Cost-effectiveness of a Dengue Vector Control Intervention in Colombia

Abstract

Dengue is a public health problem in Colombia and in the municipality of Girardot, an area of high risk for dengue transmission. We present the results of an economic evaluation from the societal perspective and 1-year time horizon comparing the regular control program for dengue prevention versus an intervention that comprised an environmental management strategy by covering the most Aedes aegypti productive breeding sites with insecticide covers, community actions, and educational activities. The effectiveness of the intervention was measured as the reduction in probability of dengue infection obtained from a community trial. Resource use was estimated from clinical records that were validated by clinical experts; unit costs were taken from national tariffs. Patient costs were obtained from a household survey. We found that the intervention generated an additional cost of USD20.9 per household and an incremental effectiveness of 0.00173 (reduction in the probability of reported dengue cases). Overall, both alternatives generate similar effectiveness, but the new intervention was associated with increasing costs. We conclude the new intervention is a potentially cost-effective option in areas where high prevalence of dengue exists.

Figure 1.

Tornado diagram: deterministic sensitivity analysis. EV = expected value; ICER = incremental cost-effectiveness ratio; WTP = willingness to pay. This figure appears in color at www.ajtmh.org.

Figure 2.

Incremental cost-effectiveness scatterplot. This figure appears in color at www.ajtmh.org.

Figure 3.

Cost-effectiveness acceptability curve. This figure appears in color at www.ajtmh.org.