Jose A. Suaya, MD, MPH, PhD, Donald S. Shepard, PhD, and Mariana Caram, MA. Schneider Institute for Health Policy, Brandeis University, 415 South Street, Waltham, MA 02454, 781 736 3904, Suaya@brandeis.edu
Dengue, a mosquito-borne viral infection, makes millions of people ill and kills thousands each year throughout the tropics. Estimations of the burden of dengue (BD) on affected countries are mainly based on passive surveillance through the report of suspected cases by medical providers. Reporting of cases, though mandatory in most of the countries, is barely enforced and varies greatly by type of care facility (primary, secondary, or tertiary) and type of ownership (private, public, other). Cost of illness (COI), which should include the cost faced by the different parties involved (providers, households, and society), is rarely estimated. When performed, however, COI is based on assumptions either applicable to other countries, to other diseases, or to specific settings. The Pediatric Dengue Vaccine Initiative has been sponsoring studies across dengue endemic countries to measure both the dengue burden and cost of illness. Our team has been selected to plan BD and COI studies and to provide technical assistance to participating countries.
This presentation includes a detailed description of the epidemiologic and cost data needed to obtain national estimates of BD and COI. We review the challenges faced to obtained reliable data to measure infection, symptomatic cases, severity, and mortality rates given the existence of misdiagnosis, misclassification, and underreporting of dengue. Similarly, we review the requirement of economic data, their sources, and interpretation challenges. Finally, we discuss the modeling and extrapolation needed to derive national estimates.
BD and COI studies will provide decision makers the opportunity to understand the epidemiologic and socioeconomic impact of dengue infection and help them to set priorities.
Presenting author's disclosure statement:
The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA