an overall seroprevalence of 7.9% (114/1,444), while 20 participants (1.4%) had equivocal results. Abdominal ultrasonography demonstrated normal findings in 76.5% of participants, whereas 23.5% had abnormal findings, including hepatobiliary, renal, pancreatic, reproductive, and postoperative echinococcosis-related lesions. These findings indicate ongoing exposure to E. granulosus within the study population and highlight the value of community-based screening for identifying both parasitic infection and previously undetected abdominal pathology.

Conclusions: Human cystic echinococcosis remains an important public health concern in southern Kyrgyzstan. Integrated community-based screening using serological testing and abdominal ultrasonography represents a practical approach for assessing disease burden and supporting surveillance in endemic regions. The findings provide baseline epidemiological evidence for future analytical studies investigating modifiable risk factors. They may contribute to the development of targeted One Health strategies for the prevention and control of cystic echinococcosis.