Burden of symptomatic dengue infection in children at primary school in Thailand: a prospective study
Department of Medicine, Division of Infectious Diseases and Immunology; Center for Infectious Disease and Vaccine Research
Immunity | Immunology and Infectious Disease | Immunology of Infectious Disease | Infectious Disease
BACKGROUND: Dengue viruses are a major cause of morbidity and mortality in tropical and subtropical areas. Our aim was to assess prospectively the burden of dengue-related illness in children in Thailand.
METHODS: We did a prospective study in a cohort of children at primary school in northern Thailand from 1998 to 2002. We assessed the burden of dengue illness as disability-adjusted life years (DALYs) and patient costs per illness.
FINDINGS: Dengue accounted for 328 (11%) of the 3056 febrile cases identified in 2114 children during the study period. The mean burden of dengue was 465.3 (SD 358.0; range 76.5-954.0) DALYs per million population per year, accounting for about 15% of DALYs lost to all febrile illnesses (3213.1 [SD 2624.2] DALYs per million per year). Non-hospitalised patients with dengue illnesses represented a substantial proportion of the overall burden of disease, with 44-73% of the total DALYs lost to dengue each year due to such illness. The infecting dengue serotype was an important determinant of DALYs lost: DEN4 was responsible for 1% of total DALYs lost, DEN1 for 9%, DEN2 for 30%, and DEN3 for 29%.
INTERPRETATION: Use of prospective data to estimate the burden of disease shows that most DALYs lost to dengue illness were the result of non-hospitalised illnesses of long duration. Thus, inclusion of non-hospitalised cases is critical to accurately assess the total burden of dengue illness.
DOI of Published Version
Lancet. 2007 Apr 28;369(9571):1452-9. DOI: 10.1016/S0140-6736(07)60671-0 Link to article on publisher's site
Lancet (London, England)
Anderson, Katie B.; Chunsuttiwat, Supamit; Nisalak, Ananda; Mammen, Mammen P.; Libraty, Daniel H.; Rothman, Alan L.; Green, Sharone; Vaughn, David W.; Ennis, Francis A.; and Endy, Timothy P., "Burden of symptomatic dengue infection in children at primary school in Thailand: a prospective study" (2007). Infectious Diseases and Immunology Publications and Presentations. 254.