Estimation of the cost of Taenia solium cysticercosis in Eastern Cape Province, South Africa.
OBJECTIVE
To provide a comprehensive estimate of the societal costs of Taenia solium cysticercosis for the Eastern Cape Province (ECP), South Africa, as an objective measure of its impact in this endemic area.


METHODS
Epidemiological data on the prevalence of epilepsy, proportion of epilepsy cases due to neurocysticercosis (NCC) and consequences of cysticercosis were gathered from published and unpublished sources. Economical data were mostly obtained from governmental sources. Three methods were used for estimating productivity losses. Monte Carlo sampling was used to represent the uncertainty of the estimates with 95% Credible Intervals (95% CI). The estimation is for 1 year using a societal approach. All costs are reported in 2004 US Dollars.


RESULTS
Overall, there were an estimated 34 662 (95% CI: 17 167-54 068) NCC-associated cases of epilepsy in ECP in 2004. The overall monetary burden (in million of US Dollars) was estimated to vary from US Dollars 18.6 (95% CI: US Dollars 9.0-32.9) to US Dollars 34.2 (95% CI: US Dollars 12.8-70.0) depending on the method used to estimate productivity losses. The agricultural sector contributed an average of Dollars 5.0 million. The prevalence of epilepsy, proportion of productivity reduction and the proportion of epilepsy cases attributable to NCC had the largest impact on the overall estimates.


CONCLUSIONS
This preliminary estimate suggests that T. solium cysticercosis results in considerable monetary costs to a region that is already economically constrained. Because this infection is preventable, these results could guide stakeholders in deciding where to invest scarce health and agricultural resources in their countries.
Carabin
H
H
Department of Biostatistics and Epidemiology, College of Public Health, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA. helene-carabin@ouhsc.edu
Krecek
R C
RC
Cowan
L D
LD
Michael
L
L
Foyaca-Sibat
H
H
Nash
T
T
Willingham
A L
AL
D000383:Agriculture / Q000191:economics; D000818:Animals; D017281:Cost of Illness; D003551:Cysticercosis / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D003663:Decision Trees; D004651:Employment / Q000191:economics; D019353:Endemic Diseases / Q000191:economics* / Q000706:statistics & numerical data; D004827:Epilepsy / Q000191:economics / Q000453:epidemiology / Q000469:parasitology; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D009010:Monte Carlo Method; D020019:Neurocysticercosis / Q000150:complications / Q000191:economics / Q000453:epidemiology; D015995:Prevalence; D012423:Rural Health; D013019:South Africa / Q000453:epidemiology; D013552:Swine; D013553:Swine Diseases / Q000191:economics / Q000453:epidemiology; D015047:Zoonoses / Q000453:epidemiology