The economic Impact of bovine Tuberculosis inEthiopia and China: A comparative study to assessthe importance of the diseas...
Aimso To demonstrate the importance of Bovine Tuberculosis  in developing nations – such as Ethiopia and China   • Particu...
Bovine Tuberculosiso   Mycobacterium bovis, is a zoonotic disease that is    prevalent across a wide range of nationso Aer...
Bovine Tuberculosis in Africao A study in Tanzania returned a rate of 1.3% for bTB positive  cases in individual animals w...
Bovine Tuberculosis in Asiao 62% of global cases of BTB are reported in the Asia  region (Cosivi et al. 1998).o Annual mor...
Methodso Animal Sector: LDPS2    o Adapted from the FAO by Zinnstag et al    o Adds economic layer on top of the livestock...
The Economic Impact of Bovine Tuberculosis in Ethiopia and China   2012
AssumptionsSeeking rateChina - 2% too poor to start treatmentTreatment seeking assumed 100% for both countries due to lack...
Results – Animal Industry (Ethiopia)                                           $10,700,000,000Average Annual NPV of Livest...
Results – Animal Industry (China)                                           $12,550,000,000Average Annual NPV of Livestock...
Results – Public Health (Ethiopia)                                                Per-Person CostsPer-Person Cost of Disea...
Results – Public Health (Ethiopia)                                              „Minimum‟ Cost to Society                 ...
Results – Public Health (China)                                     Per-Person Costs                                   $2....
Results – Public Health (China)                                     „Minimum‟ Cost to Society                             ...
Key Variables o China   o Medical Costs***   o Adherence Rate   o Daily Wage Rate o Ethiopia   o Daily Wage Rate   o Adher...
Implicationso The pasteurization barriero In nations with systematic pasteurization of milk, there is  little to no human ...
The One Health Differenceo Thus far, we have covered economics of zoonotic  diseases  • This has not been “One Health”o On...
Thank you!    The Economic Impact of Bovine Tuberculosis in Ethiopia and China   2012
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The societal impact of bovine tuberculosis in select Asian countries

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GRF One Health Summit 2012, Davos: Presentation by Adnan Ali Khan CHOUDHURY, Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Public Health Building , Herston Rd , Herston Qld 4006, Brisbane, Australia

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  • Multi-sectoral valuations
  • Humans: fever, chills, chest pain, emaciation
  • although the extent of BTB in this expenditure has not been fully investigated
  • The societal impact of bovine tuberculosis in select Asian countries

