Costs of dengue in three French territories of the Americas: an analysis of the hospital medical information system (PMSI) database

Biological invasions in France: Alarming costs and even more alarming knowledge gaps

The ever-increasing number of introduced species profoundly threatens global biodiversity. While the ecological and evolutionary consequences of invasive alien species are receiving increasing attention, their economic impacts have largely remained understudied, especially in France. Here, we aimed at providing a general overview of the monetary losses (damages caused by) and expenditures (management of) associated with invasive alien species in France. This country has a long history of alien species presence, partly due to its long-standing global trade activities, highly developed tourism, and presence of overseas territories in different regions of the globe, resulting in a conservative minimum of 2,750 introduced and invasive alien species. By synthesizing for the first time the monetary losses and expenditures incurred by invasive alien species in Metropolitan France and French overseas territories, we obtained 1,583 cost records for 98 invasive alien species. We found that they caused a conservative total amount ranging between US$ 1,280 million and 11,535 million in costs over the period 1993–2018. We extrapolated costs for species invading France, for which costs were reported in other countries but not in France, which yielded an additional cost ranging from US$ 151 to 3,030 millions. Damage costs were nearly eight times higher than management expenditure. Insects, and in particular the Asian tiger mosquito Aedes albopictus and the yellow fever mosquito Ae. aegypti, totalled very high economic costs, followed by non-graminoid terrestrial flowering and aquatic plants (Ambrosia artemisiifolia, Ludwigia sp. and Lagarosiphon major). Over 90% of alien species currently recorded in France had no costs reported in the literature, resulting in high biases in taxonomic, regional and activity sector coverages. To conclude, we report alarming costs and even more alarming knowledge gaps. Our results should raise awareness of the importance of biosecurity and biosurveillance in France, and beyond, as well as the crucial need for better reporting and documentation of cost data.

A review of the economic evidence of Aedes-borne arboviruses and Aedes-borne arboviral disease prevention and control strategies

Introduction: Aedes-borne arboviruses contributes substantially to the disease and cost burden.Areas covered: We performed a systematic review of the economic evidence surrounding aedes-borne arboviruses and strategies to prevent and control these diseases to inform disease control policy decisions and research directions. We searched four databases covering an 18-year period (2000-2018) to identify arboviral disease-related cost of illness studies, cost studies of vector control and prevention strategies, cost-effectiveness analyses and cost-benefit analyses. We identified 74 published studies that revealed substantial global total costs in yellow fever virus and dengue virus ranging from 2.1 to 57.3 billion USD. Cost studies of vector control and surveillance programs are limited, but a few studies found that costs of vector control programs ranged from 5.62 to 73.5 million USD. Cost-effectiveness evidence was limited across Aedes-borne diseases, but generally found targeted dengue vaccination programs cost-effective. This review revealed insufficient economic evidence for vaccine introduction and implementation of surveillance and vector control programs.Expert opinion: Evidence of the economic burden of aedes-borne arboviruses and the economic impact of strategies for arboviral disease prevention and control is critical to inform policy decisions and to secure continued financial support for these preventive and control measures.

Cost of illness and program of dengue: A systematic review

BACKGROUND

Studies on dengue related to the cost of illness and cost of the program are factors to describe the economic burden of dengue, a neglected disease that has global importance in public health. These studies are often used by health managers in optimizing financial resources. A systematic review of studies estimating the cost of dengue was carried out, comparing the costs between the studies and examining the cost drivers regarding the methodological choices.

METHODS

This study was done according to the guidelines of the Centre for Reviews and Dissemination (CRD). Several databases were searched: Medline, Virtual Health Library and CRD. Two researchers, working independently, selected the studies and extracted the data. The quality of the methodology of the individual studies was achieved by a checklist of 29 items based on protocols proposed by the British Medical Journal and Consolidated Health Economic Evaluation Reporting Standards. A qualitative and quantitative narrative synthesis was performed.

RESULTS

A literature search yielded 665 publications. Of these, 22 studies are in accordance with previously established inclusion criteria. The cost estimates were compared amongst the studies, highlighting the study design, included population and comparators used (study methodology). The component costs included in the economic evaluation were based on direct and indirect costs, wherein twelve studies included both costs, twelve studies adopted the societal perspective and ten studies used the perspective of the public health service provider, or of a private budget holder.

CONCLUSION

This study showed that the cost of dengue in 18 countries generated approximately US$ 3.3 billion Purchasing Power Parity (PPP) in 2015. This confirms that the burden of dengue has a great economic impact on countries with common socioeconomic characteristics and similarities in health systems, particularly developing countries, indicating a need for further studies in these countries.

Validity of International Classification of Diseases (ICD) coding for dengue infections in hospital discharge records in Malaysia

Background

Hospitalization due to dengue illness is an important measure of dengue morbidity. However, limited studies are based on administrative database because the validity of the diagnosis codes is unknown. We validated the International Classification of Diseases, 10th revision (ICD) diagnosis coding for dengue infections in the Malaysian Ministry of Health’s (MOH) hospital discharge database.

Methods

This validation study involves retrospective review of available hospital discharge records and hand-search medical records for years 2010 and 2013. We randomly selected 3219 hospital discharge records coded with dengue and non-dengue infections as their discharge diagnoses from the national hospital discharge database. We then randomly sampled 216 and 144 records for patients with and without codes for dengue respectively, in keeping with their relative frequency in the MOH database, for chart review. The ICD codes for dengue were validated against lab–based diagnostic standard (NS1 or IgM).

Results

The ICD-10-CM codes for dengue had a sensitivity of 94%, modest specificity of 83%, positive predictive value of 87% and negative predictive value 92%. These results were stable between 2010 and 2013. However, its specificity decreased substantially when patients manifested with bleeding or low platelet count.

Conclusion

The diagnostic performance of the ICD codes for dengue in the MOH’s hospital discharge database is adequate for use in health services research on dengue.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3104-z) contains supplementary material, which is available to authorized users.

Direct Medical Costs of Dengue Fever in Vietnam: A Retrospective Study in a Tertiary Hospital

BACKGROUND

In Vietnam, dengue fever is a major health concern, yet comprehensive information on its economic costs is lacking. The present study investigated treatment costs associated with dengue fever from the perspective of health care provision.

METHODS

This retrospective study was conducted between January 2013 and December 2015 in Cu Chi General Hospital. The following dengue-related treatment costs were calculated: hospitalisation, diagnosis, specialised services, drug usage and medical supplies. Average cost per case and treatment cost across different age was calculated.

RESULTS

In the study period, 1672 patients with dengue fever were hospitalised. The average age was 24.98 (SD = 14.10) years, and 47.5% were males (795 patients). Across age groups, the average cost per episode was USD 48.10 (SD = 3.22). The highest costs (USD 56.61, SD = 48.84) were incurred in the adult age group (> 15 years), and the lowest costs (USD 30.10, SD = 17.27) were incurred in the paediatric age group (< 15 years).

CONCLUSION

The direct medical costs of dengue-related hospitalisation place a severe economic burden on patients and their families. The probable economic value of dengue management in Vietnam is significant.