Feb 8, 2011 (CIDRAP News) – Researchers estimate that more than 5.6 million dengue virus infections occur in the Americas annually, costing an average of $2.1 billion, according to a study published yesterday in the American Journal of Tropical Medicine and Hygiene.
The authors say theirs is the first effort to estimate the economic impact of dengue in the Americas, where the mosquito-borne virus has resurged since the 1970s. The researchers are from Brandeis University and Sanofi Pasteur, which is currently testing a dengue vaccine.
The authors assessed the impact of dengue cases for the period of 2000 through 2007. They looked at the numbers of reported cases and then estimated the rate of underreporting for each country on the basis of published field studies. To estimate the costs, they searched the literature for relevant articles published through December 2009.
They came up with an estimate of 5,607,836 dengue fever cases per year in the Americas. By region or country, Brazil leads the list with about 2.17 million cases per year, followed by the Andean subregion with 1.6 million, Central America and Mexico with 1.2 million, the Caribbean with 448,000, the "southern cone" (Argentina, Chile, Paraguay, and Uruguay) with 137,000, and North America with 1,692.
The authors estimated the overall number of dengue hemorrhagic fever cases, the more serious form of the disease, at 33,628 per year and deaths at 453 per year.
The median cost per ambulatory case was estimated at $472 and the median cost per hospital case at $1,227, with both figures varying widely by country. About 41% of the cost burden was borne by Brazil. The shares of other regions included about 25% for the Andean region, 17.7% for Central American and Mexico, 15% for the Caribbean, 1.2% for the southern cone, and less than 0.3% for North America.
"The economic cost of dengue is substantial in many American countries, with a cost per capita greater than US $2 in four of the six American subregions considered (Andean region, Brazil, the Caribbean, and Central America and Mexico)," the report states.
About 60% of the estimated costs are indirect costs, including lost productivity and government spending, rather than direct medical costs, according to the report.
The researchers also estimated that a median of 72,277 disability-adjusted life years are lost to dengue in the entire region each year. They suggest that, in terms of economic attractiveness, vaccination for dengue may be as good as or better than vaccination for rotavirus or human papillomavirus.
A Brandeis University press release notes that dengue research at the university is supported by Sanofi Pasteur. The company is furthest along of the firms developing a dengue vaccine, with plans to launch a phase 3 clinical trial this year, the release says.
The report says the total global burden of dengue is estimated at 36 million symptomatic cases per year.
Shepard DS, Coudeville L, Halasa YA, et al. Economic impact of dengue illness in the Americas. Am J Trop Med Hyg 2011 Feb;84(2):200-7 [Abstract] [Full text]
See also:
Feb 7 Brandeis University press release
