Shepard, D. S. , et al. Economic Impact of Dengue Illness in the Americas. (2011). Am. J. Trop. Med. Hyg. 84 (2): 200-207. http://www.ajtmh.org/cgi/reprint/84/2/200.
This paper looks at the economic burden of the Dengue virus in the Americas. Dengue is mosquito born and has been emerging in countries previously considered free of disease. Increasing development, international travel, and urbanization have contributed to this upward trend in disase. From 1950-1970, the Americas were considered to be esentially dengue-free because of eradication of its host, Aedes aegypti. However, waste managemnet problems and uncontrolled urbanization led to the revival of dengue into America.
This paper reports the five major components they used in measuring the burden of disase on society:
1) the number of reported dengue cases
2) the degree of underreporting
3) the direct and indirect costs per case
4) the DALY burden per case
5) the country's demographic information
As you might guess, these data are not completely straight forward. This is why they performed a sensitivity analysis and determined that the range for the economic burden was in the range of $1-4 billion.
Dengue Surveillance and underreporting: To determine the rate at which dengue is underrepoted, the researchers found five field studies that estimate the underreporting rate.
Dengue costs per case: To figure out this number, the authors consudcted a systematic literature review in PubMD and found cost data was limited. For quality reasons, they decided on the results of two cost studies: a large sutyd in 2005 for 5 countries (Brael, El Salvador, Guatemala, Panama, and Venezuela) and one sutdy in Puerto Rice. The studies documentsd direct medical, direct non-medical, and indirect costs of dengue cases.
After being adjusted for underreporting, they found there was 5.6 million cases, with Brazil having the highest contribution. This contributed to a total of $2.1 billion lost in direct and indirect costs.
This paper demonstrates the methodology many researchers use in order to perform cost analysis for the burden of a viral illness. It demonstrates that often these calculations ar enot straight forward and authors must create ways to get around limiting data such as underreporting cases.
Source: Shepard, D. S. , et al. Economic Impact of Dengue Illness in the Americas. (2011). Am. J. Trop. Med. Hyg. 84 (2): 200-207. http://www.ajtmh.org/cgi/reprint/84/2/200.