title: Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba.
abstract: OBJECTIVE
  To assess the economic cost of routine Aedes aegypti control in an at-risk environment without dengue endemicity and the incremental costs incurred during a sporadic outbreak.
  
  
  METHODS
  The study was conducted in 2006 in the city of Guantanamo, Cuba. We took a societal perspective to calculate costs in months without dengue transmission (January-July) and during an outbreak (August-December). Data sources were bookkeeping records, direct observations and interviews.
  
  
  RESULTS
  The total economic cost per inhabitant (p.i.) per month. (p.m.) increased from 2.76 USD in months without dengue transmission to 6.05 USD during an outbreak. In months without transmission, the routine Aedes control programme cost 1.67 USD p.i. p.m. Incremental costs during the outbreak were mainly incurred by the population and the primary/secondary level of the healthcare system, hardly by the vector control programme (1.64, 1.44 and 0.21 UDS increment p.i. p.m., respectively). The total cost for managing a hospitalized suspected dengue case was 296.60 USD (62.0% direct medical, 9.0% direct non-medical and 29.0% indirect costs). In both periods, the main cost drivers for the Aedes control programme, the healthcare system and the community were the value of personnel and volunteer time or productivity losses.
  
  
  CONCLUSIONS
  Intensive efforts to keep A. aegypti infestation low entail important economic costs for society. When a dengue outbreak does occur eventually, costs increase sharply. In-depth studies should assess which mix of activities and actors could maximize the effectiveness and cost-effectiveness of routine Aedes control and dengue prevention.
authors: Instituto de Medicina Tropical 'Pedro Kourí', Habana, Cuba. baly@ipk.sld.cu
authors: Alberto
authors: A
authors: Baly
authors: Maria E
authors: ME
authors: Toledo
authors: Karina
authors: K
authors: Rodriguez
authors: Juan R
authors: JR
authors: Benitez
authors: Maritza
authors: M
authors: Rodriguez
authors: Marleen
authors: M
authors: Boelaert
authors: Veerle
authors: V
authors: Vanlerberghe
authors: Patrick
authors: P
authors: Van der Stuyft
mesh_terms: D000330:Aedes; D000818:Animals; D003365:Costs and Cost Analysis; D003462:Cuba; D003715:Dengue / Q000191:economics* / Q000517:prevention & control / Q000628:therapy / Q000635:transmission; D004196:Disease Outbreaks / Q000191:economics*; D017048:Health Care Costs; D006282:Health Personnel / Q000191:economics; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007303:Insect Vectors; D009032:Mosquito Control / Q000191:economics*; D012111:Residence Characteristics; D012306:Risk; D014838:Volunteers