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Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba

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Abstract
Objective: To assess the economic cost of routine Aedes aegypti control in an at-risk environment without dengue endemicity and the incremental costs incurred during a sporadic outbreak. Methods: The study was conducted in 2006 in the city of Guantanamo, Cuba. We took a societal perspective to calculate costs in months without dengue transmission (January-July) and during an outbreak (August-December). Data sources were bookkeeping records, direct observations and interviews. Results: The total economic cost per inhabitant (p. i.) per month. (p. m.) increased from 2.76 USD in months without dengue transmission to 6.05 USD during an outbreak. In months without transmission, the routine Aedes control programme cost 1.67 USD p. i. p. m. Incremental costs during the outbreak were mainly incurred by the population and the primary / secondary level of the healthcare system, hardly by the vector control programme (1.64, 1.44 and 0.21 UDS increment p. i. p. m., respectively). The total cost for managing a hospitalized suspected dengue case was 296.60 USD (62.0% direct medical, 9.0% direct non-medical and 29.0% indirect costs). In both periods, the main cost drivers for the Aedes control programme, the healthcare system and the community were the value of personnel and volunteer time or productivity losses. Conclusions: Intensive efforts to keep A. aegypti infestation low entail important economic costs for society. When a dengue outbreak does occur eventually, costs increase sharply. In-depth studies should assess which mix of activities and actors could maximize the effectiveness and cost-effectiveness of routine Aedes control and dengue prevention.
Keywords
dengue outbreak control, economic cost, Aedes aegypti control, Cuba, controle de l'Aedes aegypti, controle de l'epidemie de la dengue, cout economique, control de Aedes aegypti, control de un brote de dengue, coste economico, VECTOR CONTROL, AEDES-AEGYPTI, AMERICA, SURVEILLANCE, STRATEGIES, HEALTH, TRANSMISSION, SANTIAGO, LIFE, ASIA

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Chicago
Baly Gil, Alberto, Maria E Toledo, Karina Rodriguez, Juan R Benitez, Maritza Rodriguez, Marleen Boelaert, Veerle Vanlerberghe, and Patrick Van Der Stuyft. 2012. “Costs of Dengue Prevention and Incremental Cost of Dengue Outbreak Control in Guantanamo, Cuba.” Tropical Medicine & International Health 17 (1): 123–132.
APA
Baly Gil, A., Toledo, M. E., Rodriguez, K., Benitez, J. R., Rodriguez, M., Boelaert, M., Vanlerberghe, V., et al. (2012). Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba. TROPICAL MEDICINE & INTERNATIONAL HEALTH, 17(1), 123–132.
Vancouver
1.
Baly Gil A, Toledo ME, Rodriguez K, Benitez JR, Rodriguez M, Boelaert M, et al. Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba. TROPICAL MEDICINE & INTERNATIONAL HEALTH. 2012;17(1):123–32.
MLA
Baly Gil, Alberto, Maria E Toledo, Karina Rodriguez, et al. “Costs of Dengue Prevention and Incremental Cost of Dengue Outbreak Control in Guantanamo, Cuba.” TROPICAL MEDICINE & INTERNATIONAL HEALTH 17.1 (2012): 123–132. Print.
@article{4126644,
  abstract     = {Objective: To assess the economic cost of routine Aedes aegypti control in an at-risk environment without dengue endemicity and the incremental costs incurred during a sporadic outbreak.
Methods: The study was conducted in 2006 in the city of Guantanamo, Cuba. We took a societal perspective to calculate costs in months without dengue transmission (January-July) and during an outbreak (August-December). Data sources were bookkeeping records, direct observations and interviews.
Results: The total economic cost per inhabitant (p. i.) per month. (p. m.) increased from 2.76 USD in months without dengue transmission to 6.05 USD during an outbreak. In months without transmission, the routine Aedes control programme cost 1.67 USD p. i. p. m. Incremental costs during the outbreak were mainly incurred by the population and the primary / secondary level of the healthcare system, hardly by the vector control programme (1.64, 1.44 and 0.21 UDS increment p. i. p. m., respectively). The total cost for managing a hospitalized suspected dengue case was 296.60 USD (62.0\% direct medical, 9.0\% direct non-medical and 29.0\% indirect costs). In both periods, the main cost drivers for the Aedes control programme, the healthcare system and the community were the value of personnel and volunteer time or productivity losses.
Conclusions: Intensive efforts to keep A. aegypti infestation low entail important economic costs for society. When a dengue outbreak does occur eventually, costs increase sharply. In-depth studies should assess which mix of activities and actors could maximize the effectiveness and cost-effectiveness of routine Aedes control and dengue prevention.},
  author       = {Baly Gil, Alberto and Toledo, Maria E and Rodriguez, Karina and Benitez, Juan R and Rodriguez, Maritza and Boelaert, Marleen and Vanlerberghe, Veerle and Van Der Stuyft, Patrick},
  issn         = {1360-2276},
  journal      = {TROPICAL MEDICINE \& INTERNATIONAL HEALTH},
  keyword      = {dengue outbreak control,economic cost,Aedes aegypti control,Cuba,controle de l'Aedes aegypti,controle de l'epidemie de la dengue,cout economique,control de Aedes aegypti,control de un brote de dengue,coste economico,VECTOR CONTROL,AEDES-AEGYPTI,AMERICA,SURVEILLANCE,STRATEGIES,HEALTH,TRANSMISSION,SANTIAGO,LIFE,ASIA},
  language     = {eng},
  number       = {1},
  pages        = {123--132},
  title        = {Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba},
  url          = {http://dx.doi.org/10.1111/j.1365-3156.2011.02881.x},
  volume       = {17},
  year         = {2012},
}

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