Economic impact of dengue in Singapore from 2010 to 2020 and the cost-effectiveness of Wolbachia interventions

Abstract

The release of Wolbachia-infected mosquitoes is a promising disease intervention strategy that aims to control dengue and other arboviral infections. While early field trials and modelling studies suggest promising epidemiological and entomological outcomes, the overall cost effectiveness of the technology is not well studied in a resource rich setting nor under the suppression approach that aims to suppress the wild-type mosquito population through the release of Wolbachia-infected males. We used economical and epidemiological data from 2010 to 2020 to first ascertain the economic and health costs of dengue in Singapore, a high income nation where dengue is hyper-endemic. The hypothetical cost effectiveness of a national Wolbachia suppression program was then evaluated historically from 2010 to 2020. We estimated that the average economic impact of dengue in Singapore from 2010 to 2020 in constant 2010US$ ranged from $1.014 to $2.265 Billion. Using empirically derived disability weights, we estimated a disease burden of 7,645–21,262 DALYs from 2010–2020. Under an assumed steady-state running cost of a national Wolbachia suppression program in Singapore, we conservatively estimate that Wolbachia would cost an estimated $50,453–$100,907 per DALYs averted and would lead to an estimated $329.40 Million saved in economic costs over 2010 to 2020 under 40% intervention efficacy. Wolbachia releases in Singapore are expected to be highly cost-effective and its rollout must be prioritised to reduce the onward spread of dengue.

A mass rearing cost calculator for the control of Culex quinquefasciatus in Hawaiʻi using the incompatible insect technique

“…quinquefasciatus [ 10 ] using IIT, to the canonical use of SIT to eliminate screwworms [ 50 , 51 ], these tools have proven to be powerful additions to any IPM plan [ 52 ]. Although the costs of implementing an IIT or SIT tool in perpetuity may seem great, generally the benefit that the tool provides outweighs those costs [ 21 , 52 ]. For instance, the annual economic benefit to the United States from screwworm eradication using SIT is ~ $2.8 billion annually whereas the program ultimately cost $32 million as of 2016 [ 51 ].…”

“…To address the above issues a new approach was developed that combines IIT and SIT approaches to prevent the release of any residual fertile females [11]. The IIT/SIT approach is a cost-effective solution that will likely result in successful suppression of targeted mosquito populations [11,20,21]. As IIT, SIT, and IIT/SIT have been successfully developed and applied to control Cx.…”

The Diagnosis of Dengue in Patients Presenting With Acute Febrile Illness Using Supervised Machine Learning and Impact of Seasonality

“…Features used in our model (age, sex, and parameters from full blood count) are widely available and overall discrimination performance was higher compared with previously published models ( 15 , 19 ). Incorporation into routine hospital laboratory systems can further support passive dengue surveillance: in turn this can inform public health interventions including local vector control efforts, preparation healthcare facility capacity and disease-specific measures ( 20 ). The accurate classification of acute febrile illnesses has direct impacts on patient clinical outcomes and supports appropriate use of empirical antimicrobials, as a means to tackle antimicrobial resistance ( 21 ).…”

Strategies to Mitigate Establishment under the Wolbachia Incompatible Insect Technique

“…aegypti mosquitoes over time. Suppression-based programmes have been implemented in the US [19], China [20] and Singapore [21,22] to complement existing vector control efforts. Crucially, the efficacy of the suppression approach relies on the over-flooding ratio of the male Wolbachia-Aedes mosquitoes to wild type females and the success of mating [23].…”