The burden of dengue fever in travellers: a systematic literature review

Background: Dengue is a mosquito-borne viral infection with growing global impact, including international travellers travelling to and from endemic regions. This systematic literature review aimed to assess the clinical and economic burden of dengue in travellers from non-endemic countries. Methods: This systematic review was conducted following the PRISMA guidelines to assess the incidence, prevalence, mortality, healthcare resource use, and costs of dengue fever in travellers between non-endemic and endemic regions. We systematically searched MEDLINE, Embase, Google Scholar, PubMed, and Epistemonikos. Due to heterogeneity, data were synthesised descriptively without quantitative analysis. Results: Seventy unique studies were included. Heterogeneity in design, inconsistent reporting, and lack of denominator data limited the ability to calculate incidence rates or compare risks across regions. Two prospective studies provided incidence rates, reaching 58.7 cases per 1000 person-months of travel. No studies reported prevalence data. With three cases, reported mortality was rare. No cost data were identified, but limited data on healthcare resource use were identified from seven publications. Conclusions: Findings highlight the challenges in quantifying individual risk and the need for improved surveillance, prospective data collection, and targeted prevention strategies. These results support improved travel health guidance and may inform vaccination strategies for travellers to endemic regions.