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Abstract：
BACKGROUND: Despite its well-regarded vector control program, Singapore remains susceptible to dengue epidemics. To assist evaluation of dengue interventions, we aimed to synthesize current data on the epidemiologic and economic burden of dengue in Singapore.
METHODS: We used multiple databases (PubMed, Embase, Cochrane, international/national repositories, surveillance) to search for published and gray literature (2000-2022). We included observational and cost studies, and two interventional studies, reporting Singapore-specific data on our co-primary outcomes, dengue incidence and dengue-related costs. Quality was assessed using the Newcastle-Ottawa Scale and an adapted cost-of-illness evaluation checklist. We performed a narrative synthesis and grouped studies according to reported outcomes and available stratified analyses.
RESULTS: In total, 333 reports (330 epidemiological, 3 economic) were included. Most published epidemiological studies (89%) and all economic studies were of good quality. All gray literature reports were from the Ministry of Health or National Environment Agency. Based predominantly on surveillance data, Singapore experienced multiple outbreaks in 2000-2021, attaining peak incidence rate in 2020 (621.1 cases/100,000 person-years). Stratified analyses revealed the highest incidence rates in DENV-2 and DENV-3 serotypes and the 15-44 age group. Among dengue cases, the risk of hospitalization has been highest in the ≥45-year-old age groups while the risks of dengue hemorrhagic fever and death have generally been low (both <1%) for the last decade. Our search yielded limited data on deaths by age, severity, and infection type (primary, secondary, post-secondary). Seroprevalence (dengue immunoglobulin G) increases with age but has remained <50% in the general population. Comprising 21-63% indirect costs, dengue-related total costs were higher in 2010-2020 (SGD 148 million) versus the preceding decade (SGD 58-110 million).
CONCLUSIONS: Despite abundant passive surveillance data, more stratified and up-to-date data on the epidemiologic and economic burden of dengue are warranted in Singapore to continuously assess prevention and management strategies.
METHODS: We used multiple databases (PubMed, Embase, Cochrane, international/national repositories, surveillance) to search for published and gray literature (2000-2022). We included observational and cost studies, and two interventional studies, reporting Singapore-specific data on our co-primary outcomes, dengue incidence and dengue-related costs. Quality was assessed using the Newcastle-Ottawa Scale and an adapted cost-of-illness evaluation checklist. We performed a narrative synthesis and grouped studies according to reported outcomes and available stratified analyses.
RESULTS: In total, 333 reports (330 epidemiological, 3 economic) were included. Most published epidemiological studies (89%) and all economic studies were of good quality. All gray literature reports were from the Ministry of Health or National Environment Agency. Based predominantly on surveillance data, Singapore experienced multiple outbreaks in 2000-2021, attaining peak incidence rate in 2020 (621.1 cases/100,000 person-years). Stratified analyses revealed the highest incidence rates in DENV-2 and DENV-3 serotypes and the 15-44 age group. Among dengue cases, the risk of hospitalization has been highest in the ≥45-year-old age groups while the risks of dengue hemorrhagic fever and death have generally been low (both <1%) for the last decade. Our search yielded limited data on deaths by age, severity, and infection type (primary, secondary, post-secondary). Seroprevalence (dengue immunoglobulin G) increases with age but has remained <50% in the general population. Comprising 21-63% indirect costs, dengue-related total costs were higher in 2010-2020 (SGD 148 million) versus the preceding decade (SGD 58-110 million).
CONCLUSIONS: Despite abundant passive surveillance data, more stratified and up-to-date data on the epidemiologic and economic burden of dengue are warranted in Singapore to continuously assess prevention and management strategies.
摘要：
背景：尽管其备受推崇的矢量控制程序，新加坡仍然易受登革热流行的影响。协助评估登革热干预措施，我们旨在综合新加坡登革热流行病学和经济负担的最新数据.
方法：我们使用了多个数据库（PubMed，Embase,科克伦,国际/国家存储库，监视）以搜索已出版和灰色文献（2000-2022年）。我们纳入了观察性和成本性研究，和两项介入研究，报告有关我们共同主要结果的新加坡特定数据，登革热发病率和登革热相关费用。使用纽卡斯尔-渥太华量表和经过调整的疾病成本评估清单评估质量。我们根据报告的结果和可用的分层分析进行了叙述性综合和分组研究。
结果：总计，333份报告（330份流行病学报告，3经济）包括在内。大多数已发表的流行病学研究（89％）和所有经济研究都具有良好的质量。所有灰色文献报告均来自卫生部或国家环境局。主要基于监测数据，新加坡在2000-2021年经历了多次疫情，在2020年达到峰值发病率（621.1例/10万人年）。分层分析显示，DENV-2和DENV-3血清型以及15-44岁年龄组的发病率最高。在登革热病例中，≥45岁年龄组的住院风险最高,而在过去10年中,登革热出血热和死亡风险普遍较低(均<1%).我们的搜索得出的按年龄分类的死亡数据有限，严重程度,和感染类型(原发性，次要,中学后)。血清阳性率（登革热免疫球蛋白G）随年龄增长而增加，但在普通人群中仍<50％。包括21-63%的间接成本，2010-2020年与登革热相关的总成本(1.48亿新元)高于前十年(58-1.1亿新元)。
结论：尽管有大量的被动监测数据，新加坡需要更多有关登革热流行病学和经济负担的分层和最新数据,以持续评估预防和管理策略.
方法：我们使用了多个数据库（PubMed，Embase,科克伦,国际/国家存储库，监视）以搜索已出版和灰色文献（2000-2022年）。我们纳入了观察性和成本性研究，和两项介入研究，报告有关我们共同主要结果的新加坡特定数据，登革热发病率和登革热相关费用。使用纽卡斯尔-渥太华量表和经过调整的疾病成本评估清单评估质量。我们根据报告的结果和可用的分层分析进行了叙述性综合和分组研究。
结果：总计，333份报告（330份流行病学报告，3经济）包括在内。大多数已发表的流行病学研究（89％）和所有经济研究都具有良好的质量。所有灰色文献报告均来自卫生部或国家环境局。主要基于监测数据，新加坡在2000-2021年经历了多次疫情，在2020年达到峰值发病率（621.1例/10万人年）。分层分析显示，DENV-2和DENV-3血清型以及15-44岁年龄组的发病率最高。在登革热病例中，≥45岁年龄组的住院风险最高,而在过去10年中,登革热出血热和死亡风险普遍较低(均<1%).我们的搜索得出的按年龄分类的死亡数据有限，严重程度,和感染类型(原发性，次要,中学后)。血清阳性率（登革热免疫球蛋白G）随年龄增长而增加，但在普通人群中仍<50％。包括21-63%的间接成本，2010-2020年与登革热相关的总成本(1.48亿新元)高于前十年(58-1.1亿新元)。
结论：尽管有大量的被动监测数据，新加坡需要更多有关登革热流行病学和经济负担的分层和最新数据,以持续评估预防和管理策略.
