Economic losses due to cystic echinococcosis in India: Need for urgent action to control the disease.

Cystic ehinococcosis (CE) caused by Echinococcus granulosus remains a neglected zoonotic disease despite its considerable human and animal health concerns. This is the first systematic analysis of the livestock and human related economic losses due to cystic echinococcosis in India. Data about human cases were obtained from a tertiary hospital. Human hydatidosis cases with and without surgical interventions were extrapolated to be 5647 and 17075 per year assuming a total human population of 1210193422 in India. Data about prevalence of hydatid cysts in important food producing animals were obtained from previously published abattoir based epidemiological surveys that reported a prevalence of 5.39% in cattle, 4.36% in buffaloes, 3.09% in pigs, 2.23% in sheep and 0.41% in goats. Animal population data were sourced from the latest census conducted by the Department of Animal Husbandry, Dairying and Fisheries, India. Other input parameters were obtained from published scientific literature. Probability distributions were included for many input values to account for variability and uncertainty. Sensitivity analyses were conducted to evaluate the effect of important parameters on the estimated economic losses. The analysis revealed a total annual median loss of Rs. 11.47 billion (approx. US $ 212.35 million). Cattle and buffalo industry accounted for most of the losses: 93.05% and 88.88% of the animal and total losses, respectively. Human hydatidosis related losses were estimated to be Rs. 472.72 million (approx. US $ 8.75 million) but are likely to be an under-estimate due to under-reporting of the disease in the country. The human losses more than quadrupled to Rs. 1953 million i.e. approx. US $ 36.17 million, when the prevalence of human undiagnosed cases was increased to 0.2% in the sensitivity analyses. The social loss and psychological distress were not taken into account for calculating human loss. The results highlight an urgent need for a science based policy to control and manage the disease in the country.