Economic cost of dengue public prevention activities in Puerto Rico.

ABSTRACT

Dengue fever has become a major global public health problem in Puerto Rico. Approximately 5000 suspected cases were reported annually between 2002 and 2007. Vector control is currently the only approach to control the disease and includes prevention education, fumigation, inspections and clean-up campaigns. The annual cost to the public sector of dengue prevention, which includes surveillance and vector control activities, was estimated as part of a study of the economic burden of dengue in Puerto Rico. A telephonic survey was implemented to identify municipalities with vector control programmes and public agencies with dengue surveillance systems. Onsite interviews were conducted using a structured questionnaire. The economic cost of dengue was summarized by line item, function and year from 2002 through 2007. The Puerto Rico Department of Health (PRDH) and 12 municipalities out of 78 conducted vector control activities in different magnitudes during the study years. The cumulative cost of dengue vector control in the public sector was US$ 46.22 million for the years 2002–2007. PRDH spent an average of US$ 1.29 million ($0.33 per capita) per year, while the municipalities spent an average of US$ 6.41 million (US$ 1.64 per capita) per year. Clean-up campaigns had the highest share of average expenditure, followed by fumigation, surveillance and inspection. Puerto Rico’s per capita expenditure on dengue prevention activities is similar to that of other countries in the region. On average, Puerto Rico’s per capita spending on dengue illness is US$ 5.48 compared with US$ 1.97 spent on vector control.