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Shiqu County, located on the Tibetan plateau of western China, has an extremely high prevalence of both human alveolar echinococcosis (AE), and cystic echinococcosis (CE). The short form 12 version 2 quality of life survey, which was used to evaluate the extent to which morbidity associated with echinococcosis should be accounted, verified that there was a significant reduction in the mean health scores in all categories for individuals diagnosed with abdominal echinococcosis compared with an age and sex cross-matched population. Results of a larger ultrasound survey, which screened 3135 subjects, demonstrated that the prevalence rates of AE and CE were both approximately 6% with a combined prevalence rate of 11.4%. Prevalence rates adjusted for the age and sex structure of Shiqu County were 4.6% for AE and 4.9% for CE with an estimated overall adjusted prevalence rate of 9.5%. The burden of disease associated with echinococcosis was calculated using disability adjusted life years (DALYs) based on these estimated prevalence rates. Monte-Carlo techniques were used to model the uncertainty in the prevalence estimates and the disability weights. Using these methods, we estimated that the total numbers of DALYs lost due echinococcosis was 50,933 (95% confidence interval [CI] = 41,995–61,026). The DALYs lost consisted of approximately 32,978 (95% CI = 25,019–42,422) due to AE and 17,955 (95% CI = 14,268–22,128) due to CE and suggests an average of approximately 0.81 DALY lost per person. This study has clearly shown that the impact of DALYs lost due to echinococcosis, in terms of medical treatment costs, lost income, and physical and social suffering, is likely to be substantial in this highly endemic region of China.
Received December 12, 2003. Accepted for publication February 24, 2004.
Acknowledgments: We thank the local government officials and health services providers of Shiqu County for their assistance in facilitating the fieldwork associated with this project. We also thank Dr. Gareth Sparham for his translation assistance.
Financial support: This work was supported by the National Institutes of Health and the National Science Foundation (1R01TW01565-01).
Authors’ addresses: Christine M. Budke and Paul R. Torgerson, Institute of Parasitology, University of Zurich, Winterthurerstrasse 266a, CH-8057 Zurich, Switzerland, Telephone: 41-1-635-8535, Fax: 41-1-635 8907. Qiu Jiamin and Wang Qian, Sichuan Institute of Parasitic Diseases, 10 University Road, Chengdu 610041, Sichuan, People’s Republic of China, Telephone: 86-28-555-3149, Fax: 86-28-555-8409. Jakob Zinsstag, Department of Public Health and Epidemiology, Swiss Tropical Institute, PO Box, CH-4002, Basel, Switzerland, Telephone: 41-61-284-8139, Fax: 41-61-271-7951.
Reprint requests: Christine M. Budke, Institute of Parasitology, University of Zurich, Winterthurerstrasse 266a, CH-8057 Zurich, Switzerland, Telephone: 41-1-635-8535, Fax: 41-1-635-8907, E-mail: budke{at}vetparas.unizh.ch.
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