The Monetary Burden of Cystic Echinococcosis in Iran

Abstract

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.

The Seroprevalence of Human Cystic Echinococcosis in Iran: A Systematic Review and Meta-Analysis Study

“…One more thing to be kept in our mind is about cultural and religious issues existing in Iran. Here in Iran in the rural parts, most of the people have dogs and these dogs are vaccinated and cannot consider them as a source of infections [3]. These infected stray dogs can easily spread large numbers of parasite eggs on the agricultural fields where vegetables grow.…”

“…This zoonotic disease is initiated by accidental ingestion of the parasite's egg. It can be transmitted by infected feces of dogs via soil, vegetables, contact with dog, water, food, and so forth [3, 4]. …”

“…The infection rate with different strains of E. granulosus sensu lato in various domestic livestock has been reported to be 24.41%, 8.51%, 18.89%, 35.76%, and 35.21% in sheep, goat, cattle, buffalo, and camels, respectively [8–10]. The incidence of surgical cases of HCE is estimated to be 1.18–3 per 100,000 in different medical centers of Iran provinces and territories [3]. …”

Design and construction of a new recombinant fusion protein (2b2t+EPC1) and its assessment for serodiagnosis of cystic echinococcosis

“…It is considered a major public health issue and an economic concern in different regions of the world . In Iran, the financial implications of human CE have been estimated at US$93.39 million (95% CI US$6.1–222.7 million) and the annual cost associated with infected livestock was calculated at US$132 million (95% CI US$61.8–246.5 million), . The accurate diagnosis of CE remains challenging with various imaging and immunological techniques being used for diagnosis; ultrasound is a confirmative method for diagnosis of abdominal echinococcosis with active lesions, but its main disadvantage is the inability to detect pulmonary cysts .…”

Prevalence and Fertility Survey of Hydatid Cyst in Slaughtered Livestock in Hamadan Abattoir, Western Iran, 2015 - 2016

“…The results of our study revealed that 3% of sheep were infected with hydatid cyst. In most studies, the frequency of hydatidosis in goat was lower than other livestock intermediate host species, probably because of the feeding of goats through browsing rather than grazing (6,8,9,(11)(12)(13). In accordance with reports, the infection rate of goats in this study was significantly lower than sheep and cattle with frequency of 1%.…”