An economic evaluation of vector control in the age of a dengue vaccine

摘要: Introduction Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with 30-fold increase in the number of cases reported since 1960. The economic cost illness measured billions dollars annually. Environmental change and unplanned urbanization are conspiring to raise health even further beyond reach systems households. health-sector response has depended large part on control Aedes aegypti Ae. albopictus (mosquito) vectors. cost-effectiveness first-ever dengue vaccine remains be evaluated field. In this paper, we examine how it might affect sustained vector control. Methods We employ dynamic Markov model effects both vectors humans over 15-year period, six countries: Brazil, Columbia, Malaysia, Mexico, Philippines, Thailand. We evaluate (direct medical costs programme costs) control, outbreak and/or case management, presence (hypothetical) highly targeted low immunization strategy using (non-hypothetical) medium-efficacy vaccine. Results Sustained existing technologies would little more than response, given associated management. If use or upcoming (of similar price) reduce populations by 70–90%, per disability-adjusted life year averted 2013 US$ 679–1331 (best estimates) relative no intervention. Sustained could cost-effective less effective (50–70% reduction populations) vaccine. Discussion Economic evaluation ongoing. However, under very optimistic assumptions about strategy, our results suggest that will continue play an important role mitigating impact environmental human health. additional benefits for other borne diseases, such as Chikungunya, yellow fever Zika taken into account, investment stronger. High-burden endemic countries should proceed map covered control.