Monetary Burden of Taenia Solium Cysticercosis in Mexico

Cysticercosis is a parasitic disease caused by the larva of the cestode Taenia solium. The objectives of this study were to estimate 1) the annual cost of neurocysticercoss (NCC) in outpatients and hospitalized patients, 2) the pre-hospitalization, hospitalization, and post-hospitalization costs for hospitalized NCC patients, and 3) the total societal cost of cysticercosis in Mexico. In order to accomplish these objectives, a case series was conducted in two neurology referral hospitals in Mexico City. Information on presenting clinical manifestations, diagnostic tests, hospitalizations, surgical procedures, and other treatments received by NCC patients was collected from medical charts. A questionnaire was used to evaluate productivity losses and out-of-pocket expenses related to NCC. In order to estimate the societal cost of cysticercosis, epidemiologic and economic parameters were obtained from the published literature, government reports, and interviews with ministry of health workers, primary care providers, and secondary care providers. Interviews were conducted and medical charts reviewed for 224 NCC patients. The annual average per patient direct costs were U.S.$ 503 (95% CI: 414 – 592) and U.S.$ 438 (95% CI: 322 – 571) for outpatients without a history of hospitalization and/or surgery seen at the two referral hospitals. These costs increased to U.S.$ 2,506 (95% CI: 1,797 – 3,215) and U.S.$ 2,170 (95% CI: 1,303 – 3,037) for patients with a history of hospitalization and/or surgery. The medical charts of 108 patients hospitalized for NCC were reviewed to estimate pre-hospitalization, hospitalization, and post-hospitalization costs. The average per-patient pre-hospitalization and hospitalization costs were US$ 257 (95% CI: 185 – 329) and US$ 2,576 (95% CI: 2,244 – 2,908), respectively. Post-hospitalization costs decreased over time, with estimates for the first five years post-hospitalization of US$ 475 (95% CI: 423 – 527), US$ 228 (95% CI: 167 – 288), US$ 157 (95% CI: 111 – 202), US$ 150 (95% CI: 106 – 204), and US$ 91 (95% CI: 27 – 154), respectively. The total 2012 monetary losses associated with people with NCC-associated epilepsy and NCC-associated severe chronic headaches, in Mexico, along with losses to the agriculture sector, was estimated to be U.S.$250,219,772 (95% CR: 145,560,590 - 384,051,262). Cysticercosis continues to create health disparities and significant economic losses in Mexico