Abstract
BackgroundDengue is a serious public health problem with an important economic impact. This study used data from a cluster randomised controlled trial of community mobilisation for dengue prevention to estimate the household costs of treatment of dengue illness. It examined the economic impact of the trial intervention in the three coastal regions of Mexico’s Guerrero State.MethodsThe 2010 baseline survey covered households in a random sample of 90 clusters in the coastal regions; the clusters were randomly allocated to intervention or control and re-surveyed in 2012. The surveys asked about dengue cases in the last 12 months, expenditures on their treatment, and work or school days lost by patients and care givers. We did not assign monetary value to days lost, since a lost day to a person of low earning power is of equal or higher value to that person than to one who earns more.ResultsThe 12,312 households in 2010 reported 1020 dengue cases in the last 12 months (1.9% of the sample population). Most (78%) were ambulatory cases, with a mean cost of USD 51 and 10.8 work/school days, rising to USD 96 and 11.4 work/school days if treated by a private physician. Hospitalised cases cost USD 28–94 in government institutions and USD 392 in private hospitals (excluding additional inpatient charges), as well as 9.6–17.3 work/school days. Dengue cases cost households an estimated 412,825 work/school days throughout the three coastal regions. In the follow up survey, 6.1% (326/5349) of households in intervention clusters and 7.9% (405/5139) in control clusters reported at least one dengue case. The mean of days lost per case was similar in intervention and control clusters, but the number of days lost from dengue and all elements of costs for dengue cases per 1000 population were lower in intervention clusters. If the total population of the three coastal regions had received the intervention, some 149,401 work or school days lost per year could have been prevented.ConclusionThe economic effect of dengue on households, including lost work days, is substantial. The Camino Verde trial intervention reduced household costs for treatment of dengue cases.Trial registrationThe trial was registered as ISRCTN:27,581,154.
Highlights
Dengue is a serious public health problem with an important economic impact
A number of studies have estimated the economic impact of dengue illness, including direct costs of ambulatory and hospital cases and indirect costs of the loss of productive time caused by the illness [5,6,7,8,9]
In this article we report an analysis of the costs of dengue illness in Mexico from a community learning perspective, using data collected from households during the Camino Verde trial: a cluster randomised controlled trial of community mobilisation for dengue prevention in Mexico and Nicaragua [10]
Summary
Dengue is a serious public health problem with an important economic impact. This study used data from a cluster randomised controlled trial of community mobilisation for dengue prevention to estimate the household costs of treatment of dengue illness. A number of studies have estimated the economic impact of dengue illness, including direct costs of ambulatory and hospital cases and indirect costs of the loss of productive time caused by the illness [5,6,7,8,9]. These studies report costs from a societal perspective which takes into account household costs and costs to the government through free or subsidized health services. This perspective assigns a monetary value to work or school time lost by dengue sufferers and their caregivers, a value that varies according to their potential earning power
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