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1.
Value Health Reg Issues ; 18: 132-144, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31082793

RESUMO

OBJECTIVES: To review the literature on the cost-effectiveness of dengue vaccination in Southeast Asian countries and possibly to provide recommendations on promoting dengue vaccination in this region. METHODS: A systematic search was conducted to identify relevant articles in 3 major databases (ProQuest, American Society of Tropical Medicine and Hygiene, and PubMed). Complete economic evaluation studies, including willingness-to-pay (WTP) studies, that were conducted in any Southeast Asian country were included in this study. Systematic review, non-full-text, and non-English studies were specifically excluded. RESULTS: Nine selected studies highlighted the economic evaluation of dengue vaccination in Southeast Asian countries by considering many parameters (eg, vaccine cost, vaccine efficacy, cost-effectiveness threshold, economic assessment, public acceptance, and WTP). All studies confirmed that dengue vaccine can be used as a prevention strategy to reduce the incidence rate of dengue cases by providing a variance of high cost-effectiveness values. In addition, communities provided a good assessment, acceptance, and WTP value for the vaccine. CONCLUSIONS: The use of dengue vaccine could reduce the burden of disease and economic burden due to dengue infection in Southeast Asian countries. The efficacy of dengue vaccine was estimated to be 50-95% for those <9 years, 9 years, and >9 years. In particular, several studies reported that dengue vaccine could be categorized as a cost-effective intervention in Southeast Asian countries within certain conditions.


Assuntos
Vacinas contra Dengue/economia , Dengue/prevenção & controle , Ásia Sudeste , Análise Custo-Benefício , Dengue/economia , Dengue/epidemiologia , Humanos
2.
Int J Infect Dis ; 84S: S64-S67, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30826484

RESUMO

OBJECTIVES: To describe the direct cost of illness in pediatric and adult inpatients at a referral hospital in India. METHODS: Inpatients who tested positive for dengue were identified in the hospital records of a single private non-profit hospital over a period of 1 year and line-listed. Hospital discharge bills were obtained for pediatric and adult patients and the median costs by severity of illness for bed and treatment were estimated. Costs were also converted to US dollars (1 USD=64.6 Indian rupees (INR)). RESULTS: The median and interquartile range (IQR) direct costs for pediatric dengue without warning signs, dengue with warning signs, and severe dengue were 179.80 (IQR 85.51-428.51) USD, 145.06 (IQR 90.89-321.86) USD, and 933.51 (IQR 400.50-1117.43) USD, respectively. The median and IQR direct costs for adult dengue without warning signs, dengue with warning signs, and severe dengue were 312.75 (IQR 174.55-531.03) USD, 287.22 (IQR 210.96-389.34) USD, and 720.39 (IQR 389.23-1035.51) USD, respectively. CONCLUSIONS: Children and adults with dengue incur high costs when hospitalized for dengue. Since most medical costs in India are out-of-pocket expenses, these illnesses can impact households.


Assuntos
Efeitos Psicossociais da Doença , Dengue/economia , Dengue/terapia , Encaminhamento e Consulta/economia , Adolescente , Criança , Criança Hospitalizada/estatística & dados numéricos , Pré-Escolar , Feminino , Gastos em Saúde , Humanos , Masculino , Alta do Paciente
3.
PLoS Negl Trop Dis ; 13(2): e0007164, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30817776

RESUMO

BACKGROUND: Dengue fever is a rapidly growing public health problem in many parts of the tropics and sub-tropics in the world. While there are existing studies on the economic burden of dengue fever in some of dengue-endemic countries, cost components are often not standardized, making cross-country comparisons challenging. Furthermore, no such studies have been available in Africa. METHODS/PRINCIPAL FINDINGS: A patient-specific survey questionnaire was developed and applied in Burkina Faso, Kenya, and Cambodia in a standardized format. Multiple interviews were carried out in order to capture the entire cost incurred during the period of dengue illness. Both private (patient's out-of-pocket) and public (non-private) expenditure were accessed to understand how the economic burden of dengue is distributed between private and non-private payers. A substantial number of dengue-confirmed patients were identified in all three countries: 414 in Burkina Faso, 149 in Kenya, and 254 in Cambodia. The average cost of illness for dengue fever was $26 (95% CI $23-$29) and $134 (95% CI $119-$152) per inpatient in Burkina Faso and Cambodia, respectively. In the case of outpatients, the average economic burden per episode was $13 (95% CI $23-$29) in Burkina Faso and $23 (95% CI $19-$28) in Kenya. Compared to Cambodia, public contributions were trivial in Burkina Faso and Kenya, reflecting that a majority of medical costs had to be directly borne by patients in the two countries. CONCLUSIONS/SIGNIFICANCE: The cost of illness for dengue fever is significant in the three countries. In particular, the current study sheds light on the potential economic burden of the disease in Burkina Faso and Kenya where existing evidence is sparse in the context of dengue fever, and underscores the need to achieve Universal Health Coverage. Given the availability of the current (CYD-TDV) and second-generation dengue vaccines in the near future, our study outcomes can be used to guide decision makers in setting health policy priorities.


