Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.
Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand.
PLoS Negl Trop Dis. 2021 Jan 22;15(1):e0008985. doi: 10.1371/journal.pntd.0008985. eCollection 2021 Jan.
Streptoccocus suis (S.suis) infection is a neglected zoonosis disease in humans mainly affects men of working age. We estimated the health and economic burden of S.suis infection in Thailand in terms of years of life lost, quality-adjusted life years (QALYs) lost, and productivity-adjusted life years (PALYs) lost which is a novel measure that adjusts years of life lived for productivity loss attributable to disease.
A decision-analytic Markov model was developed to simulate the impact of S. suis infection and its major complications: death, meningitis and infective endocarditis among Thai people in 2019 with starting age of 51 years. Transition probabilities, and inputs pertaining to costs, utilities and productivity impairment associated with long-term complications were derived from published sources. A lifetime time horizon with follow-up until death or age 100 years was adopted. The simulation was repeated assuming that the cohort had not been infected with S.suis. The differences between the two set of model outputs in years of life, QALYs, and PALYs lived reflected the impact of S.suis infection. An annual discount rate of 3% was applied to both costs and outcomes. One-way sensitivity analyses and Monte Carlo simulation modeling technique using 10,000 iterations were performed to assess the impact of uncertainty in the model.
This cohort incurred 769 (95% uncertainty interval [UI]: 695 to 841) years of life lost (14% of predicted years of life lived if infection had not occurred), 826 (95% UI: 588 to 1,098) QALYs lost (21%) and 793 (95%UI: 717 to 867) PALYs (15%) lost. These equated to an average of 2.46 years of life, 2.64 QALYs and 2.54 PALYs lost per person. The loss in PALYs was associated with a loss of 346 (95% UI: 240 to 461) million Thai baht (US$11.3 million) in GDP, which equated to 1.1 million Thai baht (US$ 36,033) lost per person.
S.suis infection imposes a significant economic burden both in terms of health and productivity. Further research to investigate the effectiveness of public health awareness programs and disease control interventions should be mandated to provide a clearer picture for decision making in public health strategies and resource allocations.
猪链球菌（S.suis）感染是一种被忽视的人类动物源性传染病，主要影响劳动年龄段的男性。我们根据生命损失年数、质量调整生命年数（QALYs）损失和生产力调整生命年数（PALYs）损失来评估泰国 S.suis 感染的健康和经济负担，这是一种新颖的衡量标准，可根据疾病导致的生产力损失来调整所经历的生命年数。
我们开发了一个决策分析马尔可夫模型，以模拟 2019 年泰国 51 岁人群中 S. suis 感染及其主要并发症（死亡、脑膜炎和感染性心内膜炎）的影响。从已发表的资料中得出与长期并发症相关的转移概率、成本、效用和生产力受损的输入。采用终生时间范围，直至死亡或 100 岁。假设该队列未感染 S.suis，对两种模型输出在生命损失年数、QALYs 和 PALYs 上的差异进行了重复模拟，反映了 S.suis 感染的影响。对成本和结果均应用了 3%的年度贴现率。进行了单因素敏感性分析和使用 10,000 次迭代的蒙特卡罗模拟建模技术，以评估模型不确定性的影响。
该队列损失了 769 年的生命（如果未发生感染，预计生命损失年数的 14%）、826 个 QALYs（588 至 1098）和 793 个 PALYs（717 至 867）。这相当于每人平均损失 2.46 年的生命、2.64 个 QALYs 和 2.54 个 PALYs。PALYs 的损失与泰国 GDP（国内生产总值）损失 3.46 亿泰铢（1130 万美元）相关，相当于每人损失 11.3 万泰铢（36033 美元）。
S.suis 感染对健康和生产力都造成了重大的经济负担。应进一步研究公共卫生意识计划和疾病控制干预措施的有效性，以便为公共卫生战略和资源分配中的决策提供更清晰的认识。
