Abstract
Dengue is a rapidly growing public health problem in tropical and sub-tropical regions of the world. These countries are less economically developed and collectively have a current population in excess of three billion and characteristically very high population growth. Quantifying the epidemiological and economic burden of dengue is key to formulating policy decisions on research priorities, prevention programs, clinical training for management of the disease, and the introduction of new technologies such as vaccines, vector control, diagnostics or drugs. This paper describes current knowledge and gaps in measuring global dengue burden and suggests a framework for developing research priorities. There are a number of major challenges. These include lack of uniform application of the World Health Organization (WHO) case definition, limited access to or standardization of dengue diagnostic tests, misdiagnosis, lack of systematic reporting of dengue cases to WHO, limited surveillance and reliable reporting systems, and limited public awareness in endemic regions and incidence of infection among travelers. The published literature contains few studies on dengue disease burden and hence a great deal of research and allocation of limited public health resources is done in the absence of reliable evidence to guide these decisions.