BACKGROUND Lymphatic filariasis (LF) is endemic in 72 countries of Africa, Asia, Oceania, and the Americas. An estimated 25 million men live with the disabling effects of filarial hydrocele. Hydrocele can be corrected with surgery with few complications. For most men, hydrocelectomy reduces or corrects filarial hydrocele and permits them to resume regular activities of daily living and gainful employment. METHODOLOGY AND PRINCIPAL FINDINGS This study measures the economic loss due to filarial hydrocele and the benefits of hydrocelectomy and is based on pre- and post-operative surveys of patients in southern Malawi. We find the average number of days of work lost due to filarial hydrocele and daily earnings for men in rural Malawi. We calculate average annual lost earnings and find the present discounted value for all years from the time of surgery to the end of working life. We estimate the total costs of surgery. We compare the benefit of the work capacity restored to the costs of surgery to determine the benefit-cost ratio. For men younger than 65 years old, the average annual earnings loss attributed to hydrocele is US$126. The average discounted present value of lifetime earnings loss for those men is US$1684. The average budgetary cost of the hydrocelectomy is US$68. The ratio of the benefit of surgery to its costs is US$1684/US$68 or 24.8. Sensitivity analysis demonstrates that the results are robust to variations in cost of surgery and length of working life. CONCLUSION The lifetime benefits of hydrocelectomy-to the man, his family, and his community-far exceed the costs of repairing the hydrocele. Scaling up subsidies to hydrocelectomy campaigns should be a priority for governments and international aid organizations to prevent and alleviate disability and lost earnings that aggravate poverty among the many millions of men with filarial hydrocele.

中文翻译：

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马拉维丝虫鞘膜积液的经济效益和手术费用。

背景技术淋巴丝虫病（LF）在非洲，亚洲，大洋洲和美洲的72个国家中很流行。估计有2500万人患有丝虫鞘膜积液的致残作用。鞘膜积液可以通过很少的并发症进行手术矫正。对于大多数男性，水囊切除术可以减少或矫正丝状鞘膜积液，并使其恢复正常的日常生活和有酬工作。方法学和主要发现本研究基于对马拉维南部地区患者的术前和术后调查，测量了因丝虫性鞘膜积液造成的经济损失以及腔静脉切开术的益处。我们发现马拉维农村男性因丝虫鞘膜积水和男性每日收入而损失的平均工作日数。我们计算平均年损失收入，并找到从手术时间到工作寿命结束的所有年份的当前折现值。我们估计手术的总费用。我们将恢复工作能力的收益与手术费用进行比较，以确定收益成本比。对于65岁以下的男性，鞘膜积液导致的平均年收入损失为126美元。这些男人终生收入损失的平均折现现值为1684美元。进行水囊切除术的平均预算费用为68美元。手术收益与其成本之比为1684美元/ 68美元或24.8。敏感性分析表明，该结果对于手术成本和工作寿命的变化具有鲁棒性。结论进行水囊切开术对男性，他的家人，他的社区远远超出了修复鞘膜积液的费用。政府和国际援助组织应优先考虑扩大对水囊切开术运动的补贴，以预防和减轻致残数百万患有丝状鞘膜积水的男子的残疾和收入损失，从而加剧贫困。