Singh B B, Khatkar M S, Gill J P S, Dhand N K
School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab 141004, India.
Faculty of Veterinary Science, The University of Sydney, 425 Werombi Road, Camden, 2570 NSW, Australia.
Acta Trop. 2017 Jan;165:161-169. doi: 10.1016/j.actatropica.2016.01.017. Epub 2016 Jan 21.
Taenia solium is an endemic parasite in India which occurs in two forms in humans: cysticercosis (infection of soft tissues) and taeniosis (intestinal infection). Neurocysticercosis (NCC) is the most severe form of cysticercosis in which cysts develop in the central nervous system. This study was conducted to estimate health and economic impact due to human NCC-associated active epilepsy in India. Input data were sourced from published research literature, census data and other official records. Economic losses due to NCC-associated active epilepsy were estimated based on cost of treatment, hospitalisation and severe injury as well as loss of income. The disability-adjusted life years (DALYs) due to NCC were estimated by combining years of life lost due to early death and the number of years compromised due to disability taking the disease incidence into account. DALYs were estimated for five age groups, two genders and four regions, and then combined. To account for uncertainty, probability distributions were used for disease incidence data and other input parameters. In addition, sensitivity analyses were conducted to determine the impact of certain input parameters on health and economic estimates. It was estimated that in 2011, human NCC-associated active epilepsy caused an annual median loss of Rupees 12.03 billion (uncertainty interval [95% UI] Rs. 9.16-15.57 billion; US $ 185.14 million) with losses of Rs. 9.78 billion (95% UI Rs. 7.24-13.0 billion; US $ 150.56 million) from the North and Rs. 2.22 billion (95% UI Rs. 1.58-3.06 billion; US $ 34.14 million) from the South. The disease resulted in a total of 2.10 million (95% UI 0.99-4.10 million) DALYs per annum without age weighting and time discounting with 1.81 million (95% UI 0.84-3.57 million) DALYs from the North and 0.28 million (95% UI 0.13-0.55 million) from the South. The health burden per thousand persons per year was 1.73 DALYs (95% UI 0.82-3.39). The results indicate that human NCC causes significant health and economic impact in India. Programs for controlling the disease should be initiated to reduce the socio-economic impact of the disease in India.
猪带绦虫是印度的一种地方性寄生虫，在人类中有两种存在形式：囊尾蚴病（软组织感染）和绦虫病（肠道感染）。神经囊尾蚴病（NCC）是囊尾蚴病最严重的形式，其中囊肿在中枢神经系统中形成。本研究旨在评估印度人类NCC相关活动性癫痫造成的健康和经济影响。输入数据来源于已发表的研究文献、人口普查数据和其他官方记录。基于治疗成本、住院费用、重伤以及收入损失，估算了NCC相关活动性癫痫造成的经济损失。通过结合因过早死亡导致的寿命损失年数和考虑疾病发病率后因残疾导致的受损年数，估算了NCC导致的伤残调整生命年（DALYs）。针对五个年龄组、两种性别和四个地区估算了DALYs，然后进行汇总。为考虑不确定性，对疾病发病率数据和其他输入参数使用了概率分布。此外，还进行了敏感性分析，以确定某些输入参数对健康和经济估算的影响。据估计，2011年，人类NCC相关活动性癫痫每年造成的中位数损失为120.3亿卢比（不确定区间[95% UI]为91.6 - 155.7亿卢比；1.8514亿美元），其中北部损失97.8亿卢比（95% UI为72.4 - 130亿卢比；1.5056亿美元），南部损失22.2亿卢比（95% UI为15.8 - 30.6亿卢比；3414万美元）。该疾病每年导致总计210万（95% UI为99 - 410万）伤残调整生命年，未进行年龄加权和时间贴现，其中北部为181万（95% UI为84 - 357万），南部为28万（95% UI为13 - 55万）。每年每千人的健康负担为1.73个伤残调整生命年（95% UI为0.82 - 3.39）。结果表明，人类NCC在印度造成了重大的健康和经济影响。应启动控制该疾病的项目，以减少其在印度的社会经济影响。