Assuntos
Efeitos Psicossociais da Doença , Dengue/economia , Dengue/epidemiologia , Saúde Pública/economia , Burkina Faso/epidemiologia , Camboja/epidemiologia , Custos de Cuidados de Saúde , Humanos , Quênia/epidemiologia
4.
PLoS One ; 14(2): e0211401, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30785894

RESUMO

BACKGROUND: Studies on dengue related to the cost of illness and cost of the program are factors to describe the economic burden of dengue, a neglected disease that has global importance in public health. These studies are often used by health managers in optimizing financial resources. A systematic review of studies estimating the cost of dengue was carried out, comparing the costs between the studies and examining the cost drivers regarding the methodological choices. METHODS: This study was done according to the guidelines of the Centre for Reviews and Dissemination (CRD). Several databases were searched: Medline, Virtual Health Library and CRD. Two researchers, working independently, selected the studies and extracted the data. The quality of the methodology of the individual studies was achieved by a checklist of 29 items based on protocols proposed by the British Medical Journal and Consolidated Health Economic Evaluation Reporting Standards. A qualitative and quantitative narrative synthesis was performed. RESULTS: A literature search yielded 665 publications. Of these, 22 studies are in accordance with previously established inclusion criteria. The cost estimates were compared amongst the studies, highlighting the study design, included population and comparators used (study methodology). The component costs included in the economic evaluation were based on direct and indirect costs, wherein twelve studies included both costs, twelve studies adopted the societal perspective and ten studies used the perspective of the public health service provider, or of a private budget holder. CONCLUSION: This study showed that the cost of dengue in 18 countries generated approximately US$ 3.3 billion Purchasing Power Parity (PPP) in 2015. This confirms that the burden of dengue has a great economic impact on countries with common socioeconomic characteristics and similarities in health systems, particularly developing countries, indicating a need for further studies in these countries.


Assuntos
Dengue/economia , Efeitos Psicossociais da Doença , Humanos , Saúde Pública/economia , Prática de Saúde Pública/economia
5.
PLoS Negl Trop Dis ; 13(1): e0007111, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30695020

RESUMO

BACKGROUND: Despite the known burden of neglected tropical diseases (NTDs) on child health, there is limited information on current efforts to increase pediatric therapeutic options. Our objective was to quantify and characterize research activity and treatment availability for NTDs in children in order to inform the prioritization of future research efforts. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a review of the World Health Organization's (WHO) International Clinical Trials Registry Platform to assess research activity for NTDs. The burden of disease of each NTD was measured in terms of disability adjusted life years (DALYs), which was extracted from the Global Health Data Exchange. First- and second-line medications for each NTD were identified from WHO guidelines. We reviewed FDA drug labels for each medication to determine whether they were adequately labeled for use in children. Descriptive statistics, binomial tests, and Spearman's rank order correlations were calculated to assess research activity compared to burden of disease. Children comprised 34% of the 20 million DALYs resulting from NTDs, but pediatric trials contributed just 17% (63/369) of trials studying these conditions (p<0.001 for binomial test). Conditions that were particularly under-represented in pediatric populations compared to adults included rabies, leishmaniasis, scabies, and dengue. Pediatric drug trial activity was poorly correlated with pediatric burden of disease across NTDs (Spearman's rho = 0.41, p = 0.12). There were 47 medications recommended by the WHO for the treatment of NTDs, of which only 47% (n = 22) were adequately labeled for use in children. Of the 25 medications lacking adequate pediatric labeling, three were under study in pediatric trials. CONCLUSIONS/SIGNIFICANCE: There is a substantial gap between the burden of disease for NTDs in children and research devoted to this population. Most medications lack adequate pediatric prescribing information, highlighting the urgency to increase pediatric research activity for NTDs with high burden of disease and limited treatment options.


