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Clinical Characteristics and National Economic Cost of the 2005 Dengue Epidemic in Panama

In 2005, Panama experienced the largest dengue epidemic since 1993. We conducted both a prospective clinical and a national economic study. The full cost analysis measured costs of dengue cases and of dengue control efforts in the entire country. Costs are in 2005 US$. Ambulatory patients were 130 of the 136 participants, with 82% adults (18+) and 62% women. Duration of fever and illness averaged 6.1 (standard deviation [SD], 5.3) and 21.2 (SD 13.5) days, respectively. Loss in quality of life averaged 67% (SD 21) during the worst days of illness. An average ambulatory and hospitalized case cost $332 and $1,065, respectively. Although 5,489 cases were officially reported, the Ministry of Health (MOH) estimated 32,900 actual cases, implying a total cost of $11.8 million. Additionally, estimated government spending on dengue control efforts was $5 million. This dengue epidemic had a major disease impact and an economic cost of $16.9 million ($5.22 per capita).

Received January 16, 2008. Accepted for publication June 11, 2008.

Acknowledgments: This research was supported in part by the Pediatric Dengue Vaccine Initiative (PDVI). We thank the following colleagues for their assistance and support in study implementation and provision of secondary data. Ministry of Health of Panama: Camilo Alleyne, MD, Jorge Prosperi, MD, Itza Mosca, MD; Social Security System of Panama: Rosario Turner, MD, Julia Garcia, MD, Daniel Saldaña, MD, Emilia Rellan, MSc, Francisco Mayorga, BA; Gorgas Memorial Institute: Jorge Motta, MD, Elsie Madrid, BA, Itzy Gonza-lez, RN, Xiomara Campos, RN, Damaris Campos, Ruth Halleby, Neida Gonzalez; Hospital Santo Tomas: Gerardo Victoria, MD, Elda Velarde, MD, Carlos Archibolt, MD, Jose Luis Rodriguez, BA; Hospital del Niño: Luis Coronado MD, Gloria César, Damaris Vásquez, Julio Alcedo, BA; Hospital Nacional: Ivana de Medrano; Clinica Hospital Paitilla: Vilma de Arias; Hospital San Fernando: Edgardo Fernandez, MD; Translation: Rosa EC de Vargas; Brandeis University: Mariana Caram, MA, Rana Sughayyar, MS, Martha Baez, MA, Ali MacLean, MS, Erika Moldow, PhD, Clare Hurley, MM, and Chrisann Newransky, MA.

Financial support: This research was supported by research agreements from the Pediatric Dengue Vaccine Initiative (PDVI) to GMI and Brandeis University and by the endowment of the Schneider Institutes for Health Policy, Brandeis University.

^* Address correspondence to Jose A. Suaya, Schneider Institutes for Health Policy, Heller School, MS 035, Brandeis University, Waltham, MA 02454-9110. E-mail: jsuaya{at}brandeis.edu

Authors’ addresses: Blas Armien, Department of Genomics and Pro-teomics, Instituto Conmemorativo Gorgas de Estudio de la Salud de Panamá, Panamá, Tel: +507-527-4838, Fax: +507-527-4869, E-mails: barmien{at}gorgas.gob.pa and blasarmien{at}yahoo.com.mx. Jose A. Suaya, Schneider Institutes for Health Policy, Heller School, MS 035, Brandeis University, Waltham, MA 02454-9110, Tel: 781-736-3904, Fax: 781-736-1905, E-mail: jsuaya{at}brandeis.edu. Evelia Quiroz, Department of Virology, Instituto Conmemorativo Gorgas de Estudio de la Salud de Panamá Panamá, Tel: +507-527-4838, Fax: +507-527-4869, E-mail: evequiroz2000{at}yahoo.com. Binod K. Sah and Donald S. Shepard, Schneider Institutes for Health Policy, Heller School, MS 035, Brandeis University, Waltham, MA 02454-9110, Tel: 781-736-3975, Fax: 888-429-2672, E-mails: bsah{at}brandeis.edu and shepard{at}brandeis.edu. Vicente Bayard, Epidemiology Unit, Insti-tuto Conmemorativo Gorgas de Estudio de la Salud de Panamá, Panamá, Tel: +507-527-4811, Fax: +507-527-4866, E-mail: vbayard{at}gorgas.gob.pa. Loyd Marchena, Research Unit, Instituto Conmemo-rativo Gorgas de Estudio de la Salud de Panamá, Panamá, Tel: +507-527-4838, Fax: +507-527-4869, E-mail: lmarchena{at}gorgas.gob.pa. Cornelio Campos, Bch Vector Control Department, Ministry of Health of Panamá, Panamá, Tel: +507-512-9326, Fax: +507-512-9496, E-mail: cornelio.campos{at}hotmail.com.

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