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Rafikahmed SR, Mateti UV, Subramanya C, Shetty S, Sunny A, Madhusoodanan A. Assessment of direct medical cost using cost of illness analysis in patients with dengue fever - Retrospective study. Clinical Epidemiology and Global Health 2021. [DOI: 10.1016/j.cegh.2021.100842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Akbar NA, Assiri AM, Shabouni OI, Alwafi OM, Al-Raddadi R, H. Alzahrani M, Azhar EI, Amir A, Aljiffri AM, Althaqafi AO. The economic burden of dengue fever in the Kingdom of Saudi Arabia. PLoS Negl Trop Dis 2020; 14:e0008847. [PMID: 33253181 PMCID: PMC7728199 DOI: 10.1371/journal.pntd.0008847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/10/2020] [Accepted: 10/01/2020] [Indexed: 12/01/2022] Open
Abstract
Rapid urbanization, global trade, and the exceptionally great numbers of worldwide visitors during Hajj and Umrah have all placed the Kingdom of Saudi Arabia at a significant risk of introducing several vector-borne tropical diseases, such as dengue fever virus (DENV) infection. In this study we estimated DENV infection cost of illness (COI) in Saudi Arabia in the period 2013–2017, by processing national data including all declared cases recorded in referral centers in the western region, being the endemic region of the country. Using a statistically validated predictive model that was built on a representative sample of 717 laboratory-confirmed cases of DENV infection, direct costs, due to care-related expenditures, were estimated by applying the predictive equation to national data. However, indirect costs, which are due to productivity loss, were estimated using the human capital model based on gross domestic product adjusted for invalidity duration. Further, under-reporting was adjusted by using an expansion factor EF = 3. We observed highest estimated costs in 2016 with over US$168.5 Million total costs, including direct (US$29.0 Million) and indirect (US$139.5 Million) costs, for a total 4415 confirmed cases. The total DENV COI for the five years was estimated as US$551.0 Million for a total 15,369 patients (59.7%) out of 25,745 declared cases, resulting in an average cost of US$11 947.6 by patient. Depending on the year, productivity years loss costs accounted for 63.3% to 83.8% of the estimated total costs. Dengue has a substantial local economic burden that costs US$110.2 Million per year, stressing the urgent need for an effective national prevention strategy to perform considerable cost-savings besides reducing morbidity. The global incidence of DENV infection has evidenced a dramatic increase in the recent two decades with a great number of cases that are misclassified or underreported. These epidemiological characteristics generate high economic costs, especially in endemic regions and countries such as Saudi Arabia. This two-phase study aimed at providing economic data that helps political efficiency and resource prioritization for dengue prevention programs, by assessing the economic burden of disease over the last five years 2013–2017. A double-method used to estimate direct costs due to care expenses and indirect costs due to productivity loss, by using a predictive and an economic model, respectively. Assuming an expansion factor of 3 to correct under-reporting, the average estimated costs of dengue illness per year in the current study was US$117.87 million. Comparison of these findings with international reports emphasized the substantial disease burden of dengue fever in Saudi Arabia. Despite some limitations, this study provided the first economic data of dengue fever infection burden in Saudi Arabia.
