Economic Importance of Hydatid Cyst in Slaughtered Cattle of Mugla Province

Objective: This study was carried out to investigate the prevalence, seasonal distribution and economic effects of hydatid cyst infection in slaughtered cattle of Mugla province. Methods: Data from the 2019 records of the Mugla Metropolitan Municipal Abattoir were studied retrospectively. Both direct and indirect calculation methods were used to determine the economic losses incurred due to hydatid cyst. Results: Twenty-one out of 9.985 (0.21%) cattle were found to have been infected with hydatid cyst in 2019. The highest prevelance of infection was reported in February (1.17%), while no cases were observed in May, June and August. The direct economic loss attributed to liver destruction in Mugla province was 11,760 TL (1.950 $). The total indirect economic loss caused by hydatid cyst (carcass loss, milk production loss, decreased fecundity) was 122,691 TL (20,346 $). Cumulatively, the direct and indirect economic losses for hydatid cyst disease in Mugla province were 134,451 TL (22,296 $). Conclusion: According to our results, the prevalence of hydatid cyst in cattle of Mugla province was 0.21%, which was still lower than the average loss in Turkey in spite of the corresponding significant economic loss.

Estimation of the monetary burden of treated human cystic echinococcosis in Pakistan.

Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus sensu lato tapeworms, continues to be a public health problem in many endemic countries, including Pakistan. Patient level data, including age, sex, and cyst(s) location for surgically managed CE patients for the years 2013-2016 from hospitals located in Punjab and Khyber Pakhtunkhwa provinces were obtained from medical charts. Direct and indirect costs associated with surgically managed CE patients treated in private and public hospitals were then estimated and applied to country-level case numbers estimated through the Global Burden of Disease Study. A total cost of US$4,068,666 (95% CI: US$3,097,684 - US$5,295,702) was estimated for the year 2017, with US$3,951,853 (95% CI: US$2,981,400 - US$5,177,610) attributable to direct diagnosis and treatment-related costs and US$117,137 (95% CI: US$91,841 - US$146, 979) attributable to wage losses during the treatment period. Mean direct cost per patient (US$1,056) was approximately 72% of the country's per capita gross domestic product (GDP). Surgical management continues to be the treatment of choice for CE patients in Pakistan. If physicians were to adhere to World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) cyst stage-specific treatment guidelines, it is likely that the number of surgical interventions would decrease as would treatment costs.

Evaluation of zoonotic platyhelminthe infections identified in slaughtered livestock in Iran, 2015-2019.

BACKGROUND: Platyhelminth infections of livestock can result in considerable economic losses. This study aims to evaluate the spatial frequency of cystic echinococcosis (CE), dicrocoeliasis, and fascioliasis in livestock slaughtered in Iran during the years 2015-2019 and estimate direct costs associated with organ condemnation due to these parasites. METHODS: Abattoir data from 413 abattoirs representing all 31 Iranian provinces were collected from the Iran Veterinary Organization. Infection prevalence was calculated per year at the province level. The Local Moran's I statistic was performed to evaluate spatial autocorrelation of animals positive at slaughter for the years 2015-2019. Direct costs associated with condemned livers were calculated for each parasitic condition, with costs associated with condemned lungs also included for CE. RESULTS: Overall prevalence values for the study timeframe were as follows: sheep and goat fascioliasis 1.56% (95% CI: 1.56-1.56%), cattle fascioliasis 3.86% (95% CI: 3.85-3.88%), sheep and goat dicrocoeliasis 4.63% (95% CI: 4.62-4.63%), cattle dicrocoeliasis 3.08% (95% CI: 3.07-3.09%), sheep and goat CE 5.32% (95% CI: 5.32-5.33%), and cattle CE 7.26% (95% CI: 7.24-7.28%). Northwest Iran had the highest prevalence of CE and fascioliasis. High infection areas for Dicrocoelium spp. included the provinces of Zanjan, Gilan, Qazvin, and Tehran, which are located in northern Iran. Direct economic losses for sheep and goat fascioliasis, dicrocoeliasis, and CE for the study period were US$13,842,759, US$41,771,377, and US$22,801,054, respectively. Direct economic losses for cattle fascioliasis, dicrocoeliasis, and CE for the study period were US$1,989,200, US$1,668,986, and US$2,656,568, respectively. CONCLUSION: Our findings provide valuable data for future monitoring of these important parasitic diseases in Iranian livestock. Disease control strategies are required to reduce the economic and public health impact of these platyhelminths.

