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

Abstract

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.

Using qualitative approaches to explore the challenges of integrated programmes for zoonosis control in developing countries: Example of hydatidosis control in Morocco

“…The causes of the persistence of these zoonoses are multiple, including practices and beliefs of the populations, poor understanding of the pathogen life cycle, and poor management of slaughterhouses and dog population (Bardosh et al, 2016;El Berbri et al, 2015;Khan et al, 2018). For example, stray dogs are a major contributor to the persistence of CE and rabies in Pakistan, (Khan et al, 2020(Khan et al, , 2019 and also in Morocco, Tunisia and the other endemic countries (Amarir et al, 2020;Aoun et al, 2009;Brunetti & Mccloskey, 2016;Wandeler et al, 1988).…”

“…Nowadays, transmission of bovine tuberculosis to humans still occurs through consumption of contaminated meat or raw milk and contributes to the overall tuberculosis burden (Farougou et al, 2011). Specifically, twenty cases of human rabies are recorded each year (Direction de l'Epidémiologie et de Lutte contre les Maladies, 2018), the incidence of tuberculosis is 103 cases per 100,000 inhabitants (Ministrére de la santé, 2018), and 2.2 per 100,000 individuals undergo surgery for CE every year (Saadi et al, 2020). Meat control in slaughterhouses and/or the control of the dog population are common steps in the control programmes of these zoonoses in Morocco (Figure 1).…”

Public Health Policy Pillars for the Sustainable Elimination of Zoonotic Schistosomiasis

“…Nevertheless, this metric has been rarely used in costeffectiveness analyses of zoonotic diseases (65,66), and only once for schistosomiasis (67).…”

Public Health Policy Pillars for the Sustainable Elimination of Zoonotic Schistosomiasis

“…These include an additional component called animal loss equivalents, which converts expected livestock production and local per capita income losses to the equivalent number of human YLD. Nevertheless, this metric has been rarely used in cost-effectiveness analyses of zoonotic diseases (65,66), and only once for schistosomiasis (67).…”