TY - JOUR
T1 - A prospective study on the impact and out-of-pocket costs of dengue illness in international travelers
AU - Tozan, Yesim
AU - Headley, Tyler Y.
AU - Odhiambo Sewe, Maquines
AU - Schwartz, Eli
AU - Shemesh, Tamar
AU - Cramer, Jakob P.
AU - Eberhardt, Kirsten A.
AU - Ramharter, Michael
AU - Harrison, Nicole
AU - Leder, Karin
AU - Angheben, Andrea
AU - Hatz, Christoph
AU - Neumayr, Andreas
AU - Chen, Lin Hwei
AU - De Pijper, Cornelis A.
AU - Grobusch, Martin P.
AU - Wilder-Smith, Annelies
N1 - Funding Information:
Acknowledgments: This work was funded partially by EU/FP7 through the DengueTools Consortium (grant agreement number 282589). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
The impact and costs of dengue illness to patients and households have been extensively studied in dengue-endemic populations52–55; however, similar studies have never been performed in international travelers. Yet, the United Nations World Tourism Organization projected that about 1.8 billion travelers will cross international borders by 2030, with Asia and the Pacific region, where arboviral infections are endemic, highlighted as the fastest growing tourism regions in the world.56 Dengue illness can pose a considerable financial burden on international travelers because of the costs incurred while seeking and receiving medical care at destination and home country, financial losses resulting from disruption to travel itineraries of travelers and accompanying persons, and income losses if the disease persists after travelers return home. Understanding the financial burden of dengue in travelers is also important in considering the use of dengue vaccination.57–59 Within the context of a European Union funded research project on dengue,60,61 we conducted a prospective study to investigate and characterize the impact and out-of-pocket costs of travel-acquired dengue illness from the traveler’s perspective.
Publisher Copyright:
© 2019 by The American Society of Tropical Medicine and Hygiene.
PY - 2019
Y1 - 2019
N2 - Although the costs of dengue illness to patients and households have been extensively studied in endemic populations, international travelers have not been the focus of costing studies. As globalization and humantravel activities intensify, travelers are increasingly at risk for emerging and reemerging infectious diseases, such as dengue. This exploratory study aims to investigate the impact and out-of-pocket costs of dengue illness among travelers. We conducted a prospective study in adult travelers with laboratory-confirmed dengue and recruited patients at travel medicine clinics in eight different countries from December 2013 to December 2015. Using a structured questionnaire, we collected information on patients and their health-care utilization and out-of-pocket expenditures, as well as income and other financial losses they incurred because of dengue illness. A total of 90 patients participated in the study, most of whom traveled for tourism (74%) and visited countries in Asia (82%). Although 22% reported hospitalization and 32% receiving ambulatory care while traveling, these percentages were higher at 39% and 71%, respectively, after returning home. The out-of-pocket direct and indirect costs of dengue illness were US$421 (SD 744) and US$571 (SD 1,913) per episode, respectively, averaging to a total out-of-pocket cost of US$992 (SD 2,052) per episode. The study findings suggest that international travelers incur important direct and indirect costs because of dengue-related illness. This study is the first to date to investigate the impact and out-of-pocket costs of travel-related dengue illness from the patient's perspective and paves the way for future economic burden studies in this population.
AB - Although the costs of dengue illness to patients and households have been extensively studied in endemic populations, international travelers have not been the focus of costing studies. As globalization and humantravel activities intensify, travelers are increasingly at risk for emerging and reemerging infectious diseases, such as dengue. This exploratory study aims to investigate the impact and out-of-pocket costs of dengue illness among travelers. We conducted a prospective study in adult travelers with laboratory-confirmed dengue and recruited patients at travel medicine clinics in eight different countries from December 2013 to December 2015. Using a structured questionnaire, we collected information on patients and their health-care utilization and out-of-pocket expenditures, as well as income and other financial losses they incurred because of dengue illness. A total of 90 patients participated in the study, most of whom traveled for tourism (74%) and visited countries in Asia (82%). Although 22% reported hospitalization and 32% receiving ambulatory care while traveling, these percentages were higher at 39% and 71%, respectively, after returning home. The out-of-pocket direct and indirect costs of dengue illness were US$421 (SD 744) and US$571 (SD 1,913) per episode, respectively, averaging to a total out-of-pocket cost of US$992 (SD 2,052) per episode. The study findings suggest that international travelers incur important direct and indirect costs because of dengue-related illness. This study is the first to date to investigate the impact and out-of-pocket costs of travel-related dengue illness from the patient's perspective and paves the way for future economic burden studies in this population.
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U2 - 10.4269/ajtmh.18-0780
DO - 10.4269/ajtmh.18-0780
M3 - Article
C2 - 30994088
AN - SCOPUS:85067373114
SN - 0002-9637
VL - 100
SP - 1525
EP - 1533
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 6
ER -