Economics of vector-borne diseases prevention: The case of the Tiger Mosquito control and Chikungunya and Dengue prevention plan in the Emilia-Romagna region (Northern Italy)

Aedes albopictus is considered one of the most invasive mosquito species in the world. It has proved capacity for local transmission of Chikungunya and Dengue within Europe. This research evaluated public costs related to the implementation of the plan for Ae. albopictus control and Chikungunya and Dengue prevention set up in Emilia-Romagna region (Northern Italy), where a Chikungunya epidemic outbreak occurred in 2007, with 217 confirmed cases. The management plan started in 2008 by involving more than 280 municipalities and 4.3 million inhabitants within the region, and its activities mainly target the ecological conditions for the multiplication of infestation hotspots in urban areas, to reduce the probability of rapid and uncontrolled disease spreading in case of outbreaks. The study accessed to data on the expenditures supported by all the public institutions involved in the implementation of the management plan. During the 8 year’s life of the management plan, the public authorities of the region spent at least € 37.7 million for the Ae. albopictus control, although the yearly expenditure declined since the € 7.6 million of 2008 to the € 3.1 million of 2015. The assessment of this expenditure revealed a high level of variability of its costs in the various municipalities included in the plan, not easily explainable only by the territorial and environmental differences among the urban areas. The cost for the treatment of a single road drain varied in a range from ≈ € 0.04 to ≈ € 6.1 among the municipalities in the years of existence of the plan. The research also attempted a first evaluation of the expenditures incurred by households to protect themselves from mosquito bites. During the pilot phase of a dedicated project, 57 interviews were realized to a random sample, and the mean expenditure € 18.25 per household.