Abstract
Between 2006 and 2012 India reported an annual average of 20,474 dengue cases. Although dengue has been notifiable since 1996, regional comparisons suggest that reported numbers substantially underrepresent the full impact of the disease. Adjustment for underreporting from a case study in Madurai district and an expert Delphi panel yielded an annual average of 5,778,406 clinically diagnosed dengue cases between 2006 and 2012, or 282 times the reported number per year. The total direct annual medical cost was US$548 million. Ambulatory settings treated 67% of cases representing 18% of costs, whereas 33% of cases were hospitalized, comprising 82% of costs. Eighty percent of expenditures went to private facilities. Including non-medical and indirect costs based on other dengue-endemic countries raises the economic cost to $1.11 billion, or $0.88 per capita. The economic and disease burden of dengue in India is substantially more than captured by officially reported cases, and increased control measures merit serious consideration.
Highlights
Dengue, an arboviral infection transmitted by Aedes aegypti and Aedes albopictus mosquitoes, is emerging as the most important mosquito-borne viral disease
Between 2006 and 2012 India reported an annual average of 20,474 dengue cases
The increasing number of dengue cases imported from endemic countries and autochthonous transmission of dengue in non-endemic areas such as the United States (Hawaii, Florida, and Texas),[10,11] France,[12] Croatia,[13] and Angola[14] highlight the importance of global collaboration to manage dengue epidemic
Summary
An arboviral infection transmitted by Aedes aegypti and Aedes albopictus mosquitoes, is emerging as the most important mosquito-borne viral disease It is a serious global public health problem, with 2.5 billion people at risk and an annual range of 50 to 390 million infections, which include dengue fever, dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS).[1,2,3,4,5] Climate change, the expansion of dengue vectors to new geographic regions, increasing human movement across borders, global trade, and urban migration collectively have changed the scope and scale of dengue fever from a national to a global concern.[2,4,6,7,8,9] The increasing number of dengue cases imported from endemic countries and autochthonous transmission of dengue in non-endemic areas such as the United States (Hawaii, Florida, and Texas),[10,11] France,[12] Croatia,[13] and Angola[14] highlight the importance of global collaboration to manage dengue epidemic. Understanding the economic and disease burden of dengue in India is essential to assist policy makers and public health managers to prepare for and control outbreaks, and encourage international collaboration to develop and evaluate prevention, control and management measures, and technologies to control further epidemics.[18,23]
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