Abstract
In Colombia, dengue is a disease of great impact due to its morbidity and mortality, however, studies on the effects of the economic burden at the local level are scarce. Therefore, our study sought to describe the economic burden of dengue epidemics between 2010 and 2016 in the State of Meta, Colombia. A longitudinal study was performed using information from the records of the epidemiological information system (Sistema Nacional de Vigilancia en Salud Pública - SIVIGILA), and the indicator of disability-adjusted life years (DALYs) was determined as an estimator of the burden of dengue. To assess the economic impact, two assessment scenarios were considered (minimum range and maximum range), which allowed the estimate of the effects of the years of life lost (YLLs). Mortality cases presented heterogeneity in the age groups, mainly affecting groups under 15 years and over 65 years, with YLLs raging between 158.58 and 300.38. In total, 2010 showed the highest medical care costs of the study period, with USD 664,123 for women and USD 740,221 for men. In the epidemic years (2010, 2012-2015) between 91,072.3 and 184,175.1 DALYs were lost per million inhabitants, which generated social burden costs higher than the USD 669.6 million. In conclusion, dengue can be considered a disease of high cost at the local level, economically affecting the General Social Security System in Health and social welfare.
Highlights
Dengue has become the main vector-borne disease in Colombia, since there were a total of 652,221 cases of dengue, 20,543 cases of severe dengue and 1,095 deaths caused by the virus between 2010 and 2016
In 2016, the State of Meta contributed with 2,575 (1.9%) cases of dengue, 25 (1.75%) cases of severe dengue and 7 fatal cases to national statistics 1. These epidemiological characteristics show the effect on populations exposed in areas below 1,800 meters above sea level (MASL), added to the great difficulties related to their intervention, maintaining increasing epidemics since 2004, and serious economic effects, mainly in the General Social Security System in Health (GSSSH), which financed ambulatory, in-hospital care and drug supply of patients with dengue, reaching an approximate cost of more than USD 31 million in 2010 2
Our analysis show that dengue is a disease of high social impact in Meta, whose total cost represents a decrease in the income of the GDP estimated in 2% (2010), 0.46% (2011), 1.68% (2012), 3% (2013) and 4% (2014), originated by the behavior of classic dengue cases, mainly in children under 15 years of age and cases of intra-hospital care (Tables 3 and 4)
Summary
Dengue has become the main vector-borne disease in Colombia, since there were a total of 652,221 cases of dengue, 20,543 cases of severe dengue and 1,095 deaths caused by the virus between 2010 and 2016 In 2016, the State of Meta contributed with 2,575 (1.9%) cases of dengue, 25 (1.75%) cases of severe dengue and 7 fatal cases to national statistics 1 These epidemiological characteristics show the effect on populations exposed in areas below 1,800 meters above sea level (MASL), added to the great difficulties related to their intervention, maintaining increasing epidemics since 2004, and serious economic effects, mainly in the General Social Security System in Health (GSSSH), which financed ambulatory, in-hospital care and drug supply of patients with dengue, reaching an approximate cost of more than USD 31 million in 2010 2. The costs of medical care, including diagnostic tests and viral surveillance actions such as RT-PCR, viral isolation, antibody tests and histopathologies are another factor which total USD 537,088 3, as well as vector control and epidemiological surveillance actions that reached USD 36 million 2 This situation makes dengue a primary problem in public health in Colombia
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