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

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


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Communicable Diseases / complications
  • Communicable Diseases / epidemiology
  • Cost of Illness*
  • Dengue / classification
  • Dengue / economics
  • Dengue / epidemiology*
  • Female
  • Humans
  • Incidence
  • Male
  • Population Surveillance
  • Prospective Studies
  • Severe Dengue / classification
  • Severe Dengue / economics
  • Severe Dengue / epidemiology*
  • Severity of Illness Index
  • Thailand / epidemiology