Evaluation of the Economic Impact of Streptococcus suis-Associated Disease.

The economic impact of Streptococcus suis-associated disease at farm level is well known by the producers, but the cost in a region or a country is more difficult to evaluate due to the lack of a centralized data system, the different incidences, and the control measures applied by each producer. In this chapter, we describe a method based on the information gathered through interviews with veterinary practitioners. A comprehensive questionnaire created specifically for the disease can help to conduct the interviews. The questions include information about the proportions of farms, batches and animals clinically affected, mortality, metaphylactic and therapeutic treatments, use of vaccines, and proportion of cases that are diagnosed at the laboratory. As the questionnaire is quite complex, the best option to obtain the data is send the questionnaire to the selected veterinarians to allow them to collect some data and make an interview with them some days later. The information allows to estimate the costs due to mortality, antimicrobial treatments, the use of autogenous vaccines, and analyses performed. Initially they are calculated per animal in each affected production phase, and later it can be extrapolated to estimate the annual cost per affected production unit and per country. The model does not consider indirect costs such as the cost as a zoonosis, the revenues forgone, or an increase of labor.

A qualitative assessment of the context and enabling environment for the control of Taenia solium infections in endemic settings.

BACKGROUND: Taenia solium (T. solium), is a zoonotic helminth causing three diseases namely; taeniasis (in humans), neurocysticercosis (NCC, in humans) and porcine cysticercosis (PCC, in pigs) and is one of the major foodborne diseases by burden. The success or failure of control options against this parasite in terms of reduced prevalence or incidence of the diseases may be attributed to the contextual factors which underpin the design, implementation, and evaluation of control programmes. METHODOLOGY/PRINCIPAL FINDINGS: The study used a mixed method approach combining systematic literature review (SLR) and key informant interviews (KII). The SLR focused on studies which implemented T. solium control programmes and was used to identify the contextual factors and enabling environment relevant to successful inception, planning and implementation of the interventions. The SLR used a protocol pre-registered at the International prospective register of systematic reviews (PROSPERO) number CRD42019138107 and followed PRISMA guidelines on reporting of SLR. To further highlight the importance and interlinkage of these contextual factors, KII were conducted with researchers/implementers of the studies included in the SLR. The SLR identified 41 publications that had considerations of the contextual factors. They were grouped into efficacy (10), effectiveness (28) and scale up or implementation (3) research studies. The identified contextual factors included epidemiological, socioeconomic, cultural, geographical and environmental, service and organizational, historical and financial factors. The enabling environment was mainly defined by policy and strategies supporting T. solium control. CONCLUSION/SIGNIFICANCE: Failure to consider the contextual factors operating in target study sites was shown to later present challenges in project implementation and evaluation that negatively affected expected outcomes. This study highlights the importance of fully considering the various domains of the context and integrating these explicitly into the plan for implementation and evaluation of control programmes. Explicit reporting of these aspects in the resultant publication is also important to guide future work. The contextual factors highlighted in this study may be useful to guide future research and scale up of disease control programmes and demonstrates the importance of close multi-sectoral collaboration in a One Health approach.

Will an incentive-compatible indemnity policy please stand up? Livestock producer willingness to self-protect.

This study evaluates the role of private market signals and conditional indemnity policies in livestock producer willingness to self-protect against disease and invest more in biosecurity. Our focus on Tier 1 swine diseases and U.S. hog producer decision-making is timely and informative for a multitude of current disease discussions. We find biosecurity effort adjusts to economic incentives in private, livestock markets and public, indemnity policies.

Costs and Benefits of Alternative Strategies to Control the Spread of Livestock-Acquired Methicillin-Resistant Staphylococcus Aureus From Pig Production.

BACKGROUND: Livestock-acquired methicillin-resistant Staphylococcus aureus (LA-MRSA) is a concern in healthcare and a political priority in some countries. OBJECTIVE: This study investigates the net societal costs of 2 alternative strategies for controlling LA-MRSA in Denmark: (1) eradicating LA-MRSA in all pig housing units, and (2) containing LA-MRSA within the units. METHODS: Benefits and costs are considered for affected economic sectors: healthcare, pig production, pig-related industries, and public administration. RESULTS: The cost to society of eradication is estimated at €2.3 to €2.5 billion (present value). Containment will cost €55 to €93 million. For both strategies, the main cost lies in primary pig production-for containment this is mainly due to establishing and operating anterooms and shower rooms, and for eradication it is due to production losses, loss of genetic resources, and costs of cleaning and disinfection. CONCLUSION: Compared with these costs, health economic benefits are moderate for both strategies. Containment is superior to eradication when measured by a benefit-cost ratio.

