Introducing a Dengue Vaccine to Mexico: Development of a System for Evidence-Based Public Policy Recommendations

摘要

The incidence of dengue fever (DF) is steadily increasing in Mexico [1], [2], as it is in the rest of Latin America [3], burdening health systems with the consequent morbidity and mortality [4]–[6]. The incidence of DF in Mexico has increased from 1.7 cases per 100,000 inhabitants in 2000 to 43.03 cases per 100,000 inhabitants in 2012 (Table 1) [1], [2]. Growing urbanization, human migration, climate change, and ecological disruption have facilitated the expansion of dengue's vectors, Aedes aegypti and A. albopictus [3], [4]. This increase, which could be solely attributed to an improvement in epidemiological surveillance, in reality has a much more complex explanation. According to reports from the Mexican Secretariat of Health, DF in Mexico follows a cyclical pattern of approximately five years per cycle, characterized by a sudden and dramatic rise in cases subsequently followed by a period of decrement that ultimately results in years with a low number of cases. This pattern seems to have its origin in the introduction/reintroduction of new serotypes among the population [2].