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Godói IP, Da Silva LVD, Sarker AR, Megiddo I, Morton A, Godman B, Alvarez-Madrazo S, Bennie M, Guerra-Junior AA. Economic and epidemiological impact of dengue illness over 16 years from a public health system perspective in Brazil to inform future health policies including the adoption of a dengue vaccine. Expert Rev Vaccines 2019; 17:1123-1133. [PMID: 30417706 DOI: 10.1080/14760584.2018.1546581] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Dengue is a serious global health problem endemic in Brazil. Consequently, our aim was to measure the costs and disease burden of symptomatic dengue infections in Brazil from the perspective of the Brazilian Public Health System (SUS) between 2000 and 2015, using Brazilian public health system databases. Specific age group incidence estimates were used to calculate the disability-adjusted life years (DALYs) to gain a better understanding of the disease burden. Areas covered: SUS spent almost USD159 million and USD10 million to treat dengue and severe dengue, respectively, between 2000 and 2015. This is principally hospitalization costs, with the majority of patients self-treated at home with minor symptoms. The average notification rate for dengue was 273 per 100,000 inhabitants and three per 100,000 for severe dengue, with annual DALYs estimates ranging between 72.35 and 6,824.45 during the 16 years. Expert commentary: The epidemiological and morbidity burden associated with dengue is substantial in Brazil, with costs affected by the fact that most patients self-treat at home with these costs not included in SUS. The Brazilian government urgently needs to proactively evaluate the real costs and clinical benefits of any potential dengue vaccination program by the National Immunization Program to guide future decision-making.
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Affiliation(s)
- Isabella Piassi Godói
- a Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.,b SUS Collaborating Centre for Technology Assessment and Excellence in Health, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.,c Institute of Health and Biological Studies - Universidade Federal do Sul e Sudeste do Pará , Avenida dos Ipês, s/n , Cidade Universitária , Cidade Jardim , Marabá, Pará , Brazil
| | - Leonardo Vinicius Dias Da Silva
- c Institute of Health and Biological Studies - Universidade Federal do Sul e Sudeste do Pará , Avenida dos Ipês, s/n , Cidade Universitária , Cidade Jardim , Marabá, Pará , Brazil.,d Programa Interunidades de Pós Graduação em Bioinformática , Instituto de Ciências Biológicas , Belo Horizonte , Brazil
| | - Abdur Razzaque Sarker
- e Health Economics and Financing Research, Health Systems & Population Studies Division , icddr, b , Dhaka , Bangladesh.,f Department of Management Science , University of Strathclyde , Glasgow , UK
| | - Itamar Megiddo
- f Department of Management Science , University of Strathclyde , Glasgow , UK.,g Economics & Policy , The Center for Disease Dynamics , Washington , DC , USA
| | - Alec Morton
- f Department of Management Science , University of Strathclyde , Glasgow , UK
| | - Brian Godman
- h Department of Pharmacoepidemiology , Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University , Glasgow , UK.,i Division of Clinical Pharmacology, Karolinska Institute , Karolinska University Hospital , Stockholm , Sweden.,j Health Economics Centre , Liverpool University Management School , Liverpool , UK.,k School of Pharmacy, Department of Public Health and Pharmacy Management , Sefako Health Sciences University , Pretoria , South Africa
| | - Samantha Alvarez-Madrazo
- h Department of Pharmacoepidemiology , Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University , Glasgow , UK.,l Farr Institute of Health Informatics Research , University of Strathclyde, Institute of Pharmacy and Biomedical Sciences , Glasgow , UK
| | - Marion Bennie
- h Department of Pharmacoepidemiology , Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University , Glasgow , UK
| | - Augusto Afonso Guerra-Junior
- a Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.,b SUS Collaborating Centre for Technology Assessment and Excellence in Health, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
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Godói IP, Lemos LLP, de Araújo VE, Bonoto BC, Godman B, Guerra Júnior AA. CYD-TDV dengue vaccine: systematic review and meta-analysis of efficacy, immunogenicity and safety. J Comp Eff Res 2017; 6:165-180. [PMID: 28084784 DOI: 10.2217/cer-2016-0045] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Dengue virus (DENV) is a serious global health problem. CYD-TDC (Dengvaxia®) was the first vaccine to gain regulatory approval to try and address this problem. AIM Summarize all available evidence on the immunogenicity, efficacy and safety of the CYD-TDV dengue vaccine. METHOD Meta-analysis and systematic review. RESULTS The best and worst immunogenicity results were for DENV4 and DENV1, respectively. Vaccine efficacy of 60% was derived from studies with participants aged 2-16 years old, with DENV4 and DENV2 presenting the best and worst results, respectively. Erythema and swelling were more frequent with CYD-TDV. No differences were detected for systemic adverse events. CONCLUSION CYD-TDV showed moderate efficacy in children and adolescents. From the immunogenicity results in adults, we can expect satisfactory efficacy from vaccination in this population.
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Affiliation(s)
- Isabella Piassi Godói
- Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, sala 1023, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil.,SUS Collaborating Centre for Technology Assessment & Excellence in Health, sala 1042, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
| | - Livia Lovato Pires Lemos
- SUS Collaborating Centre for Technology Assessment & Excellence in Health, sala 1042, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
| | - Vânia Eloisa de Araújo
- Faculdade de Odontologia, Instituto de Ciências Biológicas e da Saúde, Pontifícia Universidade Católica de Minas Gerais, Av. Dom José Gaspar, 500 Coração Eucaristíco, Belo Horizonte, Minas Gerais, CEP 30535-901, Brazil
| | - Braúlio Cesar Bonoto
- Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, sala 1023, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
| | - Brian Godman
- University of Strathclyde Glasgow, Institute of Pharmacy & Biomedical Sciences, Pharmacoepidemiology, 161 Cathedral Street, Glasgow G4 0RE, UK.,Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, SE-141 86, Stockholm, Sweden
| | - Augusto Afonso Guerra Júnior
- Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, sala 1023, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil.,SUS Collaborating Centre for Technology Assessment & Excellence in Health, sala 1042, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
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