Assessing the epidemiological and economic impact of dengue from 1990 to 2021 in Indonesia

Problem considered Dengue fever remains a significant public health problem in Indonesia, one of the country's most severely affected in Southeast Asia. Despite ongoing control efforts, the disease continues to cause major health and economic impacts. This study aimed to evaluate the epidemiological and economic impact of dengue. Method An ecological time-trend analysis was performed using secondary data from the Global Burden of Disease (GBD) 2021 database, national health statistics, and provincial minimum wage data. Dengue incidence, mortality, and DALYs were mapped and quantified across 34 provinces, and economic losses were estimated using a human capital approach. Geospatial analyses visualized regional disparities. Results Indonesia's age-standardized dengue incidence peaked in 2015 (912.4 per 100,000 among males; 1,076.7 among females). Females showed consistently higher incidence, while males experienced higher mortality; DALYs increased sharply between 2005 and 2017 before stabilizing. The highest DALYs and economic losses (>IDR 6 trillion combined) were observed in West Java, East Java, and Central Java. Marked geographic disparities correlated with variations in population density, healthcare access, and vector control capacity. Conclusion Dengue imposes a heavy and sustained health and financial burden in Indonesia, with dense provinces most impacted. Interventions such as strengthened surveillance, region-specific vector control, improved urban sanitation, and expanded healthcare access are essential to limit further losses. Economic analysis highlights urgent needs for resource allocation and locally tailored responses to mitigate dengue's impact.