The Analysis Of Disease Burden Of Echinococcosis In China

Echinococcosis caused by the echinococcus larvae parasitizing in the host body is a kind of zoonotic parasitic disease,and it is endemic around the world,especially in China.The disease is widely endemic in the northwest regions in China,there are about 50 million people at risk,it is one of the major infectious diseases impeding local economic development.Based on cross-sectional study the hospitalization expenditure of patients with surgery in hospital was analysed,severity of echinococcosis was described by meta-analysis,disable weight was defined and disease burden of echinococcosis was estimated by quality of echinococcosis patients'life in China.It can provide the reference basis for economic evaluation in the disease control and effect.This study was during february to december in 2015 in one hospital in Tibetan region.49 hepatic echinococcosis patients with surgical treatment were selected with systematic sampling method according to the hospitalization number.The field investigation was adopted to access to medical records and hospitalization expenses lists to analysis the medical cost of surgery treatment.According to the results,average hospitalization days of surgery patients with liver echinococcosis disease were 28.57 days.Hospitalization days of CE patient were 26.36 days.Hospitalization days of AE patient were 34.69 days,which were longer than CE(P=0.035).Average auxiliary examination times were higher than recommendations.Each liver echinococcosis patient's medical fee was 47.1 thousand RMB.Drug fee,material fee,treament fee,examization fee,nurse fee was 16944.05 RMB,12902.99 RMB and 9037.88 RMB,4823.50RMB,836.19 RMB per patients,respectively,which accounted for 92.98%(43.8 thousand RMB/47.1 thousand RMB).CE patient's medical fee was 42.2 thousand RMB per person,and AE patient's medical fee was 60.8 thousand RMB per person,which was higher than CE(P=0.001).Drug fee was the most sensitive factor of medical fee.Decreasing drug fee can reduce medical fee.Through the meta-analysis of 165 articles,disease severity levels of echinococcosis were received.The severity levels of echinococcosis were asymptomatic,mild(moderate)and severe,the proportion was:6.17%,66.12%,27.71%,respectively.The severity of AE was more serious than CE(P<0.001).Treatment can reduce the case fatality rate.The case fatality rate was 0.83%.The case fatality rate of CE was 0.70%,AE was 2.49%,higher than CE(P<0.001).During November 2016 to March 2017,134 inpatients and 200 outpatients were selected by systematic random sampling from gansu,qinghai,sichuan,xinjiang.The SF-36 quality of life scale was used to measure the disease severity levels and survival quality of patients to get quality score of life and disability weights of echinococcosis patients.Severity levels of the disease were asymptomatic,mild,medium,severity,death,which accounted for 40.58%?40.88%?10.80%?5.26%?2.49%,respectively.Average quality score of life of echinococcosis patients was 0.716,CE was 0.735,AE was 0.661,AE was lower than CE(P<0.001).The disability weights(Wd)of different severity levels of echinococcosis were 0.257,0.280,0.359,0.363.The YLDs were 1.864 per patient.On the basis of prevalence rate,number of patients,the disability weights of different severity levels and demographic data,it was estimated that disease burden of echinococcosis in China(except Xizang Autonomous Region)added up to 229.68 thousand DALYs(209.15 thousand YLDs.20.52 thousand YLLs).In summary,there is controllable space in the part of medical fee of patients with echinococcosis.It needs to decrease drug fee or use alternative drug to control the medical fee.Although the severity of most echinococcosis patients' is light,and quality of whose life is high,disease burden of some advanced cases is heavy.Because the prevalence of echinococcosis in China is high and the disease threatens large population,the burden of disease is still very heavy,it needs to pay attention and increase control efforts.At the same time,the severity and mortality of AE are high than CE,it needs to pay more attention to AE in the control works.