Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108016

Hélène Carabin, PhD, Department of Biostatistics and Epidemiology, University of Oklahoma, College of Public Health, 801 NE 13th Street, Oklahoma City, OK 73104, Linda D. Cowan, PhD, Biostatistics and Epidemiology, University of Oklahoma, 801 NE 13th Street, Oklahoma City, OK 73104, A. Lee Willingham, PhD, People, Livestock and the Environment Thematic Programme, International Livestock Research Institute, ILRI, Nairobi, Kenya, Theodore Nash, PhD, Gastrointestinal Parasites Section Laboratory of Parasitic Diseases NIAID, National Institutes of Health, 9000 Rockville Pike, Bldg. 4 Rm B1-06, Bethesda, MD 20892, Rosina C. Krecek, PhD, Krecek and Krecek, PO Box 12832, Onderstepoort, 0110, South Africa, Ana L. Sanchez, PhD, Community Health Sciences, Faculty of Applied Sciences, Brock University, Brock University, St-Catharines, ON L2S 3A1, Canada, Vedantam Rajshekar, MD, Department of Neurological Sciences, Christian Medical College, Christian Medical College, Vellore, 632004, India, Humberto Foyaca-Sibat, MD, University of Transkei, Private Bag X1 UNITRA, Umtata, 5117, South Africa, and Elizabeth Wagstrom, DVM, MS, DACVPM, Science and Technology, National Pork Board, 1776 NW 114th Street, Des Moines, IA 50325, 515-223-2633, liz.wagstrom@porkboard.org.

Background: Neurocysticercosis (NCC), infection of the human brain by the larvae of Taenia solium, causes an estimated 20% - 50% of late-onset epilepsy cases globally. The parasite requires humans and pigs to complete its life cycle and the larval stage can cause disease in both humans and pigs with potentially large economical impact in least developed countries. Purpose: To estimate the societal monetary burden of cysticercosis in the Eastern Cape Province, South Africa, Honduras and India. Methods: We collected data on the frequency of infection and on associated morbidity in both human and pig populations and their costs. For each study area, we developed a decision tree to determine the expected number of cases of NCC-associated seizures or active epilepsy. NCC was divided into three categories: 1) those not seeking medical attention, 2) those seeking medical attention but without hospitalized, and 3) those seeking medical attention including hospitalized. Costs of treatment in each category were estimated. For porcine cysticercosis, losses included carcass condemnation at the abattoir, reduced value of pigs when sold in the community and/or pigs that could have been sold to an abattoir had the disease been absent. Uncertainty of results was reflected using Monte Carlo sampling and point estimates with 95% Credible Intervals (95% CI) were reported. All results are in 2004 US$. Results: The societal monetary cost of T. solium cysticercosis was estimated to US$13.4 million (95% CI: US$45.3 million-US$262.3 million), US$20.0 million (US$6.2 million—US$37.6 million), US$14.6 million (95% CI: US$7.3 million—US$24.8 million) in India, Honduras and the Eastern Cape Province, respectively. Discussion: Cysticercosis produces a very important monetary burden for some regions of the world. The cost in Honduras is equivalent to 1% of the purchasing power parity per capita. In the Eastern Cape Province, the burden per capita is US$ 2.05 which is considerable when compared to annual health expenditures of US$ 41.26. In India, the monetary burden is impressive, especially when considering that 93% of Indians are Hindus and Muslims and do not consume pork meat. There is a need to raise the awareness of international public health services about the importance of this infection in the developing world.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session shoul dbe able to

• Articulate the procedures needed to estimate the monetary burden of a zoonosis.
• Recognize the burden of Taenia solium cysticercosis to the developing world
• Discuss the limitations of the currently available data

Keywords: Economic Analysis, Communicable Disease

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.