The monetary burden of cysticercosis in Mexico.

BACKGROUND: Taenia solium cysticercosis is a public health and agricultural problem in many low and middle-income countries where health education, sanitation, pig management practices and meat inspection infrastructure are insufficient. Cysticercosis affects both human and animal health and has important economic consequences. Very few studies have been conducted to evaluate the monetary burden of cysticercosis. This study aimed at estimating the 2015 costs associated with cysticercosis in humans and pigs in Mexico. METHODS: The monetary burden of human cysticercosis was estimated based on costs incurred by living with and treating epilepsy and severe chronic headaches associated with neurocysticercosis (NCC). The estimated cost of porcine cysticercosis took into consideration losses due to the reduction in the price of cysticercosis-infected animals. Epidemiologic and economic data were obtained from the published literature, government reports, and setting-specific questionnaires. Latin hypercube sampling methods were employed to sample the distributions of uncertain parameters and to estimate 95% credible regions (95% CRs). All results are reported in 2015 U.S.$. FINDINGS: The overall monetary burden associated with NCC morbidity was estimated at U.S.$215,775,056 (95% CR U.S.$109,309,560 -U.S.$361,924,224), with U.S.$436 (95% CR: U.S.$296 -U.S.$604) lost per patient. If loss of future years of income and productivity due to NCC-associated deaths was included, this value increased by U.S.$54.26 million, assuming that these individuals earned Mexico's median wage salary. An additional U.S.$19,507,171 (95% CR U.S.$5,734,782 -U.S.$35,913,487) was estimated to be lost due to porcine cysticercosis. CONCLUSIONS: This study suggests that T. solium cysticercosis results in considerable monetary losses to Mexico.

Benefit-cost analysis to estimate the payback time and the economic value of two Mycoplasma hyopneumoniae elimination methods in breeding herds.

Mycoplasma hyopneumoniae (Mhyo) is generally accepted to be the most common porcine respiratory pathogen worldwide causing big economical losses in swine production by affecting pig's downstream performance. The objective of this study was to develop a partial budget model to determine the payback period and economic value of two Mhyo elimination protocols. Retrospective data recorded from 2004 to 2017 from 70 breeding herds that implemented herd closure or whole-herd medication protocol targeting Mhyo elimination. Close out data was used to estimate differences in downstream performance between Mhyo-negative and positive flows. Assuming a 5000 sows breed-to-finish operation producing 135,870 weaned pigs and 125,000 finishing pigs/year, the total cost for implementing Mhyo elimination was $112,100 using the herd closure protocol, and $185,700 for the medication protocol. Statistically differences (p < 0.05) in downstream performance were observed for ADG and mortality, but not for feed conversion rate. The parameters that accounts for the greatest benefits were related to the improvement in ADG, savings in antibiotic medication in growing pigs and improvement in feed conversion rate. The benefit of Mhyo elimination was $877,375 per farm per year, or $7.00 per pig marketed. The estimated project value after 1 year was $616,121 for the herd closure considering a probability of success of 83%, and $323,177 for the medication protocol for 58% chance of success. The project value reached the break-even point when the cost per sow was $145.64 for the herd closure and $101.78 for the medication protocol. The payback period was 2 months after the start of marketing Mhyo-negative pigs for the herd closure, and 7 months for the medication protocol adjusted for the probability of success for each protocol. The protocols described here can be easily applied with a good success rate and showing that the benefits obtained are greater than the costs of project failure. Even if the farm stayed negative only a year, the economic benefits downstream are worth the investment. This information may help producers and veterinarians on decision-making process to conduct a Mhyo elimination protocol in their herds.

An economic assessment of pseudorabies (Aujeszky' disease) elimination on hog farms in China.

