Cystic Echinococcosis in Agro-Pastoral Regions: A 10-Year Retrospective Study (2015-2024) and the Case for a One Health Approach.

Cystic echinococcosis (CE), a neglected zoonotic disease caused by Echinococcus granulosus sensu lato, poses a persistent public health burden in agro-pastoral regions worldwide. This study provides a large-scale epidemiological assessment of CE, highlighting sustained zoonotic transmission driven by agro-pastoral practices and human-animal interactions, and supporting the urgent implementation of One Health strategies. This ten-year retrospective study (2015-2024) analyzed 326 surgically confirmed cases from five hospitals in Djelfa. The cumulative surgical incidence was 2.04 cases per 100,000 person-years, classifying the region as hypoendemic. Females predominated (61.96%), and individuals aged 31-60 years represented 47.24% of cases. Rural residence (73.62%) and dog contact (94.17%) were major risk factors, with hepatic localization dominating (88.96%). Correlation analysis showed moderate associations between rural habitat and dog contact (V = 0.46, p < 0.001) and between sex and habitat (V = 0.34, p < 0.001), as well as weaker but significant associations for age and cyst location (V = 0.28, p < 0.001) and dog contact and cyst location (V = 0.20, p < 0.05). No postoperative mortality was recorded. These findings confirm active transmission linked to agro-pastoral practices and emphasize the need for coordinated One Health control strategies.