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Affiliation(s)
- Naeema A. Akbar
- Preventive medicine, Public Health MOH, Jeddah, Saudi Arabia
- * E-mail:
| | | | | | - Osama M. Alwafi
- Preventive medicine department, Public Health MOH, Makkah, Saudi Arabia
| | - Rajaa Al-Raddadi
- King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi Arabia
| | | | - Esam I. Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center & Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ashraf Amir
- Chief Medical Officer, International Medical center, Jeddah, Saudi Arabia
| | - Abdullah M. Aljiffri
- Infection Control Consultant, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdulhakeem O. Althaqafi
- Department of medicine, King Abdulaziz Medical city- Jeddah, King Saud bin Abdulaziz university for Health Sciences, King Abdullah Medical center, Saudi Arabia
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Salinas MA, Soto VE, Prada SI. Análisis de costo-efectividad del uso del programa VECTOS en el control rutinario de enfermedades transmitidas por Aedes aegypti en dos municipios de Santander, Colombia. biomedica 2020; 40:270-282. [PMID: 32673456 PMCID: PMC7505512 DOI: 10.7705/biomedica.4658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Indexed: 12/04/2022]
Abstract
Introducción. Las enfermedades transmitidas por Aedes aegypti son un problema de salud pública. VECTOS es un programa novedoso de integración de estrategias de control de vectores. Objetivo. Evaluar el costo-efectividad del uso del VECTOS en los programas de control rutinario de enfermedades transmitidas por el vector Aedes aegypti en el municipio de San Juan de Girón (Santander). Materiales y métodos. Se evaluó el costo-efectividad del programa empleando un modelo de análisis de decisiones desde la perspectiva de las autoridades locales de salud. Se estudió la integración de las estrategias de control de vectores mediante el programa VECTOS utilizado en el municipio de San Juan de Girón durante el 2016, con el control rutinario llevado a cabo sin VECTOS en el municipio de Floridablanca. Se calculó la razón incremental del costo-efectividad (RICE), usando como medida de efectividad los años de vida ajustados por discapacidad (AVAD). Resultados. El uso del programa VECTOS fue rentable a una tasa de ahorro de USD$ 660,4 por cada AVAD evitado en comparación con el control de rutina en Floridablanca. El modelo probabilístico indicó que el sistema fue costo-efectivo en el 70 % de las 10.000 iteraciones para un umbral entre 1 y 3 PIB per cápita. Conclusiones. El programa VECTOS fue muy costo-efectivo en el municipio de San Juan de Girón. Su uso puede adoptarse en otros municipios del país donde las enfermedades transmitidas por A. aegypti son endémicas.
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Laserna A, Barahona-Correa J, Baquero L, Castañeda-Cardona C, Rosselli D. Economic impact of dengue fever in Latin America and the Caribbean: a systematic review. Rev Panam Salud Publica 2019; 42:e111. [PMID: 31093139 PMCID: PMC6386068 DOI: 10.26633/rpsp.2018.111] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 05/29/2018] [Indexed: 12/18/2022] Open
Abstract
Objectives To assess the economic impact of dengue in Latin America and the Caribbean using a systematic review that includes studies not previously considered by other reviews. Methods Cochrane methodology was used to conduct a systematic review of the cost of dengue in Latin America. PubMed Central, EMBASE, and the Biblioteca Virtual en Salud—which includes scientific, peer-reviewed journals not indexed by other databases—were searched from inception through August 2016. All articles that reported cost of illness data for countries in Latin America were included. Included studies underwent a methodological appraisal using a seven-question instrument designed for cost of illness studies. Extracted data were direct and indirect costs for outpatient and hospitalized cases and total cost of the disease. Values were adjusted to 2015 US dollars using the consumer price index. Results From a total of 848 initial references, 17 studies were included, mainly from Brazil, Colombia, Cuba, Mexico, and Puerto Rico; costs were available for 39 countries. The methodological appraisal showed that 70% of the studies met more than 70% of the evaluated items. The main economic impact of dengue was due to productivity costs. Average annual cost was more than US$ 3 billion. Direct costs represented over 70% of the total share for hospitalized cases. For outpatients, direct medical costs were low, but social costs were significant since indirect costs may account for up to 80% of the total cost. Conclusions Dengue fever has a significant economic impact in Latin America. It is essential to develop new public health interventions, such as dengue vaccination, to decrease the propagation of the disease and its total cost.
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Affiliation(s)
- Andrés Laserna
- School of Medicine, Pontificia Universidad Javeriana, School of Medicine, Bogotá, Colombia
| | - Julián Barahona-Correa
- School of Medicine, Pontificia Universidad Javeriana, School of Medicine, Bogotá, Colombia
| | - Laura Baquero
- School of Medicine, Pontificia Universidad Javeriana, School of Medicine, Bogotá, Colombia
| | | | - Diego Rosselli
- Clinical Epidemiology and Biostatistics Department, Pontificia Universidad Javeriana, Medical School, Bogotá, Colombia
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Hung TM, Clapham HE, Bettis AA, Cuong HQ, Thwaites GE, Wills BA, Boni MF, Turner HC. The Estimates of the Health and Economic Burden of Dengue in Vietnam. Trends Parasitol 2018; 34:904-918. [PMID: 30100203 PMCID: PMC6192036 DOI: 10.1016/j.pt.2018.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 12/31/2022]
Abstract
Dengue has been estimated to cause a substantial health and economic burden in Vietnam. The most recent studies have estimated that it is responsible for 39884 disability-adjusted life years (DALYs) annually, representing an economic burden of US$94.87 million per year (in 2016 prices). However, there are alternative burden estimates that are notably lower. This variation is predominantly due to differences in how the number of symptomatic dengue cases is estimated. Understanding the methodology of these burden calculations is vital when interpreting health economic analyses of dengue. This review aims to provide an overview of the health and economic burden estimates of dengue in Vietnam. We also highlight important research gaps for future studies.
