Cost-Effectiveness of the Strategies to Reduce the Incidence of Dengue in Colima, México

• Published in: International journal of environmental research and public health Vol. 14; no. 8; p. 890
• Main Authors: Mendoza-Cano, Oliver, Hernandez-Suarez, Carlos Moisés, Trujillo, Xochitl, Ochoa Diaz-Lopez, Héctor, Lugo-Radillo, Agustin, Espinoza-Gomez, Francisco, de la Cruz-Ruiz, Miriam, Sánchez-Piña, Ramón Alberto, Murillo-Zamora, Efrén
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 08-08-2017; MDPI
• Subjects: Aedes; Animals; Citizen participation; Community; Community involvement; Community participation; Cost analysis; Cost-Benefit Analysis; Dengue - economics; Dengue - epidemiology; Dengue - prevention & control; Disease control; Disease prevention; Economic analysis; Female; Fever; Humans; Incidence; Insect Vectors; Intervention; Mexico - epidemiology; Mosquito Control - economics; Mosquito Control - methods; Mosquitoes; Municipalities; Performance evaluation; Public health; Spraying; Vector-borne diseases; Mexico; ULV spraying; economic analysis; dengue; community participation
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph14080890

Dengue fever is considered to be one of the most important arboviral diseases globally. Unsuccessful vector-control strategies might be due to the lack of sustainable community participation. The state of Colima, located in the Western region of Mexico, is a dengue-endemic area despite vector-control activities implemented, which may be due to an insufficient health economic analysis of these interventions. A randomized controlled community trial took place in five urban municipalities where 24 clusters were included. The study groups (
= 4) included an intervention to improve the community participation in vector control (A), ultra-low volume (ULV) spraying (B), both interventions (AB), and a control group. The main outcomes investigated were dengue cumulative incidence, disability-adjusted life years (DALYs), and the direct costs per intervention. The cumulative incidence of dengue was 17.4%, A; 14.3%, B; 14.4%, AB; and 30.2% in the control group. The highest efficiency and effectiveness were observed in group B (0.526 and 6.97, respectively) and intervention A was more likely to be cost-effective ($3952.84 per DALY avoided) followed by intervention B ($4472.09 per DALY avoided). Our findings suggest that efforts to improve community participation in vector control and ULV-spraying alone are cost-effective and may be useful to reduce the vector density and dengue incidence.