OBJECTIVES: Chikungunya is an arboviral disease transmitted to humans by CHIKV-infected mosquitoes. Climate change has facilitated the geographic spread of the vector species Aedes albopictus and Aedes aegypti, and recent decades have seen a rapid increase in CHIKV distribution and outbreak frequency. CHIKV is identified as a global health concern, but its economic impact remains unclear. This review aimed to collect and review recent evidence on the global economic burden of CHIKV.

METHODS: An SLR of economic evidence was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Medline and Embase were searched without date restriction, and congress abstract repositories were searched (2019–2021). Inclusion was based on PICOS criteria. A TLR on BOI studies was also performed.

RESULTS: Of 3,146 records identified in the SLR, 65 studies were included: 3 economic modelling studies, 28 cost and resource use studies, and 34 utility studies. The TLR yielded 17 studies. Reported diagnostic and treatment-related costs attributed to CHIKV infection varied widely by region, patient population, and duration and severity of illness. Substantial resource burden was associated with CHIKV outbreaks, including direct costs, indirect costs, and out-of-pocket (OOP) expenditure on healthcare and vector control interventions, with significant implications for low-income households and the impact of CHIKV on poverty. Productivity loss due to acute and chronic chikungunya symptoms was identified as a major contributor to the economic burden of CHIKV. Misdiagnosis and mistreatment of chikungunya as similar arboviral diseases was identified as a possible confounder in measuring disease burden.

CONCLUSIONS: CHIKV infection presents a considerable economic and healthcare burden to society and healthcare systems globally, highlighting the unmet need for effective preventive measures. The heterogeneity of evidence highlights the unpredictability of the disease and shows further research is required to estimate the true economic burden of CHIKV.