Abstract. A systematic literature review of cystic echinoccocosis (CE) frequency and symptoms was conducted. Studies without denominators, original data, or using one serological test were excluded. Random-effect log-binomial models were run for CE frequency and proportion of reported symptoms where appropriate. A total of 45 and 25 articles on CE frequency and symptoms met all inclusion criteria. Prevalence of CE ranged from 1% to 7% in community-based studies and incidence rates ranged from 0 to 32 cases per 100,000 in hospital-based studies. The CE prevalence was higher in females (Prevalence .7%]), respectively. The results are limited by the small number of unbiased studies. Nonetheless, the age/gender prevalence differences could be used to inform future models of CE burden.
BackgroundNeurocysticercosis (NCC) is a major public health problem in many developing countries where health education, sanitation, and meat inspection infrastructure are insufficient. The condition occurs when humans ingest eggs of the pork tapeworm Taenia solium, which then develop into larvae in the central nervous system. Although NCC is endemic in many areas of the world and is associated with considerable socio-economic losses, the burden of NCC remains largely unknown. This study provides the first estimate of disability adjusted life years (DALYs) associated with NCC in Mexico.MethodsDALYs lost for symptomatic cases of NCC in Mexico were estimated by incorporating morbidity and mortality due to NCC-associated epilepsy, and morbidity due to NCC-associated severe chronic headaches. Latin hypercube sampling methods were employed to sample the distributions of uncertain parameters and to estimate 95% credible regions (95% CRs).FindingsIn Mexico, 144,433 and 98,520 individuals are estimated to suffer from NCC-associated epilepsy and NCC-associated severe chronic headaches, respectively. A total of 25,341 (95% CR: 12,569–46,640) DALYs were estimated to be lost due to these clinical manifestations, with 0.25 (95% CR: 0.12–0.46) DALY lost per 1,000 person-years of which 90% was due to NCC-associated epilepsy.ConclusionThis is the first estimate of DALYs associated with NCC in Mexico. However, this value is likely to be underestimated since only the clinical manifestations of epilepsy and severe chronic headaches were included. In addition, due to limited country specific data, some parameters used in the analysis were based on systematic reviews of the literature or primary research from other geographic locations. Even with these limitations, our estimates suggest that healthy years of life are being lost due to NCC in Mexico.
Abstract. The objective of this study was to compare quality of life measures in patients with neurocysticercosis (NCC) to those of a matched control group. The NCC outpatients and their controls were recruited from two neurology referral hospitals in Mexico City, Mexico during [2007][2008]. The quality of life of 224 NCC patients was compared with 224 agesex-hospital-day matched controls using the short form 12 v2 (SF-12 v2) quality of life survey. Medical chart reviews were also conducted for the NCC outpatients to evaluate presenting clinical manifestations. Compared with the controls, NCC patients had a significantly lower score for each of the eight domains of health evaluated and significantly lower Physical and Mental Component Summary scores. Chart reviews indicated that hydrocephalus (48%), severe headaches (47%), and epilepsy (31%) were the most common clinical manifestations in these NCC outpatients. headaches for more than three continuous days were eligible for participation in the study. All NCC cases with the symptoms mentioned previously and who presented themselves for an outpatient appointment to the INNN from July 17, 2007 to December 7, 2007 or to the HE-IMSS from June 2, 2008 to August 12, 2008 were asked for their consent to participate in the study. All patients who provided written consent were interviewed by a trained member of the research team (i.e., a Mexican intern, resident, or social worker) at the time of their appointment.An individual who accompanied a non-NCC outpatient to either the INNN or the HE-IMSS was considered as a possible control. Eligibility for acting as a control was further narrowed by selecting only individuals who accompanied a non-related patient to reduce the potential impact of living with a person suffering from a neurological disease on quality of life. Controls were paired with an NCC patient seen at the same hospital on the same day by sex and age (±5 years) to reduce any possible confounding effect from these variables. This 1:1 matched control group was selected and interviewed in the hospital's waiting area by a member of the research team after obtaining written consent .Quality of life. The SF-12 v2 survey (Mexican Spanish version) was completed by all consenting participants. Twelve questions were used to assess eight domains of health in the survey: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. All domains were checked for missing data for each patient-control pair. If more than four health domains were missing for any case or control, that case/control pair was not included in the analysis. Data were rescored for uniformity (i.e., positive health responses received higher scores) according to Quality Metric guidelines.15 Raw scores were then transformed to a 0-100 scale in accordance with standard procedures.15 This transformation converts the lowest and highest possible scores to zero and 100, with scores between these values representing the percentage of the t...
Abstractobjectives To estimate annual costs related to the diagnosis, treatment and productivity losses among patients with neurocysticercosis (NCC) receiving treatment at two referral hospitals, the Instituto Nacional methods Information on presenting clinical manifestations, diagnostic tests, hospitalisations, surgical procedures and other treatments received by NCC outpatients was collected from medical charts, and supplemented by an individual questionnaire regarding productivity losses and out-ofpocket expenses related to NCC.results The annual average per-patient direct costs were US$ 503 (95% CI: 414-592) and US$ 438 (95% CI: 322-571) for patients without a history of hospitalisation and/or surgery seen at the INNN and the HE-IMSS, respectively. These costs increased to US$ 2506 (95% CI: 1797-3215) and US$ 2170 (95% CI: 1303-3037), respectively, for patients with a history of hospitalisation and/or surgery. The average annual per-patient indirect costs were US$ 246 (95% CI: 165-324) and US$ 114 (95% CI: 51-178), respectively, using minimum salary wages for individuals not officially employed.conclusions The total annual cost for patients who had and had not been hospitalised and/or undergone a surgical procedure for the diagnosis or treatment of NCC corresponded to 212% and 41% of an annual minimum wage salary, respectively. The disease tends to affect rural socioeconomically disadvantaged populations and creates health disparities and significant economic losses in Mexico.
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