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Assessment of the societal cost of Taenia solium in Angónia district, Mozambique

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Abstract
Background: The zoonotic parasite Taenia solium is endemic in Angonia district, Tete province, Mozambique, though the burden of the disease complex is unknown. Methods: As part of two cross-sectional studies on human and porcine cysticercosis in the area, unique epidemiological and cost data were collected in Angonia district, Mozambique in 2007. These data provided the basis for the assessment of the societal cost of T. solium in the district, which estimates the impact of the disease on human and pig populations and includes both health and economic approaches in the analysis. Results: Approximately 0.7% (95% Uncertainty Interval (UI), 0.4-0.9) and 0.4% (95% UI, 0.2-0.6) of the total population in the district was estimated to suffer from neurocysticercosis (NCC)-associated epilepsy and headache. The estimated average number of disability-adjusted life years (DALYs) due to NCC-associated epilepsy and headache was 6 (95% UI, 4-8) per thousand persons per year. The total annual costs due to T. solium cysticercosis were estimated at 90,000 USD (95% UI, 39,483-201,463) of which 72% (95% UI, 45-91) were costs linked to human cysticercosis and 28% (95% UI, 9.5-55) to pig production losses. The annual economic burden per NCC-associated epilepsy case in the district amounted to 33 USD (95% UI, 10-76). Conclusions: In this highly endemic area of Mozambique a large number of individuals suffer from symptoms associated with NCC. Healthy years of life are lost and people are left living with disabilities. Infected pork poses a serious risk to the community and affects the economy of smallholder farmers. Cost for treatment and hospitalization of patients with NCC-associated epilepsy, and lack of productivity and inability of suffering patients to work, further hinder socioeconomic development. Feasible solutions framed within a country specific algorithm and stepwise approaches are needed to control the parasite in the country.
Keywords
Taenia solium taeniosis/cysticercosis, Neurocysticercosis, Epilepsy, Migraine, Tension-type headache, Disability-adjusted life years: Societal cost, Zoonoses, ADJUSTED LIFE YEARS, DISABILITY WEIGHTS, GLOBAL BURDEN, CYSTICERCOSIS, DISEASE, NEUROCYSTICERCOSIS, EPILEPSY, TANZANIA, AFRICA, PROVINCE

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Chicago
Trevisan, Chiara, Brecht Devleesschauwer, Nicolas Praet, Alberto Pondja, Yunus Amade Assane, Pierre Dorny, Stig Milan Thamsborg, Pascal Magnussen, and Maria Vang Johansen. 2018. “Assessment of the Societal Cost of Taenia Solium in Angónia District, Mozambique.” Bmc Infectious Diseases 18.
APA
Trevisan, Chiara, Devleesschauwer, B., Praet, N., Pondja, A., Assane, Y. A., Dorny, P., Thamsborg, S. M., et al. (2018). Assessment of the societal cost of Taenia solium in Angónia district, Mozambique. BMC INFECTIOUS DISEASES, 18.
Vancouver
1.
Trevisan C, Devleesschauwer B, Praet N, Pondja A, Assane YA, Dorny P, et al. Assessment of the societal cost of Taenia solium in Angónia district, Mozambique. BMC INFECTIOUS DISEASES. 2018;18.
MLA
Trevisan, Chiara, Brecht Devleesschauwer, Nicolas Praet, et al. “Assessment of the Societal Cost of Taenia Solium in Angónia District, Mozambique.” BMC INFECTIOUS DISEASES 18 (2018): n. pag. Print.
@article{8558053,
  abstract     = {Background: The zoonotic parasite Taenia solium is endemic in Angonia district, Tete province, Mozambique, though the burden of the disease complex is unknown. 
Methods: As part of two cross-sectional studies on human and porcine cysticercosis in the area, unique epidemiological and cost data were collected in Angonia district, Mozambique in 2007. These data provided the basis for the assessment of the societal cost of T. solium in the district, which estimates the impact of the disease on human and pig populations and includes both health and economic approaches in the analysis. 
Results: Approximately 0.7\% (95\% Uncertainty Interval (UI), 0.4-0.9) and 0.4\% (95\% UI, 0.2-0.6) of the total population in the district was estimated to suffer from neurocysticercosis (NCC)-associated epilepsy and headache. The estimated average number of disability-adjusted life years (DALYs) due to NCC-associated epilepsy and headache was 6 (95\% UI, 4-8) per thousand persons per year. The total annual costs due to T. solium cysticercosis were estimated at 90,000 USD (95\% UI, 39,483-201,463) of which 72\% (95\% UI, 45-91) were costs linked to human cysticercosis and 28\% (95\% UI, 9.5-55) to pig production losses. The annual economic burden per NCC-associated epilepsy case in the district amounted to 33 USD (95\% UI, 10-76). 
Conclusions: In this highly endemic area of Mozambique a large number of individuals suffer from symptoms associated with NCC. Healthy years of life are lost and people are left living with disabilities. Infected pork poses a serious risk to the community and affects the economy of smallholder farmers. Cost for treatment and hospitalization of patients with NCC-associated epilepsy, and lack of productivity and inability of suffering patients to work, further hinder socioeconomic development. Feasible solutions framed within a country specific algorithm and stepwise approaches are needed to control the parasite in the country.},
  articleno    = {127},
  author       = {Trevisan, Chiara and Devleesschauwer, Brecht and Praet, Nicolas and Pondja, Alberto and Assane, Yunus Amade and Dorny, Pierre and Thamsborg, Stig Milan and Magnussen, Pascal and Johansen, Maria Vang},
  issn         = {1471-2334},
  journal      = {BMC INFECTIOUS DISEASES},
  keyword      = {Taenia solium taeniosis/cysticercosis,Neurocysticercosis,Epilepsy,Migraine,Tension-type headache,Disability-adjusted life years: Societal cost,Zoonoses,ADJUSTED LIFE YEARS,DISABILITY WEIGHTS,GLOBAL BURDEN,CYSTICERCOSIS,DISEASE,NEUROCYSTICERCOSIS,EPILEPSY,TANZANIA,AFRICA,PROVINCE},
  language     = {eng},
  pages        = {11},
  title        = {Assessment of the societal cost of Taenia solium in Ang{\'o}nia district, Mozambique},
  url          = {http://dx.doi.org/10.1186/s12879-018-3030-z},
  volume       = {18},
  year         = {2018},
}

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