Assuntos
Saúde da Criança , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/economia , Criança , Ensaios Clínicos como Assunto , Efeitos Psicossociais da Doença , Dengue/tratamento farmacológico , Dengue/economia , Dengue/prevenção & controle , Rotulagem de Medicamentos , Saúde Global , Humanos , Leishmaniose/tratamento farmacológico , Leishmaniose/economia , Leishmaniose/prevenção & controle , Doenças Negligenciadas/prevenção & controle , Raiva/tratamento farmacológico , Raiva/economia , Raiva/prevenção & controle , Estados Unidos , Organização Mundial da Saúde
6.
PLoS Negl Trop Dis ; 13(1): e0007038, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30629593

RESUMO

BACKGROUND: Dengue is associated with significant economic expenditure and it is estimated that the Asia Pacific region accounts for >50% of the global cost. Indonesia has one of the world's highest dengue burdens; Aedes aegypti and Aedes albopictus are the primary and secondary vectors. In the absence of local data on disease cost, this study estimated the annual economic burden during 2015 of both hospitalized and ambulatory dengue cases in Indonesia. METHODS: Total 2015 dengue costs were calculated using both prospective and retrospective methods using data from public and private hospitals and health centres in three provinces: Yogyakarta, Bali and Jakarta. Direct costs were extracted from billing systems and claims; a patient survey captured indirect and out-of-pocket costs at discharge and 2 weeks later. Adjustments across sites based on similar clinical practices and healthcare landscapes were performed to fill gaps in cost estimates. The national burden of dengue was extrapolated from provincial data using data from the three sites and applying an empirically-derived epidemiological expansion factor. RESULTS: Total direct and indirect costs per dengue case assessed at Yogyakarta, Bali and Jakarta were US$791, US$1,241 and US$1,250, respectively. Total 2015 economic burden of dengue in Indonesia was estimated at US$381.15 million which comprised US$355.2 million for hospitalized and US$26.2 million for ambulatory care cases. CONCLUSION: Dengue imposes a substantial economic burden for Indonesian public payers and society. Complemented with an appropriate weighting method and by accounting for local specificities and practices, these data may support national level public health decision making for prevention/control of dengue in public health priority lists.


Assuntos
Dengue/economia , Dengue/epidemiologia , Custos de Cuidados de Saúde , Gastos em Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Feminino , Humanos , Indonésia/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Adulto Jovem
7.
Int J Infect Dis ; 84S: S68-S73, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30641201

RESUMO

OBJECTIVES: This paper concerns a systematic analysis of dengue illness and costs in India from 2013 to 2016. A previous study for 2006-2012 found that that projected annual number of dengue cases (5.78 million) was 282 times the officially reported number (20,474), highlighting enormous uncertainty. METHODS: This study updated primary data for India from 2012 to 2014 and synthesized the latest epidemiological and economic literature through 2018 using the country and global estimates. RESULTS: The first empirically-based publication of dengue costs by country (in 2016) estimated India experienced 18,618,706 symptomatic dengue cases and 1602 deaths, and cost $1.51 billion in 2013. With a combination of increased incidence, more refined methods, and better data this 2018 study raised the latest estimates to 53,210,706 cases, 22,527 deaths, and $5.71 billion economic costs for 2016, representing increases over the previous publication of 186%, 1306%, and 278%, respectively. When consistent methods and data were used to compare 2013 to 2016, the corresponding changes were only +29%, -9%, and +12%, respectively over these 3 years. CONCLUSIONS: India's burden of dengue is substantially greater than previously estimated. Although uncertainty intervals remain wide, these latest estimates reinforce the health and economic benefits that India would realize if dengue were substantially controlled.


