The Monetary Burden of Cystic Echinococcosis in Iran

University of Zurich, Switzerland
PLoS Neglected Tropical Diseases (Impact Factor: 4.45). 11/2012; 6(11):e1915. DOI: 10.1371/journal.pntd.0001915
Source: PubMed


Cystic echinococcosis (CE) is a globally distributed parasitic infection of humans and livestock. The disease is of significant medical and economic importance in many developing countries, including Iran. However, the socioeconomic impact of the disease, in most endemic countries, is not fully understood. The purpose of the present study was to determine the monetary burden of CE in Iran. Epidemiological data, including prevalence and incidence of CE in humans and animals, were obtained from regional hospitals, the scientific literature, and official government reports. Economic data relating to human and animal disease, including cost of treatment, productivity losses, and livestock production losses were obtained from official national and international datasets. Monte Carlo simulation methods were used to represent uncertainty in input parameters. Mean number of surgical CE cases per year for 2000-2009 was estimated at 1,295. The number of asymptomatic individuals living in the country was estimated at 635,232 (95% Credible Interval, CI 149,466-1,120,998). The overall annual cost of CE in Iran was estimated at US$232.3 million (95% CI US$103.1-397.8 million), including both direct and indirect costs. The cost associated with human CE was estimated at US$93.39 million (95% CI US$6.1-222.7 million) and the annual cost associated with CE in livestock was estimated at US$132 million (95% CI US$61.8-246.5 million). The cost per surgical human case was estimated at US$1,539. CE has a considerable economic impact on Iran, with the cost of the disease approximated at 0.03% of the country's gross domestic product. Establishment of a CE surveillance system and implementation of a control program are necessary to reduce the economic burden of CE on the country. Cost-benefit analysis of different control programs is recommended, incorporating present knowledge of the economic losses due to CE in Iran.

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    • "Cystic echinococcosis (CE) or hydatid disease as a zoonotic parasitic infection caused by the larval stage of the dog tapeworm Echinococcus granulosus is still an important economic and public health concern in many countries of the world, such as Iran. The disease affects humans as well as domestic livestock including cattle, sheep, camels, pigs, horses and others [1] [2]. The final host is the dog, in which adult tapeworms attached to the intestinal epithelium undergo sexual reproduction, leading to the development of eggs. "
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    ABSTRACT: Cystic echinococcosis (hydatid cyst, CE) as a zoonotic parasitic infection caused by the larval stage of the dog tapeworm Echinococcus granulosus is still an important economic and public health concern in the world. One of the treatment options for CE is surgical removal of the cysts combined with chemotherapy using albendazole and/or mebendazole before and after surgery. Currently, many scolicidal agents, which have some complications, have been used for inactivation of the cyst contents. Therefore the development of new scolicidal agents with low side effects and more efficacies is an urgent need for surgeons. The present study was aimed to investigate the in vitro scolicidal effect of selenium nanoparticles biosynthesized by a newly isolated marine bacterial strain Bacillus sp. MSh-1 against protoscoleces of E. granulosus. Protoscolices were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations (50–500 μg/ml) of Se NPs (in size range of about 80–220 nm) were used for 10–60 min. Viability of protoscoleces was confirmed by 0.1% eosin staining. The results indicated that biogenic Se NPs at all concentrations have potent scolicidal effects especially at concentrations 500 and 250 μg/ml after 10 and 20 min of application, respectively. In conclusion, the findings of present study proven that Se NPs have potent scolicidal effects, therefore may be used in CE surgery. However, the in vivo efficacy of these NPs remains to be explored.
    International Journal of Surgery 06/2014; DOI:10.1016/j.ijsu.2014.03.017 · 1.53 Impact Factor
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    • "Hydatidosis can cause significant morbidity and mortality with considerable economic losses for both of humans and livestock.The overall of economic loss attributable to CE in humans and animals in Iran was annually estimated at about US$232.3 million (95% CI US$103.1–397.8 million) (5). Fasihi stated that, the cost of the disease estimated at 0.03% of the country's gross domestic product (5). "
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    ABSTRACT: The aim of this study was to determine the prevalence of hydatidosis in west Azerbaijan, Iran during a 10 year period (2000-2009). We surveyed medical records of infected patients with hydatid cyst who had been operated in four hospitals in Urmia City, the capital of West Azerbaijan Province, Iran. Several parameters were analyzed including age, sex, place of residency, hospitalization time, and the location of cysts. Of 294 cases, 53.3% were female and 46.7% were male with the mean age of 39.4 years (5-93). The average number of operated cysts per year was 29.4 (0.98/100,000 of population). The most affected age group was 20-30 year olds (18.7% of the cases). Cysts were localized in liver and lung in 57.5% and 21.8% of cases respectively and the average hospitalization time was 9 days. Single organ involvement was seen in the majority of patients and 28 (9.5%) cases had multiple involvement. The distribution of residence in patients showed 108 (36.9%) of them to have urban origin and 185 (63.1%) were rural residents. The lowest number (n = 17) and the highest number of operation (n= 48) recorded in 2000 and 2007, respectively. The prevalence of hydatidosis is high in this city and further studies are needed for evaluation of economic burden and risk factors for CE in this region.
    Iranian Journal of Parasitology 04/2013; 8(2):323-6. · 0.86 Impact Factor
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    ABSTRACT: Parasitic diseases present a considerable socio-economic impact to society. Zoonotic parasites can result in a considerable burden of disease in people and substantive economic losses to livestock populations. Ameliorating the effects of these diseases may consist of attempts at eradicating specific diseases at a global level, eliminating them at a national or local level or controlling them to minimise incidence. Alternatively with some parasitic zoonoses it may only be possible to treat human and animal cases as they arise. The choice of approach will be determined by the potential effectiveness of a disease control programme, its cost and the cost effectiveness or cost benefit of undertaking the intervention. Furthermore human disease burden is being increasingly measured by egalitarian non-financial measures which are difficult to apply to livestock. This adds additional challenges to the assessment of socio-economic burdens of zoonotic diseases. Using examples from the group of neglected zoonotic diseases, information regarding the socio-economic effects is reviewed together with how this information is used in decision making with regard to disease control and treatment.
    Veterinary Parasitology 04/2013; 195(3-4). DOI:10.1016/j.vetpar.2013.04.004 · 2.46 Impact Factor
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