Economic Evaluation of an E-Dengue Early Warning System for Proactive Dengue Prevention in the Mekong Delta Region, Vietnam: A Protocol

BACKGROUND: Numerous dengue early warning tools have been developed, while few have been successfully integrated into routine surveillance systems. The E-Dengue tool, designed using the "Useful, Usable, and Used" framework, aims to predict dengue epidemics three months in advance in the Mekong Delta Region (MDR) of Vietnam. This protocol outlines the economic evaluation of an early warning system in which E-Dengue alerts prompt proactive dengue prevention and control interventions. METHODS: An economic evaluation using a societal perspective will be conducted alongside a cluster-randomized controlled trial. Costs and outcomes will be compared between the E-Dengue early warning system and routine practice. The primary outcome measure will be disability-adjusted life years (DALYs) and the secondary outcome measure will be dengue cases. The mean cost of a dengue case will be quantified by conducting a cost of illness substudy that will utilize both hospital billing records and structured surveys of patients and informal caregivers and by evidence synthesis from the literature. The cost-effectiveness of E-Dengue will be assessed over a 2-year time horizon and expressed as the incremental cost per DALY averted and per dengue case averted, respectively, and compared against a prespecified cost-effectiveness threshold. The robustness of the results will be evaluated using one-way and probabilistic sensitivity analyses. DISCUSSION: Demonstrating that E-Dengue is cost-effective will provide rigorous evidence to support its integration into routine surveillance in the MDR and potentially for it to be scaled up and adapted to other areas of Vietnam and nations with similar conditions. Conversely, if E-Dengue is not cost-effective, the study will provide critical lessons for the design and implementation of future early warning tools. TRIAL REGISTRATION NO: ACTRN12626000402347.