Cystic Echinococcosis at the Human–Livestock Interface: Knowledge, Offal Disposal and Preventive Practices among Sheep Breeders in Eastern Libya

Abstract

Cystic echinococcosis (CE), caused by the Echinococcus granulosus sensu lato complex, is sustained principally through dog–livestock transmission. Sheep breeders are central to prevention because dog treatment, carcass and offal management, and everyday husbandry practices determine whether the parasite cycle can persist. This study assessed CE knowledge, dog-management practices, offal disposal, and selected environmental risk indicators among sheep breeders in eastern Libya within a One Health framework. An anonymous web-based cross-sectional survey was conducted over six months, from March through August 2026. A structured 35-item Arabic-language questionnaire was distributed through an electronic platform used by sheep breeders. Participation was voluntary, names and direct identifiers were not collected, and submission of the completed questionnaire constituted implied consent. A total of 640 complete questionnaires from eligible sheep breeders in eastern Libya were included in the primary analysis. Associations were examined using odds ratios (ORs), 95% confidence intervals (CIs), chi-square tests, and an exploratory multivariable logistic model in IBM SPSS Statistics. Overall, 66.2% (424/640; 95% CI 62.5–69.8) had heard of CE, but only 25.5% (163/640; 95% CI 22.2–29.0) recognised its zoonotic nature; among respondents who had heard of the disease, the corresponding proportion was 38.4%. More than half (51.7%) reported having observed cyst-like lesions in sheep. Dog contact at the sheep–farm interface was common: 74.7% handled or interacted with dogs near sheep, while only 18.1% reported a dog-care response that included deworming. Stray animals were reported near 48.3% of flocks; among these respondents, dogs were mentioned in 94.2% of stray-animal reports. Burial was the most common action for abnormal organs (43.3%), whereas 29.4% reported a potentially unsafe offal-disposal practice. Receipt of health education was strongly associated with recognition of the zoonotic nature of CE (OR 4.24, 95% CI 2.89–6.22). In multivariable analysis, recognition of zoonotic transmission was associated with lower odds of potentially unsafe offal disposal (adjusted OR 0.15, 95% CI 0.09–0.27), whereas handling dogs near sheep was associated with higher odds (adjusted OR 4.43, 95% CI 2.62–7.51); both associations remained directionally consistent in sensitivity analysis. Among sheep breeders in eastern Libya, general awareness of CE was more common than accurate recognition of its zoonotic nature, while important dog–offal transmission interfaces remained open. Control should prioritise veterinarian-led education, regular praziquantel deworming of dogs, prevention of canine access to raw offal, practical disposal infrastructure, and integrated human–animal–environment surveillance. These measures are consistent with One Health and support sustainable-development priorities related to communicable-disease control and environmentally responsible waste management.