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. 2017 Oct 30;11(10):e0006037.
doi: 10.1371/journal.pntd.0006037. eCollection 2017 Oct.

A multi-country study of the economic burden of dengue fever: Vietnam, Thailand, and Colombia

Jung-Seok Lee  1   2 , Vittal Mogasale  2 , Jacqueline K Lim  2 , Mabel Carabali  2 , Kang-Sung Lee  2 , Chukiat Sirivichayakul  3 , Duc Anh Dang  4 , Diana Cristina Palencia-Florez  5 , Thi Hien Anh Nguyen  4 , Arthorn Riewpaiboon  6 , Pornthep Chanthavanich  3 , Luis Villar  5 , Brian A Maskery  2 , Andrew Farlow  1
Affiliations

A multi-country study of the economic burden of dengue fever: Vietnam, Thailand, and Colombia

Jung-Seok Lee et al. PLoS Negl Trop Dis. .

Abstract

Background: Dengue fever is a major public health concern in many parts of the tropics and subtropics. The first dengue vaccine has already been licensed in six countries. Given the growing interests in the effective use of the vaccine, it is critical to understand the economic burden of dengue fever to guide decision-makers in setting health policy priorities.

Methods/principal findings: A standardized cost-of-illness study was conducted in three dengue endemic countries: Vietnam, Thailand, and Colombia. In order to capture all costs during the entire period of illness, patients were tested with rapid diagnostic tests on the first day of their clinical visits, and multiple interviews were scheduled until the patients recovered from the current illness. Various cost items were collected such as direct medical and non-medical costs, indirect costs, and non-out-of-pocket costs. In addition, socio-economic factors affecting disease severity were also identified by adopting a logit model. We found that total cost per episode ranges from $141 to $385 for inpatient and from $40 to $158 outpatient, with Colombia having the highest and Thailand having the lowest. The percentage of the private economic burden of dengue fever was highest in the low-income group and lowest in the high-income group. The logit analyses showed that early treatment, higher education, and better knowledge of dengue disease would reduce the probability of developing more severe illness.

Conclusions/significance: The cost of dengue fever is substantial in the three dengue endemic countries. Our study findings can be used to consider accelerated introduction of vaccines into the public and private sector programs and prioritize alternative health interventions among competing health problems. In addition, a community would be better off by propagating the socio-economic factors identified in this study, which may prevent its members from developing severe illness in the long run.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Overall study design.
Fig 2
Fig 2
The percentage share of the economic burden for dengue fever by (a) expenditure type and (b) payer type.
Fig 3
Fig 3. Total cost per patient by age group.
Fig 4
Fig 4. Proportion of the economic burden (OOP costs) by income group.
See this image and copyright information in PMC

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