Economic burden of dengue in urban Bangladesh: A societal perspective

Background: Dengue, a vector-borne disease, is a major public health problem in many tropical and subtropical countries including Bangladesh. The objective of this study is to estimate the societal cost of illness of dengue infections among the urban population in Dhaka, Bangladesh. Methods: A cost-of-illness study was conducted using a prevalence-based approach from a societal perspective. Costs attributable to dengue were estimated from a bottom-up strategy using the guideline proposed by the World Health Organization for estimating the economic burden of infectious diseases. Results: A total of 302 hospitalized confirmed dengue patients were enrolled in this study. The average cost to society for a person with a dengue episode was US$ 479.02. This amount was ranged between US$ 341.67 and US$ 567.12 for those patients who were treated at public and private hospitals, respectively. The households out-of-pocket cost contributed to a larger portion of the total costs of illness (66%) while the cost burden was significantly higher for the poorest households than the richest quintile. Conclusions: Dengue disease imposes a substantial financial burden on households and society. Therefore, decision-makers should consider the treatment cost of dengue infections, particularly among the poor in the population while balancing the benefits of introducing potentially effective dengue preventive programs in Bangladesh. Author summary: Dengue is a vector-borne viral disease affecting over 40 million people in Bangladesh. Dengue is endemic in urban Dhaka, Bangladesh, but the economic cost of illness is still limited. A growing literature shows that dengue imposes an enormous socio-economic burden on households, health systems, and societies. As there is no specific study estimating the economic costs of dengue infections in the Bangladesh context, the current study will serve as a benchmark to support evidence-based decision-making processes that guide the dengue prevention and control policies and allocation of health resources efficiently in Bangladesh. This study indicated, there is a substantial economic burden of dengue among the Dhaka city dwellers. We found that prevention of dengue hospitalization incidence, irrespective of the methods of prevention can save about US$ 479 per dengue case. Therefore, decision-makers should consider the treatment cost of dengue infections, particularly among the poor in the population while balancing the benefits of introducing potentially effective dengue preventive programs including vaccination strategies in Bangladesh.