Abstract
BackgroundChikungunya 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).Methodology/Principal findingsWe 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.Conclusions/SignificanceInsecticide 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.
Highlights
Chikungunya and dengue are emerging diseases that have increasingly caused outbreaks in different regions of the world
We considered residual insecticide treatment, long-lasting insecticide-treated nets used as curtains and water covers, three dengue vaccination strategies, and combinations of these interventions
We considered interventions that include residual insecticide treatment, long-lasting insecticide-treated nets used as curtains and water covers, three dengue vaccination strategies, and combinations of these interventions
Summary
Chikungunya and dengue are emerging diseases that have increasingly caused outbreaks in different regions of the world. Both viruses are spread by Aedes aegypti and Aedes albopictus mosquitos, as are Zika and yellow fever [1,2,3]. Chikungunya first spread to the Americas in 2013 and caused an epidemic in Colombia in 2014 and 2015 [1,3,7,8]. 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)
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