title: 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.
authors.affiliation: Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts 02454-9110, USA. Suaya@Brandeis.edu
authors.forename: Jose A
authors.initials: JA
authors.lastname: Suaya
authors.forename: Donald S
authors.initials: DS
authors.lastname: Shepard
authors.forename: João B
authors.initials: JB
authors.lastname: Siqueira
authors.forename: Celina T
authors.initials: CT
authors.lastname: Martelli
authors.forename: Lucy C S
authors.initials: LC
authors.lastname: Lum
authors.forename: Lian Huat
authors.initials: LH
authors.lastname: Tan
authors.forename: Sukhontha
authors.initials: S
authors.lastname: Kongsin
authors.forename: Sukhum
authors.initials: S
authors.lastname: Jiamton
authors.forename: Fàtima
authors.initials: F
authors.lastname: Garrido
authors.forename: Romeo
authors.initials: R
authors.lastname: Montoya
authors.forename: Blas
authors.initials: B
authors.lastname: Armien
authors.forename: Rekol
authors.initials: R
authors.lastname: Huy
authors.forename: Leticia
authors.initials: L
authors.lastname: Castillo
authors.forename: Mariana
authors.initials: M
authors.lastname: Caram
authors.forename: Binod K
authors.initials: BK
authors.lastname: Sah
authors.forename: Rana
authors.initials: R
authors.lastname: Sughayyar
authors.forename: Karen R
authors.initials: KR
authors.lastname: Tyo
authors.forename: Scott B
authors.initials: SB
authors.lastname: Halstead
mesh_terms: D000293:Adolescent; D000328:Adult; D001210:Asia, Southeastern / Q000453:epidemiology; D002489:Central America / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000191:economics* / Q000453:epidemiology*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D013020:South America / Q000453:epidemiology; D055815:Young Adult