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Guidelines on the cost-effectiveness of larval control programs to reduce dengue transmission in Puerto Rico

dc.contributor.authorMcConnell, K. Johnes_ES
dc.contributor.authorGubler, Duane Jes_ES
dc.date.accessioned2015
dc.date.available2015
dc.date.issued2003es_ES
dc.identifier.citationMcConnell, K. John,Gubler, Duane J (2003) Guidelines on the cost-effectiveness of larval control programs to reduce dengue transmission in Puerto Rico. Rev Panam Salud Publica;14(1) 9-16,july 2003. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892003000600003&lng=pt&nrm=iso&tlng=enes_ES
dc.identifier.urihttp://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892003000600003&lng=pt&nrm=iso&tlng=enes_ES
dc.identifier.urihttps://iris.paho.org/handle/10665.2/8485
dc.format.extenttabes_ES
dc.format.extentgrafes_ES
dc.relation.ispartofseriesRev Panam Salud Publica;14(1),jul. 2003es_ES
dc.subjectControle de Doenças Transmissíveispt_BR
dc.subjectDenguees_ES
dc.subjectDenguees_ES
dc.subjectSurtos de Doençaspt_BR
dc.subjectControle de Mosquitoses_ES
dc.subjectAedeses_ES
dc.subjectAnálise Custo-Benefícioes_ES
dc.subjectCustos e Análise de Custoes_ES
dc.subjectVírus da Denguept_BR
dc.subjectInsetos Vetorespt_BR
dc.subjectGuias de Prática Clínica como Assuntoes_ES
dc.subjectAvaliação de Programas e Projetos de Saúdept_BR
dc.subjectPorto Ricoes_ES
dc.titleGuidelines on the cost-effectiveness of larval control programs to reduce dengue transmission in Puerto Ricoes_ES
dc.typeJournal articlesen_US
dc.rights.holderPan American Health Organizationen_US
dc.description.notesOBJECTIVE: In the past 20 years, the emphasis for avoiding dengue epidemics has focused on larval control of Aedes aegypti, the principal mosquito vector of dengue viruses. A general consensus is that mosquito larval control holds the best promise for reducing dengue epidemics, although its actual effectiveness is still unknown and subject to a great deal of uncertainty. The objective of this research was to assess the cost-effectiveness of emergency larval control programs for reducing dengue transmission in the Caribbean island of Puerto Rico and to develop guidelines to help choose between carrying out a rapid-response, emergency larval control intervention and not conducting such an intervention. DESIGN AND METHODS: Data on dengue transmission and its likely impacts in Puerto Rico were used as a case study to develop intervention guidelines. A distribution of economic impacts was simulated using available data on disease rates and economic variables, including the costs of treating patients and the opportunity costs represented by lost wages. Successful larval control interventions were assessed by determining two parameters: (1) the costs of an intervention and (2) the expected reduction in the reported case rate of dengue. In addition, we examined how these guidelines would change with an early warning system that provides information on a possible outbreak of dengue. RESULTS: In Puerto Rico, larval control programs that are expected to reduce dengue transmission by 50 percent and cost less than US$ 2.50 per person will be cost-effective. Programs that cost more per person but that further reduce transmission are still likely to be cost-effective. Having an early warning system, even one that provides a low level of accuracy, can extend the range of larval control programs that are cost-effective. For example, with an early warning system, a larval control program that reduces dengue transmission by 50 percent and that costs less than US$ 4.50 per person would be expected to be cost-effective. CONCLUSIONS: Guidelines such as the ones that we developed for Puerto Rico can be useful to public health authorities in helping to decide whether or not to spend resources for a larval control program to reduce dengue transmission. The range of larval control interventions that are cost-effective can be increased by having an early warning system that provides even a small amount of information regarding possible outbreaks (AU)en_US


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