Browsing by Author "Shepard, Donald S."
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- ItemEnrollment of dengue patients in a prospective cohort study in Umphang District, Thailand, during the COVID‐19 pandemic: Implications for research and policy(2023) Shepard, Donald S.; Agarwal‐Harding, Priya; Jiamton, Sukhum; Undurraga Fourcade, Eduardo Andrés; Kongsin, SukhonthaDengue is endemic in Thailand and imposes a high burdenon the health system and society. We conducted a prospective cohort study inUmphang District, Tak Province, Thailand, to investigate the share of dengue caseswith long symptoms and their duration. Here we present the results of theenrollment process during the COVID‐19 pandemic with implications andchallenges for research and policy.
- ItemPersistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico(2015) Carolina Tiga, D.; Undurraga Fourcade, Eduardo Andrés; Ramos-Castaneda, Jose; Martinez-Vega, Ruth; Halasa, Yara A.; Shepard, Donald S.Dengue is mostly considered an acute illness with three phases: febrile, critical with possible hemorrhagic manifestations, and recovery. But some patients present persistent symptoms, including fatigue and depression, as acknowledged by the World Health Organization. If persistent symptoms affect a non-negligible share of patients, the burden of dengue will be underestimated. On the basis of a systematic literature review and econometric modeling, we found a significant relationship between the share of patients reporting persisting symptoms and time. We updated estimates of the economic burden of dengue in Mexico, addressing uncertainty in productivity loss and incremental expenses using Monte Carlo simulations. Persistent symptoms represent annually about US$22.6 (95% certainty level [CL]: US$13–US$29) million in incremental costs and 28.2 (95% CL: 21.6–36.2) additional disability-adjusted life years per million population, or 13% and 43% increases over previous estimates, respectively. Although our estimates have uncertainty from limited data, they show a substantial, unmeasured burden. Similar patterns likely extend to other dengue-endemic countries.