Prevention and control of dengue and chikungunya in Colombia: A cost-effectiveness analysis

Chikungunya and dengue are emerging diseases that have caused large outbreaks in various regions of the world. Both are both spread by Aedes aegypti and Aedes albopictus mosquitos. We developed a dynamic transmission model of chikungunya and dengue, calibrated to data from Colombia (June 2014 -Decem...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2021-12, Vol.15 (12), p.e0010086-e0010086
Main Authors: Claypool, Anneke L, Brandeau, Margaret L, Goldhaber-Fiebert, Jeremy D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aedes - drug effects
Aedes - physiology
Aedes - virology
Aedes aegypti
Analysis
Animals
Aquatic insects
Asymptomatic
Biology and Life Sciences
Calibration
Chikungunya fever
Chikungunya Fever - economics
Chikungunya Fever - epidemiology
Chikungunya Fever - mortality
Chikungunya Fever - prevention & control
Chikungunya virus
Chikungunya virus - physiology
Child
Clinical trials
Colombia - epidemiology
Control
Cost analysis
Cost benefit analysis
Dengue
Dengue - economics
Dengue - epidemiology
Dengue - mortality
Dengue - prevention & control
Dengue fever
Dengue Virus - physiology
Disability-Adjusted Life Years
Disease control
Disease prevention
Disease transmission
Epidemics
Fatalities
Female
Human diseases
Humans
Infections
Infectious diseases
Insect pests
Insecticides
Insecticides - economics
Insecticides - pharmacology
Male
Medical care, Cost of
Medicine and Health Sciences
Mortality
Mosquito Control - economics
Mosquito Vectors - drug effects
Mosquito Vectors - physiology
Mosquito Vectors - virology
Mosquitoes
Ordinary differential equations
People and places
Population
Prevention
Probability
Sensitivity analysis
Social Sciences
Transmission
Tropical diseases
Vaccination
Vaccine efficacy
Vaccines
Vector-borne diseases
Vectors
Young Adult
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Summary:Chikungunya and dengue are emerging diseases that have caused large outbreaks in various regions of the world. Both are both spread by Aedes aegypti and Aedes albopictus mosquitos. We developed a dynamic transmission model of chikungunya and dengue, calibrated to data from Colombia (June 2014 -December 2017). We evaluated the health benefits and cost-effectiveness of residual insecticide treatment, long-lasting insecticide-treated nets, routine dengue vaccination for children aged 9, catchup vaccination for individuals aged 10-19 or 10-29, and portfolios of these interventions. Model calibration resulted in 300 realistic transmission parameters sets that produced close matches to disease-specific incidence and deaths. Insecticide was the preferred intervention and was cost-effective. Insecticide averted an estimated 95 chikungunya cases and 114 dengue cases per 100,000 people, 61 deaths, and 4,523 disability-adjusted life years (DALYs). In sensitivity analysis, strategies that included dengue vaccination were cost-effective only when the vaccine cost was 14% of the current price. Insecticide to prevent chikungunya and dengue in Colombia could generate significant health benefits and be cost-effective. Because of limits on diagnostic accuracy and vaccine efficacy, the cost of dengue testing and vaccination must decrease dramatically for such vaccination to be cost-effective in Colombia. The vectors for chikungunya and dengue have recently spread to new regions, highlighting the importance of understanding the effectiveness and cost-effectiveness of policies aimed at preventing these diseases.
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0010086