title: Assessing the Economics of Dengue: Results from a Systematic Review of the Literature and Expert Survey.
abstract: BACKGROUND
  The economics of dengue is complex and multifaceted.
  
  
  OBJECTIVE
  We performed a systematic review of the literature to provide a critical overview of the issues related to dengue economics research and to form a background with which to address the question of cost.
  
  
  METHODS
  Three literature databases were searched [PubMed, Embase and Latin American and Caribbean Health Sciences Literature (LILACS)], covering a period from 1980 to 2013, to identify papers meeting preset inclusion criteria. Studies were reviewed for methodological quality on the basis of a quality checklist developed for this purpose. An expert survey was designed to identify priority areas in dengue economics research and to identify gaps between the methodology and actual practice. Survey responses were combined with the literature review findings to determine stakeholder priorities in dengue economics research.
  
  
  RESULTS
  The review identified over 700 papers. Forty-two of these papers met the selection criteria. The studies that were reviewed presented results from 32 dengue-endemic countries, underscoring the importance of dengue as a global public health problem. Cost analyses were the most common, with 21 papers, followed by nine cost-effectiveness analyses and seven cost-of-illness studies, indicating a relatively strong mix of methodologies. Dengue annual overall costs (in 2010 values) ranged from US$13.5 million (in Nicaragua) to $56 million (in Malaysia), showing cost variations across countries. Little consistency exists in the way costs were estimated and dengue interventions evaluated, making generalizations around costs difficult.
  
  
  CONCLUSIONS
  The current evidence suggests that dengue costs are substantial because of the cost of hospital care and lost earnings. Further research in this area will broaden our understanding of the true economic impact of dengue.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 855 N. Wolfe Street, Suite 600, Baltimore, 21205, USA. dconste1@jhu.edu.|Dengue Vaccine Initiative (DVI), Baltimore, USA. dconste1@jhu.edu.
authors.forename: Dagna
authors.initials: D
authors.lastname: Constenla
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 855 N. Wolfe Street, Suite 600, Baltimore, 21205, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Garcia
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 855 N. Wolfe Street, Suite 600, Baltimore, 21205, USA.
authors.forename: Noah
authors.initials: N
authors.lastname: Lefcourt
mesh_terms: D057189:Checklist / Q000191:economics*; D003362:Cost-Benefit Analysis; D003715:Dengue / Q000191:economics* / Q000628:therapy; D006801:Humans; D011634:Public Health / Q000191:economics*; D011795:Surveys and Questionnaires / Q000191:economics*