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The epidemiologic and economic burden of dengue in Singapore: A systematic review

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  • Rita Ting
  • Borame L Dickens
  • Riona Hanley
  • Alex R Cook
  • Ellyana Ismail

Abstract

Background: Despite its well-regarded vector control program, Singapore remains susceptible to dengue epidemics. To assist evaluation of dengue interventions, we aimed to synthesize current data on the epidemiologic and economic burden of dengue in Singapore. Methodology: We used multiple databases (PubMed, Embase, Cochrane, international/national repositories, surveillance) to search for published and gray literature (2000–2022). We included observational and cost studies, and two interventional studies, reporting Singapore-specific data on our co-primary outcomes, dengue incidence and dengue-related costs. Quality was assessed using the Newcastle-Ottawa Scale and an adapted cost-of-illness evaluation checklist. We performed a narrative synthesis and grouped studies according to reported outcomes and available stratified analyses. Findings: In total, 333 reports (330 epidemiological, 3 economic) were included. Most published epidemiological studies (89%) and all economic studies were of good quality. All gray literature reports were from the Ministry of Health or National Environment Agency. Based predominantly on surveillance data, Singapore experienced multiple outbreaks in 2000–2021, attaining peak incidence rate in 2020 (621.1 cases/100,000 person-years). Stratified analyses revealed the highest incidence rates in DENV-2 and DENV-3 serotypes and the 15–44 age group. Among dengue cases, the risk of hospitalization has been highest in the ≥45-year-old age groups while the risks of dengue hemorrhagic fever and death have generally been low (both

Suggested Citation

  • Rita Ting & Borame L Dickens & Riona Hanley & Alex R Cook & Ellyana Ismail, 2024. "The epidemiologic and economic burden of dengue in Singapore: A systematic review," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 18(6), pages 1-22, June.
    • Handle: RePEc:plo:pntd00:0012240
    DOI: 10.1371/journal.pntd.0012240
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    References listed on IDEAS

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    1. Donald S Shepard & Eduardo A Undurraga & Yara A Halasa, 2013. "Economic and Disease Burden of Dengue in Southeast Asia," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(2), pages 1-12, February.
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