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拉丁美洲创新型登革热病媒控制干预措施:成本几何?

Innovative dengue vector control interventions in Latin America: what do they cost?

作者信息

Alfonso-Sierra Eduardo, Basso César, Beltrán-Ayala Efraín, Mitchell-Foster Kendra, Quintero Juliana, Cortés Sebastián, Manrique-Saide Pablo, Guillermo-May Guillermo, Caprara Andrea, de Lima Edilmar Carvalho, Kroeger Axel

机构信息

a Centre for Medicine and Society, Global Health , Freiburg University , Freiburg , Germany.

b Facultad de Agronomía, Departamento de Protección Vegetal , Universidad de la República , Montevideo , Uruguay.

出版信息

Pathog Glob Health. 2016;110(1):14-24. doi: 10.1080/20477724.2016.1142057.

Abstract

BACKGROUND

Five studies were conducted in Fortaleza (Brazil), Girardot (Colombia), Machala (Ecuador), Acapulco (Mexico), and Salto (Uruguay) to assess dengue vector control interventions tailored to the context. The studies involved the community explicitly in the implementation, and focused on the most productive breeding places for Aedes aegypti. This article reports the cost analysis of these interventions.

METHODS

We conducted the costing from the perspective of the vector control program. We collected data on quantities and unit costs of the resources used to deliver the interventions. Comparable information was requested for the routine activities. Cost items were classified, analyzed descriptively, and aggregated to calculate total costs, costs per house reached, and incremental costs.

RESULTS

Cost per house of the interventions were $18.89 (Fortaleza), $21.86 (Girardot), $30.61 (Machala), $39.47 (Acapulco), and $6.98 (Salto). Intervention components that focused mainly on changes to the established vector control programs seem affordable; cost savings were identified in Salto (-21%) and the clean patio component in Machala (-12%). An incremental cost of 10% was estimated in Fortaleza. On the other hand, there were also completely new components that would require sizeable financial efforts (installing insecticide-treated nets in Girardot and Acapulco costs $16.97 and $24.96 per house, respectively).

CONCLUSIONS

The interventions are promising, seem affordable and may improve the cost profile of the established vector control programs. The costs of the new components could be considerable, and should be assessed in relation to the benefits in reduced dengue burden.

摘要

背景

在福塔莱萨(巴西)、吉拉尔多(哥伦比亚)、马查拉(厄瓜多尔)、阿卡普尔科(墨西哥)和萨尔托(乌拉圭)开展了五项研究,以评估因地制宜的登革热病媒控制干预措施。这些研究让社区明确参与实施过程,并聚焦于埃及伊蚊繁殖最活跃的场所。本文报告了这些干预措施的成本分析情况。

方法

我们从病媒控制项目的角度进行成本核算。收集了用于实施干预措施的资源数量和单位成本的数据。要求提供常规活动的可比信息。对成本项目进行分类、描述性分析并汇总,以计算总成本、每户达到的成本以及增量成本。

结果

各项干预措施的每户成本分别为18.89美元(福塔莱萨)、21.86美元(吉拉尔多)、30.61美元(马查拉)、39.47美元(阿卡普尔科)和6.98美元(萨尔托)。主要侧重于对既定病媒控制项目进行调整的干预措施组成部分似乎成本可控;在萨尔托(-21%)和马查拉的清洁庭院部分(-12%)实现了成本节约。在福塔莱萨估计增量成本为10%。另一方面,也有一些全新的组成部分需要大量资金投入(在吉拉尔多和阿卡普尔科安装经杀虫剂处理的蚊帐,每户成本分别为16.97美元和24.96美元)。

结论

这些干预措施前景良好,似乎成本可控,可能会改善既定病媒控制项目的成本状况。新组成部分的成本可能相当可观,应根据减轻登革热负担的效益进行评估。

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