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

• Main Authors: Oliver Mendoza-Cano, Carlos Moisés Hernandez-Suarez, Xochitl Trujillo, Héctor Ochoa Diaz-Lopez, Agustin Lugo-Radillo, Francisco Espinoza-Gomez, Miriam de la Cruz-Ruiz, Ramón Alberto Sánchez-Piña, Efrén Murillo-Zamora
• Format: Article
• Language: English
• Published: MDPI AG 2017-08-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: dengue; economic analysis; ULV spraying; community participation
• Online Access: https://www.mdpi.com/1660-4601/14/8/890

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 (n = 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.