title: Economic and disease burden of dengue in Southeast Asia.
abstract: BACKGROUND
  Dengue poses a substantial economic and disease burden in Southeast Asia (SEA). Quantifying this burden is critical to set policy priorities and disease-control strategies.
  
  
  RESULTS
  We estimated the economic and disease burden of dengue in 12 countries in SEA: Bhutan, Brunei, Cambodia, East-Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Viet Nam. We obtained reported cases from multiple sources--surveillance data, World Health Organization (WHO), and published studies--and adjusted for underreporting using expansion factors from previous literature. We obtained unit costs per episode through a systematic literature review, and completed missing data using linear regressions. We excluded costs such as prevention and vector control, and long-term sequelae of dengue. Over the decade of 2001-2010, we obtained an annual average of 2.9 million (m) dengue episodes and 5,906 deaths. The annual economic burden (with 95% certainty levels) was US$950m (US$610m-US$1,384m) or about US$1.65 (US$1.06-US$2.41) per capita. The annual number of disability-adjusted life years (DALYs), based on the original 1994 definition, was 214,000 (120,000-299,000), which is equivalent to 372 (210-520) DALYs per million inhabitants.
  
  
  CONCLUSIONS
  Dengue poses a substantial economic and disease burden in SEA with a DALY burden per million inhabitants in the region. This burden is higher than that of 17 other conditions, including Japanese encephalitis, upper respiratory infections, and hepatitis B.
authors: Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA. shepard@brandeis.edu
authors: Donald S
authors: DS
authors: Shepard
authors: Eduardo A
authors: EA
authors: Undurraga
authors: Yara A
authors: YA
authors: Halasa
mesh_terms: D001210:Asia, Southeastern / Q000453:epidemiology; D017281:Cost of Illness; D003715:Dengue / Q000191:economics* / Q000453:epidemiology* / Q000401:mortality; D017048:Health Care Costs; D006801:Humans; D016019:Survival Analysis