The disease burden of human cystic echinococcosis based on HDRs from 2001 to 2014 in Italy

Abstract

BackgroundCystic echinococcosis (CE) is an important neglected zoonotic parasitic infection belonging to the subgroup of seven Neglected Zoonotic Disease (NZDs) included in the World Health Organization’s official list of 18 Neglected Tropical Diseases (NTDs). CE causes serious global human health concerns and leads to significant economic losses arising from the costs of medical treatment, morbidity, life impairments and fatality rates in human cases. Moreover, CE is endemic in several Italian Regions. The aim of this study is to perform a detailed analysis of the economic burden of hospitalization and treatment costs and to estimate the Disability Adjusted Life Years (DALYs) of CE in Italy.Methods and findingsIn the period from 2001 to 2014, the direct costs of 21,050 Hospital Discharge Records (HDRs) belonging to 12,619 patients with at least one CE-related diagnosis codes were analyzed in order to quantify the economic burden of CE. CE cases average per annum are 901 (min—max = 480–1,583). Direct costs include expenses for hospitalizations, medical and surgical treatment incurred by public and private hospitals and were computed on an individual basis according to Italian Health Ministry legislation. Moreover, we estimated the DALYs for each patient. The Italian financial burden of CE is around € 53 million; the national average economic burden per annum is around € 4 million; the DALYs of the population from 2001 to 2014 are 223.35 annually and 5.26 DALYs per 105 inhabitants.ConclusionIn Italy, human CE is responsible for significant economic losses in the public health sector. In humans, costs associated with CE have been shown to have a great impact on affected individuals, their families and the community as a whole. This study could be used as a tool to prioritize and make decisions with regard to a surveillance system for this largely preventable yet neglected disease. It demonstrates the need of implementing a CE control program aimed at preventing the considerable economic and social losses it causes in high incidence areas.

The European Union summary report on trends and sources of zoonoses, zoonotic agents and food‐borne outbreaks in 2016

“…It should be noted that these three studies showed a negative trend in time in the number of hospitalisations. More recently, an extended study conducted in Italy (which is currently not reporting any human CE cases to the EU annual zoonoses monitoring data collection) identified 21,050 hospital discharge records with CE diagnosis from 2001 to 2014 related to 12,619 patients (Piseddu et al., ). The median of CE hospitalisations per year in Italy was 848, which is equal to the total number of CE and AE cases reported by all the MS in the EU annual zoonoses monitoring data collection.…”

Epidemiological distribution of Echinococcus granulosus s.l. infection in human and domestic animal hosts in European Mediterranean and Balkan countries: A systematic review

“…At global level, Budke and colleagues [3] estimated a human burden of around 1 million Disability-Adjusted Life Years (DALYs) and 760 million US$ losses due to human infection (accounting for underreporting), and annual livestock production losses of at least US$ 140 million. For what concerns Europe, in Italy, based on Hospital Discharge Records (HDR), Piseddu and colleagues [4] estimated a financial burden due to human CE of around € 53 million in 2001-2014, with a national average economic burden of € 4 million per year. In Spain, Benner and colleagues [5] estimated, for the year 2005, and overall economic loss due to human and livestock CE of about € 150 million, of which about 130 million were human-associated and about 16 million animal-associated.…”

A T‐cell diagnostic test for cystic echinococcosis based on Antigen B peptides

“…and Italy and the Mediterranean countries are considered endemic . In Italy, the prevalence in 2014, estimated on hospital discharge records, is up to 1.06/100 000 inhabitants/year, but it is expected that these data are underestimated as outpatients or asymptomatic patients are not included in the analysis . CE diagnosis and clinical management are based on ultrasound (US).…”