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A COST-EFFECTIVENESS TOOL FOR INFORMING POLICIES ON ZIKA VIRUS CONTROL
Microcefalia
Sindrome de Guillain Barre
Custo
Saúde
Gravidez
Feminino
Infecção
Políticas
doi:10.1371/journal.pntd.0004743
Author
Affilliation
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Oregon State University. College of Veterinary Medicine. Department of Biomedical Sciences. Corvallis, Oregon, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”. Pediatric Infectious Diseases Department. San José, Costa Rica
Ministerio de Salud. Programa de Control de Vectores. San José, Costa Rica
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Fundação Gonçalo Moniz, Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Department of Ecology and Evolutionary Biology. New Haven Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Oregon State University. College of Veterinary Medicine. Department of Biomedical Sciences. Corvallis, Oregon, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”. Pediatric Infectious Diseases Department. San José, Costa Rica
Ministerio de Salud. Programa de Control de Vectores. San José, Costa Rica
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Fundação Gonçalo Moniz, Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Yale University. Department of Ecology and Evolutionary Biology. New Haven Connecticut, USA
Abstract
As Zika virus continues to spread, decisions regarding resource allocations to control the
outbreak underscore the need for a tool to weigh policies according to their cost and the
health burden they could avert. For example, to combat the current Zika outbreak the US
President requested the allocation of $1.8 billion from Congress in February 2016.
Methodology/Principal Findings
Illustrated through an interactive tool, we evaluated how the number of Zika cases averted,
the period during pregnancy in which Zika infection poses a risk of microcephaly, and probabilities
of microcephaly and Guillain-Barré Syndrome (GBS) impact the cost at which an
intervention is cost-effective. From Northeast Brazilian microcephaly incidence data, we
estimated the probability of microcephaly in infants born to Zika-infected women (0.49% to
2.10%). We also estimated the probability of GBS arising from Zika infections in Brazil
(0.02% to 0.06%) and Colombia (0.08%). We calculated that each microcephaly and GBS
case incurs the loss of 29.95 DALYs and 1.25 DALYs per case, as well as direct medical
costs for Latin America and the Caribbean of $91,102 and $28,818, respectively. We demonstrated
the utility of our cost-effectiveness tool with examples evaluating funding commitments
by Costa Rica and Brazil, the US presidential proposal, and the novel approach of
genetically modified mosquitoes. Our analyses indicate that the commitments and the proposal
are likely to be cost-effective, whereas the cost-effectiveness of genetically modified
mosquitoes depends on the country of implementation.Background
As Zika virus continues to spread, decisions regarding resource allocations to control the
outbreak underscore the need for a tool to weigh policies according to their cost and the
health burden they could avert. For example, to combat the current Zika outbreak the US
President requested the allocation of $1.8 billion from Congress in February 2016.
Methodology/Principal Findings
Illustrated through an interactive tool, we evaluated how the number of Zika cases averted,
the period during pregnancy in which Zika infection poses a risk of microcephaly, and probabilities
of microcephaly and Guillain-Barré Syndrome (GBS) impact the cost at which an
intervention is cost-effective. From Northeast Brazilian microcephaly incidence data, we
estimated the probability of microcephaly in infants born to Zika-infected women (0.49% to
2.10%). We also estimated the probability of GBS arising from Zika infections in Brazil
(0.02% to 0.06%) and Colombia (0.08%). We calculated that each microcephaly and GBS
case incurs the loss of 29.95 DALYs and 1.25 DALYs per case, as well as direct medical
costs for Latin America and the Caribbean of $91,102 and $28,818, respectively. We demonstrated
the utility of our cost-effectiveness tool with examples evaluating funding commitments
by Costa Rica and Brazil, the US presidential proposal, and the novel approach of
genetically modified mosquitoes. Our analyses indicate that the commitments and the proposal
are likely to be cost-effective, whereas the cost-effectiveness of genetically modified
mosquitoes depends on the country of implementation.
Background
As Zika virus continues to spread, decisions regarding resource allocations to control the
outbreak underscore the need for a tool to weigh policies according to their cost and the
health burden they could avert. For example, to combat the current Zika outbreak the US
President requested the allocation of $1.8 billion from Congress in February 2016.
Methodology/Principal Findings
Illustrated through an interactive tool, we evaluated how the number of Zika cases averted,
the period during pregnancy in which Zika infection poses a risk of microcephaly, and probabilities
of microcephaly and Guillain-Barré Syndrome (GBS) impact the cost at which an
intervention is cost-effective. From Northeast Brazilian microcephaly incidence data, we
estimated the probability of microcephaly in infants born to Zika-infected women (0.49% to
2.10%). We also estimated the probability of GBS arising from Zika infections in Brazil
(0.02% to 0.06%) and Colombia (0.08%). We calculated that each microcephaly and GBS
case incurs the loss of 29.95 DALYs and 1.25 DALYs per case, as well as direct medical
costs for Latin America and the Caribbean of $91,102 and $28,818, respectively. We demonstrated
the utility of our cost-effectiveness tool with examples evaluating funding commitments
by Costa Rica and Brazil, the US presidential proposal, and the novel approach of
genetically modified mosquitoes. Our analyses indicate that the commitments and the proposal
are likely to be cost-effective, whereas the cost-effectiveness of genetically modified
mosquitoes depends on the country of implementation.
Conclusions/Significance
Current estimates from our tool suggest that the health burden from microcephaly and GBS
warrants substantial expenditures focused on Zika virus control. Our results justify the funding
committed in Costa Rica and Brazil and many aspects of the budget outlined in the US
president’s proposal. As data continue to be collected, new parameter estimates can be
customized in real-time within our user-friendly tool to provide updated estimates on costeffectiveness
of interventions and inform policy decisions in country-specific settings.
Keywords in Portuguese
Zika virusMicrocefalia
Sindrome de Guillain Barre
Custo
Saúde
Gravidez
Feminino
Infecção
Políticas
Publisher
Public Library of Science
Citation
MURILLO, J. A. A. et al. A Cost-Effectiveness Tool for Informing Policies on Zika Virus Control. PLOS Neglected Tropical Diseases, may. 2016.ISSN
1935-2727doi:10.1371/journal.pntd.0004743
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