Economic burden of dengue in Puerto Rico, 2010-2023.

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• Dengue is a major public health concern in endemic regions like Puerto Rico.
• The economic burden of dengue in Puerto Rico is substantial and requires updated assessment.
• Accurate estimation of dengue cases is crucial for understanding its impact.

Purpose of the Study:

• To update the economic burden of dengue in Puerto Rico using recent data.
• To provide a clearer picture of the current economic situation related to dengue.
• To estimate the total number of dengue cases seeking medical care, accounting for underreporting.

Main Methods:

• Utilized a robust statistical framework linking passive surveillance data to sentinel surveillance for case estimation.
• Collected cost data from hospitals and conducted interviews with dengue-diagnosed individuals (n=101).
• Performed a cost-of-illness analysis using Bayesian multiplier methods and a bottom-up costing approach for median and epidemic years.

Main Results:

• Estimated dengue cases ranged from 4500 outpatient/3900 hospitalized in a median year to 77,300 outpatient/67,300 hospitalized during an epidemic year.
• Median costs per hospitalized case were $5200 (children) and $6800 (adults); outpatient costs were $2300 (children) and $2700 (adults).
• Total economic burden reached $1.1 billion during an epidemic year, compared to $62.7 million in a median incidence year.

Conclusions:

• Dengue imposes a considerable financial strain, especially during epidemics.
• There is an urgent need for enhanced resource allocation and effective prevention strategies.
• Policy interventions are crucial to mitigate the economic impact of future dengue outbreaks.