Estimating the economic effects of cystic echinococcosis. Part 3: Jordan, a developing country with lower-middle income.

The economic costs of cystic echinococcosis (CE) in Jordan, a developing country of lower-middle income, were investigated. Initial cost-estimates for livestock were based on the published prevalences of Echinococcus granulosus infection in sheep and goats and the values of livestock-related products together with likely production losses. Likewise, the annual numbers of human cases of CE were estimated using published surgical incidences in man. The costs of surgery were estimated from hospital records and by costing out the procedures each patient received whilst undergoing treatment. After comparing the quality of life of patients treated for CE with that of case-matched controls, it appeared that the treated patients had some long-term morbidity caused either by the disease or the resulting treatment. A simple spreadsheet model was built up, to sum the individual cost items. Each cost item and each of the data related to prevalence and incidence was assigned a mathematical distribution and varied randomly, using Monte-Carlo techniques, throughout its range, over 10 000 simulations. The results of the study indicate that the most likely range of annual economic losses attributable to CE in Jordan (encompassing 95% confidence limits) is from U.S.$2 602 215-6533 661, with a median of U.S.$3 874 070.