Determining the Potential Payoff at City and District Levels From Up-Front Investments in New Technologies for Dengue Prevention in Two Endemic Countries (Thailand and Indonesia): Combining Surveillance, Screening and Interviewing

Author(s)

Discussion Leader: Donald Shepard, PhD, MPP, FASTMH, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
Discussants: Sukhontha Kongsin, PhD, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Nandyan Nurlaksana Wilastonegoro, MD, MScIH, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia

Presentation Documents

PURPOSE: Recent randomized trials of two new technologies (Wolbachia and Takeda's vaccine) established that each would cut dengue by ~75% without adverse effects. However, deployment would require substantial up-front investment, particularly at the city and district levels. Most existing studies overlook the many non-hospitalized cases, which impose substantial economic costs from healthcare utilization and lost productivity, thereby understating costs.

DESCRIPTION: Workshop attendees will obtain a working knowledge of approaches to provide needed data accurately, quickly, and efficiently. Prof. Shepard will lead the session and introduce the topic, describing the new technologies and limitations of existing studies. For example, dengue and other illnesses, including COVID-19, reduce presenteeism--patients' ability to maintain usual activities for income, household tasks, and schooling (10 min). Prof. Kongsin and colleagues piloted a study assessing presenteeism losses in Umphang District, Tak Province, Thailand. The pilot enrolled 22 laboratory-confirmed dengue patients, aged 7-78, from April-July, 2021 with interviews every 1-4 weeks for up to 6 months until symptoms ended. Enrollees reflected the diverse ages of dengue patients (14% under age 18, 72% aged 19-59, and 14% age 60+) and their distinct settings (27% inpatient and 73% outpatient). With participant incentives and well-trained staff, all enrollees completed every planned interview (15 min). Dr. Wilastonegoro will describe a five-step protocol for Semarang City, Indonesia (population 1.7 million): (1) Using data from the surveillance system to select a small but representative sample of public and private health centers and hospitals. (2) Promptly screening their clinically diagnosed patients for laboratory confirmation. (3) Inviting NS1-positive patients to enroll in an observational study. (4) Interviewing consenting patients every 1-4 weeks about health care utilization, absenteeism, and presenteeism. (5) Linking interviews with surveillance and screening data to weight to the city level (15 min). Audience participation in this interactive workshop will explore wider applicability and adaptation (20 min).

Conference/Value in Health Info

2022-09, ISPOR Asia Pacific 2022, Virtual

Code

W9

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