Global socioeconomic impact of cystic echinococcosis

Abstract

Cystic echinococcosis (CE) is an emerging zoonotic parasitic disease throughout the world. Human incidence and livestock prevalence data of CE were gathered from published literature and the Office International des Epizooties databases. Disability-adjusted life years (DALYs) and monetary losses, resulting from human and livestock CE, were calculated from recorded human and livestock cases. Alternative values, assuming substantial underreporting, are also reported. When no underreporting is assumed, the estimated human burden of disease is 285,407 (95% confidence interval [CI], 218,515-366,133) DALYs or an annual loss of US $193,529,740 (95% CI, $171,567,331-$217,773,513). When underreporting is accounted for, this amount rises to 1,009,662 (95% CI, 862,119-1,175,654) DALYs or US $763,980,979 (95% CI, $676,048,731-$857,982,275). An annual livestock production loss of at least US $141,605,195 (95% CI, $101,011,553-$183,422,465) and possibly up to US $2,190,132,464 (95% CI, $1,572,373,055-$2,951,409,989) is also estimated. This initial valuation demonstrates the necessity for increased monitoring and global control of CE.

Figure 1

Global distribution of zoonotic strains of Echinococcus granulosus. (Adapted from Eckert and Deplazes, 2004 (1). Copyright Institute für Parasitologie, Universität Zürich; used with permission.)

Figure 2

Annual budget (in US $) for diseases included in the United Nations Children's Fund/UNDP/World Bank/World Health Organization–supported Special Programme for Research and Training in Tropical Diseases (TDR) compared to their estimated global disability-associated life years (DALYs). The thinner lines indicate estimated DALYs lost because of cystic echinococcosis (CE) and the recommended funding level based on the TDR 2004–2005 approved program budget (Oncho, onchocerciasis; Tryp, trypanosomiasis; Schisto, schistosomiasis; Leish, leishmaniasis; LF, lymphatic filariasis; TB, tuberculosis). This figure does not take into account the substantial regional variability in both the estimates of DALYs lost and the annual budget for the diseases illustrated.