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. 2022 Dec 19;16(12):e0010966.
doi: 10.1371/journal.pntd.0010966. eCollection 2022 Dec.

Epidemiology and costs of dengue in Thailand: A systematic literature review

Usa Thisyakorn  1 , Surasak Saokaew  2   3   4 , Elaine Gallagher  5 , Randee Kastner  6 , Rosarin Sruamsiri  7 , Louisa Oliver  8 , Riona Hanley  5
Affiliations

Epidemiology and costs of dengue in Thailand: A systematic literature review

Usa Thisyakorn et al. PLoS Negl Trop Dis. .

Abstract

Background: Dengue is the fastest-spreading vector-borne viral disease worldwide. In Thailand, dengue is endemic and is associated with a high socioeconomic burden. A systematic literature review was conducted to assess and describe the epidemiological and economic burden of dengue in Thailand.

Methods: Epidemiological and economic studies published in English and Thai between 2011-2019 and 2009-2019, respectively, were searched in MEDLINE, Embase, and Evidence-Based Medicines reviews databases. Reports published by the National Ministry of Public Health (MoPH) and other grey literature sources were also reviewed. Identified studies were screened according to predefined inclusion and exclusion criteria. Extracted data were descriptively summarised and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: A total of 155 publications were included in the review (39 journal articles and 116 grey literature). Overall, dengue incidence varied yearly, with the highest rates per 100,000 population in 2013 (dengue fever (DF) 136.6, dengue haemorrhagic fever (DHF) 100.9, dengue shock syndrome (DSS) 3.58) and 2015 (DF 133.1, DHF 87.4, DSS 2.14). Peak incidence coincided with the monsoon season, and annual mortality was highest for DSS, particularly in the age group 15-24-year-olds. The highest dengue incidence rates were reported in children (10-14-year-olds) and young adults (15-24-year-olds), irrespective of dengue case definition. Economic and societal burdens are extensive, with the average cost per case ranging from USD 41 to USD 261, total cost per year estimated at USD 440.3 million, and an average of 7.6 workdays lost for DHF and 6.6 days for DF.

Conclusions: The epidemiological, economic, and societal burden of dengue in Thailand is high and underreported due to gaps in national surveillance data. The use of expansion factors (EFs) is recommended to understand the true incidence of dengue and cost-benefit of control measures. Furthermore, as dengue is often self-managed and underreported, lost school and workdays result in substantial underestimation of the true economic and societal burden of dengue. The implementation of integrated strategies, including vaccination, is critical to reduce the disease burden and may help alleviate health disparities and equity challenges posed by dengue.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: EG is an employee of Takeda. RK is a full-time employee of Takeda and is a Takeda stock holder. RS is an employee of Takeda (Thailand) Ltd. LO is an employee of Adelphi Values PROVE (Adelphi Values received budgetary compensation from Takeda for conduct of the study). RH is an employee of Takeda and has stock ownership in Takeda. Drs. UT and SS have declared no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart for epidemiology and cost studies.
D: duplicate; O: outcome; P: population; S: study design.
Fig 2
Fig 2. National number of cases and incidence rates of dengue by 1997 WHO case definition between 2011–2018; Total reported dengue cases represent dengue fever, dengue haemorrhagic fever, and dengue shock syndrome.
Source: MoPH [12].
Fig 3
Fig 3. Reported number of cases and incidence rates of dengue per age group between 2011–2018; Source MoPH [12].
Fig 4
Fig 4. National number of deaths and CFRs by 1997 WHO case definition between 2011–2018; Source MoPH [12].
CFRs, case fatality rates. Note for dengue fever, no deaths were reported in 2011, 2012, and 2014.
Fig 5
Fig 5. Regional number of cases and incidence rates of dengue by 1997 WHO case definition between 2011–2018; Source MoPH [12].
Fig 6
Fig 6. Number of dengue cases by 1997 WHO case definition per month between 2011–2018; Source MoPH [12].
See this image and copyright information in PMC

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