| Schistosomiasis is still one of the parasitic diseases, which is serious hazard to human health at present. Schistosomiasis is very popular in developing countries, such as China, India, Thailand, and Cameroon. WHO only evaluated the individual burden (DALY) of Schistosomiasis in GBD, and the burden was serious underestimated. There is no comprehensive evaluation of Schistosomiasis burden in China at present. Thus, the comprehensive and precise evaluation of the Schistosomiasis burden is necessary, so as to allocate the limited health resource reasonably.Objective: To study the disease burden of chronic schistosomiasis japonica, with the following specific aims: 1. to estimate the disability weights (DW) for chronic schistosomiasis japonica and measure the years lived with disability (YLD); 2. to assess the family burden of chronic schistosomiasis japonica with FBS; 3. to calculate the direct economic burden and indirect economic burden of chronic schistosomiasis japonica.Method: Surveillance sites of schistosomiasis in Yangxin County were selected as study sites. All chronic schistosomiasis patients diagnosed in 2006 would be considered as eligible study targets. The contents of questionnaire include past medical history, diagnosis and treatment history, self-reported symptoms, disability status, family burden, economic burden and so on. 1. Using six disability classes to define patients'disabling status, and establish age-specific and sex-specific disability weight for chronic schistosomiasis japonica. The multi-factor cumulative logistic regression was used to analysis the risk factors of disability weight. Years lived with disability (YLD) were calculated and classified by age and sex in the base of disability weight. 2. Family burden was estimated with Family Burden Scale of disease (FBS). 3. Direct economic burden was calculated by questionnaire survey. The human capital method combined with YLD was adopted to evaluate indirect economic burden.Results: 1.Overall, 839(22.31%) of 3761 residents were positive for S.japonicum by IHA. Of these people submitted a stool specimen and 226(6.01%) residents were positive; 2. The average disability weight of chronic schistosomiasis japonica was 0.122. The age-specific disability weight ranged from 0.020 to 0.280, which was higher than 0.005～0.006 GBD identified. The disability weights increased with age, and the difference between age groups was significant (χ2 = 152.590,P<0.001). It was assigned that a disability weight of 0.103 in male and 0.147 in female, and the difference between them was significant (Z= 2.405,P<0.05). The multi-factor cumulative logistic regression showed that disability weight has obvious dependence with age (OR=1.173, 95%CI: 1.130-1.217), and the income levels was a protective factor (OR= 0.497, 95%CI: 0.319-0.775), while sex is a confounding factor. 3. Chronic schistosomiasis japonica caused the loss of 31.33 YLD in four surveillance sites one year. YLD per 1000 people was 3.71 year, and YLD per patients was 0.14 year. 4. The positive rate of the dimensions of family economic burden and family entertainment was 54.8 percent and 47.0 percent, respectively. The remaining dimensions were lower(3.2%～37.9%). 5. Results of the questionnaire survey among 219 chronic schistosomiasis patients showed that the total economic burden was 353480.59 yuan, and it was 1614.07 yuan per person. The direct and indirect economic burden was 61679(17.45%) yuan and 291801.59(82.55%) yuan, respectively. The average direct economic burden was 281.64 yuan per person, and it was 1332.43 yuan per person with respect to indirect economic burden.Conclusions: This study indicates that the DW for schistosomiasis used in the Global Burden of Disease has indeed been underestimated and should be revised; The average disability weight of 0.122 for chronic schistosomiasis japonica indicated that 1/8 healthy year lost for each survived life year of them; The age-specific disability weight ranged from 0.020 to 0.280; Working-age population was the main crowd of disease burden. The family burden of chronic schistosomiasis japonica was serious. With regard to the income level of local residents, the economic burden of chronic schistosomiasis japonica was heavy to every patient, especially indirect economic burden.
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