The global burden of dengue: an analysis from the Global Burden of Disease Study 2013

Jeffrey D. Stanaway, Donald S. Shepard, Eduardo A. Undurraga, Yara A. Halasa, Luc Edgar Coffeng, Oliver J. Brady, Simon I. Hay, Neeraj Bedi, Isabela M. Bensenor, Carlos A. Castañeda-Orjuela, Ting-Wu Chuang, Katherine B. Gibney, Ziad A. Memish, Anwar Rafay, Kingsley N. Ukwaja, Naohiro Yonemoto, Christopher J L Murray

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Abstract

Background Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and surveillance data using the Cause of Death Ensemble Modelling tool. We modelled incidence from officially reported cases, and adjusted our raw estimates for under-reporting based on published estimates of expansion factors. In total, we had 1780 country-years of mortality data from 130 countries, 1636 country-years of dengue case reports from 76 countries, and expansion factor estimates for 14 countries. Findings We estimated an average of 9221 dengue deaths per year between 1990 and 2013, increasing from a low of 8277 (95% uncertainty estimate 5353–10 649) in 1992, to a peak of 11 302 (6790–13 722) in 2010. This yielded a total of 576 900 (330 000–701 200) years of life lost to premature mortality attributable to dengue in 2013. The incidence of dengue increased greatly between 1990 and 2013, with the number of cases more than doubling every decade, from 8·3 million (3·3 million–17·2 million) apparent cases in 1990, to 58·4 million (23·6 million–121·9 million) apparent cases in 2013. When accounting for disability from moderate and severe acute dengue, and post-dengue chronic fatigue, 566 000 (186 000–1 415 000) years lived with disability were attributable to dengue in 2013. Considering fatal and non-fatal outcomes together, dengue was responsible for 1·14 million (0·73 million–1·98 million) disability-adjusted life-years in 2013. Interpretation Although lower than other estimates, our results offer more evidence that the true symptomatic incidence of dengue probably falls within the commonly cited range of 50 million to 100 million cases per year. Our mortality estimates are lower than those presented elsewhere and should be considered in light of the totality of evidence suggesting that dengue mortality might, in fact, be substantially higher. Funding Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)712-723
Number of pages12
JournalThe Lancet Infectious Diseases
Volume16
Issue number6
DOIs
Publication statusPublished - Jun 1 2016

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Dengue
Mortality
Incidence
Arbovirus Infections
Global Burden of Disease
Severe Dengue
Premature Mortality
Quality-Adjusted Life Years
Uncertainty
Fatigue
Cause of Death
Autopsy

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Stanaway, J. D., Shepard, D. S., Undurraga, E. A., Halasa, Y. A., Coffeng, L. E., Brady, O. J., ... Murray, C. J. L. (2016). The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. The Lancet Infectious Diseases, 16(6), 712-723. https://doi.org/10.1016/S1473-3099(16)00026-8

The global burden of dengue : an analysis from the Global Burden of Disease Study 2013. / Stanaway, Jeffrey D.; Shepard, Donald S.; Undurraga, Eduardo A.; Halasa, Yara A.; Coffeng, Luc Edgar; Brady, Oliver J.; Hay, Simon I.; Bedi, Neeraj; Bensenor, Isabela M.; Castañeda-Orjuela, Carlos A.; Chuang, Ting-Wu; Gibney, Katherine B.; Memish, Ziad A.; Rafay, Anwar; Ukwaja, Kingsley N.; Yonemoto, Naohiro; Murray, Christopher J L.

In: The Lancet Infectious Diseases, Vol. 16, No. 6, 01.06.2016, p. 712-723.

