title: The societal cost of Taenia solium cysticercosis in Tanzania.
abstract: Taenia solium is a zoonotic parasite prevalent in many low income countries throughout Latin America, Asia and sub-Saharan Africa, including Tanzania. The parasite is recognized as a public health threat; however the burden it poses on populations of Tanzania is unknown. The aim of this study was to estimate the societal cost of T. solium cysticercosis in Tanzania, by assessing both the health and economic burden. The societal cost of T. solium cysticercosis was assessed in humans and pigs based on data obtained by a systematic review. Experts' opinion was sought in cases where data were not retrievable. The health burden was assessed in terms of annual number of neurocysticercosis (NCC) associated epilepsy incident cases, deaths and disability-adjusted life years (DALYs), while the economic burden was assessed in terms of direct and indirect costs imposed by NCC-associated epilepsy and potential losses due to porcine cysticercosis. Based on data retrieved from the systematic review and burden assessments, T. solium cysticercosis contributed to a significant societal cost for the population. The annual number of NCC-associated epilepsy incident cases and deaths were 17,853 (95% Uncertainty Interval (UI), 5666-36,227) and 212 (95% UI, 37-612), respectively. More than 11% (95% UI, 6.3-17) of the pig population was infected with the parasite when using tongue examination as diagnostic method. For the year 2012 the number of DALYs per thousand person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6). Around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Our results show that T. solium imposes a serious public health, agricultural and economic threat for Tanzania. We urge that a One Health approach, which involves the joint collaboration and effort of veterinarians, medical doctors, agricultural extension officers, researchers and relevant governmental agencies, is taken to find sustainable solutions for prevention, control and elimination of T. solium.
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark. Electronic address: chiara@sund.ku.dk.
authors.forename: Chiara
authors.initials: C
authors.lastname: Trevisan
authors.affiliation: Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
authors.forename: Brecht
authors.initials: B
authors.lastname: Devleesschauwer
authors.affiliation: Department of Neurology, Technische Universität München, Munich, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Schmidt
authors.affiliation: Department of Neurology, Technische Universität München, Munich, Germany.
authors.forename: Andrea Sylvia
authors.initials: AS
authors.lastname: Winkler
authors.affiliation: Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Wendy
authors.initials: W
authors.lastname: Harrison
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
authors.forename: Maria Vang
authors.initials: MV
authors.lastname: Johansen
mesh_terms: D000822:Animal Husbandry / Q000191:economics*; D000818:Animals; D017281:Cost of Illness; D004651:Employment / Q000191:economics; D004827:Epilepsy / Q000191:economics / Q000453:epidemiology / Q000469:parasitology*; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D020019:Neurocysticercosis / Q000191:economics / Q000453:epidemiology*; D015995:Prevalence; D011634:Public Health / Q000191:economics; D019057:Quality-Adjusted Life Years; D034421:Sus scrofa / Q000469:parasitology*; D013552:Swine; D013553:Swine Diseases / Q000191:economics / Q000453:epidemiology / Q000469:parasitology*; D041201:Taenia solium / Q000302:isolation & purification*; D013636:Tanzania / Q000453:epidemiology
keywords: Disability-adjusted life years; Epilepsy; Parasitic zoonoses; Societal cost; Taenia solium taeniosis/cysticercosis; Tanzania