Simulation-based economic evaluation of the Wolbachia method in Brazil: a cost-effective strategy for dengue control

Zimmermann, Ivan Ricardo; Alves Fernandes, Ricardo Ribeiro; Santos da Costa, Márcia Gisele; Pinto, Márcia; Peixoto, Henry Maia

doi:10.1016/j.lana.2024.100783

Cited by 3 publications

(3 citation statements)

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“…[19] Third, this study's number of sites (11) substantially exceeds the numbers in previous economic analyses--3 in Indonesia [17] and 7 in Brazil. [19] These multiple sites provided the insight that not only was Wolbachia beneficial overall, but it was especially 29 valuable in cities with high dengue incidence. High population density in the release area was associated with somewhat more favorable outcomes.…”

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confidence: 57%

“…[40] As 64% of Colombia's workers were in the informal sector in 2020 and generally earned less than formal sector workers, [52] this approach is more realistic than applying formal sector wages to indirect costs of all cases, including those not employed or working informally, as was done elsewhere. [19] Third, this study's number of sites (11) substantially exceeds the numbers in previous economic analyses--3 in Indonesia [17] and 7 in Brazil. [19] These multiple sites provided the insight that not only was Wolbachia beneficial overall, but it was especially 29 valuable in cities with high dengue incidence.…”

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confidence: 57%

“…[17] In Vietnam, another study found the technology similarly cost effective based on the 10-year time horizon, and cost-saving at the 20-year time horizon. [18] A simulation across seven Brazilian cities also found Wolbachia cost-effective across all 7 cities modeled, though not cost saving [19] in 2 of the 7 cities. In Suva, Fiji, a much smaller city, Wolbachia was acceptably cost-effective, but in Port Vila, Vanuatu, the relatively small target population and lower population density would not make the approach cost-effective there.…”

Section: Introductionmentioning

confidence: 91%

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Economic evaluation ofWolbachiadeployment in Colombia: A modeling study

Shepard,

Lee,

Halasa-Rappel

et al. 2024

Preprint

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Background and AimsWolbachiaare bacteria that inhibit dengue virus replication within the mosquito. A cluster-randomized trial foundWolbachiareduced virologically-confirmed dengue cases by 77% and previous models predictedWolbachiato be highly cost-effective in Indonesia, Vietnam, and Brazil. in Colombia,Wolbachiawas introduced in the Aburrá Valley in 2015 and Cali in 2020. To inform decisions about future extensions, we performed economic evaluations of the potential expansion ofWolbachiadeployments to 11 target Colombian cities.MethodsWe assembled quantities and the distribution by severity of reported dengue cases from Colombia’s national disease surveillance system and the health service provision registry (RIPS). An epidemiological panel of three experts estimated the shares of non-medical cases and adjustments for under-reporting and misclassifications. We determined costs (in 2020 US dollars) of treating dengue illness from the benchmark insurance tariff, RIPS data on treatment services per symptomatic dengue case, and the national government database for establishing insurance premiums. A cluster randomized trial quantified the effectiveness ofWolbachiaagainst symptomatic dengue cases.ResultsProjecting impact over 10 years for Cali, we estimated a net health-sector savings of USD4.95 per person. We also estimated averting 369 disability-adjusted life years (DALYs) per 100,000 population. From a societal perspective, at 10 yearsWolbachiadeployment is expected to have highly favorableConclusionsOver 10 years,Wolbachiais highly beneficial on economic grounds, and almost universally cost saving. That is,Wolbachia’ssavings in health care costs alone would more than offset deployment costs nationally and in 9 target cities (those with adjusted annual dengue incidence at least 50/100,000 population). In these 9 target cities,Wolbachiawould generate at least USD3.00 in benefits per dollar invested, giving substantial confidence thatWolbachiadeployment would be cost-beneficial in Colombia.

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confidence: 57%

Section: Introductionmentioning

confidence: 91%

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Economic evaluation ofWolbachiadeployment in Colombia: A modeling study

Shepard,

Lee,

Halasa-Rappel

et al. 2024

Preprint

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Dengue and severe dengue with neurological complications: a challenge for prevention and control

Francelino,

Puccioni-Sohler

2024

Arq Neuropsiquiatr

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Dengue is the main urban arbovirus in the Americas. The disease manifests in a varied spectrum: from asymptomatic cases to those with neurological involvement, which is considered a severe form of the disease. Its annual reemergence represents a serious public health problem. The rise in the number of cases causes an increase in the number of patients with neurological manifestations of the disease, which can range from headaches to more serious conditions such as encephalitis and Guillain-Barré syndrome, with high potential of death or sequelae. Dengue prevention and control strategies should also be a concern for neurologists. The aim of the present study is to carry out a narrative review of the current methods to prevent dengue fever and its severe forms, such as cases with neurological complications. The main control measures include vaccination, which is still carried out on a small scale, vector control, and individual protection. The CYD-TDV/Dengvaxia and TAK-003/DENVax vaccines, licensed for use by the Brazilian National Health Regulatory Agency (Agência Nacional de Vigilância Sanitária, ANVISA, in Portuguese), show efficacy against hospitalizations of 72.7% (95% confidence interval [95%CI]: 62.3–80.3%) and of 90.4% (95%CI: 82.6–94.7%) respectively. The TV003/TV005 vaccine, which is being studied by Intituto Butantan in Brazil, shows promising results, with an efficacy of 79.6% for symptomatic dengue. Vector control is based on biotechnological and behavioral measures, as well as on the improvement of basic sanitation conditions. The main individual protection measure is the use of topical repellents (icaridin). All of these actions represent important tools for the prevention of dengue fever and its neurological complications.

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