Preliminary estimate of immediate cost of chikungunya and dengue to Gujarat, India.

This study aims to provide a preliminary estimate of the immediate cost of chikungunya and dengue to household in the Indian state of Gujarat. Combining nine earlier studies and data from interviews, we analysed the costs of non-fatal illness and of intervention programmes; building a more comprehensive picture of the immediate cost of these Aedes aegypti mosquito-borne diseases to Gujarat. The “RUHA matrix” was used to estimate the cost of illness by combining the shares of reported (R) and unreported (U) hospitalized (H) and ambulatory (A) cases of chikungunya and dengue with ambulatory and hospitalization costs per case and the number of reported cases. Using Monte Carlo sensitivity analysis, the immediate cost to households incurred on account of chikungunya and dengue to Gujarat was estimated to be 3.8 (range 1.6–9.1) billion Indian rupees (INR) per annum (US$ 90 million, range US$ 38 and US$ 217 million). It is hoped that this preliminary estimate will trigger more refined studies on cost of illness as well as cost-effectiveness of vaccines and other interventions to combat these neglected tropical diseases.

Immediate cost of dengue to Malaysia and Thailand: an estimate.

We have analysed the average annual cost of dengue in Malaysia during the period 2002–2007 and in Thailand between 2000 and 2005. The key cost components, estimated by combining existing data from both published and unpublished studies, consist of: (i) costs of non-fatal illness; (ii) vector (Aedes mosquitoes) control costs; and (iii) research and development (R&D) costs incurred by government institutions. We found the immediate cost of dengue to Malaysia to be in the range of US$ 88 million to US$ 215 million (mean US$ 133 million) per annum. For Thailand, the corresponding range is US$ 56 million to US$ 264 million (mean US$ 135 million) per annum. For the period analysed, Thailand has 3.6 times more total cases of dengue, but Malaysia has a 4.6 times higher cost per case. In Malaysia, the most important parameters creating uncertainty in the immediate cost are reporting rate, hospitalization rate, and cost per ambulatory case. The corresponding parameters in Thailand are cost per ambulatory case, cost per hospitalized case, and reporting rate. Better estimates of cost per ambulatory case and reporting rate are therefore needed for both countries. Future studies should also refine the estimates of hospitalization rate in Malaysia and the cost per hospitalized case in Thailand.Malaysia’s immediate cost of dengue is substantial and is equivalent to 3%–7% of the government’s spending on health care. According to our estimates the illness costs due to dengue are 11 times (range 5 to 28 times) the amount of government spending on Aedes vector control in Malaysia, and 13 times (range 1 to 106 times) the government’s spending on Aedes vector control in Thailand. This relationship shows that increased investment on prevention could potentially generate large offsets in illness costs. In addition to the immediate costs reported here, dengue may also adversely impact tourism and create emotional and long-term burdens on families affected by illness and deaths.