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Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico

Dengue is mostly considered an acute illness with three phases: febrile, critical with possible hemorrhagic manifestations, and recovery. But some patients present persistent symptoms, including fatigue and depression, as acknowledged by the World Health Organization. If persistent symptoms affect a...

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Autores principales: Tiga, D. Carolina, Undurraga, Eduardo A., Ramos-Castañeda, José, Martínez-Vega, Ruth A., Tschampl, Cynthia A., Shepard, Donald S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856607/
https://www.ncbi.nlm.nih.gov/pubmed/26976885
http://dx.doi.org/10.4269/ajtmh.15-0896
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author Tiga, D. Carolina
Undurraga, Eduardo A.
Ramos-Castañeda, José
Martínez-Vega, Ruth A.
Tschampl, Cynthia A.
Shepard, Donald S.
author_facet Tiga, D. Carolina
Undurraga, Eduardo A.
Ramos-Castañeda, José
Martínez-Vega, Ruth A.
Tschampl, Cynthia A.
Shepard, Donald S.
author_sort Tiga, D. Carolina
collection PubMed
description Dengue is mostly considered an acute illness with three phases: febrile, critical with possible hemorrhagic manifestations, and recovery. But some patients present persistent symptoms, including fatigue and depression, as acknowledged by the World Health Organization. If persistent symptoms affect a non-negligible share of patients, the burden of dengue will be underestimated. On the basis of a systematic literature review and econometric modeling, we found a significant relationship between the share of patients reporting persisting symptoms and time. We updated estimates of the economic burden of dengue in Mexico, addressing uncertainty in productivity loss and incremental expenses using Monte Carlo simulations. Persistent symptoms represent annually about US$22.6 (95% certainty level [CL]: US$13–US$29) million in incremental costs and 28.2 (95% CL: 21.6–36.2) additional disability-adjusted life years per million population, or 13% and 43% increases over previous estimates, respectively. Although our estimates have uncertainty from limited data, they show a substantial, unmeasured burden. Similar patterns likely extend to other dengue-endemic countries.
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spelling pubmed-48566072016-05-19 Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico Tiga, D. Carolina Undurraga, Eduardo A. Ramos-Castañeda, José Martínez-Vega, Ruth A. Tschampl, Cynthia A. Shepard, Donald S. Am J Trop Med Hyg Articles Dengue is mostly considered an acute illness with three phases: febrile, critical with possible hemorrhagic manifestations, and recovery. But some patients present persistent symptoms, including fatigue and depression, as acknowledged by the World Health Organization. If persistent symptoms affect a non-negligible share of patients, the burden of dengue will be underestimated. On the basis of a systematic literature review and econometric modeling, we found a significant relationship between the share of patients reporting persisting symptoms and time. We updated estimates of the economic burden of dengue in Mexico, addressing uncertainty in productivity loss and incremental expenses using Monte Carlo simulations. Persistent symptoms represent annually about US$22.6 (95% certainty level [CL]: US$13–US$29) million in incremental costs and 28.2 (95% CL: 21.6–36.2) additional disability-adjusted life years per million population, or 13% and 43% increases over previous estimates, respectively. Although our estimates have uncertainty from limited data, they show a substantial, unmeasured burden. Similar patterns likely extend to other dengue-endemic countries. The American Society of Tropical Medicine and Hygiene 2016-05-04 /pmc/articles/PMC4856607/ /pubmed/26976885 http://dx.doi.org/10.4269/ajtmh.15-0896 Text en ©The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Tiga, D. Carolina
Undurraga, Eduardo A.
Ramos-Castañeda, José
Martínez-Vega, Ruth A.
Tschampl, Cynthia A.
Shepard, Donald S.
Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico
title Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico
title_full Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico
title_fullStr Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico
title_full_unstemmed Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico
title_short Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico
title_sort persistent symptoms of dengue: estimates of the incremental disease and economic burden in mexico
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856607/
https://www.ncbi.nlm.nih.gov/pubmed/26976885
http://dx.doi.org/10.4269/ajtmh.15-0896
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