Economic burden estimation associated with dengue and chikungunya in Gujarat, India

Dengue and chikungunya have been emerging as major vector-borne diseases. The global burden of the diseases is rising as a public health problem. The complexity of disease is governed by multiple constraints including only symptomatic treatment and inflicts heavy social and economic burden on society. The present study is designed to assess the economic burden of dengue and chikungunya infection by calculating cost per patient in Gujarat, India.

A total of 210 patients were enrolled in the study from Ahmedabad and Kheda district of Gujarat from May 2018 to December 2019 of which 150 had dengue and 60 chikungunya infections, subject to the willingness of participation in the survey. Information on wage loss days, cost associated with medicines, diagnosis, special food and travel cost, etc., for the calculation of the direct and indirect costs associated with dengue and chikungunya were collected from these participants using a structured questionnaire. Informed consent was taken before including any participant in the study.

In the dengue sample, 86 were males (57.3%) and the rest were females, and in the chikungunya sample, 31 were males (51.7%) and the rest females. The median age of the participants with dengue and chikungunya was 18 (p25 to p75: 8 to 26) and 30 (p25 to p75: 21 to 45) years respectively. Median family income was recorded as Rs 15,000 (p25 to p75: 9000 to 25500) and Rs 12,000 (p25 to p75: 9000 to 18500) for the dengue and chikungunya cases, respectively. The average duration of the illness was observed to be higher in chikungunya (median days (P25 to p75): 15 (7-45)) than dengue (median days (P25 to p75): 10 (5-15)). The median indirect cost in the case of dengue was Rs 1,931 (p25 to p75: 300 to 4500) while Rs 2,550 (p25 to p75: 0 to 5250) was observed for chikungunya cases. Two types of direct cost, namely, direct cost related to medical expenses and direct cost related to other expenses were calculated. Direct cost related to medical expenses was observed to be higher in dengue (Md (P25 to p75): Rs 2,450 (400-5000)) than chikungunya (Md (P25 to p75): Rs 1,500 (150-5200)) while indirect cost related to other expenses were comparable between dengue (Md (P25 to p75): Rs 1,575 (1300-2600)) and chikungunya (Md (P25 to p75): Rs 1500 (850-2850)). The average total cost for one dengue episode was estimated to be Rs 6,860 (3700-12525) whereas it was Rs 7,000 (2550-14000) for one episode of Chikungunya.

Overall, patients have to bear high costs while suffering from dengue and chikungunya infections. Furthermore, the duration of illness while suffering from viral diseases also contributes to the substantial economic burden. Improved knowledge about the impact of the cost and the economic burden associated with dengue and chikungunya will help policymakers allocate and appropriate resources accordingly.