Summary
BackgroundDengue 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.
