Volume 93, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Dengue fever, an arbovirus disease transmitted by mosquitoes, has recently spread rapidly, especially in the tropical countries of the Americas and Asia-Pacific regions. It is endemic in Malaysia, with an annual average of 37,937 reported dengue cases from 2007 to 2012. This study measured the overall economic impact of dengue in Malaysia, and estimated the costs of dengue prevention. In 2010, Malaysia spent US$73.5 million or 0.03% of the country's GDP on its National Dengue Vector Control Program. This spending represented US$1,591 per reported dengue case and US$2.68 per capita population. Most (92.2%) of this spending occurred in districts, primarily for fogging. A previous paper estimated the annual cost of dengue illness in the country at US$102.2 million. Thus, the inclusion of preventive activities increases the substantial estimated cost of dengue to US$175.7 million, or 72% above illness costs alone. If innovative technologies for dengue vector control prove efficacious, and a dengue vaccine was introduced, substantial existing spending could be rechanneled to fund them.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Guzman A, Istúriz RE, , 2010. Update on the global spread of dengue. Int J Antimicrob Agents 36S: S40S42.[Crossref] [Google Scholar]
  2. Halstead SB, , 2007. Dengue. Lancet 370: 16441652.[Crossref] [Google Scholar]
  3. Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF, George DB, Jaenisch T, Wint GRW, Simmons CP, Scott TW, Farrar JJ, Hay SI, , 2013. The global distribution and burden of dengue. Nature 496: 504507.[Crossref] [Google Scholar]
  4. Shepard DS, Undurraga EA, Halasa YA, , 2013. Economic and disease burden of dengue in southeast Asia. PLoS Negl Trop Dis 7: e2055.[Crossref] [Google Scholar]
  5. Suaya JA, Shepard DS, Siqueira JB, Martelli CT, Lum LCS, Tan LH, Kongsin S, Jiamton S, Garrido F, Montoya R, Armien B, Huy R, Castillo L, Caram M, Sah BK, Sughayyar R, Tyo KR, Halstead SB, , 2009. Cost of dengue cases in eight countries in the Americas and Asia: a prospective study. Am J Trop Med Hyg 80: 846855. [Google Scholar]
  6. Undurraga EA, Halasa YA, Shepard DS, , 2013. Use of expansion factors to estimate the burden of dengue in southeast Asia: a systematic analysis. PLoS Negl Trop Dis 7: e2056.[Crossref] [Google Scholar]
  7. Lam SK, , 1993. Two decades of dengue in Malaysia. Trop Med 35: 195200. [Google Scholar]
  8. Poovaneswari S, , 1993. Dengue situation in Malaysia. Malays J Pathol 15: 37. [Google Scholar]
  9. Al-Muhandis N, Hunter PR, , 2011. The value of educational messages embedded in a community-based approach to combat dengue fever: a systematic review and meta regression analysis. PLoS Negl Trop Dis 5: e1278.[Crossref] [Google Scholar]
  10. World Health Organization, 2014. Update on the Dengue Situation in the Western Pacific Region. Available at: http://www.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/#content. Accessed August 24, 2014. [Google Scholar]
  11. Shepard DS, Undurraga EA, Lees RS, Halasa YA, Lum LCS, Ng CW, , 2012. Use of multiple data sources to estimate the economic cost of dengue illness in Malaysia. Am J Trop Med Hyg 87: 796805.[Crossref] [Google Scholar]
  12. Shepard DS, Undurraga E, Lees R, Halasa YA, Lum LCS, Ng C, , 2013. Errata. Am J Trop Med Hyg 88: 606.[Crossref] [Google Scholar]
  13. Ministry of Health Malaysia, 2008. Vector Borne Diseases Control Sector. Putrajaya, Malaysia: Disease Control Division, MoH Malaysia. [Google Scholar]
  14. Capeding MR, Tran NH, Hadinegoro SRS, Ismail HIHJM, Chotpitayasunondh T, Chua MN, Luong CQ, Rusmil K, Wirawan DN, Nallusamy R, Pitisuttithum P, Thisyakorn U, Yoon I-K, van der Vliet D, Langevin E, Laot T, Hutagalung Y, Frago C, Boaz M, Wartel TA, Tornieporth NG, Saville M, Bouckenooghe A, , 2014. Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial. Lancet 384: 13581365.[Crossref] [Google Scholar]
