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.
    Full-text · Article · Jun 2014 · International Journal of Surgery
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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.
    Full-text · Article · Apr 2013 · Iranian Journal of Parasitology
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    ABSTRACT: Background: Hydatid cyst disease (HCD) or echinococcosis has a worldwide distribution and is endemic in many countries of Mediterranean region. In Iran, due to various climatic conditions, the rate of the disease is diverse in different parts. The most infected regions are the domains of Alborz and Zagros Mountains where there is a high rate of ruminants and the main carrier of people are animal husbandry. Due to the importance of this zoonotic helminth and the lack of information about hydatid cyst disease in Guilan province, we conducted a retrospective study from 2000 to 2010 to evaluate the HCD inpatients in this region. Objectives: The aims of the study are to evaluate HCD inpatients and to review the clinical presentations of different organs affected by cysts and postoperative outcomes of hydatid cyst in Guilan province. Materials and Methods: A retrospective descriptive investigation was performed by reviewing the medical records of patients with HCD, admitted to four private and governmental hospitals, in Rasht, capital of Guilan province from 2000 -2010. Results: Sixty-two patients (38 males, 24 females) with a mean age of 46.38 ± 18.36 years (aged between 8 and 81 years old), with HCD were evaluated. In the 40 -60 years old group, there was highest rate of HCD (40.3%). Housewives had the highest rate of infection (40.3%) followed by farmers (22.6%), pupil (8.1%), animal husbandries (6.5%) and others (22.6%). The most prevalent complaint of the patients with liver involvement were abdominal pain (75%) and nausea and vomiting (9.1%) and the most common findings of the inpatients with lung involvement the most common complaint was cough (40%). Seventy one percent of the patients had liver involvement and 16.1% had lung involvement. The most common diagnostic method was ultrasonography (48.14%). Computed tomography was diagnostic in 43.20% of cases and chest X-ray in 8.6% of cases. Overall, 96.8% of patients were cured and the mortality rate was 3.2%. Conclusions: Echinococcosis is still an important health problem in Iran that needs further studies. Therefore, accurate information on the distribution of the disease is the first step to control and prevent it. In general, the situation of the hydatidosis in the human in Guilan shows somehow a resemblance with the other areas in Iran.
    Full-text · Article · Oct 2012
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