    1. 1. The economic Impact of bovine Tuberculosis inEthiopia and China: A comparative study to assessthe importance of the disease in Asia Author & Presenter: Adnan Choudhury Co-Authors: Jakob Zinsstag, Vanessa Racloz, Maxine Whittaker The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    2. 2. Aimso To demonstrate the importance of Bovine Tuberculosis in developing nations – such as Ethiopia and China • Particularly in Asiao To demonstrate the importance of both economic evaluations and the One Health Approach The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    3. 3. Bovine Tuberculosiso Mycobacterium bovis, is a zoonotic disease that is prevalent across a wide range of nationso Aerosol transmission between hosts (man, cattle, wildlife)o Causes TB Symptoms in humanso In Animal emaciation, fever, obstructed airways/vesselso Countries such as the United Kingdom spend £100 million a year in control efforts against the spread of bTB.o Less developed nations are usually unable to afford the steep costs of bTB controlo As such the disease spreads and becomes prevalent The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    4. 4. Bovine Tuberculosis in Africao A study in Tanzania returned a rate of 1.3% for bTB positive cases in individual animals while (Shirima et al. 2003)o Nigeria reported 1.08% (Ibrahim et al. 2010).o Herd prevalence up to 48%o The incidence of TB in Ethiopia was 353/100000 in 2004o Estimated 430,000 fatal cases in Africa due to TB (WHO 2011b). • 3.1% attributable to bTB (Worldwide)o High prevalence of consumption of unboiled milk The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    5. 5. Bovine Tuberculosis in Asiao 62% of global cases of BTB are reported in the Asia region (Cosivi et al. 1998).o Annual mortality due to all strains of tuberculosis in South-East Asia is estimated by the WHO to be 480,000o China, the fifth largest producer of milko Intensive production setups to cope with the overwhelming demand o Risk factor for aerosol transmissiono Evidence suggests that human results disease- associated costs of TB equate to 91% of annual household income, (Jackson et al. 2006). The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    6. 6. Methodso Animal Sector: LDPS2 o Adapted from the FAO by Zinnstag et al o Adds economic layer on top of the livestock demographic system o Allows the simulation of changes to the NPV of livestock industry due to the prevalence of Bovine Tuberculosiso Human Sector: Decision-Tree o Markov-Chain decision tree o Probabilistic model that simulates the disease cycle, interventions, treatment seeking etc o Life tables used to simulate the life cycle of 1000 individualso Uncertainty analysis: Monte Carlo Simulation The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    7. 7. The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    8. 8. AssumptionsSeeking rateChina - 2% too poor to start treatmentTreatment seeking assumed 100% for both countries due to lack of data, tempered by adherence and too poor to start.Adherence rateChina – 65% (literature)Ethiopia – no data available, assumed to be 75% with a pert distribution (low 0.5, high 0.9)PricesChina – derived from literature review for human TB medication. After weighted average of studies as well as conversion to USD, treatment costs were assumed to be $US148.80 per person for a full treatment.Ethiopia – Very low treatment cost assumed – due to poor data available The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    9. 9. Results – Animal Industry (Ethiopia) $10,700,000,000Average Annual NPV of Livestock Industry $10,650,000,000 $10,600,000,000 $10,550,000,000 $10,500,000,000 $10,450,000,000 $10,400,000,000 0% 1% 2% 4% 8% 10% 15% Prevalence The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    10. 10. Results – Animal Industry (China) $12,550,000,000Average Annual NPV of Livestock Industry $12,500,000,000 $12,450,000,000 $12,400,000,000 $12,350,000,000 $12,300,000,000 $12,250,000,000 0% 1% 2% 4% 8% 10% 15% Prevalence The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    11. 11. Results – Public Health (Ethiopia) Per-Person CostsPer-Person Cost of Disease to Society ($US) $0.14 $0.12 $0.10 $0.08 Mean $0.06 LCI 95% HCI 95% $0.04 $0.02 $0.00 1% 2% 3% 8% 10% % of bTB attributable to TB Cases The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    12. 12. Results – Public Health (Ethiopia) „Minimum‟ Cost to Society $1,800,000.00 $1,600,000.00Minimum Cost of Disease to Society ($US) $1,400,000.00 $1,200,000.00 $1,000,000.00 Mean $800,000.00 LCI 95% HCI 95% $600,000.00 $400,000.00 $200,000.00 $0.00 1% 2% 3% 8% 10% % of bTB attributable to TB Cases The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    13. 13. Results – Public Health (China) Per-Person Costs $2.50 $2.00Cost to Society Per-Person ($US) $1.50 Mean LCI 95% $1.00 HCI 95% $0.50 $0.00 1% 2% 4.20% 8% 10% % of bTB attributable to TB Cases The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    14. 14. Results – Public Health (China) „Minimum‟ Cost to Society $25,000,000.00 $20,000,000.00"Minimum" Cost to Society ($US) $15,000,000.00 LCI 95% Mean $10,000,000.00 HCI 95% $5,000,000.00 $0.00 10% 8% 4.20% 2% 1% % of bTB attributable to TB Cases The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    15. 15. Key Variables o China o Medical Costs*** o Adherence Rate o Daily Wage Rate o Ethiopia o Daily Wage Rate o Adherence Rate o LDPS2 – Differences in influential variables reflect industry demand o China: Milk o Ethiopia: Traction The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    16. 16. Implicationso The pasteurization barriero In nations with systematic pasteurization of milk, there is little to no human bTBo In most developing nations, there is little or no systematic pasteurization of milk • Therefore, bTB remains a disease of significance to human health The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    17. 17. The One Health Differenceo Thus far, we have covered economics of zoonotic diseases • This has not been “One Health”o One Health in the next stepo One health is when we evaluate the true societal costs and benefits of pasteurization • The reduction of animal and human costs • The added value to dairy products and benefits to farmers • The social benefits of purchasing milk safely from your local store The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012
    18. 18. Thank you! The Economic Impact of Bovine Tuberculosis in Ethiopia and China 2012

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