Direct Medical Costs of Hospitalized Dengue Fever in Muscat Governorate, Oman (2022-2023): A Retrospective Cross-Sectional Cost-of-Illness Study

Direct Medical Costs of Hospitalized Dengue Fever in Muscat Governorate, Oman (2022-2023): A Retrospective Cross-Sectional Cost-of-Illness Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Direct Medical Costs of Hospitalized Dengue Fever in Muscat Governorate, Oman (2022-2023): A Retrospective Cross-Sectional Cost-of-Illness Study Ibtisam Khalifa Al-Maskari, Sanjay Jaju, Zainab Mahmood Al-Zadjali, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8899461/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives: Dengue fever (DF) is a re-emerging mosquito-borne viral infection posing a major public health concern in tropical and subtropical regions, including Oman. While the clinical burden is well documented, data on its economic impact remain limited, particularly direct medical costs of hospitalized cases. This study estimated direct medical costs of managing admitted DF cases in two tertiary hospitals in Muscat Governorate, Oman, during 2022–2023 from provider perspective. Methods: A retrospective, cross-sectional cost-of-illness study used national surveillance and hospital electronic records. Laboratory-confirmed dengue patients admitted during 2022–2023 were included. Costs were estimated using a bottom-up micro-costing approach. Results: Among 345 hospitalized patients (98.6% locally acquired), total direct medical costs were OMR 113,097 (~ INT $ 628,316 using 2024 World Bank PPP conversion factor for private consumption), Mean per-patient costs increased from OMR 173 in 2022 to OMR 301 in 2023. Laboratory investigations (53%) and hospitalization (34%) dominated costs, and hospital stay accounted for most of the total costs. Costs were substantially higher in severe dengue (Group C), patients with complications, and those aged ≥ 50 years. Cluster analysis revealed five patient profiles, with the highest costs in older age with severe disease and complications. Conclusions: Hospitalized dengue imposes a substantial and increasing economic burden on Oman's healthcare system. Early diagnosis, outpatient management of mild cases, and targeted prevention for high-risk groups could help reduce avoidable hospitalizations and costs, informing resource allocation and policy. Epidemiology Statistical Epidemiology dengue fever cost-of-illness direct medical costs Hospitalization Oman Muscat health economic Full Text Additional Declarations The authors declare no competing interests. Supplementary Files Supplementary1Methodiology.docx Supplementary2SampleSize.docx Supplementry3STROBEchecklistv4crosssectional.doc Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8899461","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":592617858,"identity":"29978aea-ce5c-4c43-a58c-162c7bf7d40e","order_by":0,"name":"Ibtisam Khalifa Al-Maskari","email":"data:image/png;base64,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","orcid":"https://orcid.org/0009-0005-3877-5332","institution":"Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Oman","correspondingAuthor":true,"prefix":"","firstName":"Ibtisam","middleName":"Khalifa","lastName":"Al-Maskari","suffix":""},{"id":592617970,"identity":"5268d0d8-bf56-4308-958f-3f49cbb24bd1","order_by":1,"name":"Sanjay Jaju","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzklEQVRIiWNgGAWjYJACAwYGGwiLhwQtaSRqAYLDJGiRbz97oOBn23l7vhsJjA/etjHI6TYQctSZvATD3rbbiTNvJDAbzm1jMDY7QEgLQ46BAW/b7QSDGwls0rxtDInbCGmR739jYPi37Zw9UAv7b6K0MNzIMTDmbTvAuAFoCzNRWgxuvDEwljmXnDjzzMNmyTnnJAj7Rb4/x8zwTZmdPd/x5IMf3pTZyBHUAgRsBoxsQOoAYwOQlCCsHgiYHzD8AWkhSvEoGAWjYBSMRAAAeDFCTjubtKcAAAAASUVORK5CYII=","orcid":"","institution":"Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Oman","correspondingAuthor":true,"prefix":"","firstName":"Sanjay","middleName":"","lastName":"Jaju","suffix":""},{"id":592618063,"identity":"f80b9f64-5990-47f4-b034-c438b7794648","order_by":2,"name":"Zainab Mahmood Al-Zadjali","email":"","orcid":"https://orcid.org/0009-0003-2993-2813","institution":"Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Oman","correspondingAuthor":false,"prefix":"","firstName":"Zainab","middleName":"Mahmood","lastName":"Al-Zadjali","suffix":""},{"id":592618215,"identity":"ad3790db-ba7a-4085-957c-4a75388de9c6","order_by":3,"name":"Hana Al Sumri","email":"","orcid":"","institution":"Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat","correspondingAuthor":false,"prefix":"","firstName":"Hana","middleName":"Al","lastName":"Sumri","suffix":""},{"id":592618440,"identity":"22ec4605-d4cf-4a3f-a6ab-659518599da9","order_by":4,"name":"Adil Al Wahaibi","email":"","orcid":"","institution":"Directorate General for Disease Surveillance and Control, Ministry of Health, Oman],","correspondingAuthor":false,"prefix":"","firstName":"Adil","middleName":"Al","lastName":"Wahaibi","suffix":""},{"id":592618503,"identity":"d174fe64-cff6-4cc8-9d4e-db3f597b96ad","order_by":5,"name":"Khaleefathullah A. Sheriff","email":"","orcid":"","institution":"Ministry of Health, Royal Hospital, Microbiology Lab, Oman],","correspondingAuthor":false,"prefix":"","firstName":"Khaleefathullah","middleName":"A.","lastName":"Sheriff","suffix":""},{"id":592618647,"identity":"8992d331-2842-42e2-9ca4-a1a9581f1040","order_by":6,"name":"Hilal Al Sidairi","email":"","orcid":"","institution":"Ministry of Health, Royal Hospital, Microbiology Lab, Oman","correspondingAuthor":false,"prefix":"","firstName":"Hilal","middleName":"Al","lastName":"Sidairi","suffix":""},{"id":592618648,"identity":"7336d4ed-cf9a-4b20-9b67-5457d89026d9","order_by":7,"name":"Sathish