The socio-economic burden of cystic echinococcosis in Morocco: A combination of estimation method.

Cystic echinococcosis (CE) is a major zoonosis in Morocco despite the launch of a national control programme in 2005. As its economic consequences have not been studied yet in Morocco, this study estimated CE impact in terms of monetary losses, disability-adjusted life years (DALY), and DALY for zoonotic diseases (zDALY) in the entire country and in specific regions for the 2011 to 2014 period. The direct monetary losses were related to organ seizure from infected animal in slaughterhouses, and to healthcare expenses as well as lost wages for infected humans. Animal production losses concerned milk yield, fertility, carcass weight, and wool production. Losses due to human infection were also composed of disability and productivity losses at work. Monte Carlo simulations were used to estimate monetary losses and zDALY values. Nationwide, the estimated DALY was 0.5 years per 100,000 persons per year, and the zDALY was 55 years per 100,000 persons per year. Total yearly losses were estimated at 73 million USD (54-92 million USD). However, losses differed significantly among regions. Most of the economic losses consisted of unperceived consequences, i.e. decreased animal production and reduced productivity of asymptomatic individuals. Future studies should determine the socioeconomic and epidemiological factors underlying the differences in economic losses among regions to develop better adapted control programmes.

Cystic echinococcosis in the Eastern Mediterranean region: Neglected and prevailing!

Cystic echinococcosis (CE) is distributed worldwide, extending from China to the Middle East and from Mediterranean countries to the sub-Saharan Africa and South America. According to WHO, one million people around the world are suffering from CE with an estimated burden of 183,573 DALYs. The annual monetary burden of the disease due to treatment costs and CE-related livestock losses has been estimated at US$ 3 billion. CE is endemic in all countries within the WHO Eastern Mediterranean Regional Office (EMRO). The region, which includes most of the Middle East and North Africa, is one of the most ancient foci of the domestic cycle of CE and is recognized as one of the major hotspots of CE. There are 22 countries in the EMRO, where about 688 million people are living at risk of CE. In many EMRO countries, little is known about CE epidemiology and transmission. WHO included echinococcosis in a list of 17 neglected tropical diseases (NTDs) and 12 neglected zoonotic diseases (NZDs). Accordingly, different regional offices of WHO organized several initiatives for CE control and prevention. WHO's Western Pacific regional office considered echinococcosis as one of the region's major health topics, and several preventive measures have been implemented in the American region with the support of Pan American Health Organization (PAHO) in Argentina, Peru, Uruguay, and Chile. Although CE is endemic in all 22 EMRO countries, surprisingly, CE is absent from the health topics list of diseases and conditions in this region. Therefore, CE clearly requires further attention in the WHO EMRO agenda, and the need for elaboration of specific measures for CE control is becoming apparent in EMRO countries, where substantial collaborations among the member states and WHO EMRO is of paramount importance. Major topics of collaborative activities include training programs and health communication on different aspects of CE control, analysis of CE burden, national and international surveillance and disease registry systems, technical support to promote epidemiological studies for collecting baseline data, cost-benefit analysis of control interventions, and intersectoral cooperation among the agriculture, veterinary, medical, and health sectors.

Assessment of the direct economic losses associated with hydatid disease (Echinococcus granulosus sensu stricto) in beef cattle slaughtered at an Australian abattoir.

