基于模拟的经济评估的沃尔巴基亚方法在巴西:为登革热控制的成本效益的战略
Ivan Ricardo Zimmermann1, Ricardo Ribeiro Alves Fernandes2, Márcia Gisele Santos da Costa3
1Department of Public Health, University of Brasilia, Brasilia, Brazil.
Lancet regional health. Americas
|June 24, 2024
概括
沃尔巴基亚蚊子替代方法是巴西成本有效的登革热控制策略,显著减少病例和医疗保健成本. 这种方法避免了数百万登革热病例,并带来了巨大的经济效益,证明了其在公共卫生倡议中的价值.
科学领域:
- 公共卫生 公共卫生
- 医学昆虫学 医学昆虫学
- 卫生经济学 卫生经济学
背景情况:
- 登革热病毒 (DENV) 在巴西造成了严重的健康和经济负担,由埃及蚊子传播.
- 严重的登革热状况,如出血热和登革热休克综合征,具有广泛的不良影响.
- 沃尔巴基亚蚊子替代方法为登革热控制提供了一个有前途的战略.
研究的目的:
- 为了估计在巴西七个城市实施Wolbachia蚊子替代方法的经济影响.
- 评估本登革热控制战略的成本效益和投资回报率.
主要方法:
- 一个数学微模拟模型在20年内追踪了大约2300万居民.
- 该模型包含了五种健康状况之间的过渡:易感,无关,门诊,住院和死亡.
- 经济分析包括直接成本 (登革热控制,Wolbachia实施,护理) 和间接成本 (生产力损失,DALYs避免).
主要成果:
- 预计沃尔巴基亚方法可以在20年内避免超过129万例登革热病例,而潜在的176万例.
- 实施带来了显著的成本节约,平均成本差异为每1000名居民538,233.68美元,长达20年.
- 所有七个城市都观察到积极的净货币收益和有利的收益成本比率,这表明投资回报强.
结论:
- 沃尔巴基亚方法是巴西成本有效的登革热控制策略,与国际发现保持一致.
- 敏感性分析和替代情景证实了这些经济预测的稳定性和可靠性.
- 这项研究支持Wolbachia在巴西广泛采用,用于预防登革热和经济效益.
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