Kumar Jayapal","email":"","orcid":"","institution":"Medical City for Security Services, Oman","correspondingAuthor":false,"prefix":"","firstName":"Sathish","middleName":"Kumar","lastName":"Jayapal","suffix":""},{"id":592618649,"identity":"acf212a9-9128-4b73-8887-3b3d37e6bc97","order_by":8,"name":"Sultana Al Sabahi","email":"","orcid":"","institution":"Financing Department, Ministry of Health, Oman],","correspondingAuthor":false,"prefix":"","firstName":"Sultana","middleName":"Al","lastName":"Sabahi","suffix":""}],"badges":[],"createdAt":"2026-02-17 09:18:14","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8899461/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8899461/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102964050,"identity":"db27f7af-919a-4172-a34e-3a0e9ca26c95","added_by":"auto","created_at":"2026-02-19 04:21:18","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":692661,"visible":true,"origin":"","legend":"","description":"","filename":"DirectMedicalCostsofHospitalizedDengue.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8899461/v1_covered_683c9996-7b22-4f0a-a9dd-ae0a6654cc12.pdf"},{"id":102928972,"identity":"8fe8dde0-9f13-4f73-8ddd-d98b3deed90f","added_by":"auto","created_at":"2026-02-18 14:31:32","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":29032,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementary1Methodiology.docx","url":"https://assets-eu.researchsquare.com/files/rs-8899461/v1/bf137ab1374d8920ebaf2346.docx"},{"id":102928969,"identity":"ba479e5f-e6ef-4e45-ba91-39c6682d4e6d","added_by":"auto","created_at":"2026-02-18 14:31:31","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":70990,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementary2SampleSize.docx","url":"https://assets-eu.researchsquare.com/files/rs-8899461/v1/6e98128bdb8f89f89372b12f.docx"},{"id":102928971,"identity":"5ce81c1f-d222-4a0b-8b6b-4f77d504fa6d","added_by":"auto","created_at":"2026-02-18 14:31:32","extension":"doc","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":90112,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementry3STROBEchecklistv4crosssectional.doc","url":"https://assets-eu.researchsquare.com/files/rs-8899461/v1/4b27c1f30a747db049b2812a.doc"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eDirect Medical Costs of Hospitalized Dengue Fever in Muscat Governorate, Oman (2022-2023): A Retrospective Cross-Sectional Cost-of-Illness Study\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Sultan Qaboos University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"dengue fever, cost-of-illness, direct medical costs, Hospitalization, Oman, Muscat, health economic","lastPublishedDoi":"10.21203/rs.3.rs-8899461/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8899461/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives:\u003c/h2\u003e \u003cp\u003eDengue fever (DF) is a re-emerging mosquito-borne viral infection posing a major public health concern in tropical and subtropical regions, including Oman. While the clinical burden is well documented, data on its economic impact remain limited, particularly direct medical costs of hospitalized cases. This study estimated direct medical costs of managing admitted DF cases in two tertiary hospitals in Muscat Governorate, Oman, during 2022\u0026ndash;2023 from provider perspective.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA retrospective, cross-sectional cost-of-illness study used national surveillance and hospital electronic records. Laboratory-confirmed dengue patients admitted during 2022\u0026ndash;2023 were included. Costs were estimated using a bottom-up micro-costing approach.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eAmong 345 hospitalized patients (98.6% locally acquired), total direct medical costs were OMR 113,097 (~\u0026thinsp;INT\u003cspan\u003e$\u003c/span\u003e 628,316 using 2024 World Bank PPP conversion factor for private consumption), Mean per-patient costs increased from OMR 173 in 2022 to OMR 301 in 2023. Laboratory investigations (53%) and hospitalization (34%) dominated costs, and hospital stay accounted for most of the total costs. Costs were substantially higher in severe dengue (Group C), patients with complications, and those aged\u0026thinsp;\u0026ge;\u0026thinsp;50 years. Cluster analysis revealed five patient profiles, with the highest costs in older age with severe disease and complications.\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e \u003cp\u003eHospitalized dengue imposes a substantial and increasing economic burden on Oman's healthcare system. Early diagnosis, outpatient management of mild cases, and targeted prevention for high-risk groups could help reduce avoidable hospitalizations and costs, informing resource allocation and policy.\u003c/p\u003e","manuscriptTitle":"Direct Medical Costs of Hospitalized Dengue Fever in Muscat Governorate, Oman (2022-2023): A Retrospective Cross-Sectional Cost-of-Illness Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-18 14:31:26","doi":"10.21203/rs.3.rs-8899461/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fbc477a4-15e1-45c3-9ce4-e016e52f40e8","owner":[],"postedDate":"February 18th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":63057894,"name":"Epidemiology"},{"id":63057895,"name":"Statistical Epidemiology"}],"tags":[],"updatedAt":"2026-02-18T14:31:27+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-18 14:31:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8899461","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8899461","identity":"rs-8899461","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}