A prospective study on the impact and out-of-pocket costs of dengue illness in international travelers

Yesim Tozan, Tyler Y. Headley, Maquines Odhiambo Sewe, Eli Schwartz, Tamar Shemesh, Jakob P. Cramer, Kirsten A. Eberhardt, Michael Ramharter, Nicole Harrison, Karin Leder, Andrea Angheben, Christoph Hatz, Andreas Neumayr, Lin Hwei Chen, Cornelis A. De Pijper, Martin P. Grobusch, Annelies Wilder-Smith

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1525-1533
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume100
Issue number6
DOIs
StatePublished - Jan 1 2019

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Cost of Illness
Dengue
Health Expenditures
Prospective Studies
Emerging Communicable Diseases
Travel Medicine
Patient Acceptance of Health Care
Internationality
Ambulatory Care
Population
Hospitalization
Economics
Costs and Cost Analysis

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

A prospective study on the impact and out-of-pocket costs of dengue illness in international travelers. / Tozan, Yesim; Headley, Tyler Y.; Odhiambo Sewe, Maquines; Schwartz, Eli; Shemesh, Tamar; Cramer, Jakob P.; Eberhardt, Kirsten A.; Ramharter, Michael; Harrison, Nicole; Leder, Karin; Angheben, Andrea; Hatz, Christoph; Neumayr, Andreas; Chen, Lin Hwei; De Pijper, Cornelis A.; Grobusch, Martin P.; Wilder-Smith, Annelies.

In: American Journal of Tropical Medicine and Hygiene, Vol. 100, No. 6, 01.01.2019, p. 1525-1533.

Research output: Contribution to journalArticle

Tozan, Y, Headley, TY, Odhiambo Sewe, M, Schwartz, E, Shemesh, T, Cramer, JP, Eberhardt, KA, Ramharter, M, Harrison, N, Leder, K, Angheben, A, Hatz, C, Neumayr, A, Chen, LH, De Pijper, CA, Grobusch, MP & Wilder-Smith, A 2019, 'A prospective study on the impact and out-of-pocket costs of dengue illness in international travelers', American Journal of Tropical Medicine and Hygiene, vol. 100, no. 6, pp. 1525-1533. https://doi.org/10.4269/ajtmh.18-0780
Tozan, Yesim ; Headley, Tyler Y. ; Odhiambo Sewe, Maquines ; Schwartz, Eli ; Shemesh, Tamar ; Cramer, Jakob P. ; Eberhardt, Kirsten A. ; Ramharter, Michael ; Harrison, Nicole ; Leder, Karin ; Angheben, Andrea ; Hatz, Christoph ; Neumayr, Andreas ; Chen, Lin Hwei ; De Pijper, Cornelis A. ; Grobusch, Martin P. ; Wilder-Smith, Annelies. / A prospective study on the impact and out-of-pocket costs of dengue illness in international travelers. In: American Journal of Tropical Medicine and Hygiene. 2019 ; Vol. 100, No. 6. pp. 1525-1533.
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AU - Odhiambo Sewe, Maquines

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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

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