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Use of Insecticide-Treated School Uniforms for Prevention of Dengue in Schoolchildren: A Cost-Effectiveness Analysis

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  • Yesim Tozan
  • Pitcha Ratanawong
  • Valérie R Louis
  • Pattamaporn Kittayapong
  • Annelies Wilder-Smith

Abstract

Background: Dengue-related illness is a leading cause of hospitalization and death, particularly among children. Practical, acceptable and affordable measures are urgently needed to protect this age group. Schools where children spend most of their day is proposed as an ideal setting to implement preventive strategies against day-biting Aedes mosquitoes. The use of insecticide-treated school uniforms is a promising strategy currently under investigation. Methods: Using a decision-analytic model, we evaluated the cost-effectiveness of the use of insecticide-treated school uniforms for prevention of dengue, compared with a “do-nothing” alternative, in schoolchildren from the societal perspective. We explored how the potential economic value of the intervention varied under various scenarios of intervention effectiveness and cost, as well as dengue infection risk in school-aged children, using data specific to Thailand. Results: At an average dengue incidence rate of 5.8% per year in school-aged children, the intervention was cost-effective (ICER≤$16,440) in a variety of scenarios when the intervention cost per child was $5.3 or less and the intervention effectiveness was 50% or higher. In fact, the intervention was cost saving (ICER $16,440). Conclusions: Our results present the potential economic value of the use of insecticide-treated uniforms for prevention of dengue in schoolchildren in a typical dengue endemic setting and highlight the urgent need for additional research on this intervention.

Suggested Citation

  • Yesim Tozan & Pitcha Ratanawong & Valérie R Louis & Pattamaporn Kittayapong & Annelies Wilder-Smith, 2014. "Use of Insecticide-Treated School Uniforms for Prevention of Dengue in Schoolchildren: A Cost-Effectiveness Analysis," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-9, September.
    • Handle: RePEc:plo:pone00:0108017
    DOI: 10.1371/journal.pone.0108017
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    References listed on IDEAS

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    1. Samir Bhatt & Peter W. Gething & Oliver J. Brady & Jane P. Messina & Andrew W. Farlow & Catherine L. Moyes & John M. Drake & John S. Brownstein & Anne G. Hoen & Osman Sankoh & Monica F. Myers & Dylan , 2013. "The global distribution and burden of dengue," Nature, Nature, vol. 496(7446), pages 504-507, April.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    3. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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