Economic impact of dengue in Mexico considering reported cases for 2012 to 2016

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 15 Dec 2018)

Research Article
Economic impact of dengue in Mexico considering reported cases for 2012 to 2016
Adriana Zubieta-Zavala, Malaquias López-Cervantes, Guillermo Salinas-Escudero, Adrian Ramírez-Chávez, José Ramos Castañeda, Sendy Isarel Hernández-Gaytán, Juan Guillermo López Yescas, Luis Durán-Arenas
| published 14 Dec 2018 PLOS Neglected Tropical Diseases
Abstract
Background
Given that dengue disease is growing and may progress to dengue hemorrhagic fever (DHF), data on economic cost and disease burden are important. However, data for Mexico are limited.
Methodology/Principal findings
Burden of dengue fever (DF) and DHF in Mexico was assessed using official databases for epidemiological information, disabilities weights from Shepard et al, the reported number of cases and deaths, and costs. Overall costs of dengue were summed from direct medical costs to the health system, cost of dengue to the patient (out-of-pocket expenses [medical and non-medical], indirect costs [loss of earnings, patient and/or caregiver]), and other government expenditures on prevention/surveillance. The first three components, calculated as costs per case by a micro-costing approach (PAATI; program, actions, activities, tasks, inputs), were scaled up to overall cost using epidemiology data from official databases. PAATI was used to calculate cost of vector control and prevention, education, and epidemiological surveillance, based on an expert consensus and normative construction of an ideal scenario.

Disability-adjusted life years (DALYs) for Mexico in 2016 were calculated to be 2283.46 (1.87 per 100,000 inhabitants). Overall economic impact of dengue in Mexico for 2012 was US$144 million, of which US$44 million corresponded to direct medical costs and US$5 million to the costs from the patient’s perspective. The estimated cost of prevention/surveillance was calculated with information provided by federal government to be US$95 million. The overall economic impact of DF and DHF showed an increase in 2013 to US$161 million and a decrease to US$133, US$131 and US$130 million in 2014, 2015 and 2016, respectively.
Conclusions/Significance
The medical and economic impact of dengue were in agreement with other international studies, and highlight the need to include governmental expenditure for prevention/surveillance in overall cost analyses given the high economic impact of these, increasing the necessity to evaluate its effectiveness.
Author summary
Dengue fever is caused by a flavivirus transmitted predominantly by the mosquito Aedes aegypti. Infection causes a broad spectrum of clinical signs and symptoms, from mild disease, such as dengue fever to a life threatening form known as dengue hemorrhagic fever. The disease is widespread in tropical regions. Measures such as vector control can slow the spread of infection, and most countries where the disease is endemic, Mexico included, have programs in place to this end. However, faced with other health issues that also require attention, it is important to quantify the suffering caused by dengue and also its economic costs. In this study, we aimed to produce detailed figures for Mexico to complement and refine those available from international studies. Such information will help guide how the money budgeted for health in dengue is spent.