Economic burden of dengue infections in India

Abstract

Dengue infections are a significant cause of morbidity and mortality and lead to adverse economic effects in many developing tropical countries. In this study, we estimated the economic burden faced by India during the 2006 dengue epidemic. Costs incurred in managing a cohort of serologically confirmed dengue patients at a tertiary-level private hospital in north India were calculated. The median cost of treatment per hospitalised dengue patient was US$432.2 (95% CI US$343.6-625). A sensitivity analysis was performed to estimate the costs to the health system in India using a regression model. Variables with potentially large variations, including the ratio of unreported to reported cases and of hospitalised to ambulatory cases, the proportion requiring transfusions, loss of economic activities due to loss of workdays and deaths, were used. The average total economic burden was estimated to be US$27.4 million (95% CI US$25.7-29.1 million). Costs in the private heath sector were estimated to be almost four times public sector expenditures. Considerable economic losses (at a macro level) are incurred by developing countries like India during each dengue epidemic. Accurate estimates of the proportions of reported to unreported and of hospitalised to ambulatory dengue cases in India are needed to refine further the estimates of financial burden due to dengue in India.

Towards Sustainable Public Health Surveillance in India: Using Routinely Collected Electronic Emergency Medical Service Data for Early Warning of Infectious Diseases

“…The government reporting only includes cases of dengue that were diagnosed at public hospitals and/or that had been confirmed by government-recognized laboratories. With only limited health data for dengue fever cases collected, any cost estimation for the social and economic burden of dengue fever in India is limited [36,37]. Furthermore, interviewed experts estimate the share between the public and private healthcare sector in India to be 30% and 70% of patients, respectively.…”

Total Economic Cost and Burden of Dengue in Nicaragua: 1996–2010

“…35 Instead of using the disability weight D of 0.21, as described in the GBD, we used 0.81 for both DF and DHF, as has been described by Meltzer and used throughout the literature as a more appropriate assessment of the disability of a DF or DHF infection, as even mild dengue cases can impede an individual from conducting their normal daily activities for some time. 11,21,23,27,32,33 According to the PAHO data used in this analysis, overall mortality rates of dengue in Nicaragua varied and were calculated to be between 0.5% and 1% of the total reported cases of dengue. Productivity losses vary depending on age at death, with children losing a greater amount of productive years than adults; this fact was incorporated into the model through an age-group dependent productivity loss factor.…”

Rising Mean Platelet Volume (MPV) Heralding Platelets Recovery in Dengue?

“…[2] Furthermore, the significant chunk of hospital expense is resultant to platelet transfusion, as a single transfusion cost around Rs.12,000 ($200); in fact, the economic burden of 2006 Dengue epidemic in Delhi is an estimated, $27.4 million. [16] Clinicians in practice have a tendency to 'chase platelets' with consequent multiple transfusions at predefined platelet thresholds (triggers), such behavior on the part of clinicians is reinforced by patients family members, and is curiously termed: "The Dengue Panic Syndrome." [17] Lab parameters to guide the clinician of an impending thrombocytopenia recovery is urgently needed; as it can result in significant out-of-pocket saving; one such recent parameter reported recently is Immature platelet fraction (IPF) estimation, which predicts platelet recovery and outcome.…”