• 1.

    Craig PS, Budke CM, Schantz PM, Li T, Qiu J, Yang Y, Zeyhle E, Rogan MT, Ito A, 2007. Human echinococcosis: a neglected disease? Trop Med Health 35: 283292.

  • 2.

    McManus DP, Thompson RCA, 2003. Molecular epidemiology of cystic echinococcosis. Parasitology 127: S37S51.

  • 3.

    Pawłowski ZS, Eckert J, Vuitton DA, Ammann RW, Kern P, Craig PS, Dar KF, De Rosa F, Filice C, Gottstein B, Grimm F, Macpherson CNL, Sato N, Todorov T, Uchino J, von Sinner W, Wen H, 2001. Echinococcosis in humans: clinical aspects, diagnosis and treatment. Eckert J, Gemmell MA, Meslin F-X, Pawłowski ZS, eds. WHO/OIE Manual on Echinococcosis in Humans and Animals: A Public Health Problem of Global Concern. Paris, France: World Organisation for Animal Health, 2066.

    • Search Google Scholar
    • Export Citation
  • 4.

    Brunetti E, Kern P, Vuitton DA, 2010. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 114: 116.

    • Search Google Scholar
    • Export Citation
  • 5.

    Brunetti E, Garci HH, Junghanss T, 2011. Cystic echinococcosis: chronic, complex, and still neglected. PLoS Negl Trop Dis 5: e1146.

  • 6.

    Mastrandrea S, Stegel G, Piseddu T, Ledda S, Masala G, 2012. A retrospective study on burden of human echinococcosis based on hospital discharge records from 2001 to 2009 in Sardinia, Italy. Acta Trop 123: 184189.

    • Search Google Scholar
    • Export Citation
  • 7.

    Beaty L, 2005. Understanding diagnostic related groups (DRGs) and inpatient hospital reimbursement. Gastroenterol Nurs 28: 363368.

  • 8.

    Rinaldi F, Brunetti E, Neumayr A, Maestri M, Goblirsch S, Tamarozzi F, 2014. Cystic echinococcosis of the liver: a primer for hepatologists. World J Hepatol 6: 293.

    • Search Google Scholar
    • Export Citation
  • 9.

    Golemanov B, Grigorov N, Mitova R, Genov J, Vuchev D, Tamarozzi F, Brunetti E, 2011. Efficacy and safety of PAIR for cystic echinococcosis: experience on a large series of patients from Bulgaria. Am J Trop Med Hyg 84: 4851.

    • Search Google Scholar
    • Export Citation
  • 10.

    Benner C, Carabin H, Sánchez-Serrano LP, Budke CM, Carmena D, 2010. Analysis of the economic impact of cystic echinococcosis in Spain. Bull World Health Organ 88: 4957.

    • Search Google Scholar
    • Export Citation
  • 11.

    Budke CM, Deplazes P, Torgerson PR, 2006. Global socioeconomic impact of cystic echinococcosis. Emerg Infect Dis 12: 296303.

  • 12.

    Carabin H, Budke CM, Cowan LD, Willingham AL, Torgerson PR, 2005. Methods for assessing the burden of parasitic zoonoses: echinococcosis and cysticercosis. Trends Parasitol 21: 327333.

    • Search Google Scholar
    • Export Citation
  • 13.

    Piccoli L, Tamarozzi F, Cattaneo F, Mariconti M, Filice C, Bruno A, Brunetti E, 2014. Long-term sonographic and serological follow-up of inactive echinococcal cysts of the liver: hints for a “watch-and-wait” approach. PLoS Negl Trop Dis 8: e3057.

    • Search Google Scholar
    • Export Citation
 
 
 
 

 

 
 

 

 

 

 

 

 

Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy

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  • 1 Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
  • | 2 World Health Organization Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy.
  • | 3 Division of General Surgery, San Matteo Hospital Foundation, Pavia, Italy.
  • | 4 Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas.
  • | 5 Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy.

Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the “San Matteo” Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach.

Author Notes

* Address correspondence to Francesca Tamarozzi, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100 Pavia, Pavia, Italy. E-mail: f_tamarozzi@yahoo.com

Financial support: This study was partly funded by the FP7 Human Cystic Echinococcosis ReseArch in CentraL and Eastern Societies (HERACLES) project (to Enrico Brunetti).

Authors' addresses: Roberta Narra, Francesca Tamarozzi, Mara Mariconti, Giovanni J. Nicoletti, and Francesca Rinaldi, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy, E-mails: roberta.narra1989@gmail.com, f_tamarozzi@yahoo.com, maramariconti@libero.it, jacopo.nicoletti@yahoo.it, and francescarinaldi16@yahoo.it. Marcello Maestri, Division of General Surgery, IRCCS San Matteo Hospital Foundation, Pavia, Italy, E-mail: mmaestri@smatteo.pv.it. Christine M. Budke, Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, E-mail: cbudke@cvm.tamu.edu. Enrico Brunetti, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and Division of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy, E-mail: enrico.brunetti@unipv.it.

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