Economic and Disease Burden of Dengue in Southeast Asia

BACKGROUND: Dengue poses a substantial economic and disease burden in Southeast Asia (SEA). Quantifying this burden is critical to set policy priorities and disease-control strategies. METHODS AND FINDINGS: We estimated the economic and disease burden of dengue in 12 countries in SEA: Bhutan, Brunei, Cambodia, East-Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Viet Nam. We obtained reported cases from multiple sources--surveillance data, World Health Organization (WHO), and published studies--and adjusted for underreporting using expansion factors from previous literature. We obtained unit costs per episode through a systematic literature review, and completed missing data using linear regressions. We excluded costs such as prevention and vector control, and long-term sequelae of dengue. Over the decade of 2001-2010, we obtained an annual average of 2. 9 million (m) dengue episodes and 5, 906 deaths. The annual economic burden (with 95% certainty levels) was US950m (US610m-US1, 384m) or about US1. 65 (US1. 06-US2. 41) per capita. The annual number of disability-adjusted life years (DALYs), based on the original 1994 definition, was 214, 000 (120, 000-299, 000), which is equivalent to 372 (210-520) DALYs per million inhabitants. CONCLUSION: Dengue poses a substantial economic and disease burden in SEA with a DALY burden per million inhabitants in the region. This burden is higher than that of 17 other conditions, including Japanese encephalitis, upper respiratory infections, and hepatitis B.