Assuntos
Efeitos Psicossociais da Doença , Dengue/economia , Dengue/epidemiologia , Dengue/mortalidade , Humanos , Índia/epidemiologia
8.
Int J Infect Dis ; 84S: S74-S79, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30641207

RESUMO

INTRODUCTION: Controlled human infection models (CHIM) have been used in vaccine development to up-select and down-select potential vaccine candidates and to provide proof of vaccine efficacy, and have also been used as a basis for licensure of vaccines for cholera and typhoid by regulatory agencies. CHIM IN DENGUE VACCINES DEVELOPMENT: Dengue fever results in ∼400 million infections a year and is of significant health concern especially in India. There are currently no antivirals for the disease and the only licensed vaccine for dengue is not widely used owing to safety concerns. Controlled dengue human challenge models (DHCM) are currently being used to assess the efficacy of vaccines in development for dengue. DENGUE CHIM IN INDIA: Conducting CHIM studies in India especially for evaluation of dengue vaccine candidates will be hugely beneficial as the disease is endemic to India and hence the effect of pre-exposure to the virus on vaccine safety and efficacy can be established. However, to date no CHIM studies have been conducted in India and there is a need to educate ethics committee members, policy makers and the public on the importance of such studies and what they entail.


Assuntos
Bioética , Vacinas contra Dengue/imunologia , Dengue/prevenção & controle , Desenvolvimento de Medicamentos/ética , Animais , Dengue/economia , Dengue/virologia , Vacinas contra Dengue/administração & dosagem , Vacinas contra Dengue/genética , Desenvolvimento de Medicamentos/economia , Humanos , Modelos Biológicos
9.
PLoS Negl Trop Dis ; 12(12): e0006938, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30550569

RESUMO

BACKGROUND: Given that dengue disease is growing and may progress to dengue hemorrhagic fever (DHF), data on economic cost and disease burden are important. However, data for Mexico are limited. METHODOLOGY/PRINCIPAL FINDINGS: Burden of dengue fever (DF) and DHF in Mexico was assessed using official databases for epidemiological information, disabilities weights from Shepard et al, the reported number of cases and deaths, and costs. Overall costs of dengue were summed from direct medical costs to the health system, cost of dengue to the patient (out-of-pocket expenses [medical and non-medical], indirect costs [loss of earnings, patient and/or caregiver]), and other government expenditures on prevention/surveillance. The first three components, calculated as costs per case by a micro-costing approach (PAATI; program, actions, activities, tasks, inputs), were scaled up to overall cost using epidemiology data from official databases. PAATI was used to calculate cost of vector control and prevention, education, and epidemiological surveillance, based on an expert consensus and normative construction of an ideal scenario. Disability-adjusted life years (DALYs) for Mexico in 2016 were calculated to be 2283.46 (1.87 per 100,000 inhabitants). Overall economic impact of dengue in Mexico for 2012 was US$144 million, of which US$44 million corresponded to direct medical costs and US$5 million to the costs from the patient's perspective. The estimated cost of prevention/surveillance was calculated with information provided by federal government to be US$95 million. The overall economic impact of DF and DHF showed an increase in 2013 to US$161 million and a decrease to US$133, US$131 and US$130 million in 2014, 2015 and 2016, respectively. CONCLUSIONS/SIGNIFICANCE: The medical and economic impact of dengue were in agreement with other international studies, and highlight the need to include governmental expenditure for prevention/surveillance in overall cost analyses given the high economic impact of these, increasing the necessity to evaluate its effectiveness.


Assuntos
Dengue/economia , Dengue Grave/economia , Adolescente , Adulto , Idoso , Cuidadores , Criança , Pré-Escolar , Dengue/epidemiologia , Dengue/prevenção & controle , Pessoas com Deficiência , Programas Governamentais , Custos de Cuidados de Saúde , Gastos em Saúde , Humanos , Lactente , México/epidemiologia , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Dengue Grave/epidemiologia , Dengue Grave/prevenção & controle , Adulto Jovem
10.
Cad Saude Publica ; 34(12): e00044518, 2018 11 29.
Artigo em Espanhol | MEDLINE | ID: mdl-30517314

RESUMO

The aim of this study was to measure the costs of vector-borne disease control programs at the local level in Colombia (2016). A cost analysis was performed for this purpose from the policymaker's perspective in the municipalities (counties) of Girón and Guadalajara de Buga, specifically for the Aedes aegypti control program, the principal mosquito vector of dengue, Zika, and chikungunya. The analysis involved the quantification of all the costs required for each of the prevention and control strategies in vector-borne diseases. The costs were classified as operating and capital costs, and for purposes of comparison the costs were also calculated per case and per capita. The programs' total estimated costs were USD 146,651 in Girón and USD 97,936 in Guadalajara de Buga. Per capita cost was USD 0.88 in Girón and USD 0.99 in Guadalajara de Buga. In general, the predominant cost strategies were chemical spraying of adult mosquitos, accounting for 26% of the total costs in Girón and 47% in Guadalajara de Buga, with personnel representing 40% of the total costs for this strategy in Girón and 66% of the operating costs in Guadalajara de Buga.


