Estimativa de custo do programa de controle e prevenção da dengue em Goiânia-GO
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2013-02-27
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Universidade Federal de Goiás
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Introduction: Dengue is an acute febrile illness of significant magnitude in Brazil, caused by four antigenically distinct serotypes. Between 2002 and2010 approximately four million probable dengue cases were reported in Brazil, with major outbreaks in 2002, 2008, and 2010. Dengue vaccines are currently in phase 3 clinical trials, and it is expected that such vaccine will reduce the number of cases, disease costs, and costs of dengue prevention and control programs, particularly during epidemic. Thus, cost of program studies are essential to subsidize cost-effectiveness analysis, which are important for decision making regarding dengue vaccine introduction. Objective: Estimate the costs of dengue control program (PMCD) in the municipality of Goiânia-GO, Brazil. Methods: We conducted a retrospective analysis, considering epidemic (October/2009-April/2010), and endemic (May-September/2010) periods of dengue transmission. The public healthcare system (SUS) perspective was considered. We considered the following cost components: human resources, training, infrastructure, equipment and office supplies, transportation, personal protective equipment (PPE), field and laboratory equipment, insecticides and social mobilization, considering capital and recurrent costs. Except for the costs of insecticide purchase and Central Ultra Low Volume (ULV) which are beared by the federal and state levels, respectively, the remaining costs of the PMCD are incurred by the municipal level. Information sources included Goiânia Municipal Health Department and the Brazilian Central Bank. Costs by dengue transmission period and cost category were estimated. Unlike recurring costs, capital costs estimated for both transmission periods combined. Results: The total and monthly recurring costs of the PMCD during the epidemic period was R$8.307.590,02 (U.S.$4.988.345,15) and R$1.400.819,19 (U.S.$841.130,77) respectively; and in the endemic period was R$5.848.678,18 (U.S.$3.511.875,94) and R$949.878,86 (U.S.$570.360,79), respectively. Capital costs for both periods were estimated at R$683,314.98 (U.S.$410,300.82). The most significant component of recurrent costs was that of human resources (84% and 86% respectively). Transportation (80%) and infrastructure (13%) accounted for the largest proportion among capital costs. Regarding source of funding, 83%, 13% and 3% of costs are incurred by municipal, federal, and state levels, respectively. Conclusion: The PMCD costs estimate on epidemic and endemic periods allows to know the excess cost that an epidemic burdens to the government, especially at the municipal level. By the way it is necessary to enable the introduction of a technology that not only reduces the incidence of dengue but also reduce the epidemic peaks.
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SANTOS, Sandra Maria dos. Estimativa de custo do programa de controle e prevenção da dengue em Goiânia-GO. 2013. 108 f. Dissertação (Mestrado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2013.