| Background:Dengue fever is an acute infectious disease caused by dengue virus,mainly transmitted by Aedes aegypti and Aedes albopictus.Currently,it is prevalent in more than 100 countries and regions around the world,and about half of the population is at risk of dengue fever.In recent years,the situation of dengue fever in China has become increasingly serious.The risk of imported dengue fever has been increasing.The areas threatened by dengue fever have spread from the southeast coast to other coastal and inland areas,and by 2019,the number of affected areas has reached the highest level in history.In view of the increasing severity of dengue,it is important to quantify and assess the damage caused by dengue.Therefore,this study aims to assess the disease burden of dengue fever in China,and to provide a scientific basis for policy makers to formulate dengue prevention and control measures and rationally allocate health resources.Methods:The disease burden of dengue fever in China was assessed from two aspects,for epidemiological burden and economic burden.For the epidemiological burden study,according to the method proposed by the World Health Organization(WHO),combined with the case data reported by the legal infectious disease surveillance system,use the morbidity,mortality,and disability-adjusted life years(DALY)as indicators to estimate dengue burden in different years.And to learn the impact of dengue fever on the health of the Chinese population in different genders and different ages.For the economic burden study,we estimated it in family perspective and society perspective.For the family perspective economic burden study,get the information of the economic burden through retrospective investigation,and estimated the cost of each dengue fever patient and their family,and then estimated the total economic burden of dengue fever in China in 2019.For the social perspective economic burden study,it includes a series of costs invested by the state for the prevention and control of dengue fever and the costs borne by the state for the treatment of dengue fever patients.In order to get the data for dengue prevention and control,we collected the relevant expenses from the government,CDC,neighborhoods and other departments through retrospective investigations.And get the cost data for treating patients from the hospital's medical record room or medical insurance office.Then we estimated the total economic burden of dengue fever.Results:From 2005 to 2019,there were 93688 cases of dengue fever have been reported in China,with a distribution of cases reported every year.The incidence rate in 2005 was the lowest(<0.01/100000),and the incidence rates in other years ranged from 0.01/100000 to 3.52/100000.There were 14 deaths,with an annual mortality rate of less than 0.01/100 000.The cumulative DALY of dengue fever from 2005 to 2019 was 3731 person-years,which was 2.80 person-years per million people after standardization and the average DALY in 15 years was 248.73 person-years.The average DALY for men is 132.07 person-years,and for women is 116.67 person-years,with a relative ratio of 1.13(male/female).The disease burden is mainly caused by the population of 15-29,30-44 and 45-59 age groups,which accounted for 85.25%in total,and the 30-44 year old age group accounts for the largest proportion.The burden of dengue fever in China has shown an overall upward trend from 2005 to 2019,the DALY burden is mainly due to the YLD burden,and the YLL burden contributes less.For the economic burden of family perspective,the direct cost,the indirect cost and the total cost for outpatients was 569.00 yuan,144.00 yuan and 767.00 yuan,and for inpatients was 1957.00 yuan,504.00 yuan and 2536.00 yuan.The total cost of outpatients and inpatients accounts for 2.72%and 8.98%of China's per capita disposable income respectively.For different economic levels of provinces,the direct cost was 2774.50 yuan,1541.00 yuan and 1413.00 yuan,the indirect cost was 882.00 yuan,432.00 yuan and 385.00 yuan,and the total cost was 3690.50 yuan,1881.00 yuan and 1857.00 yuan,which accounted for 13.07%,6.67%and 6.58%of the per capita disposable income in China respectively.It is estimated that the direct economic burden of dengue fever in China in 2019 was about 36.93 million yuan,the indirect economic burden was about 10.58 million yuan,and the total economic burden was about 46.81 million yuan.For the economic burden of social perspective,the median total cost of dengue fever for prevention and control in counties without cases,in counties with imported cases and in counties with local cases was 205800.00 yuan,731180.00 yuan and 6934378.00 yuan.The economic burden for prevention and control of dengue fever was about 3166.66 million yuan,and the cost of curing dengue patients invested by the state was about 23.13 million yuan.The total direct economic burden was about 3189.79 million yuan in China in 2019.The labor loss caused by dengue fever is transformed into indirect economic burden was about 38.07 million yuan.From a social perspective,it is estimated that the total economic burden of dengue fever in China in 2019 was about 3227.86 million yuan,which accounted for 0.04‰ of the country's GDP.Conclusions:From 2005 to 2019,the cumulative DALY of dengue fever in China was 3731 person-years,and the average DALY was 248.73 person-years.The overall disease burden of dengue fever was on the rise in the past 15 years,and the risk to the population was increasing continuously.The disease burden is mainly caused by the population of 15-29,30-44 and 45-59 age groups,which accounted for more than 85%,and the disease burden level of male is slightly higher than that of female.From the perspective of family,the economic burden of dengue fever in China was over 40 million yuan,among which the direct economic burden is the main component of the economic burden of dengue patients.It is suggested that to increase the proportion of medical insurance reimbursement for dengue fever related treatment expenses in order to reduce the economic burden of patients.From the perspective of society,the economic burden of dengue fever in China in 2019 was about 3.2 billion yuan,which accounted for 0.04‰ of the country's GDP.The cost invested by the government and CDC was far more than that invested by the grassroots departments such as the streets and communities.Therefore,we should increase the funding for the grassroots health service institutions to ensure the smooth progress of the epidemic prevention work at the grassroots level. |
PDF Full Text Request