An economic evaluation of Wolbachia deployments for dengue control in Vietnam

Abstract

Introduction Dengue is a major public health challenge and a growing problem due to climate change. The release of Aedes aegypti mosquitoes infected with the intracellular bacterium Wolbachia is 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 scaled Wolbachia deployments as a form of dengue control in Vietnam–targeted at the highest burden urban areas. Methods Ten settings within Vietnam were identified as priority locations for potential future Wolbachia deployments (using a population replacement strategy). The effectiveness of Wolbachia deployments 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. Results From the health sector perspective, the Wolbachia intervention 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 of Wolbachia releases 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 Conclusion Overall, we found that targeting high burden cities with Wolbachia deployments would be a cost-effective intervention in Vietnam and generate notable broader benefits besides health gains.

Updates on traditional methods for combating malaria and emerging Wolbachia-based interventions

“…Tantowijoyo, Tanamas ( Tantowijoyo et al., 2022 ) confirmed that introducing Wolbachia to reduce dengue had effective outcomes, as the mosquito population and insecticide resistance showed no significant differences between treated and untreated groups in the Applying Wolbachia to Eliminate Dengue trial. Turner, Quyen ( Turner et al., 2023 ) proposed that Wolbachia -infected mosquitoes to control dengue in high-risk urban areas of Vietnam is cost-effective, with a projected cost of $420 per health year saved. It was proposed that Releasing Wolbachia mosquitoes in ten high-burden cities that make up 40% of the country’s dengue cases, could prevent 6.2 million cases over 20 years, bringing significant health and economic benefits.…”

Economic evaluation ofWolbachiadeployment in Colombia: A modeling study

“…[17] In Vietnam, another study found the technology similarly cost effective based on the 10-year time horizon, and cost-saving at the 20-year time horizon. [18] A simulation across seven Brazilian cities also found Wolbachia cost-effective across all 7 cities modeled, though not cost saving[19] in 2 of the 7 cities. In Suva, Fiji, a much smaller city, Wolbachia was acceptably cost-effective, but in Port Vila, Vanuatu, the relatively small target population and lower population density would not make the approach cost-effective there.…”