Assuntos
Aedes , Dengue/economia , Controle de Mosquitos/economia , Animais , Colômbia/epidemiologia , Custos e Análise de Custo , Dengue/epidemiologia , Dengue/prevenção & controle , Dengue/transmissão , Humanos , Controle de Mosquitos/métodos , Controle de Mosquitos/estatística & dados numéricos , Mosquitos Vetores
11.
Expert Rev Vaccines ; 17(12): 1123-1133, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30417706

RESUMO

INTRODUCTION: Dengue is a serious global health problem endemic in Brazil. Consequently, our aim was to measure the costs and disease burden of symptomatic dengue infections in Brazil from the perspective of the Brazilian Public Health System (SUS) between 2000 and 2015, using Brazilian public health system databases. Specific age group incidence estimates were used to calculate the disability-adjusted life years (DALYs) to gain a better understanding of the disease burden. Areas covered: SUS spent almost USD159 million and USD10 million to treat dengue and severe dengue, respectively, between 2000 and 2015. This is principally hospitalization costs, with the majority of patients self-treated at home with minor symptoms. The average notification rate for dengue was 273 per 100,000 inhabitants and three per 100,000 for severe dengue, with annual DALYs estimates ranging between 72.35 and 6,824.45 during the 16 years. Expert commentary: The epidemiological and morbidity burden associated with dengue is substantial in Brazil, with costs affected by the fact that most patients self-treat at home with these costs not included in SUS. The Brazilian government urgently needs to proactively evaluate the real costs and clinical benefits of any potential dengue vaccination program by the National Immunization Program to guide future decision-making.


Assuntos
Efeitos Psicossociais da Doença , Vacinas contra Dengue/administração & dosagem , Dengue/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Bases de Dados Factuais , Dengue/economia , Dengue/prevenção & controle , Feminino , Política de Saúde , Custos Hospitalares/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Programas de Imunização/organização & administração , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/organização & administração , Saúde Pública , Adulto Jovem
12.
Am J Trop Med Hyg ; 99(6): 1458-1465, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30277202

RESUMO

As dengue causes about 4,000 symptomatic nonfatal episodes for every dengue death globally, quantitative disability assessments are critical to assess the burden of dengue and the cost-effectiveness of dengue control interventions. This systematic analysis of disability or quality of life lost from a symptomatic nonfatal dengue episode combined a systematic literature review, statistical modeling, and probabilistic sensitivity analyses. We conceptualized a dengue episode as having two phases: acute and persistent symptoms. Our estimates for the acute phase, consisting of onset and recovery periods and defined as the first 20 days (0.054 year), were based on literature review. We searched PubMed, POPLINE, EconLit, Google Scholar, scientific conferences, and other sources, for "dengue" plus "quality of life" or related terms. From 4,322 initial entries, six met our criteria (original studies with empirical data). The median disability-adjusted life year (DALY) burden for the acute phase was 0.011 (95% certainty interval [CI]: 0.006-0.015) for ambulatory episodes, 0.015 (CI: 0.010-0.020) for hospitalized episodes, and 0.012 (CI: 0.006-0.019) overall. Using literature reviews about persistent dengue, we estimated that 34% of episodes experienced persistent symptoms with a median duration of symptoms of 0.087 (CI: 0.040-0.359) year, which resulted in median DALYs of 0.019 (CI: 0.008-0.082). Thus, the overall median DALY burden was 0.031 (CI: 0.017-0.092) for ambulatory episodes, 0.035 (CI: 0.024-0.096) for hospitalized episodes, and 0.032 (CI: 0.018-0.093) overall. Our dengue-specific burden of a dengue episode was 2.1 times the 2013 Global Burden of Disease estimate. These literature-based estimates provide an empirical summary for policy and cost-effectiveness analyses.