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Affiliation(s)
- Trinh Manh Hung
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Hannah E Clapham
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Alison A Bettis
- London Centre for Neglected Tropical Disease Research, London, UK; Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London W2 1 PG, UK
| | | | - Guy E Thwaites
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Bridget A Wills
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Maciej F Boni
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Hugo C Turner
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Basso C, García da Rosa E, Lairihoy R, Caffera RM, Roche I, González C, da Rosa R, Gularte A, Alfonso-Sierra E, Petzold M, Kroeger A, Sommerfeld J. Scaling Up of an Innovative Intervention to Reduce Risk of Dengue, Chikungunya, and Zika Transmission in Uruguay in the Framework of an Intersectoral Approach with and without Community Participation. Am J Trop Med Hyg 2017; 97:1428-1436. [PMID: 28820690 PMCID: PMC5817745 DOI: 10.4269/ajtmh.17-0061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/15/2017] [Indexed: 01/25/2023] Open
Abstract
To contribute to the prevention of dengue, chikungunya, and Zika, a process of scaling up an innovative intervention to reduce Aedes aegypti habitats, was carried out in the city of Salto (Uruguay) based on a transdisciplinary analysis of the eco-bio-social determinants. The intervention in one-third of the city included the distributions of plastic bags for all households to collect all discarded water containers that were recollected by the Ministry of Health and the Municipality vector control services. The results were evaluated in 20 randomly assigned clusters of 100 households each, in the intervention and control arm. The intervention resulted in a significantly larger decrease in the number of pupae per person index (as a proxy for adult vector abundance) than the corresponding decrease in the control areas (both areas decreased by winter effects). The reduction of intervention costs ("incremental costs") in relation to routine vector control activities was 46%. Community participation increased the collaboration with the intervention program considerably (from 48% of bags handed back out of the total of bags delivered to 59% of bags handed back). Although the costs increased by 26% compared with intervention without community participation, the acceptability of actions by residents increased from 66% to 78%.
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Affiliation(s)
- César Basso
- Unidad de Entomología, Departamento de Protección Vegetal, Facultad de Agronomía, Universidad de la República, Montevideo, Uruguay
| | - Elsa García da Rosa
- Departamento de Parasitología Veterinaria, Facultad de Veterinaria, Universidad de la República, Salto, Uruguay
| | - Rosario Lairihoy
- Departamento de Parasitología Veterinaria, Facultad de Veterinaria, Universidad de la República, Salto, Uruguay
| | - Ruben M. Caffera
- Departamento de Sistemas Ambientales, Facultad de Agronomía, Universidad de la República, Montevideo, Uruguay
| | - Ingrid Roche
- Instituto de Teoría de la Arquitectura y Urbanismo, Facultad de Arquitectura, Diseño y Urbanismo, Universidad de la República, Montevideo, Uruguay
| | - Cristina González
- Dirección Departamental de Salud de Salto, Ministerio de Salud Pública, Salto, Uruguay
| | - Ricardo da Rosa
- Dirección Departamental de Salud de Salto, Ministerio de Salud Pública, Salto, Uruguay
| | - Alexis Gularte
- Dirección Departamental de Salud de Salto, Ministerio de Salud Pública, Salto, Uruguay
| | | | - Max Petzold
- Centre of Applied Biostatistics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Axel Kroeger
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Johannes Sommerfeld
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization (WHO), Geneva, Switzerland