Hog pseudorabies (Aujeszky's disease) can incur serious losses for farm owners and even the entire hog industry by causing infertility, abortion, and stillbirth among sows, as well as diarrhoea, respiratory failure, and death among piglets. Pseudorabies virus could be prevented, controlled, and eliminated by clean-up at both farm and regional levels through a strict procedure of vaccination, quarantine, diagnosis, elimination of positive animals, and healthy animals nurturing. Using data from 63 large-scale hog farms from nine provinces (municipalities, autonomous regions) of China, we evaluated the economic consequences of hog pseudorabies clean-up in China's hog farms based on a partial budgeting method. By comparing large-scale hog farms that have performed pseudorabies clean-up with similar farms that have not, we analysed how clean-up affected farm profit and whether there existed sufficient economic incentives for farm owners to adopt pseudorabies control measures. Further, we examined how the economic consequences varied with factors such as clean-up history and farm size. The findings showed that, on average, clean-up adopters outperformed non-adopters by 8.02 million yuan per farm per year within the four years post clean-up adoption. Also, we found that the net profit changes attributable to pseudorabies clean-up increased over time and with farm size. Although we cannot extrapolate to all Chinese hog farms, these findings suggest that the earlier a hog farm adopted pseudorabies clean-up, the larger the economic benefits would be, especially for large-scale farms.

A cost-benefit assessment of Salmonella-control strategies in pigs reared in the United Kingdom.

Pork and pork products are a major source of human salmonellosis in the United Kingdom (UK). Despite a number of surveillance programmes, the prevalence of Salmonella in the UK slaughter pig population remains over 20%. Here, we present the results of a Cost-Benefit Analysis comparing five on-farm control strategies (where the cost is the cost of implementation and the benefits are the financial savings for both the human health and pig industries). The interventions considered were: wet feed, organic acids in feed, vaccination, enhanced cleaning and disinfection and movement of outdoor breeding units. The data originate from published papers and recent UK studies. The effectiveness was assessed by adapting a previous risk assessment, originally developed for the European Food Safety Authority. Using this method, none of the intervention strategies produced a net cost-benefit. Our results suggest that the cost of implementation outweighed the savings for all interventions, even if the effectiveness could be improved. Therefore, to achieve a net cost-benefit it is essential to reduce the cost of interventions. Analyses concluded that large cost reductions (up to 96%) would be required. Use of organic acids required the smallest reduction in cost (22.7%) to achieve a net cost benefit. Uncertainty analysis suggested that a small net gain might be possible, for some of the intervention measures. But this would imply that the model greatly underestimated some key parameters, which was considered unlikely. Areas of key uncertainty were identified as the under-reporting factor (i.e. the proportion of community cases of Salmonella) and the source attribution factor (i.e. the proportion of human Salmonella cases attributable to pork products).

Cystic echinococcosis in animals and humans of Maharashtra State, India.

Echinococcosis/hydatidosis which is a neglected parasitic zoonosis in the developing country like India. The study was conducted during April, 2010 to March, 2017 to determine the prevalence among slaughtered food animals, dogs and human. The samples were collected from the various slaughterhouses situated in different regions of Maharashtra state. A total of 9464 cattle (male), 3661 buffalo, 47189 sheep, 33350 goats and 13579 pigs were scientifically examined during PM inspection at different slaughterhouses. The study revealed that the prevalence of disease in cattle (3.00%) was highest followed by buffalo (2.05%), pig (1.28%), sheep (0.09%) and goat (0.01%), by PM examination. The average estimated economic losses (direct and indirect) due to hydatidosis were Rs. 8,65,83,566 in cattle, Rs. 44,33,93,900 in buffalo, Rs. 7,24,50,615 in sheep, Rs. 1,88,29,359 in goat and Rs. 5,20,49,081 in pigs. Dog faecal samples analyzed and showed the prevalence of echinococcosis as 4.34% (19/438) by sedimentation method and positive samples were confirmed by PCR assay, whereas in high risk human, 11.09% sera samples were found to be positive for echinococcosis. However, based on data collection for seven years, 58 patients were found to be surgically operated for hydatid cyst removal. The results of the present study indicated that cystic echinococcosis/hydatidosis is prevalent in both human and animal population in study areas which attracts serious attention from veterinary and public health authority to reduce economic burden and in designing appropriate strategy for prevention and control of disease.

Assessment of the societal cost of Taenia solium in Angónia district, Mozambique.

