ArticleInfectious diseases of poverty2026
Economic burden of dengue in Puerto Rico, 2010-2023.
Article in Infectious diseases of poverty, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Article
- Evaluation of Effectiveness of Autocidal Gravid Ovitraps for Preventing Zika Virus Infection, Puerto Rico, USA.Emerging infectious diseases · 2026Article
- Utility of sentinel surveillance as an early warning system for emerging pathogens in a low-resource setting: Correlations of dengue, chikungunya, Zika, and COVID-19 trends between sentinel and passive surveillance systems in Puerto Rico, 2012-2023.PLOS global public health · 2026Article
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14 authors.
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Abstract
backgroundDengue remains a major public health challenge, particularly in endemic areas like Puerto Rico, where its economic burden is substantial. This study aimed to update the economic burden of dengue in Puerto Rico using recent data from patients, hospitals, and insurance companies, providing a clearer picture of the current situation. We estimated the total number of dengue cases with fever who sought care by adjusting for underreporting through a robust statistical framework linking island-wide passive surveillance data to sentinel acute febrile illness surveillance.
methodsWe obtained cost data from hospitals and conducted interviews with a random sample of people diagnosed with dengue (n = 101) from December 2021-November 2022, collecting detailed information on direct medical costs, non-medical costs, and indirect costs. We analyzed median, epidemic and long-term dengue incidence patterns from 2010-2023. We conducted a cost-of-illness analysis using Bayesian multiplier methods to adjust for underreporting, followed by a bottom-up costing approach during a typical median incidence year and an epidemic year to illustrate the current economic burden of dengue in Puerto Rico.
resultsIn the median incidence year (2014), from 597 reported dengue cases we estimated 4500 [95% credible interval (95% CrI): 3700-5400] outpatient and 3900 (95% CrI: 3200-4700) hospitalized cases. During an epidemic year (2010), these figures rose substantially from the reported 10,359 dengue cases to an estimated 77,300 (95% CrI: 64,600-93,200) outpatient and 67,300 (95% CrI: 56,100-81,700) hospitalized cases. The median cost per hospitalized dengue case was 5200 USD for children and USD 6800 for adults, while outpatient costs were 2300 USD for children and 2700 USD for adults. Direct medical costs and indirect costs constituted the largest share of total costs. The total economic burden was 1.1 billion USD (95% CrI: 785 million-1.6 billion) during the epidemic year, compared to 62.7 million USD (95% CrI: 45.9-95.4 million) in the median incidence year.
conclusionsThese findings highlight the considerable financial strain of dengue, particularly during epidemics, and underscore the urgent need for enhanced resource allocation, effective prevention strategies, and policy interventions to mitigate the economic impact of future outbreaks.
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