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Lancet. 2007 Apr 28;369(9571):1452-1459. doi: 10.1016/S0140-6736(07)60671-0.

Burden of symptomatic dengue infection in children at primary school in Thailand: a prospective study.

Author information

1
Division of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
2
Ministry of Public Health, Nonthaburi, Thailand.
3
Department of Virology, Armed Forces Institute of Medical Research, Bangkok, Thailand.
4
Center For Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, MA, USA.
5
Military Infectious Disease Research Program, Ft Detrick, MD, USA.
6
Division of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, Silver Spring, MD, USA. Electronic address: endyt@upstate.edu.

Abstract

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.

PMID:
17467515
DOI:
10.1016/S0140-6736(07)60671-0
[Indexed for MEDLINE]

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