Bovine hydatid disease, characterised by fluid-filled hydatid cysts, is regularly found in the offal of beef cattle at slaughter. Organs found to be infected at slaughter are removed to preclude them from entering the human food chain. The organs are either downgraded to pet food or condemned. Previous studies have focussed on total economic losses, but have not calculated the cost of disease per animal, which would be useful information for producers when determining how best to manage hydatid disease. This study estimated the direct losses associated with hydatid disease in beef cattle slaughtered at an Australian beef abattoir both at the population (all cattle slaughtered) and individual animal level. Data on annual prevalence of hydatid disease in beef cattle were obtained from an Australian abattoir for the years 2011-2017. The direct losses resulting from the condemnation and downgrading of offal infected with hydatid cysts at the abattoir were estimated using data stratified by age, sex and feed-type. Official and literature-based sources of organ weight and price were used to estimate direct losses associated with hydatid disease in beef cattle slaughtered at the abattoir. Uncertainty and variability in input parameters were represented using uniform distributions and Monte Carlo sampling was used to model output parameter uncertainty. Out of 1,097,958 beef cattle slaughtered between January 2011 and December 2017, 97,832 (8.9%) were reported infected with hydatid disease. The median estimated direct loss to the abattoir for the duration of the study period was AU$655,560 (95% confidence interval [CI] AU$544,366-787,235). This equated to approximately AU$6.70 (95% CI AU$5.56-8.05) lost per infected animal. The annual median estimated direct losses due to hydatid disease at the abattoir were AU$93,651 (95% CI AU$77,767-112,462). Direct losses varied each year of the study and ranged from AU$38,683 in 2016 to AU$163,006 in 2014. This estimate of the direct losses associated with bovine hydatid disease most likely underestimates the true extent of the overall losses because indirect losses such as reduced carcass weights were not estimated in this study. Nevertheless, these estimates illustrate the negative economic impact of bovine hydatid disease and demonstrate that improved surveillance to enable control of hydatid disease should be considered both in Australia and globally. It would be worthwhile to estimate the losses in other beef abattoirs for the same time period to compare results, and to investigate the cost-benefit of control programs for bovine hydatid disease.

Retrospective Analysis of Cystic Echinococcosis Results in Aydin Adnan Menderes University Training and Research Hospital Parasitology Laboratory Between 2005 and 2017

Objective: Echinococcus granulosus is the causative helminth of cystic echinococcosis (CE). The parasite is known to form fluid-filled cysts that grow slowly in the internal organs, particularly the liver and/or lungs. This disease is still important in terms of public health and economically in Turkey and other countries where animal husbandry is widespread. The aim of our study was to retrospectively evaluate the cases that were admitted to the Adnan Menderes University, Training and Research Hospital Parasitology laboratory on suspicion of CE between January 2005 and January 2017. Methods: Totally, 3446 sera (from 2019 female and 1427 male) were tested with an in-house ELISA for the presence of E. granulosus specific IgG antibodies at the timeswhen they were sent. Socio-demographic characteristics (age, gender, residence, and dog ownership), positivity titers, and cyst locations of pathologically confirmed CE patients were analyzed retrospectively. Results: The ages of patients varied between 4-87 years. It was found that 1104 (32%) of the 3446 sera were positive, and of them, 642 (58.1%) were female and 462 (41.9%) were male. Patients who had pathologically confirmed CE diagnosis constituted 247 (22.3%) of the total seropositive sera. Liver was the most commonly affected organ (81.8%), followed by lungs (6.1%). Conclusion: CE remains an important public health problem in our city; therefore, it is once again emphasized that preventive studies should be planned.

[COMPARATIVE ANALYSIS OF THE COST OF TREATMENT OF ECHINOCOCCOSIS BY THERAPEUTIC AND SURGICAL METHODS (BASED ON THE STEP-DOWN METHODOLOGY)].

The aim of the study was to carry out a comparative economic analysis of the costs of therapeutic and surgical treatment of liver echinococcosis based on the developed methodological approaches and principles for calculating the cost of complex medical services in accordance with the «step-down¼ methodology. The model for calculating the cost of complex medical services for the treatment of echinococcosis was justified. The sum of costs of outpatient and inpatient units that directly provide medical care (direct costs) to the costs of support centers (indirect costs) was adjusted, which among simple medical services based on the chosen criterion were distributed. Calculation of costing items out on the basis of the direct-cost costing method was carried. Based on the proposed model, a comparative analysis of the cost of treatment of liver echinococcosis using therapeutic and surgical methods was carried out. As a result of the study, it was proved that the therapeutic method is less expensive than the surgical method. This is the basis to recommend it for wider use in medical practice, especially in cases when there is a problem of choosing the method of treatment of echinococcosis. Cost optimization is facilitated by a combination of surgical intervention and therapeutic treatment.

Evaluation of direct costs associated with alveolar and cystic echinococcosis in Austria.

