IMPACT OF A DENGUE EPISODE ON QUALITY OF LIFE OR DALYS: SYSTEMATIC REVIEW

• Published in: Value in health Vol. 20; no. 5; p. A80
• Main Authors: Shepard, DS, Zeng, W, Halasa, YA, Durand, L, Coudeville, L
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.05.2017
• Subjects: Cost analysis; Dengue fever; Disability adjusted life years; Hospitalized; Immunization; Infections; Intervention; Literature reviews; Quality adjusted life years; Quality of life; Recovery; Systematic review; Vaccination; Vector-borne diseases
• ISSN: 1098-3015; 1524-4733

OBJECTIVES: With about 4,000 times as many symptomatic non-fatal dengue cases as dengue deaths, quantitative disability assessments are critical to assessing the cost-effectiveness of dengue control interventions. Yet, most cost-effectiveness studies assess disability only subjectively or through proxy conditions (e.g., any acute infection). To strengthen the needed evidence base, we conducted a systematic literature review of the disability or quality of life lost from a symptomatic dengue episode. METHODS: We searched major data bases for entries in English, Spanish, Portuguese or French through 2016 with "dengue" combined with "quality of life" or disability, quality-adjusted life year, QALY, disability-adjusted life year, DALY, or foreign equivalents. We first examined titles and abstracts from Cochrane Database of Systematic Reviews, PubMed, POPLINE, EconLit, and Google Scholar for relevance. We next excluded duplicates, obtained the full text of relevant entries, and analyzed entries with numerical quality-of-life assessments. We scored these entries' relevance using a 6-attribute scale (0-100%). Fitting level of disability (0.00-1.00) as a function of time from the dengue episode's start until recovery, we computed the average duration, average loss per day, and episode loss in DALYs (area under the disability curve). RESULTS: We identified 4,335 entries, reviewed full text of 17, and found 6 meeting our criteria (Armien, 2008; Lum, 2008; Luengas, 2016; Martelli, 2011; Nguyen, 2013; Whitehorn, 2016). Their median score was 76% (range 58-89%). All but Luengas studied acute cases, giving the following medians (with ranges) for ambulatory episodes: duration in days 10.2 (9.5-20.0), disability weight 0.500 (0.235-0.800), and area 0.0162 (0.0041-0.0367). For studies including hospitalized episodes, disability ranged 16%-47% higher than for ambulatory episodes. CONCLUSIONS: As the burden of dengue episodes varies across sites, pooled results are more robust. This systematic review should contribute to evidence-based effectiveness measures for cost-effectiveness studies of vaccination, vector control and other dengue control interventions.