Assuntos
Efeitos Psicossociais da Doença , Dengue/economia , Avaliação da Deficiência , Hospitalização/economia , Modelos Estatísticos , Anos de Vida Ajustados por Qualidade de Vida , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Análise Custo-Benefício/estatística & dados numéricos , Dengue/patologia , Dengue/psicologia , Dengue/virologia , Vírus da Dengue/patogenicidade , Pessoas com Deficiência/psicologia , Saúde Global/economia , Saúde Global/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Qualidade de Vida/psicologia
13.
Infect Dis Poverty ; 7(1): 83, 2018 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-30173675

RESUMO

BACKGROUND: The control of vector-borne diseases (VBD) is one of the greatest challenges on the global health agenda. Rapid and uncontrolled urbanization has heightened the interest in addressing these challenges through an integrated vector management (IVM) approach. The aim was to identify components related to impacts, economic evaluation, and sustainability that might contribute to this integrated approach to VBD prevention. MAIN BODY: We conducted a scoping review of available literature (2000-2016) using PubMed, Web of Science, Cochrane, CINAHL, Econlit, LILACS, Global Health Database, Scopus, and Embase, as well as Tropical Diseases Bulletin, WHOLIS, WHO Pesticide Evaluation Scheme, and Google Scholar. MeSH terms and free-text terms were used. A data extraction form was used, including TIDieR and ASTAIRE. MMAT and CHEERS were used to evaluate quality. Of the 42 documents reviewed, 30 were focused on dengue, eight on malaria, and two on leishmaniasis. More than a half of the studies were conducted in the Americas. Half used a quantitative descriptive approach (n = 21), followed by cluster randomized controlled trials (n = 11). Regarding impacts, outcomes were: a) use of measures for vector control; b) vector control; c) health measures; and d) social measures. IVM reduced breeding sites, the entomology index, and parasite rates. Results were heterogeneous, with variable magnitudes, but in all cases were favourable to the intervention. Evidence of IVM impacts on health outcomes was very limited but showed reduced incidence. Social outcomes were improved abilities and capacities, empowerment, and community knowledge. Regarding economic evaluation, only four studies performed an economic analysis, and intervention benefits outweighed costs. Cost-effectiveness was dependent on illness incidence. The results provided key elements to analyze sustainability in terms of three dimensions (social, economic, and environmental), emphasizing the implementation of a community-focused eco-bio-social approach. CONCLUSIONS: IVM has an impact on reducing vector breeding sites and the entomology index, but evidence of impacts on health outcomes is limited. Social outcomes are improved abilities and capacities, empowerment, and community knowledge. Economic evaluations are scarce, and cost-effectiveness is dependent on illness incidence. Community capacity building is the main component of sustainability, together with collaboration, institutionalization, and routinization of activities. Findings indicate a great heterogeneity in the interventions and highlight the need for characterizing interventions rigorously to facilitate transferability.


Assuntos
Dengue/economia , Leishmaniose/economia , Malária/economia , Saúde da População Urbana/economia , Animais , Dengue/prevenção & controle , Dengue/transmissão , Vetores de Doenças , Humanos , Leishmaniose/prevenção & controle , Leishmaniose/transmissão , Malária/prevenção & controle , Malária/transmissão
14.
Trends Parasitol ; 34(10): 904-918, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30100203

RESUMO

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.


Assuntos
Dengue/economia , Dengue/epidemiologia , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Pesquisa/tendências , Vietnã/epidemiologia
15.
Trans R Soc Trop Med Hyg ; 112(8): 369-377, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-29982700

RESUMO

Background: After new analysis, Sanofi Pasteur now recommends their dengue vaccine (Dengvaxia) should only be given to individuals previously infected with dengue and the World Health Organization's recommendations regarding its use are currently being revised. As a result, the potential costs of performing large-scale individual dengue screening and/or dengue serosurveys have become an important consideration for decision making by policymakers in dengue-endemic areas. Methods: We used an ingredients-based approach to estimate the financial costs for conducting both a school-based dengue serosurvey and school-based individual dengue screening within a typical province in Vietnam, using an existing commercial indirect immunoglobulin G enzyme-linked immunosorbent assay kit. This costing is hypothetical and based on estimates regarding the resources that would be required to perform such activities. Results: We estimated that performing a school-based individual screening of 9-year-olds would cost US$9.25 per child tested or US$197,827 in total for a typical province. We also estimated that a school-based serosurvey would cost US$10,074, assuming one class from each of the grades that include 8- to 11-year-olds are sampled at each of the 12 selected schools across the province. Conclusions: The study indicates that using this vaccine safely on a large-scale will incur noteworthy operational costs. It is crucial that these be considered in future cost-effectiveness analyses informing how and where the vaccine is deployed.