  15. Huet N, , 2014. Final Trial Confirms Efficacy of Sanofi's Dengue Vaccine. Reuters Edition U.S. Available at: http://www.reuters.com/article/2014/09/03/us-sanofi-dengue-idUSKBN0GY0C520140903. Accessed October 3, 2014. [Google Scholar]
  16. Lacroix R, McKemey AR, Raduan N, Wee LK, Ming WH, Ney TG, Siti Rahidah AA, Salman S, Subramaniam S, Nordin O, Norhaida Hanum AT, Angamuthu C, Mansor SM, Lees RS, Naish N, Scaife S, Gray P, Labbé G, Beech C, Nimmo D, Alphey L, Vasan SS, Lim LH, Wasi AN, Murad S, , 2012. Open field release of genetically engineered sterile male Aedes aegypti in Malaysia. PLoS One 7: e42771.[Crossref] [Google Scholar]
  17. Hoffmann AA, Montgomery BL, Popovici J, Iturbe-Ormaetxe I, Johnson PH, Muzzi F, Greenfield M, Durkan M, Leong YS, Dong Y, Cook H, Axford J, Callahan AG, Kenny N, Omodei C, McGraw EA, Ryan PA, Ritchie SA, Turelli M, O'Neill SL, , 2011. Successful establishment of Wolbachia in Aedes populations to suppress dengue transmission. Nature 476: 454457.[Crossref] [Google Scholar]
  18. Gubler DJ, , 2002. How effectively is epidemiological surveillance used for dengue programme planning and epidemic response? Dengue Bull 26: 96106. [Google Scholar]
  19. Lim LH, Vasan SS, Birgelen L, Murtola TM, Hong-Fei G, Field RW, Mavalankar DV, Ahmad NW, Hakim LS, Murad S, Ng CW, Lum LCS, Suaya JA, Shepard DS, , 2010. Immediate cost of dengue to Malaysia and Thailand: an estimate. Dengue Bull 34: 7788. [Google Scholar]
  20. Coller BAG, Clements DE, , 2011. Dengue vaccines: progress and challenges. Curr Opin Immunol 23: 391398.[Crossref] [Google Scholar]
  21. Ministry of Health Malaysia, 2008. Health Facts. Available at: http://www.moh.gov.my/images/gallery/stats/heal_fact/health_fact_2008_page_by_page.pdf. Accessed May 29, 2014. [Google Scholar]
  22. Ministry of Health Malaysia, 2009. Health Facts. Available at: http://www.moh.gov.my/images/gallery/stats/heal_fact/healthfact-P_2009.pdf. Accessed May 29, 2014. [Google Scholar]
  23. Ministry of Health Malaysia, 2010. Health Facts. Available at: http://www.moh.gov.my/images/gallery/stats/heal_fact/health_facts_2010.pdf. Accessed May 29, 2014. [Google Scholar]
  24. Ministry of Health Malaysia, 2012. Health Facts. Available at: http://www.moh.gov.my/images/gallery/stats/heal_fact/health_fact_2012_page_by_page.pdf. Accessed May 29, 2014. [Google Scholar]
  25. Ministry of Health Malaysia, 2013. Health Facts. Available at: http://www.youblisher.com/p/723128-MOH-Malaysia/. Accessed May 29, 2014. [Google Scholar]
  26. Turner AG, , 2003. Sampling Strategies. Statistics Division, United Nation Secretariat. Available at: http://unstats.un.org/unsd/demographic/meetings/egm/Sampling_1203/docs/no_2.pdf. Accessed May 14, 2011. [Google Scholar]
  27. Wordsworth S, Ludbrook A, Caskey F, Macleod A, , 2005. Collecting unit cost data in multicentre studies; creating comparable methods. Eur J Health Econ 50: 3844.[Crossref] [Google Scholar]
  28. Creese A, Parker D, , 1994. Cost Analysis in Primary Health Care: A Training Manual for Programme Managers. Geneva, Switzerland: World Health Organization. [Google Scholar]
  29. Shepard DS, Hodgkin D, Anthony YE, , 2000. Analysis of Hospital Costs: A Manual for Managers. World Health Organization. Available at: http://people.brandeis.edu/∼shepard/w-manual.PDF. Accessed January 5, 2012. [Google Scholar]
  30. Gold M, Siegel J, Russell L, Weinstein M, , Eds., 1996. Cost-Effectiveness in Health and Medicine. New York, NY: Oxford University Press. [Google Scholar]
  31. Department of Statistics Malaysia, 2011. Malaysian Economic Statistics Report Time Series 2011. Available at: www.statistics.gov.my/portal/download_Economics/files/DATA_SERIES/2011/Penerbitan_Time_Series_2011.pdf. Accessed September 23, 2012. [Google Scholar]
  32. Yansaneh IS, , 2003. Construction and Use of Sample Weights: Expert Group Meeting to Review the Draft Handbook on Designing of Household Sample Surveys. United Nations Secretariat, Statistics Division. Available at: http://unstats.un.org/unsd/demographic/meetings/egm/Sampling_1203/docs/no_5.pdf. Accessed August 3, 2012. [Google Scholar]
