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. 2012 Oct;87(4):616-22.
doi: 10.4269/ajtmh.2012.12-0146. Epub 2012 Aug 13.

Total economic cost and burden of dengue in Nicaragua: 1996-2010

Zachary S Wettstein  1 , Michael Fleming, Aileen Y Chang, David J Copenhaver, Angela R Wateska, Sarah M Bartsch, Bruce Y Lee, Rajan P Kulkarni
Affiliations

Total economic cost and burden of dengue in Nicaragua: 1996-2010

Zachary S Wettstein et al. Am J Trop Med Hyg. 2012 Oct.

Abstract

The burden of dengue in Nicaragua has been steadily rising during the last three decades; however, there have been few efforts to quantify the burden (measured in disability-adjusted life years [DALYs]) and cost to society. Using primary data from the Nicaraguan Ministry of Health (MINSA), the total cost and burden of dengue were calculated from 1996 to 2010. Total costs included both direct costs from medical expenditures and prevention activities and indirect costs from lost productivity. The annual disease burden ranged from 99 to 805 DALYs per million, with a majority associated with classic dengue fever. The total cost was estimated to be US$13.5 million/year (range: US$5.1-27.6 million). This analysis can help improve allocation of dengue control resources in Nicaragua and the region. As one of the most comprehensive analyses of its type to date in Nicaragua and Latin America, this study can serve as a model to determine the burden and cost of dengue.

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Figures

Figure 1.
Figure 1.
Stacked bar graph of the incident cases of dengue illness reported to the Nicaraguan Ministry of Health (MINSA) from 1996 to 2010, broken down by type of dengue illness. Classic dengue (DF) represents the majority of cases (81–99%), with dengue hemorrhagic fever (DHF) representing 0–18% of the total cases. Deaths directly attributable to dengue were uncommon and ranged from 0 to 23 (0–1% of total cases) annually in this study period.
Figure 2.
Figure 2.
(A) Bar graph of the disease burden associated with dengue illness in Nicaragua from 1996 to 2010, measured in disability-adjusted life years (DALYs) per million population, with 95% confidence intervals displayed. (B) Breakdown of total DALYs per million population by dengue outcome (primarily asymptomatic, classic dengue [DF], dengue hemorrhagic fever [DHF], or death). The majority contribution to the total DALY burden was caused by DF; deaths contributed a variable amount.
Figure 3.
Figure 3.
Stacked area plot of the total costs (includes direct and indirect costs) associated with dengue illness in Nicaragua from 1996 to 2010. For both direct and indirect costs, the factors that had the greatest impact on costs were length of illness and expansion factor.
See this image and copyright information in PMC

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