Cost of Dengue Cases in Eight Countries in the Americas and Asia: A Prospective Study

Abstract

Despite the growing worldwide burden of dengue fever, the global economic impact of dengue illness is poorly documented. Using a common protocol, we present the first multicountry estimates of the direct and indirect costs of dengue cases in eight American and Asian countries. We conducted prospective studies of the cost of dengue in five countries in the Americas (Brazil, El Salvador, Guatemala, Panama, and Venezuela) and three countries in Asia (Cambodia, Malaysia, and Thailand). All studies followed the same core protocol with interviews and medical record reviews. The study populations were patients treated in ambulatory and hospital settings with a clinical diagnosis of dengue. Most studies were performed in 2005. Costs are in 2005 international dollars (I$). We studied 1,695 patients (48% pediatric and 52% adult); none died. The average illness lasted 11.9 days for ambulatory patients and 11.0 days for hospitalized patients. Among hospitalized patients, students lost 5.6 days of school, whereas those working lost 9.9 work days per average dengue episode. Overall mean costs were I$514 and I$1,394 for an ambulatory and hospitalized case, respectively. With an annual average of 574,000 cases reported, the aggregate annual economic cost of dengue for the eight study countries is at least I$587 million. Preliminary adjustment for under-reporting could raise this total to $1.8 billion, and incorporating costs of dengue surveillance and vector control would raise the amount further. Dengue imposes substantial costs on both the health sector and the overall economy.

Spatio-temporal patterns of dengue in Malaysia: combining address and sub-district level

“…Effective vector control relies critically on the determination of the proper scale to address dengue virus transmission (Getis et al, 2003;Suaya et al, 2009). Different geographical scales have been suggested, ranging from finer scales based on the vector's flight range (Getis et al, 2003;Yoon et al, 2012) to larger scales due to the relative importance the closeness of neighbouring communities and human movement (Shepard et al, 2012).…”

Lineage II of Southeast Asian/American DENV-2 is Associated with a Severe Dengue Outbreak in the Peruvian Amazon

“…[4][5][6][7][8][9] In many resource-poor countries, the costs associated with a DENV infection significantly exceed the average monthly income of the patient. 5,[9][10][11][12][13][14][15][16][17][18] Historically, southeast Asia has borne the brunt of severe dengue disease, but severe disease has also been on the rise in the Americas, where the number of DHF cases has increased more than eightfold over the last 30 years from 13,398 during the 1980s to 111,724 between 2000 and 2007. 19 The increase in dengue disease severity in the Americas has been attributed to a shift from single-serotype endemism to hyperendemicity (cocirculation of multiple serotypes) of DENV coupled with the introduction of new genotypes with relatively high pathogenicity.…”

Environmental influences on antibody-enhanced dengue disease outcomes

“…In endemic areas, where DHF incidence remains high, mosquito vectors are abundant and multiple in- p = 0.0162 fections are often thought to involve different serotypes (Gubler & Meltzer 1999, Thomas et al 2003, Suaya et al 2009). In addition, an analysis of repeated hospital admissions for dengue showed that at least 10% of repeat dengue admission patients may correspond to a third or fourth infection with all secondary admissions due to secondary dengue infection (Gibbons et al 2007).…”