Impact of human adherence level to control measures on cystic echinococcosis transmission.

Cystic echinococcosis (CE) is a widespread zoonotic disease that poses a serious threat to both human health and livestock production. Its control effectiveness largely depends on human adherence. A game-theoretic epidemiological model is developed to couple disease transmission with human behavioral responses, aiming to investigate the effects of human adherence on CE transmission. The equilibria and threshold dynamics are derived, and numerical simulations are conducted to explore how key factors influence disease prevalence, behavioral strategy switching, and control effectiveness. The results indicate that human adherence affects both transmission risk and infection levels, while a higher cost-to-risk ratio suppresses adherence, thereby weakening control outcomes. Model application to Xinjiang Province in China suggests that although CE transmission is currently under control (R0 < 1), recurrence may occur when the initial adherence level falls below the threshold (xA*=0.5706), indicating that when human behavior is considered, relying solely on the basic reproduction number R0 is insufficient to predict long-term transmission dynamics.