BACKGROUND: The zoonotic parasite Taenia solium is endemic in Angónia district, Tete province, Mozambique, though the burden of the disease complex is unknown. METHODS: As part of two cross-sectional studies on human and porcine cysticercosis in the area, unique epidemiological and cost data were collected in Angónia district, Mozambique in 2007. These data provided the basis for the assessment of the societal cost of T. solium in the district, which estimates the impact of the disease on human and pig populations and includes both health and economic approaches in the analysis. RESULTS: Approximately 0.7% (95% Uncertainty Interval (UI), 0.4-0.9) and 0.4% (95% UI, 0.2-0.6) of the total population in the district was estimated to suffer from neurocysticercosis (NCC)-associated epilepsy and headache. The estimated average number of disability-adjusted life years (DALYs) due to NCC-associated epilepsy and headache was 6 (95% UI, 4-8) per thousand persons per year. The total annual costs due to T. solium cysticercosis were estimated at 90,000 USD (95% UI, 39,483-201,463) of which 72% (95% UI, 45-91) were costs linked to human cysticercosis and 28% (95% UI, 9.5-55) to pig production losses. The annual economic burden per NCC-associated epilepsy case in the district amounted to 33 USD (95% UI, 10-76). CONCLUSIONS: In this highly endemic area of Mozambique a large number of individuals suffer from symptoms associated with NCC. Healthy years of life are lost and people are left living with disabilities. Infected pork poses a serious risk to the community and affects the economy of smallholder farmers. Cost for treatment and hospitalization of patients with NCC-associated epilepsy, and lack of productivity and inability of suffering patients to work, further hinder socioeconomic development. Feasible solutions framed within a country specific algorithm and stepwise approaches are needed to control the parasite in the country.

Taenia solium from a community perspective: Preliminary costing data in the Katete and Sinda districts in Eastern Zambia.

The tapeworm Taenia solium is endemic in Zambia, however its socioeconomic cost is unknown. During a large-scale interventional study conducted in Zambia, baseline economic costs of human and porcine T. solium infections were measured. Questionnaire surveys were conducted within three neighbourhoods in Zambia's Eastern province in 2015 and 2016. A human health questionnaire, capturing costs of clinical symptoms commonly attributable to human cysticercosis and taeniasis, was conducted in randomly selected households (n = 267). All pig-keeping households were administered a pig socioeconomic questionnaire (n = 271) that captured pig demographic data, costs of pig-keeping, and economic losses from porcine cysticercosis. Of all respondents 62% had reportedly experienced at least one of the surveyed symptoms. Seizure-like episodes were reported by 12%, severe chronic headaches by 36%, and vision problems by 23% of respondents. These complaints resulted in 147 health care consultations and 17 hospitalizations in the five years preceding the study, and an estimated productivity loss of 608 working days per year. Of all pigs 69% were bought within villages. Nearly all adult pigs were sold to local traders, and tongue palpation for detection of cysticerci was commonly performed. Reportedly, 95% of pig owners could not sell tongue-positive pigs, while infected pigs fetched only 45% of the normal sale value. These preliminary costing data indicate that human and porcine T. solium infections substantially impact endemic areas of Eastern Zambia. A full socioeconomic burden assessment may enable improved T. solium management in sub-Saharan Africa.

Financial Impact of Foot-and-mouth disease outbreaks on pig farms in the Republic of Korea, 2014/2015.

The financial impact of foot-and-mouth disease (FMD) that occurred in 180 piggeries (100 farrow-to-finish and 80 fattening farms) confirmed infected during the 2014/2015 epidemic in the Republic of Korea was estimated at the farm level. The median loss due to slaughtering of pigs prior to their expected market weights was US$ 71.8 (uncovered compensation-compensation loss) plus US$ 57.3 (foregone net gain) per pig. Median loss per farm was US$ 27,487 (55.6% of total loss) for compensation and US$ 15,925 (44.4%) for foregone net gain. The total loss per farm (median, 25th-75th percentile) was US$ 43,822 (9,767-115,893), which represented 49.4% (11.5-112.8) of the annual net gain of pig farms. The total financial loss in 180 FMD outbreak pig farms was US$ 25.2 million, which was nearly one-half of the control cost (US$ 58.3 million) spent by the Korean government on this epidemic. The findings in this study should help planning to help reduce the impact at the farm level in the Republic of Korea in the future.

Understanding the virulence of Streptococcus suis: A veterinary, medical, and economic challenge.

Streptococcus suis is a major swine pathogen worldwide and causes considerable economic losses in the swine industry. S. suis is also an emerging zoonotic agent, mainly in Asia. In pigs and humans, S. suis can cause septicemia, pneumonia, endocarditis, arthritis, and meningitis with irreversible sequelae. Identification and characterization of the virulence factors produced by S. suis are major advances in the understanding of the pathogenesis of S. suis infections and has therefore opened promising avenues for vaccine development against this pathogen. This literature review aimed to update the current knowledge of the virulence mechanisms of S. suis and of the vaccination strategies tested until now.