BACKGROUND: Cystic echinococcosis (CE) is a globally occurring zoonosis, whereas alveolar echinococcosis (AE) is endemic only in certain parts of the Northern Hemisphere. The socioeconomic impact of human echinococcosis has been shown to be considerable in highly endemic regions. However, detailed data on direct healthcare-related costs associated with CE and AE are scarce for high income countries. The aim of this study was to evaluate direct costs of human disease caused by CE and AE in Austria. METHODS: Clinical data from a registry maintained at a national reference center for echinococcosis at the Medical University of Vienna were obtained for the years 2012-2014. These data were used in conjunction with epidemiological data from Austria's national disease reporting system and diagnostic reference laboratory for echinococcosis to assess nationwide costs attributable to CE and AE. RESULTS: In Austria, total modelled direct costs were 486,598€ (95%CI 341,825€ - 631,372€) per year for CE, and 683,824€ (95%CI 469,161€ - 898,486€) for AE. Median costs per patient with AE from diagnosis until the end of a 10-year follow-up period were 30,832€ (25th- 75th percentile: 23,197€ - 31,220€) and 62,777€ (25th- 75th percentile: 60,806€ - 67,867€) for inoperable and operable patients, respectively. Median costs per patients with CE from diagnosis until end of follow-up after 10 years were 16,253€ (25th- 75th percentile: 8,555€ - 24,832€) and 1,786€ (25th- 75th percentile: 736€ - 2,146€) for patients with active and inactive cyst stages, respectively. The first year after inclusion was the most cost-intense year in the observed period, with hospitalizations and albendazole therapy the main contributors to direct costs. CONCLUSIONS: This study provides detailed information on direct healthcare-related costs associated with CE and AE in Austria, which may reflect trends for other high-income countries. Surgery and albendazole therapy, due to surprisingly high drug prices, were identified as important cost-drivers. These data will be important for cost-effectiveness analyses of possible prevention programs.

Foodborne Parasitic Diseases in Europe: Social Cost-Benefit Analyses of Interventions.

Social cost-benefit analysis (SCBA) can be used to evaluate the benefit to society as a whole of a particular intervention. Describing preliminary steps of an SCBA for two foodborne parasitic diseases, echinococcosis and cryptosporidiosis, indicates where data are needed in order to identify those interventions of greatest benefit.

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.

[Evaluation of economic expenditure related to human hydatidosis in Junín, Peru]. / Evaluación del gasto económico en la atención de hidatidosis humana en Junín, Perú.

The objective of the present study was to calculate the economic loss caused by the treatment of human hydatidosis. For this purpose, a cost analysis of the cases reported in the Junin region of Peru in 2013 was conducted. The total cost (direct and indirect) per patient assisted by the Ministry of Health (Ministerio de Salud-Minsa), the social security system (EsSalud), and private health care was 1,220, 3,051, and 4,090 US dollars (USD), respectively. The mean annual loss considering the number of health care services for uncomplicated cases of human hydatidosis was USD 24,542 in Minsa, USD 369,292 in EsSalud, and USD 130,566 in private health care. Overall, the rate of loss of human productivity was a small proportion. Our findings indicate that hydatidosis imposes a heavy economic burden in the Junin region of Peru.

El objetivo del presente estudio fue determinar la pérdida económica que ocasiona el tratamiento de la hidatidosis humana, para lo cual se realizó un análisis de costos de los casos reportados en la región Junín en Perú, durante el año 2013. El costo total (directo e indirecto) en dólares americanos por paciente atendido por el Ministerio de Salud (Minsa) fue USD 1 220,0; por el seguro social (EsSalud) fue USD 3 051,0 y por la atención privada fue USD 4 090,7. La pérdida media anual según el número de atenciones por hidatidosis humana no complicada fue USD 24 542,0 en el Minsa, USD 369 292,0 en EsSalud y USD 130 566,4 en la atención privada. Las pérdidas de productividad humana constituyen la minoría. Nuestros hallazgos indican que la hidatidosis impone una pesada carga económica en la región Junín.

Evaluación del gasto económico en la atención de hidatidosis humana en Junín, Perú / Evaluation of economic expenditure related to human hydatidosis in Junín, Peru

RESUMEN El objetivo del presente estudio fue determinar la pérdida económica que ocasiona el tratamiento de la hidatidosis humana, para lo cual se realizó un análisis de costos de los casos reportados en la región Junín en Perú, durante el año 2013. El costo total (directo e indirecto) en dólares americanos por paciente atendido por el Ministerio de Salud (Minsa) fue USD 1 220,0; por el seguro social (EsSalud) fue USD 3 051,0 y por la atención privada fue USD 4 090,7. La pérdida media anual según el número de atenciones por hidatidosis humana no complicada fue USD 24 542,0 en el Minsa, USD 369 292,0 en EsSalud y USD 130 566,4 en la atención privada. Las pérdidas de productividad humana constituyen la minoría. Nuestros hallazgos indican que la hidatidosis impone una pesada carga económica en la región Junín.

