ABSTRACT
This study aims to provide a preliminary estimate of the immediate cost of chikungunya and dengue to household in the Indian state of Gujarat. Combining nine earlier studies and data from interviews, we analysed the costs of non-fatal illness and of intervention programmes; building a more comprehensive picture of the immediate cost of these Aedes aegypti mosquito-borne diseases to Gujarat. The “RUHA matrix” was used to estimate the cost of illness by combining the shares of reported (R) and unreported (U) hospitalized (H) and ambulatory (A) cases of chikungunya and dengue with ambulatory and hospitalization costs per case and the number of reported cases. Using Monte Carlo sensitivity analysis, the immediate cost to households incurred on account of chikungunya and dengue to Gujarat was estimated to be 3.8 (range 1.6–9.1) billion Indian rupees (INR) per annum (US$ 90 million, range US$ 38 and US$ 217 million). It is hoped that this preliminary estimate will trigger more refined studies on cost of illness as well as cost-effectiveness of vaccines and other interventions to combat these neglected tropical diseases.
Subject(s)
Dengue , Chikungunya Fever , Health Care Costs , Cost of IllnessABSTRACT
BACKGROUND: Indoor residual spray (IRS), with appropriate insecticide, is an effective weapon for the control of malaria. Two rounds of indoor residual spray, with synthetic pyrethroid, are given in highly malaria endemic areas. It aims to prevent transmission of malaria by adult vector mosquitoes. AIMS: To assess the impact of indoor residual spray in the highly malaria-endemic villages of Kalol taluka in Gandhinagar district. DESIGN: High risk population for malaria, based on last three-year malaria situation. SETTING: Malaria endemic rural areas in Gandhinagar district where indoor residual spray was undertaken with synthetic pyrethroid in 2006 and 2007. STUDY VARIABLES: Exploratory - Rural areas; Outcome - coverage, acceptance. ANALYSIS: Percentage and proportions. RESULTS: Prior to the introduction of synthetic pyrethroid, in 2005, the annual parasitic incidence of the sprayed villages was 33.4. It came down to 8.8 in 2006. Continuation of this strategy in the same villages further brought down the annual parasitic incidence to 1.5 in 2007. A similar trend of steady decline was observed in actual numbers of cases and other malariometric indices as well. CONCLUSION: IRS, it still has a major role in the control of malaria if implemented with proper supervision, better coverage and community participation.
ABSTRACT
BACKGROUND: Mass drug administration (MDA) means once-in-a-year administration of diethyl carbamazine (DEC) tablet to all people (excluding children under 2 years, pregnant women and severely ill persons) in identified endemic areas. It aims at cessation of transmission of lymphatic filariasis. OBJECTIVE: What has been the coverage and compliance of MDA in Gujarat during the campaign in December 2006? STUDY DESIGN: Cross-sectional population based house-to-house visit. SETTING: Urban and rural areas in Gujarat identified as endemic for filariasis where MDA 2006 was undertaken. STUDY VARIABLES: Exploratory - Rural and urban districts; Outcome - coverage, compliance, actual coverage, side effects. ANALYSIS: Percentage and proportions. RESULTS: Twenty-six clusters, each comprising 32 households from six endemic districts, yielded an eligible population of 4164. The coverage rate was 85.2% with variation across different areas. The compliance with drug ingestion was 89% with a gap of 11% to be targeted by intensive IEC. The effective coverage (75.8%) was much below the target (85%). Side effects of DEC were minimum, transient and drug-specific. Overall coverage was marginally better in rural areas. The causes of poor coverage and compliance have been discussed and relevant suggestions have been made.
