Abstract:
Cystic Echinococcosis (CE) is caused by the larval stage of the tapeworm Echinococcus
granulosus. The disease occurs worldwide, and is highly endemic in parts of Kenya,
especially Turkana and Maasai areas. The life cycle involves dogs and other canids as
definitive hosts and livestock as intermediate hosts. Humans are aberrant intermediate
hosts. It’s a chronic debilitating disease resulting in morbidity, mortality and economic
losses in human and animal populations. The outcome of the infection in livestock and
human is cyst development in the liver, abdomen, lungs and other organ systems. In
resource poor countries like Kenya surgical intervention is the main mode of treatment
in CE infected individuals. In livestock the infection is typically asymptomatic and the
most reliable diagnostic method
is cyst detection during meat inspection and
postmortem. Condemnation of animal organs (liver, lungs) at meat inspection results in
CE-associated direct monetary loss. This study involved a retrospective review of CE
patients’ medical records obtained from AMREF-Kenya (1991-2011), with patients
originating from Turkana North district of Kenya. Retrogressive annual meat inspection
record review (5 years) and slaughter house surveys from selected regions (Kisumu East
and West, Isiolo and Kajiado North districts) were conducted to assess the livestock CEassociated
direct monetary loss. Data obtained were used to calculate CE-associated
direct losses in human and livestock populations. A total of 586 surgical cases treated at
Kakuma Mission Hospital, Turkana, Kenya were evaluated. The ratio of male: female
infection was 1:2, individuals in the 31-40 age groups being most prevalent. The average
direct cost of a CE surgical treatment was Kshs 60,000.00. The total direct cost for 586
surgical patients, including an additional factor of 10% for unreported and nonhealthcare
seeking
patients,
over
the
20
year
study
period
was
Kshs
38,649,000.00
with
an
average of Kshs 1,932,450.00 per year. Annual indirect CE-associated monetary
losses were calculated based on the lost economic opportunities by a herdsman or
housewife in the Turkana community due to CE morbidity or mortality; this amounted to
Kshs 411,250.00 for a herdsman and Kshs 117,716.00 for a house wife. The total direct
