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. 2013;7(2):e2055.
doi: 10.1371/journal.pntd.0002055. Epub 2013 Feb 21.

Economic and disease burden of dengue in Southeast Asia

Donald S Shepard  1 , Eduardo A Undurraga, Yara A Halasa
Affiliations

Economic and disease burden of dengue in Southeast Asia

Donald S Shepard et al. PLoS Negl Trop Dis. 2013.

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.

Methods and findings: 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.

Conclusion: 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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Direct costs per non-fatal dengue episode for hospitalized and ambulatory cases by per capita GDP (2010 US$).
Source: Authors' calculations from , , , –, , , –, .
Figure 2
Figure 2. Indirect costs per non-fatal dengue episode for hospitalized and ambulatory cases by per capita GDP (2010 US$).
Source: Authors' calculations from , , , –, , , –, .
Figure 3
Figure 3. Aggregate values of dengue episodes and economic burden by year for 12 countries in SEA (2001–2010).
Source: Authors' calculations.
See this image and copyright information in PMC

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