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南非东开普省猪带绦虫囊尾蚴病的成本估算。

Estimation of the cost of Taenia solium cysticercosis in Eastern Cape Province, South Africa.

作者信息

Carabin H, Krecek R C, Cowan L D, Michael L, Foyaca-Sibat H, Nash T, Willingham A L

机构信息

Department of Biostatistics and Epidemiology, College of Public Health, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.

出版信息

Trop Med Int Health. 2006 Jun;11(6):906-16. doi: 10.1111/j.1365-3156.2006.01627.x.

Abstract

OBJECTIVES

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of epilepsy cases due to neurocysticercosis (NCC) and consequences of cysticercosis were gathered from published and unpublished sources.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.

CONCLUSION

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.

摘要

目的

全面评估南非东开普省猪带绦虫囊尾蚴病的社会成本,以此作为该病在这一流行地区影响的客观衡量指标。

方法

关于癫痫患病率、由神经囊尾蚴病(NCC)导致的癫痫病例比例以及囊尾蚴病后果的流行病学数据,从已发表和未发表的资料中收集。经济数据大多从政府来源获取。采用三种方法估算生产力损失。使用蒙特卡洛抽样法以95%可信区间(95%CI)表示估算的不确定性。采用社会视角对1年进行估算。所有成本均以2004年美元报告。

结果

总体而言,2004年东开普省估计有34662例(95%CI:17167 - 54068)与NCC相关的癫痫病例。根据估算生产力损失所采用的方法不同,总体货币负担(以百万美元计)估计在1860万美元(95%CI:900万美元 - 3290万美元)至3420万美元(95%CI:1280万美元 - 7000万美元)之间。农业部门平均贡献500万美元。癫痫患病率、生产力降低比例以及NCC所致癫痫病例比例对总体估算的影响最大。

结论

这一初步估算表明,猪带绦虫囊尾蚴病给一个本已经济拮据的地区带来了相当大的货币成本。鉴于这种感染是可预防的,这些结果可为利益相关者在其国家决定将稀缺的卫生和农业资源投资于何处提供指导。

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