The health and economic impact of chikungunya is likely to be underestimated

Modeling study provides first global assessment of the health and economic burden of chikungunya, revealing previously underestimated impacts on health systems around the world

In a recent article published in BMJ Global Healthresearchers assessed the global burden of chikungunya from 2011 to 2020, including economic and medical costs.

They concluded that the burden of the disease is higher than previously thought and could strain local health systems.

background

Chikungunya fever is a mosquito-borne viral disease caused by the chikungunya virus (CHIKV). Aedes mosquito. The outbreak was first reported in Tanzania in 1952 and is now a global health concern. In 2022, CHIKV has been found in more than 110 countries.

Acute symptoms of chikungunya include fatigue, rash, joint pain, and fever, but chronic effects can range from long-term joint pain and other complications, severely impacting the quality of life of those affected. may give. In severe cases, it can affect multiple organs and cause serious health problems and death.

This disease has a serious impact on the economy, creating a significant economic burden due to disruption to the local economy, response to the epidemic, and hospitalization. Aedes Mosquitoes are becoming more prevalent due to environmental change, urbanization, and globalization, increasing the risk of outbreaks around the world.

Current knowledge gaps include underreporting of chikungunya due to misdiagnosis, limited diagnostic tools, and issues related to healthcare access. The true global burden of chikungunya remains unclear and is often underestimated.

About research

Researchers hope to fill current knowledge gaps by modeling the global economic and health burden of chikungunya to guide public health policy, improve surveillance, and effectively allocate resources. I aimed for

They built a data-based simulation model to estimate the global burden of the disease from 2011 to 2020, following Global Burden of Disease (GBD) guidelines. Key outcomes include economic burden (social and medical costs), disability-adjusted life years (DALYs), and global numbers of people infected.

After collecting case data from multiple sources, including local ministries of health, researchers grouped the data into seven GBD super-regions for comparison. They used estimates from a seroepidemiological study conducted in Puerto Rico and adjusted the model based on regional surveillance systems and global health safety indices to correct for underreporting of cases.

DALYs included years lived with disability (YLD) and years of life lost (YLL). Since mortality mainly occurs during the acute phase of the disease, this was the phase used to calculate YLL. The researchers estimated YLD using a disability weight (DW) that can be compared to other diseases such as moderate dengue fever for acute cases and rheumatoid arthritis for chronic cases. The mortality rate was assumed to be 0.07%, and the average age of death was 51 years.

In cost calculations, direct costs include medical resources used during the chronic and acute phases, particularly medications, outpatient treatment, and hospitalization. Indirect costs include absenteeism for patients as well as caregivers. Costs were adjusted for inflation and purchasing power parity (PPP). Proxy methods were used to estimate costs, especially in countries where detailed data were lacking.

Survey results

From 2011 to 2020, 18.7 cases of chikungunya were reported in 110 countries and territories, of which 7.9 million progressed to the chronic stage. Researchers estimated that 13,000 people died, but the death rate could range from a low of 2,242 to a high of 336,286.

The highest number of infections were recorded in the Caribbean and Latin America, with 3.2 million in Brazil, 2.7 million in the Dominican Republic and 1.6 million in French Polynesia. Central Asia and Eastern and Central Europe recorded the lowest number of infections (202), likely due to transmission from returnees. The number of infections peaked in 2014 (8.7 million cases).

Global health burden calculations show that 1.95 million DALYs were lost from 2011 to 2020, of which 76% were due to chronic diseases and the rest to acute diseases. YLD accounted for 77% of DALYs. The Caribbean and Latin America accounted for 80% of DALYs, while Oceania, East Asia, and Southeast Asia accounted for 12%. 17% of the global burden of DALYs was borne by Brazil, 14% by the Dominican Republic, and 9% by French Polynesia.

The global economic loss from chikungunya during this period was approximately $49.9 billion, of which $25.1 billion is believed to be due to chronic cases. The majority of this amount (94.3%) is indirect costs, primarily due to absenteeism. Brazil bore the largest burden of $9.8 billion. The average cost per case was $2,700.

conclusion

These findings indicate that the economic and health burden of chikungunya may be underestimated, even though certain costs such as vector eradication are not included. Understanding the impact of this disease is critical for global health security, public health interventions, and resource allocation. This study provides valuable insights for decision makers and future research on the global burden of chikungunya.