Research output: Contribution to journalArticle

Stanaway, JD, Shepard, DS, Undurraga, EA, Halasa, YA, Coffeng, LE, Brady, OJ, Hay, SI, Bedi, N, Bensenor, IM, Castañeda-Orjuela, CA, Chuang, T-W, Gibney, KB, Memish, ZA, Rafay, A, Ukwaja, KN, Yonemoto, N & Murray, CJL 2016, 'The global burden of dengue: an analysis from the Global Burden of Disease Study 2013', The Lancet Infectious Diseases, vol. 16, no. 6, pp. 712-723. https://doi.org/10.1016/S1473-3099(16)00026-8
Stanaway JD, Shepard DS, Undurraga EA, Halasa YA, Coffeng LE, Brady OJ et al. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. The Lancet Infectious Diseases. 2016 Jun 1;16(6):712-723. https://doi.org/10.1016/S1473-3099(16)00026-8
Stanaway, Jeffrey D. ; Shepard, Donald S. ; Undurraga, Eduardo A. ; Halasa, Yara A. ; Coffeng, Luc Edgar ; Brady, Oliver J. ; Hay, Simon I. ; Bedi, Neeraj ; Bensenor, Isabela M. ; Castañeda-Orjuela, Carlos A. ; Chuang, Ting-Wu ; Gibney, Katherine B. ; Memish, Ziad A. ; Rafay, Anwar ; Ukwaja, Kingsley N. ; Yonemoto, Naohiro ; Murray, Christopher J L. / The global burden of dengue : an analysis from the Global Burden of Disease Study 2013. In: The Lancet Infectious Diseases. 2016 ; Vol. 16, No. 6. pp. 712-723.
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abstract = "Background Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and surveillance data using the Cause of Death Ensemble Modelling tool. We modelled incidence from officially reported cases, and adjusted our raw estimates for under-reporting based on published estimates of expansion factors. In total, we had 1780 country-years of mortality data from 130 countries, 1636 country-years of dengue case reports from 76 countries, and expansion factor estimates for 14 countries. Findings We estimated an average of 9221 dengue deaths per year between 1990 and 2013, increasing from a low of 8277 (95{\%} uncertainty estimate 5353–10 649) in 1992, to a peak of 11 302 (6790–13 722) in 2010. This yielded a total of 576 900 (330 000–701 200) years of life lost to premature mortality attributable to dengue in 2013. The incidence of dengue increased greatly between 1990 and 2013, with the number of cases more than doubling every decade, from 8·3 million (3·3 million–17·2 million) apparent cases in 1990, to 58·4 million (23·6 million–121·9 million) apparent cases in 2013. When accounting for disability from moderate and severe acute dengue, and post-dengue chronic fatigue, 566 000 (186 000–1 415 000) years lived with disability were attributable to dengue in 2013. Considering fatal and non-fatal outcomes together, dengue was responsible for 1·14 million (0·73 million–1·98 million) disability-adjusted life-years in 2013. Interpretation Although lower than other estimates, our results offer more evidence that the true symptomatic incidence of dengue probably falls within the commonly cited range of 50 million to 100 million cases per year. Our mortality estimates are lower than those presented elsewhere and should be considered in light of the totality of evidence suggesting that dengue mortality might, in fact, be substantially higher. Funding Bill & Melinda Gates Foundation.",
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AU - Coffeng, Luc Edgar

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N2 - Background Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and surveillance data using the Cause of Death Ensemble Modelling tool. We modelled incidence from officially reported cases, and adjusted our raw estimates for under-reporting based on published estimates of expansion factors. In total, we had 1780 country-years of mortality data from 130 countries, 1636 country-years of dengue case reports from 76 countries, and expansion factor estimates for 14 countries. Findings We estimated an average of 9221 dengue deaths per year between 1990 and 2013, increasing from a low of 8277 (95% uncertainty estimate 5353–10 649) in 1992, to a peak of 11 302 (6790–13 722) in 2010. This yielded a total of 576 900 (330 000–701 200) years of life lost to premature mortality attributable to dengue in 2013. The incidence of dengue increased greatly between 1990 and 2013, with the number of cases more than doubling every decade, from 8·3 million (3·3 million–17·2 million) apparent cases in 1990, to 58·4 million (23·6 million–121·9 million) apparent cases in 2013. When accounting for disability from moderate and severe acute dengue, and post-dengue chronic fatigue, 566 000 (186 000–1 415 000) years lived with disability were attributable to dengue in 2013. Considering fatal and non-fatal outcomes together, dengue was responsible for 1·14 million (0·73 million–1·98 million) disability-adjusted life-years in 2013. Interpretation Although lower than other estimates, our results offer more evidence that the true symptomatic incidence of dengue probably falls within the commonly cited range of 50 million to 100 million cases per year. Our mortality estimates are lower than those presented elsewhere and should be considered in light of the totality of evidence suggesting that dengue mortality might, in fact, be substantially higher. Funding Bill & Melinda Gates Foundation.

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