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Mata VE, Passos SRL, Hökerberg YHM, Berardinelli GM, dos Santos MAB, Fukuoka LVB, Maciel ACFSR, dos Santos Rodrigues CD, da Silva Santos A, de Vasconcellos Carvalhaes de Oliveira R. Precisão e confiabilidade de um teste imuno-cromatográfico rápido NS1 para diagnóstico DENV-1 no ponto de atendimento e no laboratório. BMC Infect Dis 2017; 17:594. [PMID: 28851293 PMCID: PMC5576130 DOI: 10.1186/s12879-017-2679-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/10/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Rapid immunochromatographic tests (ICT) for dengue non-structural protein 1 (NS1) have shown good performance for diagnosing acute-phase dengue in serum in laboratory settings, but rarely have been assessed in whole blood and at point of care (POC). This study compare the accuracy and inter- and intra-observer reliability of the NS1 Bioeasy™ ICT in whole blood at POC versus serum in the laboratory, during a DENV-1 epidemic. METHODS Cross-sectional study involving 144 adults spontaneously demanding care in an emergency department within 4 days of onset of acute febrile illness. Accuracy of NS1 Bioeasy™ ICT was compared in whole blood and serum, both at 15 and 30 min, blinded to the reference RT-PCR or NS1 ELISA. Non-dengue patients were also tested for Zika virus with RT-PCR. Reliability of whole blood and serum readings by the same or different observers was measured by simple kappa (95% CI). RESULTS At 15 min, sensitivity (Sn) of NS1 Bioeasy™ ICT in whole blood/POC was 76.7% (95% CI: 68.0-84.1) and specificity (Sp) was 87.0% (95% CI: 66.4-97.2). Sn in serum/laboratory was 82% (95% CI: 74.1-88.6) and Sp 100% (95% CI: 85.8-100). Positive likelihood ratio was 5.9 (95% CI: 2.0-17.0) for whole blood/POC and 19.8 (95% CI: 2.9-135.1) for serum/laboratory. Reliability of matched readings of whole blood/POC and serum/laboratory by the same observer (k = 0.83, 95% CI: 0.74-0.93) or different observers (k = 0.81, 95% CI: 0.72-0.92) was almost perfect, with higher discordant levels in the absence of dengue. Results did not differ statistically at 5%. CONCLUSIONS NS1 Bioeasy™ ICT in DENV-1 epidemics is a potentially confirmatory test. Invalid results at 15 min should be reread at 30 min. To optimize impact of implementing ICT in the management of false-negatives it should be incorporated into an algorithm according to setting and available specimen. TRIAL REGISTRATION UTN U1111-1145-9451 .
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Vo NTT, Phan TND, Vo TQ. Direct Medical Costs of Dengue Fever in Vietnam: A Retrospective Study in a Tertiary Hospital. Malays J Med Sci 2017; 24:66-72. [PMID: 28814934 DOI: 10.21315/mjms2017.24.3.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/14/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND In Vietnam, dengue fever is a major health concern, yet comprehensive information on its economic costs is lacking. The present study investigated treatment costs associated with dengue fever from the perspective of health care provision. METHODS This retrospective study was conducted between January 2013 and December 2015 in Cu Chi General Hospital. The following dengue-related treatment costs were calculated: hospitalisation, diagnosis, specialised services, drug usage and medical supplies. Average cost per case and treatment cost across different age was calculated. RESULTS In the study period, 1672 patients with dengue fever were hospitalised. The average age was 24.98 (SD = 14.10) years, and 47.5% were males (795 patients). Across age groups, the average cost per episode was USD 48.10 (SD = 3.22). The highest costs (USD 56.61, SD = 48.84) were incurred in the adult age group (> 15 years), and the lowest costs (USD 30.10, SD = 17.27) were incurred in the paediatric age group (< 15 years). CONCLUSION The direct medical costs of dengue-related hospitalisation place a severe economic burden on patients and their families. The probable economic value of dengue management in Vietnam is significant.