ABSTRACT The objective of the present study was to calculate the economic loss caused by the treatment of human hydatidosis. For this purpose, a cost analysis of the cases reported in the Junin region of Peru in 2013 was conducted. The total cost (direct and indirect) per patient assisted by the Ministry of Health (Ministerio de Salud-Minsa), the social security system (EsSalud), and private health care was 1,220, 3,051, and 4,090 US dollars (USD), respectively. The mean annual loss considering the number of health care services for uncomplicated cases of human hydatidosis was USD 24,542 in Minsa, USD 369,292 in EsSalud, and USD 130,566 in private health care. Overall, the rate of loss of human productivity was a small proportion. Our findings indicate that hydatidosis imposes a heavy economic burden in the Junin region of Peru.

Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy.

Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the "San Matteo" Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach.

The Economic Impact of Cystic Echinococcosis in Rio Negro Province, Argentina.

Cystic echinococcosis (CE), a parasitic zoonosis with substantial human health and economic consequences, is highly endemic in Rio Negro Province, Argentina. The objective of this study was to estimate the direct and indirect human and livestock-associated monetary losses attributable to CE, in Rio Negro Province, for the year 2010. Human costs were estimated using data obtained from hospital chart reviews, patient interviews, and government reports. Livestock-associated losses were estimated using data from government reports and scientific publications. Spreadsheet models were developed utilizing Latin Hypercube sampling to account for uncertainty in the input parameters. In 2010, the estimated total cost of CE, in Rio Negro Province, ranged from US$4,234,000 (95% credible interval [CI]: US$2,709,000-US$6,226,000) to US$5,897,000 (95% CI: US$3,452,000-US$9,105,000), with livestock-associated losses representing between 80% and 94% of the total losses, depending on whether non-healthcare-seeking human cases were included and if livestock slaughter values were adjusted to account for underreporting. These estimates suggest that CE is responsible for considerable human and livestock-associated monetary losses in Rio Negro Province. Stakeholders and policymakers can use these data to better allocate public health and agricultural resources for this region.

[Cost Analysis of Dog Deworming in Echinococcosis Control Program in Daofu，Sichuan Province].

Objective: To estimate the cost of dog deworming in Daofu, Sichuan Province and analyze the factors influencing the cost, in order to provide a scientific basis for the investment for echinococcosis control. Methods: Thirty villages were randomly selected in Daofu, Sichuan Province in November 2015, according to the proportion of agricultural and pastoral areas. Data concerning the cost during each step of dog deworming were collected. The unit cost was estimated, the cost composition in each step, element, and institution were described, and the main cost-influencing factors were analyzed using the linear regression method. Results: The mean cost of dog deworming in the 30 surveyed villages was 3.76 yuan/dog-times, comprising drug cost of 0.38 yuan/dog-times, bait cost of 0.37 yuan/dog-times, drug delivery cost of 0.09 yuan/dog-times, mobilization cost of 0.19 yuan/dog-times, household deworming cost of 2.05 yuan/dog-times, faeces disposal cost of 0.35 yuan/dog-times, training cost of 0.29 yuan/dog-times, and supervision cost of 0.04 yuan/dog-times. Among the deworming steps, household deworming cost occupied the most （2.05 yuan/dog-times）; among the cost elements, labour cost had the highest proportion （2.55 yuan/dog-times）; among the different-leveled institutions, village-level cost was the most important part（2.82 yuan/dog-times）. Linear regression analysis revealed that the type of production and the distance among households were the major influencing factors. The labour price was the most sensitive factor for cost-estimation in the dog deworming activities. Conclusion: The labor cost of dog deworming is very high. Governments should increase investment according to local situations.

Present status, actions taken and future considerations due to the findings of E. multilocularis in two Scandinavian countries.

