Abstract
Introduction: Kerala is hyperendemic for dengue. Determining State and district specific DALY are crucial in prioritizing, implementing and evaluating actions, but are seldom done. The objective of this study was to compute and compare the DALY due to Dengue in the districts of Kerala for 2014 and 2015.
Methods: DALY was computed using the DALY package, accessible in the R statistical program. The parameters that were inputed are incidence/1000, mortality rate, mean age of mortality, disability weights, proportion of cases treated. Reported incidence/1000 and mortality rates were calculated using the reported cases and deaths from the state surveillance unit. Estimates of dengue incidence/1000 were made using the fever surveillance and sentinel surveillance data. DALY was computed based on reported and estimated dengue burden. Absolute DALY (AD) and Relative DALY (RD) with their 95% CI were computed.
Results: AD and RD was high for some districts and low for others. Thrissur, had the highest in 2014 (AD- 840, RD-26.91/lakh population [95%CI: 11.50-39.60]) and Kasargode (AD-2601; RD-198.95/lakh [95%CI: 85.67-291.42]) in 2015.Thiruvananthapuram recorded the second highest DALY consistently for both years (AD- 801; RD-24.26/lakh [95% CI: 11.27-35.04] and AD-2312; RD- 70.03[95% CI: 30.68-102.71]). Districts with highest incidence were not the same as those with highest DALY.
Conclusion: There is gross inequity in the burden of Dengue in the districts of Kerala. Estimated DALY in some districts are very much higher than the global estimates. Prioritization for action can be misleading if incidence is used as measure of burden.
Keywords: Dengue, DALY, Kerala, Districts, Burden of disease.
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Corresponding Author
Zinia T. Nujum
Associate Professor, Community, Medicine,
Government Medical College, Thiruvananthapuram
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.68
