Immediate cost of dengue to Malaysia and Thailand: An estimate

Dengue Bulletin – Volume 34, 2010


Lee HL, Vasan SS, Birgelen L, Murtola TM, Gong HF, Field RW, Mavalankar DV, Nazni WA, Lokman SH, Murad S, Wan NC, Lum CS, Suaya JA, Shepard DS


WHO Collaborating Centre for Ecology, Taxonomy and Control of Vectors of Malaria, Filariasis and Dengue, Institute for Medical Research, Medical Entomology Section, Ministry of Health Malaysia. E-mail:; Tel and fax: +603 2616-2688
University of Malaya, Centre for Research in Biotechnology for Agriculture (CEBAR), IPS Building, Kuala Lumpur, Malaysia
Oxitec Limited, 71 Milton Park, Oxford OX14 4RX, UK
University of Oxford, Department of Engineering Science, Parks Road, Oxford, UK
Aalto University, Department of Mathematics and Systems Analysis, Aalto, Finland
Centre for Management of Health Services, Indian Institute of Management, Vastrapur, Ahmedabad, India
University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, Kuala Lumpur, Malaysia
University of Malaya, Department of Paediatrics, Faculty of Medicine, Kuala Lumpur, Malaysia
Brandeis University, Schneider Institutes for Health Policy, Heller School, Waltham, USA


We have analysed the average annual cost of dengue in Malaysia during the period 2002–2007 and in Thailand between 2000 and 2005. The key cost components, estimated by combining existing data from both published and unpublished studies, consist of: (i) costs of non-fatal illness; (ii) vector (Aedes mosquitoes) control costs; and (iii) research and development (R&D) costs incurred by government institutions.

We found the immediate cost of dengue to Malaysia to be in the range of US$ 88 million to US$ 215 million (mean US$ 133 million) per annum. For Thailand, the corresponding range is US$ 56 million to US$ 264 million (mean US$ 135 million) per annum. For the period analysed, Thailand has 3.6 times more total cases of dengue, but Malaysia has a 4.6 times higher cost per case. In Malaysia, the most important parameters creating uncertainty in the immediate cost are reporting rate, hospitalization rate, and cost per ambulatory case. The corresponding parameters in Thailand are cost per ambulatory case, cost per hospitalized case, and reporting rate. Better estimates of cost per ambulatory case and reporting rate are therefore needed for both countries. Future studies should also refine the estimates of hospitalization rate in Malaysia and the cost per hospitalized case in Thailand.

Malaysia’s immediate cost of dengue is substantial and is equivalent to 3%–7% of the government’s spending on health care. According to our estimates the illness costs due to dengue are 11 times (range 5 to 28 times) the amount of government spending on Aedes vector control in Malaysia, and 13 times (range 1 to 106 times) the government’s spending on Aedes vector control in Thailand. This relationship shows that increased investment on prevention could potentially generate large offsets in illness costs. In addition to the immediate costs reported here, dengue may also adversely impact tourism and create emotional and long-term burdens on families affected by illness and deaths.


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