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Epidemiological and Economic Burden of Dengue in Dhaka, Bangladesh

Dengue, an arbovirus infection with an explosive epidemic potential, is a major public health problem in many tropical and subtropical countries today. With an estimated 50-100 million symptomatic infections each year, dengue is ranked the most important mosquito-borne disease. Dengue is highly seasonal in Bangladesh with an increased incidence during the monsoon. Although the first recognized outbreak of dengue in Dhaka, the capital city of Bangladesh, was recorded in 1964 and followed by sporadic cases of dengue fever during 1977–78 and 1996–1. Last year, approximately 100,537 cases and 129 death has been reported which indicated significance health and economic burden of dengue infections in Bangladesh (DGHS, 2019). A risk factor study on presence of dengue infections conducted in urban Dhaka observed that nearly 82% of the identified immature mosquitoes were Aedes aegypti which is responsible for dengue. Indeed, Dengue infections is emerging public health problem in urban Dhaka and the cost of dengue infections is high than any parts of the country due to livelihood cost and nature of an urban Dhaka as Dhaka is the capital of Bangladesh. Therefore, health and economic burden of dengue infections on urban dwellers is crucial and requires urgent attention for priority settings for introducing effective intervention for tackling future dengue cases. A growing literature shows that these illness related costs pose a severe economic burden on households, health care systems, and governments. Since the data about the cost of treatment is limited and varied across settings, therefore, specific epidemiological and economic burden data from Dhaka city is essential due to recent out-break of dengue infections and requires urgent attention for control of Dengue. 

The overall assignment of this project is to estimate the epidemiological and economic burden of Dengue infections among the city dwellers in urban Dhaka in 2019. The specific objectives of the study are:

1. To estimate the proportion of population infected with dengue virus in Dhaka city in 2019

2. To estimate the economic burden of dengue from societal perspective (i.e., both household and hospital) in Dhaka city during the year 2019

3. To find out the possible factors that are liable for spreading Dengue in Dhaka city.

4. To develop a policy brief in line with the findings on the initiatives to be taken by the Government.

The analysis will be based on the household, health system and broader societal points of view. In health system perspective the costs of dengue related medical care will be included; whereas in the societal perspective both direct medical (e.g., medicine, diagnostic), direct non-medical cost (e.g., transportation, lodging), and indirect cost (e.g., income loss of patients and caregivers) will be included. Finally, the societal cost of illness will be estimated by adding provider’s actual cost of illness per patients with the cost incurred per household. In this context, the evidence-based study focusing economic cost and care seeking patterns will help to justify the introduction of any preventive measures or adopting future cost-effective programs for controlling dengue infection in Bangladesh. We believe, these data may support national level public health decision making for prevention/control of dengue in public health priority lists.

Principal Investigator/Study Director: Dr. Abdur Razzaque Sarker 

Study Team: Dr. S M. Zahedul Islam Chowdhury, Maruf Ahmed and Dr. Abdur Razzaque Sarker

Funding Agency:  Health Economics Unit, Ministry of Health and Family Welfare, Bangladesh

Duration July 2020 to November 2020.

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