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Preliminary estimates of economic impact of liver fluke infection in Thailand and the feasibility of irradiation as a control measure.

Liver fluke infection by Opisthorchis viverrini is the leading cause of food-borne parasitic disease in Thailand. Approximately one third of the population in the northeastern region of the country, ie, 6-7 million, are infected by this parasite through the habit of consuming raw or insufficiently cooked freshwater fish, especially those of cyprinoid family. A recent survey showed that 60% of the work force in the Northeast between the age of 15 and 60 is infected. The estimated wage loss of this population may be approximately Baht 1,620 million (US$65 million) per annum. The estimated direct cost of medical care may be as high as Baht 495 million (US$19.4 million) per annum. Thus, the total direct cost of the infected work force is estimated to be Baht 2115 million (US$84.6 million) per annum. Irradiation of fish flesh infected by metacercaria of O. viverrini has been demonstrated as an effective method of control. A minimum dose of 0.1 kGy is effective without changing physiochemical properties of the fish flesh. This technology, therefore, shows promise as a method to control infection by O. viverrini acquired by the habit of consuming raw freshwater fish in the country. Preliminary economic analyses indicate that the public health benefit from preventing infection with this parasite could outweigh the investment cost of irradiation facilities. Detailed economic feasibility studies should be carried out to demonstrate the practical efficacy and cost-effectiveness of the treatment as a public health intervention measure in the country.