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Affiliation(s)
- Nhung Thi Tuyet Vo
- Department of Pharmacy Administration, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City 700000, Vietnam
| | - Trang Ngo Diem Phan
- Department of Pharmacy, Cu Chi General Hospital, Ho Chi Minh City 700000, Vietnam
| | - Trung Quang Vo
- Department of Pharmacy Administration, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City 700000, Vietnam
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Heydari N, Larsen DA, Neira M, Beltrán Ayala E, Fernandez P, Adrian J, Rochford R, Stewart-Ibarra AM. Household Dengue Prevention Interventions, Expenditures, and Barriers to Aedes aegypti Control in Machala, Ecuador. Int J Environ Res Public Health 2017; 14:E196. [PMID: 28212349 DOI: 10.3390/ijerph14020196] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/24/2017] [Accepted: 02/14/2017] [Indexed: 01/25/2023]
Abstract
The Aedes aegypti mosquito is an efficient vector for the transmission of Zika, chikungunya, and dengue viruses, causing major epidemics and a significant social and economic burden throughout the tropics and subtropics. The primary means of preventing these diseases is household-level mosquito control. However, relatively little is known about the economic burden of Ae. aegypti control in resource-limited communities. We surveyed residents from 40 households in a high-risk community at the urban periphery in the city of Machala, Ecuador, on dengue perceptions, vector control interventions, household expenditures, and factors influencing purchasing decisions. The results of this study show that households spend a monthly median of US$2.00, or 1.90% (range: 0.00%, 9.21%) of their family income on Ae. aegypti control interventions. Households reported employing, on average, five different mosquito control and dengue prevention interventions, including aerosols, liquid sprays, repellents, mosquito coils, and unimpregnated bed nets. We found that effectiveness and cost were the most important factors that influence people’s decisions to purchase a mosquito control product. Our findings will inform the development and deployment of new Ae. aegypti control interventions by the public health and private sectors, and add to prior studies that have focused on the economic burden of dengue-like illness.
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Castro MC, Wilson ME, Bloom DE. Disease and economic burdens of dengue. Lancet Infect Dis 2017; 17:e70-e78. [PMID: 28185869 DOI: 10.1016/s1473-3099(16)30545-x] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 01/07/2023]
Abstract
The burden of dengue is large and growing. More than half of the global population lives in areas with risk of dengue transmission. Uncertainty in burden estimates, however, challenges policy makers' ability to set priorities, allocate resources, and plan for interventions. In this report, the first in a Series on dengue, we explore the estimations of disease and economic burdens of dengue, and the major estimation challenges, limitations, and sources of uncertainty. We also reflect on opportunities to remedy these deficiencies. Point estimates of apparent dengue infections vary widely, although the confidence intervals of these estimates overlap. Cost estimates include different items, are mostly based on a single year of data, use different monetary references, are calculated from different perspectives, and are difficult to compare. Comprehensive estimates that decompose the cost by different stakeholders (as proposed in our framework), that consider the cost of epidemic years, and that account for productivity and tourism losses, are scarce. On the basis of these estimates, we propose the most comprehensive framework for estimating the economic burden of dengue in any region, differentiated by four very different domains of cost items and by three potential stakeholders who bear the costs. This framework can inform future estimations of the economic burden of dengue and generate demand for additional routine administrative data collection, or for systematic incorporation of additional questions in nationally representative surveys in dengue-endemic countries. Furthermore, scholars could use the framework to guide scenario simulations that consider ranges of possible values for cost items for which data are not yet available. Results would be valuable to policy makers and would also raise awareness among communities, potentially improving dengue control efforts.
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Affiliation(s)
- Marcia C Castro
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Mary E Wilson
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA; School of Medicine, University of California, San Francisco, CA, USA
| | - David E Bloom
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
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Alfonso-Sierra E, Basso C, Beltrán-Ayala E, Mitchell-Foster K, Quintero J, Cortés S, Manrique-Saide P, Guillermo-May G, Caprara A, de Lima EC, Kroeger A. Innovative dengue vector control interventions in Latin America: what do they cost? Pathog Glob Health 2017; 110:14-24. [PMID: 26924235 PMCID: PMC4870030 DOI: 10.1080/20477724.2016.1142057] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Five studies were conducted in Fortaleza (Brazil), Girardot (Colombia), Machala (Ecuador), Acapulco (Mexico), and Salto (Uruguay) to assess dengue vector control interventions tailored to the context. The studies involved the community explicitly in the implementation, and focused on the most productive breeding places for Aedes aegypti. This article reports the cost analysis of these interventions. Methods We conducted the costing from the perspective of the vector control program. We collected data on quantities and unit costs of the resources used to deliver the interventions. Comparable information was requested for the routine activities. Cost items were classified, analyzed descriptively, and aggregated to calculate total costs, costs per house reached, and incremental costs. Results Cost per house of the interventions were $18.89 (Fortaleza), $21.86 (Girardot), $30.61 (Machala), $39.47 (Acapulco), and $6.98 (Salto). Intervention components that focused mainly on changes to the established vector control programs seem affordable; cost savings were identified in Salto (−21%) and the clean patio component in Machala (−12%). An incremental cost of 10% was estimated in Fortaleza. On the other hand, there were also completely new components that would require sizeable financial efforts (installing insecticide-treated nets in Girardot and Acapulco costs $16.97 and $24.96 per house, respectively). Conclusions The interventions are promising, seem affordable and may improve the cost profile of the established vector control programs. The costs of the new components could be considerable, and should be assessed in relation to the benefits in reduced dengue burden.
