Estimation of the health and economic burden of human brucellosis in India.

ABSTRACT

High seroprevalence estimates of brucellosis in livestock species and humans in India suggest that the disease is a significant public health concern in the country. We developed an economic model and conducted an assessment of the impact of human brucellosis in India to describe the current situation to help formulate prevention and control strategies. Economic losses of human brucellosis were calculated based on the official records and the data from epidemiological surveys conducted in India. These data were used to estimate the disability adjusted life years (DALYs) due to human brucellosis. Uncertainty was incorporated in the model by applying probability distributions for certain input parameters. The analyses were further supplemented by conducting sensitivity analyses to determine which parameters had the biggest influence on the outcome of economic losses. The annual median losses due to human brucellosis were estimated to be Rs 627.5 million (uncertainty interval [95% UI] Rs 534.8-741.2 million; US $ 10.46 million) with a loss of Rs 442.3 million (95% UI 371.0-516.0; US $ 7.37 million) among adults and Rs 185.0 million (95% UI 124.0-255.0; US $ 3.08 million) among children. Human brucellosis in India caused a loss of 177 601 (95% UI 152 695-214 764) DALYs at the rate of 0.15 (95% UI 0.13-0.17) DALYs per thousand persons per year. The DALYs were found to be 0.29 (95% UI 0.08-0.70) per thousand persons per year in occupational and 0.13 (95% UI 0.06-0.18) in non-occupational adult population. This is the first systematic analysis of the health impact of human brucellosis in India and of indirect/production losses occurring due to human brucellosis anywhere in the world. The results indicate that brucellosis causes considerable economic losses and has a reasonable health impact, particularly among occupational groups. Intervention policies need to be strengthened to reduce the socio-economic impact of human brucellosis in India.