200649 Estimation of the monetary burden of cystic echinococcosis in Spain

Monday, November 9, 2009: 8:45 AM

Christine Benner, MPH , Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Hélène Carabin, DVM, PhD , Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Christine Budke, DVM PhD , Department of Veterinary Integrative Biosciences College of Veterinary Medicine, Texas A&M University, College Station, TX
Luisa Sanchez , Public Health Surveillance Unit, Institute of Health Carlos III, Madrid, Spain
David Carmena Jimenez, PhD , MRC Clinical Sciences Centre, Imperial College, London, United Kingdom
Objective: Estimate the overall economic losses due to human and animal cystic echinococcosis (CE) in Spain in 2005.

Methods: Epidemiological data on annual CE incidence were obtained from surveillance and abattoir data and CE-related treatment, mortality and productivity losses were obtained from the literature for humans and animals. Costs associated with diagnosis, chemotherapy, medical care and hospitalization in humans and condemnation of offal in livestock (sheep, goats, pigs, and cattle) were included in the direct costs. Indirect costs included human productivity losses and the reduction in growth, fecundity, and milk production in livestock species.

Results: The annual economic loss attributable to CE-associated illness in humans and animals was 12,326,147 €/year [range: 10,127,954-14,613,912]. Animal-associated costs constituted 92% of total losses [mean: 11,463,100 €/year, range: 9,264,907-13,507,865]. Human-associated losses were much smaller [mean 865,048 €/year].

Discussion: This first estimate of the economical burden of CE in Spain demonstrates that this neglected zoonosis is still a veterinary public health issue for the country. Our results may even underestimate the burden since animal productivity reduction, losses associated with asymptomatic and undiagnosed cases, and the incapacity to fully account for long-term disability and disease re-occurrence were not included here. Our results clearly show that CE continues to afflict areas with extensive and semi-extensive farming activity despite the success of several control initiatives beginning in 1980. Sustaining efforts to reduce disease prevalence should be an integral component in Spain's national health policy, aided considerably by improvements in disease surveillance, data-collection techniques, and greater inter-agency cooperation.

Learning Objectives:
1) Demonstrate the relative importance of direct and indirect costs in the treatment of a neglected zoonosis. 2) Evaluate the importance of the monetary burden of a neglected zoonosis to a European country 3) Identify the variable with the largest impact on the monetary burden of cystic echinococcosis in Spain

Keywords: Economic Analysis, Infectious Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted all the analysis and have been in charge of the project. I have also interpreted the results
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.