Economic effects of echinococcosis

Cystic echinococcosis (CE) has a number of important economic effects. The most tangible of these is the cost of expensive medical treatment for human cases. Each confirmed case of CE can cost the health services or individual several thousand dollars. In addition to these costs, the additional cost of loss of edible offal from agricultural animals is well known. This may result in the entire loss of an infected organ or at least the trimming and downgrading of that organ, depending on local legislature. However, these losses may only be a relatively small percentage of the economic losses attributed to CE. Recent evidence suggests, through quality of life surveys, that patients treated for CE never fully recover and have a significant and permanent decreased quality of life. This has yet to be translated into monetary terms, but it almost certainly will result in the loss of income, possibly through a lower paid job, and/or the additional expense of increased ill health. Furthermore, in most reports, between 1 and 2% of CE cases are fatal. The death of these individuals results in the loss of the potential lifetime's economic output of these individuals. With alveolar echinococcosis the mortality rate is much higher and such consequences more severe. There is also a considerable amount of Soviet literature, and small amounts published elsewhere which suggests that CE also significantly affects animal productivity. Thus, infected sheep tend to give birth to fewer lambs, have lower levels of food conversion, produce less milk and have poorer quality fleeces then non-infected sheep. The total cost of the disease is the sum of the various costs to the health services, costs of morbidity and losses in animal productivity. Due to the uncertainty of many of these costs, it is appropriate to model these losses using techniques that can give a range of cost estimates. By using analytical techniques such as Monte-Carlo analysis, on parameters that are difficult to determine accurately, all such variables can be randomly varied simultaneously along likely frequency distributions. The results of this give a useful sensitivity analysis of economic costs. In addition, the purchasing power of money in the local economy must also be taken into account. One US $ buys much more in a developing country than in an industrialized economy. Consequently, each lost $ will be more acutely felt in poor countries. Estimates of the financial burden of disease are beneficial in deciding priorities for control. They are also potentially useful tools to lobby donors or non-governmental organizations to fund control programs in poor countries. (C) 2002 Elsevier Science B.V. All rights reserved.