Presentation (CTI)

OBJECTIVES: Japanese encephalitis (JE), a mosquito-borne viral infection causes high fatality and neurological sequelae. Despite the availability of treatments and effective vaccines, the disease burden remains considerable, continuing to pose significant challenges to healthcare systems. This systematic review of literature aimed to identify the economic burden of JE in the Asia-Pacific.
METHODS: A systematic search following PRISMA guidelines was conducted in Embase® (Embase.com) and MEDLINE® (PubMed). English-language articles (2015 onwards), reporting real-world data from observational studies on the economic burden and healthcare resource utilization of JE in the Asia-Pacific, were included.
RESULTS: Of the 445 studies retrieved from biomedical databases, ten were included after primary and secondary screening (China: 4, Bangladesh: 2, Indonesia: 2, Philippines: 1, multi-country: 1). There was variability in the direct medical costs per case, ranging from $106 (Bangladesh) to $1,644 (China). Medical costs in China increased at JE diagnosis, with subsequent year costs remaining significantly higher than pre-diagnosis (p<0.05). Inpatient services, presence of comorbid diabetes, neurological complications, and being adult were associated with higher medical costs. Hospitalization duration varied from 4-759 days, with an average intensive care unit stay of 29 days. Productivity losses showed substantial variation, with workday loss ranging from 5-860 person-days leading to indirect cost of $3.69 million during 2013-2018. Cost related to caregiver absenteeism during child’s average stay of 14 days in hospital was $398.
CONCLUSIONS: This review highlights the significant economic burden of JE in Asia-Pacific, driven by direct medical costs and productivity losses. However, gaps in real-world data, particularly in Japan, and limitations like fragmented/limited data and small sample sizes hinder comprehensive understanding and impact generalizability of the findings. Future research is needed to fill these gaps and inform public health strategies aimed at reducing the economic impact of JE along with efforts to improve vaccination coverage.