Assuntos
Vacinas contra Dengue/economia , Vírus da Dengue/imunologia , Dengue/prevenção & controle , Programas de Imunização/economia , Programas de Rastreamento/economia , Serviços de Saúde Escolar/economia , Vacinação/economia , Criança , Análise Custo-Benefício , Custos e Análise de Custo , Assistência à Saúde/economia , Dengue/economia , Dengue/virologia , Vírus da Dengue/classificação , Ensaio de Imunoadsorção Enzimática/economia , Previsões , Humanos , Programas de Rastreamento/métodos , Seleção de Pacientes , Desenvolvimento de Programas/economia , Instituições Acadêmicas , Estudos Soroepidemiológicos , Sorogrupo , Vietnã , Organização Mundial da Saúde
16.
Epidemiol Serv Saude ; 27(2): e2017232, 2018 06 28.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29995105

RESUMO

OBJECTIVE: to describe the incidence of dengue cases and associated costs in the period before and after the construction of the Jirau and Santo Antônio hydroelectric power plants (HPP), in Rondônia State, Brazil. METHODS: economic evaluation study, based on data from the Notifiable Diseases Information System (SINAN) and the National Hospital Information System (SIH/SUS); dengue direct costs were calculated and segmented regression analysis was carried out. RESULTS: dengue incidence mean was higher in the period after HPP construction (880.29/100,000 inhabitants) than before them (356.34/100,000 inhabitants) (p≤0.05); direct costs were estimated at US$3.47 million in the pre-construction period and US$7.1 million in the post-construction period. CONCLUSION: there was an increase in the incidence and direct costs of dengue after HPP construction; the environmental licensing process should include more detailed health impact assessments.


Assuntos
Dengue/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos , Centrais Elétricas , Brasil/epidemiologia , Dengue/economia , Notificação de Doenças , Sistemas de Informação Hospitalar , Humanos , Incidência , Análise de Regressão
17.
Artigo em Inglês | MEDLINE | ID: mdl-29874790

RESUMO

Dengue fever (DF) outbreaks occur intermittently in Vietnam, and the most recent epidemic happened in 2017. However, attempts to measure the burden of DF in relation to the quality of life and the cost of treatment for patients during an epidemic period are constrained. This study explored the health-related quality of life (HRQOL) and the cost of illness among patients with dengue fever in Vietnam. A cross-sectional study was conducted in Bach Mai Hospital from September to November 2017. The EuroQol-5 dimensions-5 levels (EQ-5D-5L) was used to measure HRQOL. Cost-of illness was measured by collecting data about the direct medical cost, the non-medical cost, and the indirect cost. Among 225 patients, most of the participants experienced problems regarding mobility (62.3%), self-care (71.8%), usual activities (64.6%), and anxiety/depression (64.1%). The mean EQ-5D index was 0.66 (SD = 0.24). The median cost of illness for inpatient and outpatient groups were US $110.10 (IQR = US $4.40⁻1200.00) and US $36.10 (IQR = US $1.80⁻816.30), respectively. Indirect costs accounted for a major proportion in both groups. Lower-skilled workers and those with a higher severity of the disease had significantly lower HRQOL. Meanwhile, people who were inpatients, had comorbidities, had higher incomes, and who experienced a longer disease duration, had a higher cost of treatment. In conclusion, high costs and severe health deterioration, especially in psychological dimensions, were found in patients with DF in Vietnam. Strengthening primary health care services and communication campaigns are necessary to relieve the burden of diseases and could possibly contribute to effective DF control and prevention strategies.


Assuntos
Efeitos Psicossociais da Doença , Dengue/economia , Dengue/psicologia , Surtos de Doenças/economia , Recursos em Saúde/economia , Qualidade de Vida , Adulto , Estudos Transversais , Dengue/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Vietnã/epidemiologia , Adulto Jovem
18.
Acta Trop ; 178: 318-326, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29197500

RESUMO

In history disease has caused social and economic damage. Dengue is an illness typically found in the tropics that has affected more and more people. In Brazil, according to the Brazilian Institute of Geography and Statistics (IBGE), in 2013 at least 12.9% of the population (25.8 million) reported already having had dengue in their life. So, how wide are the economic impacts that dengue's contagion has on the gross national product? Using Leontief's method, it became possible to estimate the direct and indirect impact on the workforce and output by one country. Workforce absenteeism reduced the national productiveness and welfare state where we found maximum inoperability of 0.027% and a minimum of 0.002%. This paper develops a methodology for estimation of the impact dengue has incurred in each sector of an economy; designing a ranking with sectors that have been more affected and forecasting the propagation of the endemic throughout a region. This research measures the impact of dengue on economy, the result was that the total loss of the Brazilian economy in 2013 was around BRL 1,023,174,876.83; the importance of 0.02% of the Gross Domestic Product.


