Estimating the burden of disease and the economic cost attributable to chikungunya, Andhra Pradesh, India, 2005–2006

Abstract

To estimate the burden and cost of chikungunya in India, we searched for cases of fever and joint pain in the village of Mallela, Andhra Pradesh, and collected information on the demography, signs, symptoms, healthcare utilization and expenditure associated with the disease. We estimated the burden of the disease using disability-adjusted life years (DALYs). We estimated direct and indirect costs and made projections for the district and state using surveillance data corrected for under-reporting. On average, from December 2005 to April 2006, each of the 242 cases in the village led to a burden of 0.0272 DALYs (95% CI 0.0224-0.0319) and a cost of US$37.50 (95% CI 30.6-44.3). Overall, chikungunya in Mallela led to 6.57 DALYs and a loss of US$9100. Out-of-pocket direct medical costs accounted for 68% of the total. From January to December 2006 the burden for Kadapa district was 160 DALYs (cost: US$290 000). Over the same period the burden for Andhra Pradesh was 6600 DALYs (cost: US$12 400 000). While the burden was moderate, costs were high and mostly out of pocket.

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

“…In a country where the average gross domestic product (GDP) per capita is US$3000, this cost represents a substantial burden, as well as resources that could be directed toward other efforts if an effective dengue vaccine were available. The costs of dengue in Nicaragua are similar to those described for dengue and chikungunya in India 39 in 2006 and dengue in Panama 12 in 2005. In determining the direct costs of dengue in Nicaragua, each case brought to medical attention was found to cost the government~US$5/ambulatory clinic visit and roughly US$250/day if hospitalized.…”

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

“…India is regularly affected by dengue fever, malaria, Chikungunya and tuberculosis [35]. Nonspecific high fever is a common complaint that is often associated with the aforementioned diseases [18].…”

Burden of chikungunya in Latin American countries: estimates of disability-adjusted life-years (DALY) lost in the 2014 epidemic

“…4 Although no disability weight is available for pCHIK-CIR we used the reported for rheumatoid arthritis (RA) (0.233). 2,5,6 Expected incident cases progressing to pCHIK-CIR and its duration was assumed as reported. 3 According with our estimates (Table 1), the expected burden of pCHIK-CIR in many countries is consistently higher than the reported in the 2006 epidemics in India (25,888 DALYs).…”

“…3 According with our estimates (Table 1), the expected burden of pCHIK-CIR in many countries is consistently higher than the reported in the 2006 epidemics in India (25,888 DALYs). 2,5,6 In Latin America the low burden was estimated in 151,031 DALYs during 2014. Even though, we did not include acute phase DALYs lost and the burden could be even higher.…”