Suaya Jose A, Shepard Donald S, Siqueira João B, Martelli Celina T, Lum Lucy C S, Tan Lian Huat, Kongsin Sukhontha, Jiamton Sukhum, Garrido Fàtima, Montoya Romeo, Armien Blas, Huy Rekol, Castillo Leticia, Caram Mariana, Sah Binod K, Sughayyar Rana, Tyo Karen R, Halstead Scott B
Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts 02454-9110, USA.
Am J Trop Med Hyg. 2009 May;80(5):846-55.
Despite the growing worldwide burden of dengue fever, the global economic impact of dengue illness is poorly documented. Using a common protocol, we present the first multicountry estimates of the direct and indirect costs of dengue cases in eight American and Asian countries. We conducted prospective studies of the cost of dengue in five countries in the Americas (Brazil, El Salvador, Guatemala, Panama, and Venezuela) and three countries in Asia (Cambodia, Malaysia, and Thailand). All studies followed the same core protocol with interviews and medical record reviews. The study populations were patients treated in ambulatory and hospital settings with a clinical diagnosis of dengue. Most studies were performed in 2005. Costs are in 2005 international dollars (I$). We studied 1,695 patients (48% pediatric and 52% adult); none died. The average illness lasted 11.9 days for ambulatory patients and 11.0 days for hospitalized patients. Among hospitalized patients, students lost 5.6 days of school, whereas those working lost 9.9 work days per average dengue episode. Overall mean costs were I$514 and I$1,394 for an ambulatory and hospitalized case, respectively. With an annual average of 574,000 cases reported, the aggregate annual economic cost of dengue for the eight study countries is at least I$587 million. Preliminary adjustment for under-reporting could raise this total to $1.8 billion, and incorporating costs of dengue surveillance and vector control would raise the amount further. Dengue imposes substantial costs on both the health sector and the overall economy.
尽管登革热在全球范围内的负担日益加重，但登革热疾病对全球经济的影响却鲜有文献记载。我们采用通用方案，首次对8个美洲和亚洲国家登革热病例的直接和间接成本进行了多国估算。我们在美洲的5个国家（巴西、萨尔瓦多、危地马拉、巴拿马和委内瑞拉）以及亚洲的3个国家（柬埔寨、马来西亚和泰国）开展了登革热成本的前瞻性研究。所有研究均遵循相同的核心方案，包括访谈和病历审查。研究对象为在门诊和医院接受治疗且临床诊断为登革热的患者。大多数研究于2005年进行。成本以2005年国际美元（I$）计。我们研究了1695名患者（48%为儿童，52%为成人）；无人死亡。门诊患者平均病程为11.9天，住院患者为11.0天。在住院患者中，学生平均每例登革热发作缺课5.6天，而在职人员平均误工9.9天。门诊和住院病例的总体平均成本分别为514国际美元和1394国际美元。8个研究国家每年平均报告57.4万例病例，登革热的年度总经济成本至少为5.87亿美元。对漏报情况进行初步调整后，这一总数可能升至18亿美元，若将登革热监测和病媒控制成本纳入计算，这一数字还会进一步提高。登革热给卫生部门和整体经济都带来了巨大成本。