Assuntos
Dengue/economia , Dengue/epidemiologia , Produto Interno Bruto , Brasil/epidemiologia , Doenças Endêmicas , Humanos
19.
J Infect Public Health ; 11(2): 215-223, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28757293

RESUMO

BACKGROUND: Determining the disease and economic burden of dengue is critical for the allocation of public health resources. Several studies have used disability-adjusted life-years (DALYs) to estimate the disease burden of dengue in different regions. However, there are no published studies discussing the estimates of dengue-related economic and disease burden specifically in Taiwan. OBJECTIVES: We assessed the economic cost and disease burden of dengue infections in Taiwan for the period 1998-2014, and compared these during epidemic and non-epidemic years. METHODS: We estimated the annual DALYs per million population using the disability weights for dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and death cases. Economic costs were estimated and divided into direct (medical costs) and indirect costs (lost work days and caregiver fees). RESULTS: For the period 1998-2014, a mean of 115.3 (range: 6.3-934.3) DALYs per million population annually were lost to dengue. In epidemic years, direct costs associated with dengue resulted mostly from hospitalization (86.09%), emergency (7.77%), outpatient (6.10%), and drug costs (0.03%). For indirect costs, lost productivity due to death (70.76%) was the dominant contributor. Overall, the costs were 12.3 times higher in epidemic years than in non-epidemic years (Wilcoxon rank sum test, p<0.05). CONCLUSIONS: This study is the first to evaluate the economic costs and disease burden of dengue infections for this period in Taiwan, and reveals significant differences in economic impact between epidemic and non-epidemic years.


Assuntos
Efeitos Psicossociais da Doença , Dengue/economia , Dengue/epidemiologia , Epidemias , Ásia Sudeste/epidemiologia , Dengue/complicações , Dengue/mortalidade , Pessoas com Deficiência , Feminino , Humanos , Masculino , Anos de Vida Ajustados por Qualidade de Vida , Dengue Grave/economia , Dengue Grave/epidemiologia , Taiwan/epidemiologia
20.
Am J Trop Med Hyg ; 97(6): 1898-1903, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29141713

RESUMO

A tetravalent dengue vaccine (CYD-TDV) has recently been approved in 12 countries in southeast Asia and Latin America for individuals aged 9-45 years or 9-60 years (age indication approvals vary by country) living in endemic areas. Data on utilization of medical and nonmedical resources as well as time lost from school and work were collected during the active phase of two phase III efficacy studies performed in 10 countries in the Asia-Pacific region and Latin America (NCT01373281; NCT01374516). We compared dengue-related resource utilization and costs among vaccinated and nonvaccinated participants. Country-specific unit costs were derived from available literature. There were 901 virologically confirmed dengue episodes among participants aged ≥ 9 years (N = 25,826): corresponding to 373 episodes in the CYD-TDV group (N = 17,230) and 528 episodes in the control group (N = 8,596). Fewer episodes in the CYD-TDV group resulted in hospitalization than in the control group (7.0% versus 13.3%; P = 0.002), but both had a similar average length of stay of 4 days. Overall, a two-thirds reduction in resource consumption and missed school/work days was observed in the CYD-TDV group relative to the control group. The estimated direct and indirect cost (2014 I$) associated with dengue episodes per participant in the CYD-TDV group was 73% lower than in the control group (I$6.72 versus I$25.08); representing a saving of I$I8.36 (95% confidence interval [CI]:17.05-19.78) per participant with vaccination. This is the first study providing information on dengue costs among vaccinated individuals and direct confirmation that vaccination has the potential to reduce dengue illness costs.


Assuntos
Custos e Análise de Custo , Vacinas contra Dengue/uso terapêutico , Dengue/economia , Adolescente , Anticorpos Antivirais/sangue , Ásia , Criança , Pré-Escolar , Dengue/prevenção & controle , Vacinas contra Dengue/administração & dosagem , Vírus da Dengue , Feminino , Hospitalização/economia , Humanos , América Latina , Masculino , Vacinação/economia
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