Cost-effectiveness of a community-based approach intertwined with a vertical Aedes control program.
We compared in a 5-year intervention study the cost-effectiveness of community-based environmental management intertwined with routine vertical Aedes control and of routine vertical control only. At baseline (year 2000), Aedes infestation levels and economic costs for vector control were comparable in intervention and control areas (house index, 2.23% versus 2.21% and US$21 versus US$24/yr/inhabitant, respectively). By 2004, house indices became 0.22% versus 2.36% and the costs were 29.8 US$ versus 36.7 US$/yr/inhabitant, respectively. The community cost made up 38.6% of the total economic cost in 2004 in the intervention areas against 23.5% in 2000. The average cost-effectiveness ratio for the intervention period 2001-2004, expressed as the societal cost incurred for the reduction (from baseline) of Aedes foci, was US$831.1 per focus in the intervention areas versus US$2,465.6 in the control areas. The intervention produced economic savings and health benefits that were sustained over the whole observation period.
Baly
Alberto
A
Instituto de Medicina Tropical Pedro Kourí, Department of Epidemiology, La Habana, Cuba. baly@ipk.sld.cu
Toledo
Maria Eugenia
ME
Vanlerberghe
Veerle
V
Ceballos
Enrique
E
Reyes
Alicia
A
Sanchez
Idalmis
I
Carvajal
Marinelli
M
Maso
Rizel
R
La Rosa
Maite
M
Denis
Orestes
O
Boelaert
Marleen
M
Van der Stuyft
Patrick
P
D000330:Aedes; D000818:Animals; D003153:Community Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D009032:Mosquito Control / Q000191:economics*