What the study found
The study found that dengue imposed a large financial burden in Puerto Rico, with much higher costs during epidemic years than during median-incidence years. It also found that reported cases likely understated the number of people who sought care for dengue fever.
Why the authors say this matters
The authors conclude that the findings highlight the considerable financial strain of dengue, especially during epidemics. They say the results underscore the need for greater resource allocation, prevention strategies, and policy interventions to reduce the economic impact of future outbreaks.
What the researchers tested
The researchers updated estimates of dengue’s economic burden in Puerto Rico using recent data from patients, hospitals, and insurance companies. They adjusted for underreporting with a statistical framework that linked island-wide passive surveillance data to sentinel acute febrile illness surveillance, then used a cost-of-illness analysis with Bayesian multiplier methods and a bottom-up costing approach.
What worked and what didn't
In the median incidence year of 2014, 597 reported cases were estimated to represent about 4,500 outpatient cases and 3,900 hospitalized cases. In the epidemic year of 2010, 10,359 reported cases were estimated to represent about 77,300 outpatient cases and 67,300 hospitalized cases, and the total economic burden was estimated at 1.1 billion USD compared with 62.7 million USD in the median year. Median costs per case were higher for hospitalized cases than outpatient cases, and direct medical costs and indirect costs made up the largest share of total costs.
What to keep in mind
The abstract does not describe detailed study limitations. The estimates are based on specific data sources, a sample of 101 people diagnosed with dengue, and modeled adjustments for underreporting, so the reported totals are estimates rather than direct counts.
Key points
- Dengue’s total economic burden in Puerto Rico was estimated at 1.1 billion USD in an epidemic year.
- The estimated burden in a median incidence year was 62.7 million USD.
- Reported dengue cases were adjusted upward substantially to account for underreporting.
- Hospitalized dengue cases had higher median costs than outpatient cases for both children and adults.
- Direct medical costs and indirect costs were the largest parts of total costs.
Disclosure
- Research title:
- Dengue’s economic burden in Puerto Rico was highest during epidemic years
- Authors:
- Daniel Camprubí-Ferrer, Maile B. Thayer, Zachary J. Madewell, J. Mac McCullough, Liliana Sánchez-González, Aidsa Rivera, Janice Perez-Padilla, Dania M. Rodríguez, Jomil Torres Aponte, Michael A. Johansson, Gabriela Paz-Bailey, Vanessa Rivera-Amill, Melissa Marzan-Rodriguez, Laura E. Adams
- Institutions:
- Barcelona Institute for Global Health, Boise State University, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Hospital Clínic de Barcelona, Ponce Health Sciences University, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Puerto Rico Department of Health, Universitat de Barcelona
- Publication date:
- 2026-01-27
- OpenAlex record:
- View
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