Reproductive effects of arteriviruses: equine arteritis virus and porcine reproductive and respiratory syndrome virus infections.

Equine arteritis virus (EAV) and porcine reproductive and respiratory syndrome virus (PRRSV) are the most economically important members of the family Arteriviridae. EAV and PRRSV cause reproductive and respiratory disease in equids and swine, respectively and constitute a significant economic burden to equine and swine industries around the world. Furthermore, they both cause abortion in pregnant animals and establish persistent infection in their natural hosts, which fosters viral shedding in semen leading to sexual transmission. The primary focus of this article is to provide an update on the effects of these two viruses on the reproductive tract of their natural hosts and provide a comparative analysis of clinical signs, virus-host interactions, mechanisms of viral pathogenesis and viral persistence.

The economics of animal welfare.

This paper examines four examples of animal welfare issues, demonstrating the interactions between welfare and economic principles. Welfare issues associated with purebred companion animals are examined in terms of predicted inherited diseases, highlighting the power of supply and demand in perpetuating traits in pets that compromise their well-being. The livestock industry is presented from the point of view of pig production and the impact that a major disease (pleurisy) has on production and the animals' welfare. The authors investigate the conflicting and complementary demands of animal welfare and economic gains during the transport and slaughter of livestock and poultry. Finally, wildlife species are considered in terms of their prevalence as pests, and the different types of economic analysis that have been conducted to understand the losses caused by these organisms. Also included in this example are decisions made about cost effectiveness and opportunity costs, and regulatory and financial barriers to the development of humane control agents. In conclusion, animal welfare is illustrated as a central factor in the benefits that humans enjoy from the role played by animals in society. There are, however, tradeoffs between optimal animal welfare and meeting the needs of modern human society.

Les auteurs analysent les effets réciproques du bien-être animal et des principes de l'économie à travers quatre exemples. La problématique du bienêtre des animaux de compagnie de race est examinée en lien avec les maladies à prédisposition génétique, ce qui permet de souligner l'influence de l'offre et de la demande dans la perpétuation de traits génétiques particuliers à ces animaux, au péril de leur bien-être. Le secteur de l'élevage est examiné à travers l'exemple de la production porcine en étudiant l'impact d'une maladie majeure (pleurésie) sur la production et le bien-être des porcs. Les auteurs abordent ensuite les exigences antinomiques ou complémentaires du bien-être animal et de la rentabilité économique dans le domaine du transport et de l'abattage des animaux d'élevage et des volailles. Enfin, les espèces sauvages sont examinées du point de vue de leur rôle en tant que nuisibles, en exposant les différentes manières d'expliquer au moyen d'analyses économiques les pertes causées par les nuisibles. Cet exemple aborde également les décisions en matière de rentabilité et les coûts d'opportunité, ainsi que les obstacles réglementaires et financiers à l'utilisation d'agents pouvant servir à contrôler les maladies par des méthodes respectueuses du bien-être animal. En conclusion, le bien-être animal apparaît comme un facteur central des bénéfices que les humains retirent des animaux et de leur rôle dans la société. Il y a néanmoins des compromis à trouver entre l'optimisation du bien-être animal et les exigences d'une société moderne.

Apoyándose en cuatro ejemplos de bienestar animal, los autores ponen de manifiesto cuán imbricados están entre sí los temas de bienestar y los principios económicos. Ante todo examinan los problemas de bienestar que sufren los animales de compañía de pura raza por lo que respecta a sus previsibles enfermedades hereditarias, subrayando el poder de la ley de la oferta y la demanda para perpetuar en ellos una serie de rasgos que comprometen su bienestar. A continuación se detienen en la ganadería industrial, y más concretamente en la producción porcina y la influencia que ejerce una enfermedad importante (la pleuresía) en el bienestar de los animales y en la propia producción. Después exponen los imperativos antagónicos y complementarios que se plantean en clave de bienestar animal y de beneficio económico durante las operaciones de transporte y sacrificio de ganado y aves de corral. Por último, considerando las especies de animales salvajes desde el punto de vista de su prevalencia como plagas, exponen los distintos tipos de análisis económico que se han realizado para aprehender las pérdidas resultantes de las plagas. Valiéndose de este ejemplo examinan también las decisiones adoptadas en materia de rentabilidad y de costos de oportunidad, así como las barreras reglamentarias y económicas que dificultan un funcionamiento más compasivo de los agentes de control. El bienestar animal, en conclusión, aparece como un factor central de los beneficios que extrae el ser humano de la función que cumplen los animales en la sociedad. Sin embargo, es preciso hallar un compromiso entre los niveles óptimos de bienestar animal y la satisfacción de las necesidades de la sociedad humana moderna.

