Projected prevalence of cystic echinococcosis in North Africa and the Middle East to 2040: unmasking heterogeneous trends through the lens of epidemiological transition
Gastroenterology and Hepatology from Bed to Bench,
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2 March 2026
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Page 1-13 (e21)
https://doi.org/10.22037/ghfbb.v19i01.3295
Abstract
Aim: This study projected the future burden of cystic echinococcosis (CE) across the 21 countries of the North Africa and Middle East (NAME) region in the context of epidemiological transition.
Background: CE remains a major zoonotic threat in the NAME region, where it continues to cause substantial human morbidity and economic losses linked to livestock–dog transmission cycles.
Methods: Hence, our study projects the prevalence of CE in the NAME region through 2040. We estimated the future prevalence of CE using an illness-death model (IDM) calibrated with historical Global Burden of Disease (GBD) data from 1990 to 2023. To contextualize the findings, we also calculated the Epidemiological Transition Estimate (ETE) for each country.
Results: Our analysis reveals that a modest regional age standardized prevalence rate (ASPR) decline of 2.57% by 2040. While Afghanistan projects a substantial 48.15% decline in ASPR (2.74 per 100,000; 95% CI: 2.58–2.91), Turkey projects a severe 49.62% increase (9.66 per 100,000; 95% CI: 9.63–9.69). Lebanon, Palestine, and the Syrian Arab Republic are projected to have the highest ASPR by 2040, at 21.08, 19.28, and 19.24 per 100,000, respectively. These trends show a clear concordance with the ETE, underscoring the ETE's utility in contextualizing the observed disparities. Moreover, we observed higher rates of CE among females across most countries.
Conclusion: This study demonstrates that national epidemiological profiles for CE are non-uniform, shaped critically by surveillance capacity, governance, and local transmission ecology. The ETE enables the distinction of true epidemiological shifts from surveillance artifacts. We therefore recommend that control strategies be tailored to local transmission dynamics and benchmarked against ETE-defined health system capacity to effectively reduce the CE burden through 2040.
- Cystic echinococcosis
- Age-standardized prevalence rate
- North Africa and Middle East (NAME)
- Epidemiological profile
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