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Abstract：
BACKGROUND: Dengue is spreading in (sub)tropical areas, and half of the global population is at risk. The macroeconomic impact of dengue extends beyond healthcare costs. This study evaluated the impact of dengue on gross domestic product (GDP) based on approaches tailored to two dengue-endemic countries, Thailand and Brazil, from the tourism and workforce perspectives, respectively.
RESULTS: Because the tourism industry is a critical economic sector for Thailand, lost tourism revenues were estimated to analyze the impact of a dengue outbreak. An input-output model estimated that the direct effects (on international tourism) and indirect effects (on suppliers) of dengue on tourism reduced overall GDP by 1.43 billion US dollars (USD) (0.26%) in the outbreak year 2019. The induced effect (reduced employee income/spending) reduced Thailand\'s GDP by 375 million USD (0.07%). Overall, lost tourism revenues reduced Thailand\'s GDP by an estimated 1.81 billion USD (0.33%) in 2019 (3% of annual tourism revenue). An inoperability input-output model was used to analyze the effect of workforce absenteeism on GDP due to a dengue outbreak in Brazil. This model calculates the number of lost workdays associated with ambulatory and hospitalized dengue. Input was collected from state-level epidemiological and economic data for 2019. An estimated 22.4 million workdays were lost in the employed population; 39% associated with the informal sector. Lost workdays due to dengue reduced Brazil\'s GDP by 876 million USD (0.05%).
CONCLUSIONS: The economic costs of dengue outbreaks far surpass the direct medical costs. Dengue reduces overall GDP and inflicts national economic losses. With a high proportion of the population lacking formal employment in both countries and low income being a barrier to seeking care, dengue also poses an equity challenge. A combination of public health measures, like vector control and vaccination, against dengue is recommended to mitigate the broader economic impact of dengue.
RESULTS: Because the tourism industry is a critical economic sector for Thailand, lost tourism revenues were estimated to analyze the impact of a dengue outbreak. An input-output model estimated that the direct effects (on international tourism) and indirect effects (on suppliers) of dengue on tourism reduced overall GDP by 1.43 billion US dollars (USD) (0.26%) in the outbreak year 2019. The induced effect (reduced employee income/spending) reduced Thailand\'s GDP by 375 million USD (0.07%). Overall, lost tourism revenues reduced Thailand\'s GDP by an estimated 1.81 billion USD (0.33%) in 2019 (3% of annual tourism revenue). An inoperability input-output model was used to analyze the effect of workforce absenteeism on GDP due to a dengue outbreak in Brazil. This model calculates the number of lost workdays associated with ambulatory and hospitalized dengue. Input was collected from state-level epidemiological and economic data for 2019. An estimated 22.4 million workdays were lost in the employed population; 39% associated with the informal sector. Lost workdays due to dengue reduced Brazil\'s GDP by 876 million USD (0.05%).
CONCLUSIONS: The economic costs of dengue outbreaks far surpass the direct medical costs. Dengue reduces overall GDP and inflicts national economic losses. With a high proportion of the population lacking formal employment in both countries and low income being a barrier to seeking care, dengue also poses an equity challenge. A combination of public health measures, like vector control and vaccination, against dengue is recommended to mitigate the broader economic impact of dengue.
摘要：
背景：登革热在（亚）热带地区蔓延，全球一半的人口处于危险之中。登革热的宏观经济影响超出了医疗成本。这项研究根据针对两个登革热流行国家的方法评估了登革热对国内生产总值（GDP）的影响。泰国和巴西,从旅游业和劳动力的角度来看，分别。
结果：因为旅游业是泰国的重要经济部门，估计旅游收入损失，以分析登革热爆发的影响。投入产出模型估计，登革热对旅游业的直接影响（对国际旅游业）和间接影响（对供应商）在2019年爆发年度使整体GDP减少了14.3亿美元（美元）（0.26％）。诱发效应（员工收入/支出减少）使泰国的GDP减少了3.75亿美元（0.07％）。总的来说,2019年，旅游收入的损失使泰国的GDP减少了约18.1亿美元（0.33%）（占年度旅游收入的3%）。使用不可操作性的投入产出模型来分析由于巴西登革热爆发而导致的劳动力缺勤对GDP的影响。该模型计算与门诊和住院登革热相关的损失工作日数。输入来自2019年州一级的流行病学和经济数据。就业人口估计损失了2240万工作日；39%与非正规部门有关。由于登革热造成的工作日损失使巴西的GDP减少了8.76亿美元（0.05％）。
结论：登革热暴发的经济成本远远超过直接医疗成本。登革热降低了整体GDP并造成了国家经济损失。两国缺乏正规就业的人口比例很高，低收入是寻求护理的障碍，登革热也构成了公平挑战。公共卫生措施的结合，比如病媒控制和疫苗接种，建议预防登革热，以减轻登革热对更广泛的经济影响。
结果：因为旅游业是泰国的重要经济部门，估计旅游收入损失，以分析登革热爆发的影响。投入产出模型估计，登革热对旅游业的直接影响（对国际旅游业）和间接影响（对供应商）在2019年爆发年度使整体GDP减少了14.3亿美元（美元）（0.26％）。诱发效应（员工收入/支出减少）使泰国的GDP减少了3.75亿美元（0.07％）。总的来说,2019年，旅游收入的损失使泰国的GDP减少了约18.1亿美元（0.33%）（占年度旅游收入的3%）。使用不可操作性的投入产出模型来分析由于巴西登革热爆发而导致的劳动力缺勤对GDP的影响。该模型计算与门诊和住院登革热相关的损失工作日数。输入来自2019年州一级的流行病学和经济数据。就业人口估计损失了2240万工作日；39%与非正规部门有关。由于登革热造成的工作日损失使巴西的GDP减少了8.76亿美元（0.05％）。
结论：登革热暴发的经济成本远远超过直接医疗成本。登革热降低了整体GDP并造成了国家经济损失。两国缺乏正规就业的人口比例很高，低收入是寻求护理的障碍，登革热也构成了公平挑战。公共卫生措施的结合，比如病媒控制和疫苗接种，建议预防登革热，以减轻登革热对更广泛的经济影响。
