The global health and economic burden of chikungunya from 2011 to 2020: a model-driven analysis on the impact of an emerging vector-borne disease

Abstract

Introduction: Chikungunya is a mosquito-borne arboviral disease posing an emerging global public health threat. Understanding the global burden of chikungunya is critical for designing effective prevention and control strategies. However, current estimates of the economic and health impact of chikungunya remain limited and are potentially underestimated. This study aims to provide a comprehensive overview of the chikungunya burden worldwide.

Methods: We analysed the global burden of chikungunya between 2011 and 2020 and calculated disability-adjusted life years (DALYs) and direct and indirect costs using a data-driven simulation model. The main outcomes were the number of cases, the total DALY burden, and the direct and indirect costs of acute and chronic chikungunya between 2011 and 2020.

Results: Our study revealed a total of 18.7 million chikungunya cases in 110 countries between 2011 and 2020, causing 1.95 million DALYs. Most of this burden was found in the Latin American and Caribbean region. The total economic burden caused by chikungunya over these 10 years was estimated at $2.8 billion in direct costs and $47.1 billion in indirect costs worldwide. Long-term chronic illness was the source of most costs and DALYs.

Conclusion: Chikungunya has a higher disease burden than was previously estimated and costs related to the disease are substantial. Especially in combination with its unpredictable nature, chikungunya could significantly impact local health systems. Insights from this study could inform decision makers on the impact of chikungunya on population health and help them to appropriately allocate resources to protect vulnerable populations from this debilitating disease.

Keywords: Arboviruses; Global Health; Health economics.

Figure 1. Global DALY burden of chikungunya between 2011 and 2020. The total disability-adjusted life year (DALY) burden between 2011 and 2020 is 1.95 million. Most of these DALYs can be found in the Latin-American and Caribbean super region, as shown in the figure. Grey countries have either no data or no case numbers reported.

Figure 2. One-way sensitivity analysis DALYs tornado diagram. This tornado diagram shows the impact of the different input parameters on the total disability-adjusted life year (DALY) outcomes. The parameters are sorted in descending order by their outcome impact. All input parameters are varied with ±10% from the base case. The vertical line represents the base case DALY outcome of 1 951 854. The figure shows that the underreporting factor has the most impact on the base case, varying from 1 756 669 to 2 147 040.

Figure 3. One-way sensitivity analysis costs tornado diagram. This tornado diagram shows the impact of the different input parameters on the total cost outcomes. The parameters are sorted in descending order by their outcome impact. All input parameters are varied with ±10% from the base case. The vertical line represents the base case cost outcome of $49 912 076 268. The figure shows that the underreporting factor has the most impact on the base case, varying from $44 920 868 641 to $54 903 283 894.