Herd-specific interventions to reduce antimicrobial usage in pig production without jeopardising technical and economic performance.

Pig farmers are strongly encouraged to reduce their antimicrobial usage in order to reduce the risk of antimicrobial resistance. Herd-level intervention is needed to achieve national and European reduction targets. Alternative, especially preventive measures, have to be implemented to reduce the need for antimicrobial treatments. However, little is known about the feasibility, effectiveness and return on investment of such measures. The objective of this study was to assess, across four countries, the technical and economic impact of herd-specific interventions aiming at reducing antimicrobial usage in pig production while implementing alternative measures. An intervention study was conducted between February 2014 and August 2015 in 70 farrow-to-finish pig farms located in Belgium, France, Germany and Sweden. Herd-specific interventions were defined together with the farmer and the herd veterinarian. Farms were followed over one year and their antimicrobial usage and technical performance were compared with values from the year before intervention. Compliance with the intervention plan was also monitored. Changes in margin over feed cost and net farm profit were estimated in a subset of 33 Belgian and French farms with sufficient data, using deterministic and stochastic modeling. Following interventions, a substantial reduction in antimicrobial use was achieved without negative impact the overall farm technical performance. A median reduction of 47.0% of antimicrobial usage was achieved across four countries when expressed in terms of treatment incidence from birth to slaughter, corresponding to a 30.5% median reduction of antimicrobial expenditures. Farm compliance with intervention plans was high (median: 93%; min-max: 20; 100) and farms with higher compliance tended to achieve bigger reduction (ρ=-0.18, p=0.162). No association was found between achieved reduction and type or number of alternative measures implemented. Mortality in suckling piglets, weaners and fatteners, daily weight gain and feed conversion ratio did not significantly change over the course of the study, while the number of weaned piglets per sow per year slightly increased. The median change in net farm profit among Belgian and French farms was estimated to be €4.46 (Q25-Q75:-32.54; 80.50) and €1.23 (Q25-Q75:-32.55; 74.45) per sow per year using the detererministic and stochastic models, respectively. It was more influenced by a change in feed conversion ratio and daily weight gain than by a change in antimicrobial expenditures or intervention direct net cost. Therefore, costs of alternative measures should not be perceived as a barrier, but rather as an opportunity to optimise production practices for sustained productivity and improved animal health.

Point of truth calibration for disease prioritisation-A case study of prioritisation of exotic diseases for the pig industry in Australia.

The objective of this study was to trial point of truth calibration (POTCal) as a novel method for disease prioritisation. To illustrate the application of this method, we used a previously described case-study of prioritisation of exotic diseases for the pig industry in Australia. Disease scenarios were constructed from criteria which described potential impact and pig-producers were asked to score the importance of each scenario. POTCal was used to model participants' estimates of disease importance as a function of the criteria, to derive a predictive model to prioritise a range of exotic diseases. The best validation of producers' estimates was achieved using a model derived from all responses. The highest weighted criteria were attack rate, case fatality rate and market loss, and the highest priority diseases were the vesicular diseases followed by swine fevers and zoonotic encephalitides. Comparison of results with a previous study in which probabilistic inversion was used to prioritise diseases for the same group of producers highlighted differences between disease prioritisation methods. Overall, this study demonstrated that POTCal can be used for disease prioritisation. An advantage of POTCal is that valid models can be developed that reflect decision-makers' heuristics. Specifically, this evaluation of the use of POTCal in animal health illustrates how the judgements of participants can be incorporated into a decision-making process. Further research is needed to investigate the influence of scenarios presented to participants during POTCal evaluations, and the robustness of this approach applied to different disease issues (e.g. exotic versus endemic) and production types (e.g. intensive versus extensive). To our knowledge, this is the first report of the use of POTCal for disease prioritisation.

Break-even analysis of costs for controlling Toxoplasma gondii infections in slaughter pigs via a serological surveillance program in the Netherlands.

