Economic burden of Peste des Petits Ruminants in India: A meta-analysis with probabilistic uncertainty assessment

Peste des petits ruminants (PPR) is an enzootic disease of small ruminants and imposes substantial economic losses. This study estimated the national-level economic burden attributable to PPR in India through meta-analysis based on mortality loss, body-weight loss, treatment cost, opportunity cost of labour, distress sale loss and milk loss (for goats) by systematically synthesizing available evidence. Since several studies reporting per-animal economic losses did not provide measures of dispersion, a reference variability of 15% of the reported loss estimates was assumed for the primary meta-analysis, while alternative assumptions of 5%, 10%, 20% and 30% were evaluated through sensitivity analysis. Incidence and mortality rates were separately pooled through meta-analysis. Goat and sheep populations for 2024 were forecasted using log-trend growth models. The pooled epidemiological parameters, per-animal loss estimates and forecast populations were integrated to estimate the national economic burden. Under the 15% reference variability assumption, the estimated economic loss due to PPR in 2024 was USD 331.32 million (INR 27,830.59 million), comprising USD 219.91 million in goats and USD 111.41 million in sheep. Ten thousand bootstrap samples were generated with replacement for different loss components to characterize uncertainty associated with the limited evidence base and meta-analysis was performed for distribution parameterization. Monte Carlo simulation was subsequently employed to characterize uncertainty in the epidemiological and economic parameters. The findings demonstrate that PPR continues to impose a substantial economic burden on India's small-ruminant sector and provide an updated evidence base for strengthening disease-control and eradication efforts.