Research Article: Cost of illness and program of dengue: A systematic review

Date Published: February 20, 2019

Publisher: Public Library of Science

Author(s): Luana Nice da Silva Oliveira, Alexander Itria, Erika Coutinho Lima, Ray Borrow.


Studies on dengue related to the cost of illness and cost of the program are factors to describe the economic burden of dengue, a neglected disease that has global importance in public health. These studies are often used by health managers in optimizing financial resources. A systematic review of studies estimating the cost of dengue was carried out, comparing the costs between the studies and examining the cost drivers regarding the methodological choices.

This study was done according to the guidelines of the Centre for Reviews and Dissemination (CRD). Several databases were searched: Medline, Virtual Health Library and CRD. Two researchers, working independently, selected the studies and extracted the data. The quality of the methodology of the individual studies was achieved by a checklist of 29 items based on protocols proposed by the British Medical Journal and Consolidated Health Economic Evaluation Reporting Standards. A qualitative and quantitative narrative synthesis was performed.

A literature search yielded 665 publications. Of these, 22 studies are in accordance with previously established inclusion criteria. The cost estimates were compared amongst the studies, highlighting the study design, included population and comparators used (study methodology). The component costs included in the economic evaluation were based on direct and indirect costs, wherein twelve studies included both costs, twelve studies adopted the societal perspective and ten studies used the perspective of the public health service provider, or of a private budget holder.

This study showed that the cost of dengue in 18 countries generated approximately US$ 3.3 billion Purchasing Power Parity (PPP) in 2015. This confirms that the burden of dengue has a great economic impact on countries with common socioeconomic characteristics and similarities in health systems, particularly developing countries, indicating a need for further studies in these countries.

Partial Text

Dengue is a systemic viral disease, and the main vector of epidemiological importance in the transmission of dengue virus (DENV) is Aedes aegypti [1].

The systematic review of costs of dengue, began in September 2015, in the Medline (via Pubmed), VHL, CRD databases, found 665 references. Of these, 56 were selected initially by titles and abstracts. After the removal of duplicates, 50 references remained. After analyzing full texts, 22 articles [14–35] were selected, according to the inclusion criteria previously established (Fig 1). The reason for exclusion in the last step has been declared (S1 Table).

Although there were methodological variations between the studies, the costs found within their perspectives analyzed in the included studies demonstrate that our results support that dengue has a great impact on the economy. The sum of dengue costs for the articles [14;15;16;17;19;20;22;23;25;26;28;29;30;31;32;33;34;35] showed that 18 countries generated a cost of approximately US$ 3.3 billion PPP in 2015.




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