Toxoplasma gondii (T. gondii) is a food safety hazard which causes a substantial human disease burden and cost-of-illness. Infected pig meat is a common source of toxoplasmosis. A break-even analysis was conducted to estimate the point for which the intervention cost at fattening pig farms equaled the cost of averted human disease burden and cost-of-illness minus the costs of a T. gondii surveillance program. The surveillance program comprised serological testing of blood samples taken at slaughter. Break-even points were determined given alternative levels of the effectiveness of the intervention program (10% up to 90% in steps of 10%), the value of an averted DALY (20,000, 50,000 and 80,000 Euro), and threshold of sample prevalence for a farm to be under intervention (5% up to 50% out of 20 samples in steps of 5%). Since test characteristics are a determining factor in the break-even analysis, and literature is inconclusive concerning sensitivity (se) and specificity (sp) of the serological test kit used, two alternative sets of assumptions were analysed. The estimated maximum costs of an intervention if only benefits for domestic consumers were accounted amounted approximately 2981 Euro (se=98.9% and sp=92.7%) versus 4389 Euro (se=65.2% and sp=97.4%) per year per fattening pig farm under intervention assuming an effectiveness of 50%, 50,000 Euro per averted DALY and threshold T. gondii sample prevalence of 5% for a farm to be under intervention. Since almost 80% of the gross domestic production is exported corresponding break-even values increased up to 12,034 Euro and 18,366 Euro if benefits for consumers abroad were included as well. Empirical research to strengthen the knowledge about the efficacy of a farm intervention measures is recommended.

Application of discrete choice experiment to assess farmers' willingness to report swine diseases in the Red River Delta region, Vietnam.

A discrete choice experiment (DCE) is carried out to value socio-economic factors influencing the farmer's decision to report swine diseases and to assess the willingness of farmers to report swine diseases. Data were collected between March and July 2015 in two provinces in the Red River Delta, Northern Vietnam, from 196 pig producers by face-to face interview. A conditional logit model is used to measure the relative importance of the socio-economic factors and calculate the expected probability of disease reporting under changes of levels of these factors. Results of the study indicated that the likelihood of compensation and the type of culling implemented (all or only unrecovered pigs) are the two most important factors influencing farmer reporting. Compensation level, movement restriction and delay in compensation payment also have significant impacts on farmer's decision to report animal disease but they are not as important as the above factors. Three different scenarios including changes in six different factors (attributes) are tested to predict probability of animal disease reporting. Under the current situation (uncertainty of being compensated), only 4% of the farmers would report swine disease outbreak to the official surveillance system if the culling policy involves all pigs in affected farms. This number is increased to 26% if culling in affected farms is restricted to unrecovered pigs only. Ensuring certainty of compensation increases reporting probability by up to 50% and 90% if all or only unrecovered pigs are destroyed, respectively. The results of this study are important for improving the performance and sustainability of swine disease surveillance system in Vietnam.

Reprint of "Neurocysticercosis-related mortality in Brazil, 2000-2011: Epidemiology of a neglected neurologic cause of death".

Neurocysticercosis (NCC) is an important cause of severe neurological disease mainly in low- and middle-income countries, but data on NCC mortality from endemic areas are scarce. Here we analysed the epidemiological patterns of NCC-related mortality in Brazil. We included all deaths recorded in Brazil between 2000 and 2011, in which NCC was mentioned on death certificates, either as underlying or as associated cause of death. NCC was identified in 1829/12,491,280 deaths (0.015%), 1130 (61.8%) as underlying cause, and 699 (38.2%) as associated cause. Overall age-adjusted mortality rate for the period was 0.97 deaths/1,000,000 inhabitants (95% confidence interval [CI]: 0.83-1.12). The highest NCC-related mortality rates were found in males, elderly, white race/colour and residents in endemic states/regions. Age-adjusted mortality rates at national level decreased significantly over time (annual percent change [APC]: -4.7; 95% CI: -6.0 to -3.3), with a decrease in the Southeast, South and Central-West regions, and a non-significant increasing trend in the North and Northeast regions. We identified spatial and spatiotemporal high-risk mortality clusters located mainly in NCC-endemic areas. Conditions related to the nervous system were the most commonly associated causes of death when NCC was mentioned as an underlying cause, and HIV/AIDS was the main underlying cause when NCC was an associated cause. NCC is a neglected and preventable cause of severe neurologic disease and death with high public health impact in Brazil. There is a clear need to strengthen nationwide epidemiological surveillance and control for the taeniasis/cysticercosis complex.