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APHA Scientific Session and Event Listing

Recorded presentation

Jose A. Suaya, MD, MPH, PhD and Donald S. Shepard, PhD. Schneider Institute for Health Policy, Brandeis University, 415 South Street, Waltham, MA 02454, 781 736 3904, Suaya@brandeis.edu

Dengue, a viral infection transmitted by a mosquito, affects millions of people every year throughout the tropics with a very large but precisely unknown consumption of health resources and cost to health providers, households, and third parties. Misdiagnosis, misclassification, and misreporting of dengue cases make it difficult to derive reliable national estimates of disease burden and its cost.

The Pediatric Dengue Vaccine Initiative has been sponsoring studies across dengue endemic countries in the Americas and Asia 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 analyzes alternative study designs and probabilistic sampling strategies to obtain national representative estimates of BD and COI in dengue endemic countries.

We review the strengths and limitations of two main study designs: multi-health facility and community-based. We use capture-recapture methods between available dengue surveillance and reporting sources to validate both study designs. Furthermore, we propose a combination of study designs to strengthen the reliability of the national estimates.

We also examine probabilistic sampling strategies to include representative health care facilities for dengue patients and propose stratification by type of ownership (public and private), type of facility (ambulatory and inpatient), hierarchy of the hospital (local, provincial, or national), size of hospital, and region of the country. Finally, we propose the use of cluster sampling to reduce study costs. Should facilities decline to participate, we propose random replacement from the same stratum.

Learning Objectives:

• 1- To identify alternative study designs and sampling strategies to obtain national representative estimates of dengue burden and cost of illness studies
• 2- To recognize challenges in implementing dengue burden and cost of illness studies and review alternative solutions.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation