The elusive global burden of dengue

Abstract

Dengue has emerged in the past two decades as a rapidly growing and widespread public health problem, with over half of the world's countries and people now at risk. 1 Bhatt S Gething PW Brady OJ et al. The global distribution and burden of dengue. Nature. 2013; 496: 504-507 Crossref PubMed Scopus (5711) Google Scholar In new estimates from the Global Burden of Disease study published in The Lancet Infectious Diseases, Jeffrey Stanaway and colleagues 2 Stanaway JD Shepard DS Undurraga EA et al. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis. 2016; (published online Feb 10.)http://dx.doi.org/10.1016/S1473-3099(16)00026-8 Summary Full Text Full Text PDF Scopus (615) Google Scholar suggest that dengue incidence has increased six-fold from 1990 to 2013, accompanied by much flatter mortality trends. Dengue is still regarded as a neglected disease, 3 Horstick O Tozan Y Wilder-Smith A Reviewing dengue: still a neglected tropical disease?. PLoS Negl Trop Dis. 2015; 9: e0003632 Crossref Scopus (54) Google Scholar yet its incidence is increasing at an alarming rate, by contrast with declines in other neglected diseases. 4 Global Burden of Disease Study CollaboratorsGlobal, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 386: 743-800 Summary Full Text Full Text PDF PubMed Scopus (4424) Google Scholar WHO estimates that 50 million to 100 million cases occur annually. 5 WHODengue: guidelines for diagnosis, treatment, prevention and control. new edition. 2009 edn. World Health Organization, Geneva2009 Google Scholar In 2012, however, formal modelling put the number of dengue infections as high as 390 million (95% credible interval 284 million–528 million), but included both inapparent and apparent cases. 1 Bhatt S Gething PW Brady OJ et al. The global distribution and burden of dengue. Nature. 2013; 496: 504-507 Crossref PubMed Scopus (5711) Google Scholar Their estimated number of apparent cases (96 million, 95% credible interval 67 million–136 million) lies at the high end of the WHO estimates. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013Although lower than other estimates, our results offer more evidence that the true symptomatic incidence of dengue probably falls within the commonly cited range of 50 million to 100 million cases per year. Our mortality estimates are lower than those presented elsewhere and should be considered in light of the totality of evidence suggesting that dengue mortality might, in fact, be substantially higher. Full-Text PDF