When Echinococcus (E.) multilocularis was first detected in mainland Scandinavia in Denmark in 2000, surveillance was initiated/intensified in Sweden, mainland Norway and Finland. After 10 years of surveillance these countries all fulfilled the requirements of freedom from E. multilocularis as defined by the EU, i.e. a prevalence in final hosts <1% with 95% confidence level. However, in 2011 E. multilocularis was detected in Sweden for the first time and surveillance was increased in all four countries. Finland and mainland Norway are currently considered free from E. multilocularis, whereas the prevalence in foxes in Sweden and Denmark is approximately 0.1% and 1.0%, respectively. E. multilocularis has been found in foxes from three different areas in Denmark: Copenhagen (2000), Højer (2012-14) and Grindsted (2014). Unlike Sweden, Norway and Finland, human alveolar echinococcosis (AE) is not notifiable in Denmark, and the number of human cases is therefore unknown. In Sweden, E. multilocularis has been found in foxes in four counties, Västra Götaland, Södermanland, Dalarna (2011) and Småland (2014). E. multilocularis has also been found in an intermediate host in Södermanland (2014). Two cases of AE have been reported in humans (2012), both infected abroad. No cases of E. multilocularis or AE have been reported in Finland and Norway. Recommendations and future considerations are discussed further.

Echinococcosis: An Economic Evaluation of a Veterinary Public Health Intervention in Rural Canada.

Echinococcosis is a rare but endemic condition in people in Canada, caused by a zoonotic cestode for which the source of human infection is ingestion of parasite eggs shed by canids. The objectives of this study were to identify risk factors associated with infection and to measure the cost-utility of introducing an echinococcosis prevention program in a rural area. We analyzed human case reports submitted to the Canadian Institutes for Health Information between 2002 and 2011. Over this 10 year period, there were 48 cases associated with E. granulosus/E. canadensis, 16 with E. multilocularis, and 251 cases of echinococcosis for which species was not identified (total 315 cases). Nationally, annual incidence of echinococcosis was 0.14 cases per 100,000 people, which is likely an underestimate due to under-diagnosis and under-reporting. Risk factors for echinococcosis included female gender, age (>65 years), and residing in one of the northern territories (Nunavut, Yukon, or Northwest Territories). The average cost of treating a case of cystic echinococcosis in Canada was $8,842 CAD. Cost-utility analysis revealed that dosing dogs with praziquantel (a cestocide) at six week intervals to control cystic echinococcosis is not currently cost-effective at a threshold of $20,000-100,000 per Quality Adjusted Life Year (QALY) gained, even in a health region with the highest incidence rate in Canada ($666,978-755,051 per QALY gained). However, threshold analysis demonstrated that the program may become cost-saving at an echinococcosis incidence of 13-85 cases per 100,000 people and therefore, even one additional CE case in a community of 9000 people could result in the monetary benefits of the program outweighing costs.

Major causes of organ/carcass condemnation and financial loss estimation in animals slaughtered at two abattoirs in Bursa Province, Turkey.

An abattoir survey was conducted from July 2012 to December 2012 to determine the major causes of organ and carcass condemnation and to estimate the associated direct financial loss at two abattoirs in Bursa Province in Turkey. A total of 22,872 sheeps and 5363 cattle were examined by postmortem inspection using standard inspection procedures. The total economic loss in two abattoirs was estimated from the summation of organ and carcass condemnation in six-month period. The retail prices of offal (lung, liver, kidney, heart, and spleen) and kg price of cattle and sheep carcasses were obtained from local markets. The results of postmortem examination indicated that a total of 658 (2.33%) offals and 93 (0.32%) carcasses were condemned. While the main causes of organ condemnation were hydatidosis and fasciolosis, carcasses were condemned mainly due to tuberculosis and jaundice. The total revenue in 2012 for all animals (164,080 sheeps and 56,035 cattle) slaughtered in 15 abattoirs in Bursa Province was 144,401,765 USD. This study showed that financial loss due to organ and carcass condemnations at two abattoirs in six-month period was 245,483 USD (0.17% of the total annual revenue of all slaughtered animals at 15 abattoirs). In sheep, six-month financial loss was estimated at 3281 USD and 4015 USD from organ condemnation due to fasciolosis and hydatidosis, respectively. In cattle, total loss was calculated as 4042 USD and 12,321 USD due to fasciolosis and hydatidosis, respectively. A common cause of carcass condemnation in cattle was tuberculosis, totalling 214,995 USD in losses, whereas condemnation due to tuberculosis was not determined in sheep. The current study also showed that six-month monetary losses from carcass condemnation of sheep and cattle due to jaundice were 8099 USD and 6026 USD, respectively. From the data obtained in this study, it can be concluded that bacterial and parasitic diseases remain common and cause considerable economic loss in Bursa Province, Turkey. The result of this abattoir study provided regional information on major causes of organ and carcass condemnation in sheep and cattle slaughtered at two abattoirs as well as giving an estimation of the direct financial losses.