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Affiliation(s)
- Eduardo Alfonso-Sierra
- a Centre for Medicine and Society, Global Health , Freiburg University , Freiburg , Germany
| | - César Basso
- b Facultad de Agronomía, Departamento de Protección Vegetal , Universidad de la República , Montevideo , Uruguay
| | - Efraín Beltrán-Ayala
- c Departamento de Ciencias de la Salud , Universidad Técnica de Machala , Machala , Ecuador.,d Servicio Nacional de Control de Enfermedades Transmitidas por Vectores Artrópodos , Guayaquil , Ecuador
| | - Kendra Mitchell-Foster
- e Interdisciplinary Studies Graduate Program/Global Health Research Program, School of Population and Public Health , University of British Columbia , Vancouver , Canada
| | | | | | - Pablo Manrique-Saide
- g Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias , Universidad Autónoma de Yucatán , Mérida , México
| | - Guillermo Guillermo-May
- g Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias , Universidad Autónoma de Yucatán , Mérida , México
| | - Andrea Caprara
- h Department of Public Health , University of Ceará State (UECE) , Fortaleza , Brazil
| | | | - Axel Kroeger
- i Special Programme for Research and Training in Tropical Diseases (TDR) , World Health Organization , Geneva , Switzerland.,j Liverpool School of Tropical Medicine , Liverpool , UK
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Viennet E, Ritchie SA, Williams CR, Faddy HM, Harley D. Public Health Responses to and Challenges for the Control of Dengue Transmission in High-Income Countries: Four Case Studies. PLoS Negl Trop Dis 2016; 10:e0004943. [PMID: 27643596 PMCID: PMC5028037 DOI: 10.1371/journal.pntd.0004943] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Dengue has a negative impact in low- and lower middle-income countries, but also affects upper middle- and high-income countries. Despite the efforts at controlling this disease, it is unclear why dengue remains an issue in affluent countries. A better understanding of dengue epidemiology and its burden, and those of chikungunya virus and Zika virus which share vectors with dengue, is required to prevent the emergence of these diseases in high-income countries in the future. The purpose of this review was to assess the relative burden of dengue in four high-income countries and to appraise the similarities and differences in dengue transmission. We searched PubMed, ISI Web of Science, and Google Scholar using specific keywords for articles published up to 05 May 2016. We found that outbreaks rarely occur where only Aedes albopictus is present. The main similarities between countries uncovered by our review are the proximity to dengue-endemic countries, the presence of a competent mosquito vector, a largely nonimmune population, and a lack of citizens’ engagement in control of mosquito breeding. We identified important epidemiological and environmental issues including the increase of local transmission despite control efforts, population growth, difficulty locating larval sites, and increased human mobility from neighboring endemic countries. Budget cuts in health and lack of practical vaccines contribute to an increased risk. To be successful, dengue-control programs for high-income countries must consider the epidemiology of dengue in other countries and use this information to minimize virus importation, improve the control of the cryptic larval habitat, and engage the community in reducing vector breeding. Finally, the presence of a communicable disease center is critical for managing and reducing future disease risks.
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Affiliation(s)
- Elvina Viennet
- Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
- Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
- * E-mail:
| | - Scott A. Ritchie
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia
| | - Craig R. Williams
- Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Helen M. Faddy
- Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - David Harley
- Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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Augustovski F, Zárate V, Caro J, Ferraz MB. Brief Latin American Update: One More ViHRI Annual Issue, and Another Exciting Biennial ISPOR Conference. Value Health Reg Issues 2015; 8:137-138. [PMID: 29698166 DOI: 10.1016/j.vhri.2015.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Federico Augustovski
- Institute for Clinical Effectiveness and Health Policy (IECS), University of Buenos Aires, Buenos Aires, Argentina
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