Abstract
An integrated model, based on a One Health approach, was implemented to estimate the epidemiological and economic outcomes of cystic echinococcosis (CE) in Veneto region, an hypo-endemic area of Northern Italy, and the costs for its prevention. Data and information needed to populate the model were retrieved from published literature, official statistics, expert opinions, or actively searched through data mining (i.e., Hospital and slaughterhouse data), when fundamental data were not available. Human-health and animal-health costs, both public and private, were considered. The overall impact of CE in the study area was estimated in an yearly cost of about 0.5 million €, due to an average of 19.5 human hospitalized cases and about 200 infected animals among cattle and sheep, per year. The human:animal costs ratio was about 8:1. Most of the infected animals were autochthonous, while the identification of an autochthonous source of the infection for the human cases was extremely difficult, and unlikely in most cases. No specific action resulted to be in place for human surveillance, while veterinary surveillance accounted for a yearly cost of about 22,000 €. Sheepherders were found to pay privately an overall amount of around 2000 € for the preventive treatment of their dogs every year, but the applied protocol proved to be sub-optimal. The source of most of the human cases was likely external to the study area, and their economic impact accounts for a cost that is far exceeding that of surveillance and preventive actions in place in the veterinary sector. Although autochthonous human cases appeared to be very rare, the strengthening of preventive actions and surveillance systems can reduce the risk of their increment.
Highlights
Evaluation in the domain of health is often mono-disciplinary, and tends to disregard the complexity of drivers and outcomes belonging to different scientific domains
The source of most of the human cases was likely external to the study area, and their economic impact accounts for a cost that is far exceeding that of surveillance and preventive actions in place in the veterinary sector
The One Health (OH) concept is a shift in this context, as it looks at the consequences of human actions in all the sectors involved in health, according to a cross-sectoral approach [2]
Summary
Evaluation in the domain of health is often mono-disciplinary, and tends to disregard the complexity of drivers and outcomes belonging to different scientific domains. The methodological approach for the evaluation of health measures and policies is changing toward a more comprehensive vision of health-related problems [1]. This study represents the outcome of a research project aimed at evaluating public/private health interventions to control cystic echi nococcosis (CE) in the Veneto region, North-Eastern Italy, to properly advise regional public health authorities. In Italy, regional health authorities have an important role in defining disease control programs and implementing surveillance activities. This project implemented an innovative evaluation methodology to investigate where policy strate gies might be improved through a rational, cross-sectorial and inter disciplinary approach. The study area corresponded to the administrative territory of the Veneto region and CE was chosen as a case study, in consideration of its emerging nature in the area
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