Use of insecticide-treated school uniforms for prevention of dengue in schoolchildren: A cost-effectiveness analysis

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

Research output: Contribution to journalArticle

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,0) in all scenarios in which the intervention cost per child was $2.9 or less per year and the intervention effectiveness was 50% or higher. The results suggested that this intervention would be of no interest to Thai policy makers when the intervention cost per child was $10.6 or higher per year regardless of intervention effectiveness (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.

Original languageEnglish (US)
Article numbere108017
JournalPLoS One
Volume9
Issue number9
DOIs
StatePublished - Sep 23 2014

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Clothing
dengue
school children
Dengue
cost effectiveness
Cost effectiveness
Insecticides
Cost-Benefit Analysis
insecticides
Costs and Cost Analysis
Costs
economic valuation
Economics
Aedes
Thailand
Culicidae
Administrative Personnel
Cause of Death
Hospitalization
death

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Use of insecticide-treated school uniforms for prevention of dengue in schoolchildren : A cost-effectiveness analysis. / Tozan, Yesim; Ratanawong, Pitcha; Louis, Valérie R.; Kittayapong, Pattamaporn; Wilder-Smith, Annelies.

In: PLoS One, Vol. 9, No. 9, e108017, 23.09.2014.

Research output: Contribution to journalArticle

Tozan, Yesim ; Ratanawong, Pitcha ; Louis, Valérie R. ; Kittayapong, Pattamaporn ; Wilder-Smith, Annelies. / Use of insecticide-treated school uniforms for prevention of dengue in schoolchildren : A cost-effectiveness analysis. In: PLoS One. 2014 ; Vol. 9, No. 9.
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