BackgroundGiven that dengue disease is growing and may progress to dengue hemorrhagic fever (DHF), data on economic cost and disease burden are important. However, data for Mexico are limited.Methodology/Principal findingsBurden of dengue fever (DF) and DHF in Mexico was assessed using official databases for epidemiological information, disabilities weights from Shepard et al, the reported number of cases and deaths, and costs. Overall costs of dengue were summed from direct medical costs to the health system, cost of dengue to the patient (out-of-pocket expenses [medical and non-medical], indirect costs [loss of earnings, patient and/or caregiver]), and other government expenditures on prevention/surveillance. The first three components, calculated as costs per case by a micro-costing approach (PAATI; program, actions, activities, tasks, inputs), were scaled up to overall cost using epidemiology data from official databases. PAATI was used to calculate cost of vector control and prevention, education, and epidemiological surveillance, based on an expert consensus and normative construction of an ideal scenario.Disability-adjusted life years (DALYs) for Mexico in 2016 were calculated to be 2283.46 (1.87 per 100,000 inhabitants). Overall economic impact of dengue in Mexico for 2012 was US$144 million, of which US$44 million corresponded to direct medical costs and US$5 million to the costs from the patient’s perspective. The estimated cost of prevention/surveillance was calculated with information provided by federal government to be US$95 million. The overall economic impact of DF and DHF showed an increase in 2013 to US$161 million and a decrease to US$133, US$131 and US$130 million in 2014, 2015 and 2016, respectively.Conclusions/SignificanceThe medical and economic impact of dengue were in agreement with other international studies, and highlight the need to include governmental expenditure for prevention/surveillance in overall cost analyses given the high economic impact of these, increasing the necessity to evaluate its effectiveness.
Introducción: Desde la introducción en América de Virus Chikungunya (CHIKV) en el 2013, se ha convertido en un problema de salud pública en el mundo por la morbilidad y la carga económica que genera. El diagnóstico de laboratorio es una herramienta vital en la evaluación de la enfermedad y de las posibles complicaciones, así como en la vigilancia de la infección en el vector. Objetivo: Estandarizar una técnica de Reacción en Cadena de la Polimerasa Transcriptasa Reversa (RT-PCR) en tiempo real para la detección de CHIKV. Materiales y métodos: Se obtuvieron muestras sanguíneas de personas con fiebre y exantema residentes en el Área Metropolitana de Bucaramanga. Se hizo extracción de RNA viral con estuche de Qiagen. Se probaron tres técnicas reportadas en literatura, de RT-PCR en tiempo real SYBR Green One-Step, la de Ho que amplifica un fragmento del gen de la proteína nsP2 y las de Ummul y Agarwal del gen de la proteína E1. Se usó el equipo StepOnePlus de Applied Biosystem. Resultados: En una muestra se detectó CHIKV por las técnicas de Ummul (Ct 27,14) y de Agarwal (Ct 26,78). Ho mostró resultados inespecíficos (Ct 35,85 y 36,97). Conclusiones: Las técnicas que permitieron detectar CHIKV fueron Ummul y Agarwal, siendo congruente con los límites de detección reportados en la literatura (4,12 x 100 copias RNA/ml y 100 copias/25ml, respectivamente). Considerando lo reportado por Ho se asume que la cantidad de RNA viral presente en la muestra es menor al detectado por esta técnica (102 PFU/ml).
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