Dengue fever, an arbovirus disease transmitted by Aedes mosquitoes, has spread rapidly, especially in the tropical countries of the Americas and Asia-Pacific regions. It is endemic in Malaysia, with an annual average of 35,403 reported dengue cases from 2001 to 2010. The economic burden of dengue for Malaysia in 2009 was MYR 359.79 million (US102.2million)buttheseestimatesareincompletebecausethepublicsectorcostsofdiseasecontrolhadnotbeenconsidered.ThisstudyestimatedthecostsofdenguecontrolandpreventioninMalaysiaandmeasuredtheoveralleconomicimpactofdengueinthecountry.ItalsoexaminedthevariationsindenguevectorcontrolcostsandresourcesconsumptionbetweentheDistrictHealthDepartments(DHDs)andLocalAuthorities(LAs)toassistinformeddecisionmakingastothefuturerolesoftheseagenciesinthedeliveryofdenguevectorcontrolservicesinMalaysia.DatawerecollectedfromrepresentativevectorcontrolunitsofDHDs,StateHealthDepartments(SHDs)andFederalHealthDepartment(FHD)fromMinistryofHealthMalaysiaandthecorrespondingLAsatthesampleddistricts.Thecostsandresourcesconsumptionbycapitalandrecurrentitemsin2010werecaptured.Thedatawasrecordedbylevelinamatrixbylineitemsandfunctions.Lineitemsconsistofhumanpersonnel,buildings,vehicles,equipment,pesticides,personalprotectiveequipment(PPE)andoutsourcingoffoggingservicestoprivatepestcontrolcompanies.Acostanalysisoffunctionsincludescostsofinspectionofpremises,larvicidingandfoggingactivities,entomologicalsurveillanceandhealtheducationactivities.Forthecomparisonofcostsbetweenserviceproviders,namelytheDHDsandLAs,onlythevectorcontrolactivitieswereconsidered.Thosevectorcontrolactivitieswereinspectionofpremises,foggingandlarvicidingofpotentialbreedingsites.MalaysiaspentMYR235.05mil(US 73.45 mil)
or 0.03% of the country’s GDPfor dengue vector control and prevention. This expenditure represented MYR 5,091 (US1,591)perreporteddenguecaseandMYR8.58(US 2.68) per capita population. Notably, 92.2% of this spending occurred in the district-level primarily for fogging activities. From this total expenditure, the national DHDs and LAs expenditure were MYR 169.12 mil (US52.85mil)andMYR47.63mil(US 14.88 mil) respectively. The comparison of dengue vector control costs between service providers at the sampled districts revealed that the DHDs spent MYR 17.98 mil (US5.62mil)orMYR2,172(US 679) per reported dengue case, and LAs spent MYR 8.34 mil (US2.61mil)orMYR1,598(US 499) per reported case. The highest expenditure was fogging, being 51.0% of costs for DHDs and 45.8% for the LAs. The DHDs had higher resource costs for human personnel, vehicles, pesticides and equipment. The findings provide some evidence to rationalize delivery of dengue vector control services in Malaysia. The inclusion of control and preventive activities increased substantially the estimated economic burden of dengue to MYR 594.84 mil (US$ 175.71 mil), or 72% above illness costs alone. The quantification of dengue economic burden informs policy makers and stakeholders regarding the implementation of existing and new technologies for controlling dengue