An economic evaluation ofWolbachiadeployments for dengue control in Vietnam

Abstract

AbstractBackgroundDengue is a major public health challenge and a growing problem due to climate change. The release ofAedes aegyptimosquitoes infected with the intracellular bacteriumWolbachiais a novel form of vector control against dengue. However, there remains a need to evaluate the benefits of such an intervention at a large scale. In this paper, we evaluate the potential economic impact and cost-effectiveness of scaledWolbachiadeployments as a form of dengue control in Vietnam – targeted at the highest burden urban areas.MethodsTen settings within Vietnam were identified as priority locations for potential futureWolbachiadeployments (using a population replacement strategy). The effectiveness ofWolbachiadeployments in reducing the incidence of symptomatic dengue cases was assumed to be 75%. We assumed that the intervention would maintain this effectiveness for at least 20 years (but tested this assumption in the sensitivity analysis). A cost-utility analysis and cost-benefit analysis were conducted.ResultsFrom the health sector perspective, theWolbachiaintervention was projected to cost US$420 per disability-adjusted life year (DALY) averted. From the societal perspective, the overall cost-effectiveness ratio was negative, i.e. the economic benefits outweighed the costs. These results are contingent on the long-term effectiveness ofWolbachiareleases being sustained for 20 years. However, the intervention was still classed as cost-effective across the majority of the settings when assuming only 10 years of benefits.ConclusionOverall, we found that targeting high burden cities withWolbachiadeployments would be a cost-effective intervention in Vietnam and generate notable broader benefits besides health gains.