Ecological and host-related drivers of spatial clustering and persistence of human echinococcosis in Xinjiang, China.

OBJECTIVES: Xinjiang, China, remains heavily affected by echinococcosis, requiring a long-term investigation examining spatial clustering, transmission dynamics, and future trends at fine spatial scales and integrating human, animal, and environmental data. METHODS: A comprehensive spatiotemporal analysis of human echinococcosis was conducted using 2005-2024 Xinjiang surveillance data. Global spatial autocorrelation analysis was performed to identify clustering patterns, and Kriging interpolation was used to estimate the spatial distribution of infection rates among animal hosts. Bayesian models were developed to assess incidence trends, evaluate associations with environmental factors, and predict future transmission patterns. FINDINGS: During the study period, 21,822 humans' echinococcosis cases were reported in Xinjiang. Significant spatial clustering was identified, with prominent high-incidence clusters in the Yili River Valley in northern Xinjiang and Wuqia County in southern Xinjiang. Bayesian modeling revealed persistent transmission in these regions and predicted that they will remain major echinococcosis centers. Environmental and host-related factors contributed to the heterogeneous spatial distribution of disease risk across the region. CONCLUSION: Human echinococcosis continues to pose a substantial public health burden in Xinjiang, characterized by clear spatial clustering and sustained transmission in high-risk areas. Strengthened, geographically targeted control strategies that prioritize high-incidence clusters and integrate an ecological and host-related approach are required.