Aedes Aegypt: Economic Impact of Prevention Versus Palliation of Diseases Caused By The Mosquito

OBJECTIVES: Aedes aegypt is responsible for transmitting four diseases that had major outbreaks recently in Brazil: dengue, zika, chikungunya and yellow fever. Our goal was to analyze the expenditures of the Brazilian government with these outbreaks (palliation), comparing them with the expenditures in prevention campaigns. METHODS: searches were performed on MEDLINE using the following terms: aedes aegypt AND costs, dengue AND costs, chikungunya AND costs, zika AND costs e yellow fever AND costs) and completed with hand search on the reference list of included articles. Language was limited for English or Portuguese, and publication date for 2010-2017. We extracted data on government expenditures for the treatment of patients during the outbreaks of dengue, zika, chikungunya and yellow fever in those years. In the absence of data from Brazil, the search was expanded to Latin America. Official data from the Brazilian Ministry of Health (MoH) and the World Health Organization (WHO) were also reviewed. RESULTS: we retrieved 423 articles, 410 were excluded due to duplicity, because they did not address our topic or Latin America and due to design inadequacies. Thirteen studies were included for analysis. Data from the literature estimated the cost of treating dengue at around R$ 1 billion per year. TYeatment of microcephaly and Guillain-Barre syndrome, the most severe consequences of zika, was estimated at U$91,102. The economic impact of chikungunya treatment was projected at U$73.6 million. For the current outbreak of yellow fever, the economic impact has not yet been estimated. The Brazilian government has spent R$ 13.7 million to combat aedes aegypt according to official data from MoH since the outbreak of dengue in 2013. CONCLUSIONS: There is a need for greater investment in the prevention and control of the vector, which would save resources and avoid new outbreaks of these and other diseases transmitted by aedes aegypt.