The Study On The Economic Burden And Impacts Of Advanced Schistosomiasis In Yunnan Province

OBJECTIVETo understand the distribution and characteristics of advanced shistosomiasis and to explore the factors that influences the economic burden and HRQOL of advanced shistosomiasis patients. So it will provide some scientific references for the control and assistance approach for advanced schistosomiasis in Yunnan.METHODSBase on the historical data, the spreadsheet data and household survey, analysis the distribution and characteristics of advanced shistosomiasis patients. Matched case-control design was used to survey the economic burden and HRQOL between 120 advanced schistosomiasis Patients and 120 individuals without advanced schistosomiasis from schistosomiasis epidemic area,.he sampling methods are stratified sampling and judgemental sampling, and the matched factors are sex, age and address. Estimate the economic burden of advanced schistosomiasis in 2010 in Yunnan. Analyze the main factors using Single factor analysis, Multivariate regression analysis and binary logistic analysis.RESULTSThe prevalence rate of advanced schistosomiasis was decreased from54.91 per 100,000 in 2007 to 48.73 per 100,000 in 2010. There are 52 new discovery cases in 791 prevalent cases. The duration was from 1 to 67 years (median 31 year).448 cases were Splenomegaly (56.64%),198were Aseitisas (25.03%),5cases were Colonie (0.63%),16cases were Dwarfism (2.02%) and 124 cases were nlargement of liver and spleen (15.68%). The age range of investigation object was from 24 to 87 years, and with 160 males and 631 females, who were distributed in 11 counties (districts). The most of patients are famers, married and low education. All of the patiens receiving the treatment and 452 were free.The economic burden from advanced schistosomiasis is 7938.94Yuan per patient in 2010 in Yunnan; it was 4.32 times for individuals without advanced schistosomiasis. Including the direct medical expenditure was 6005.79 Yuan per patient per year, the indirect medical expenditure is 693.22 Yuan per patient per year, and the indirect economic burden is 1239.93 Yuan per patient per year. All of the expenditures are higher than the controls.Multivariate regression analysis showed that age, concomitant disease, symptoms or signs modified, Epidemic Coefficient, surgical treatment and medical assistance have statistical significance correlations on advanced schistosomiasis economic burden.The EQVAS score of advanced schistosomiasis patients(68.32±10.97) was lower than individuals without advanced schistosomiasis(84.03±9.48), and each dimension of EQ-5D+C has a higher proportion of problems.Factors including age, sex, national, educational level, marital status, number of family members, family income level, drinking water type, toilet type, epidemic types, concomitant disease, labour ability, Course, surgical treatment and medical assistance had statistical significance correlations with HRQOL of advanced schistosomiasis Patients.CONCLUSIONSThe prevalence rate of advanced schistosomiasis was decreased in Yunnan. The main advanced cases come from the farmer in transmission control areas and plateau canyon, they are very elderly.The advanced shistosomiasis have brought heavy economic burden to patient in Yunnan. Consequently, it is extremely necessary to take some control work for the advanced shistosomiasis.The EQVAS score of advanced schistosomiasis patients was lower than individuals without advanced schistosomiasis; efforts to improve the HRQOL of advanced schistosomiasis patients include provide the services both on the clinical treatment and psychological nursing to patients, enhance the cultural quality of the patients, rapid local economic development, formulate the effective performance of the control programme and perfect policy of the medical assistance for advanced schistosomiasis.