  33. Ministry of Health Malaysia, 2010. Health Indicators 2010. Indicators for Monitoring and Evaluation of Strategy Health for All. Health Informatics Centre, Planning and Development Unit. Available at: http://www.moh.gov.my/images/gallery/publications/md/hi/hi_2010.pdf. Accessed October 16, 2013. [Google Scholar]
  34. Director General of Health Malaysia, 2011. Current Situation of Dengue Fever and Chikungunya in Malaysia for Week 52/2010 [Press Statement]. Available at: https://www.google.com.my/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0CC4QFjAB&url=http%3A%2F%2Fwww.moh.gov.my%2Findex.php%2Fdatabase_stores%2Fattach_download%2F337%2F78&ei=wBl-U93_H4718QWD9ID4Dw&usg=AFQjCNFasCpa8zx5GEs5OfKgjA_JL0YOsg&bvm=bv.67229260,d.dGc. Accessed May 22, 2014. [Google Scholar]
  35. The World Bank, 2014. GDP (Current US$). Available at: http://data.worldbank.org/indicator/NY.GDP.MKTP.CD. Accessed September 10, 2014. [Google Scholar]
  36. Ministry of Health Malaysia, 2013. Malaysia National Health Accounts. Health Expenditure Report (1997–2011). Available at: http://hklg.moh.gov.my/files/MNHA_health.pdf. Accessed April 18, 2014. [Google Scholar]
  37. Suaya JA, Shepard DS, Moh-Seng C, Caram M, Hoyer S, Socheat D, Chantha N, Nathan MB, , 2007. Cost-effectiveness of annual targeted larviciding campaigns in Cambodia against the dengue vector Aedes aegypti . Trop Med Int Health 12: 10261036.[Crossref] [Google Scholar]
  38. Carrasco LR, Lee LK, Lee VJ, Ooi EE, Shepard DS, Thein TL, Gan V, Cook AR, Lye D, Ng LC, Leo YS, , 2011. Economic impact of dengue illness and the cost-effectiveness of future vaccination programs in Singapore. PLoS Negl Trop Dis 5: el426.[Crossref] [Google Scholar]
  39. Kongsin S, Jiamton S, Suaya JA, Vasanawathanad S, Sirisuvana P, Shepard DS, , 2010. Cost of dengue in Thailand. Dengue Bull 34: 7788. [Google Scholar]
  40. Chan HH, Mustafa FFW, Zairi J, , 2011. Assessing the susceptibility status of Aedes albopictus on Penang Island using two different assays. Trop Biomed 28: 464470. [Google Scholar]
  41. Esu E, Lenhart A, Smith L, Horstick O, , 2010. Effectiveness of peridomestic space spraying with insecticide on dengue transmission; systematic review. Trop Med Int Health 15: 619631. [Google Scholar]
  42. Koenraadt CJM, Aldstadt J, Kijchalao U, Kengluecha A, Jones JW, Scott TW, , 2007. Spatial and temporal patterns in the recovery of Aedes aegypti (Diptera: Culicidae) populations after insecticide treatment. J Med Entomol 44: 6571.[Crossref] [Google Scholar]
  43. Shafie FA, Mohd Tahir MP, Sabri NM, , 2012. Aedes mosquitoes resistance in urban community setting. Procedia Soc Behav Sci 36: 7076.[Crossref] [Google Scholar]
  44. Thammapalo S, Meksawi S, Chongsuvivatwong V, , 2012. Effectiveness of space spraying on the transmission of dengue/dengue hemorrhagic fever (df/dhf) in an urban area of southern Thailand. J Trop Med 2012: 652564.[Crossref] [Google Scholar]
  45. Lloyd LS, Winch P, Ortega-Canto J, Kendall A, , 1994. The design of a community-based health education intervention for the control of Aedes aegypti . Am J Trop Med Hyg 50: 401411. [Google Scholar]
  46. Renganathan E, Parks W, Lloyd L, Nathan MB, Hosein E, Odugleh A, Clark GG, Gubler DJ, Prasittisuk C, Palmer K, San Martín J-L, , 2003. Towards sustaining behavioural impact in dengue prevention and control. Dengue Bull 27: 612. [Google Scholar]
  47. Wong LP, AbuBakar S, , 2013. Health beliefs and practices related to dengue fever: a focus group study. PLoS Negl Trop Dis 7: e2310.[Crossref] [Google Scholar]
  48. Nathan Y, , 2013. MPSJ Combats Dengue in Puchong. Star Publications. Available at: http://www.thestar.com.my/News/Community/2013/10/05/MPSJ-combats-dengue-in-Puchong-Toxorhynchites-mosquitoes-released-at-Sri-Tanjung-Apartments/. Accessed October 16, 2014. [Google Scholar]

Data & Media loading...

  • Received : 21 Oct 2014
  • Accepted : 20 Aug 2015
  • Published online : 04 Nov 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error