Epidemiological and Economic Burden of Dengue in Dhaka in 2019, Bangladesh
Dengue, a mosquito-borne viral disease, poses a tremendous threat to public health and imposes a substantial economic burden in Bangladesh. A growing literature shows that dengue imposes an enormous socioeconomic burden on households, health care systems, and health expenditures by the governments in endemic countries, particularly during the outbreaks. In this context, this study aims to estimate the epidemiological and economic burden of dengue in Dhaka in 2019 from a societal perspective. A cross-sectional study design was adopted for this study. A combination of three different surveys was conducted to address the study objectives; (i) a community-based household survey for the epidemiological burden of dengue in Dhaka city, (ii) the hospital-based dengue patients’ survey was conducted to estimate the economic burden of dengue at the household level, and (iii) a hospital survey was also conducted to capture the provider cost of dengue patients.
A total of 1,176 households were surveyed from both Dhaka North City Corporation (DNCC) and Dhaka South City Corporation (DSCC). The prevalence of dengue patient was about 1.87% in 2019 while the prevalence was higher (2.27%) in DSCC than DNCC (1.37%). The highest dengue prevalence (2.01%) was observed among the adults aged between 19 to 50 years old (2.01%), females (2.19%) and among small households (4.07%). The risk for dengue infection was higher for people who did not use mosquito nets (3.85%), mosquito repellents (2.39%), presence of garden in the house (2.41%), presence of waste bon near households (3%), presence of open water pot/tire/tube in the house (3.18%) and who didn’t clean their refrigerator water tray regularly (2.9%). Dengue prevalence was higher among those individuals who visited/walked the parks regularly at evening and in the morning (3.38%).
A total of 302 hospitalized confirmed dengue patients were enrolled for the economic burden of dengue study. The average economic cost for treating the dengue patient was BDT 33,817 (US$ 406.06) from a household perspective, whereas BDT 22,379 (US$ 268.72) and BDT 47,230 (US$ 567.12) were required for treating dengue cases from public hospitals and private hospitals, respectively. Further, BDT 6,076 (US$ 73) was spent by the public hospital per patient per episode of dengue.
The societal (household + provider) cost of treatment per dengue episode was BDT 39,893 (US$ 479), whereas the average societal cost of treatment was BDT 28,455 (US$ 341.67) and BDT 47,230 (US$ 567.12) if the patient was treated in public and private facilities, respectively in Bangladesh. The poorest households spent 139% of their total household income for treating dengue cases, which indicated that they often relied on savings, borrowing from friends and families, and even selling assets.
The findings of this study acknowledged the substantial health and economic burden of dengue infection among Dhaka city dwellers, which underscores the urgent need for an effective national dengue prevention strategy to bring down the dengue prevalence and reduce the economic burden of households. Therefore, various community-based awareness program should be initiated and monitored to wipe out Ades mosquito completely. Various social protection schemes including ‘Shasthyo Surokhsha Karmasuchi (SSK)’ may be introduced in urban Dhaka for poor and vulnerable households to tackle the catastrophic health burden against dengue infections.
Dr. Abdur Razzaque Sarker, PhD
Research Fellow, BIDS
Funded by: Health Economics Unit, Ministry of Health and Family Welfare (MoHFW)