Dengue: Coordinated efforts needed to control
Dr Matiur Rahman :
The number of dengue patients and deaths in the country is increasing daily. One hundred thirteen people died of dengue this year by the end of the third week of October, and 179 people died in 2019. So far this year, 31,034 people have been infected with dengue and 30,492 have been hospitalized for treatment. In 2019, 101,354 dengue patients were admitted to the hospital.
Although the number of hospitalized patients is still lower than in 2019, the trend is undoubtedly alarming. Because in many cases, many people infected with dengue are not admitted to the hospital and they consider it a coronavirus fever or other seasonal fever and take treatment home. If the condition worsens, they are admitted to the hospital, and as a result, the patient’s risk of death increases. Although dengue infection cases have decreased this year, the death toll has increased.
An alarming pattern has already been observed in dengue cases and hospitalizations. Some hospital reports showed that 64 percent of patients died within three days of hospitalization. Physicians believe the public’s delayed response to the disease may have contributed to the high death rate after hospitalization. They think that if infected people were admitted to the hospital as soon as dengue symptoms appeared, the death toll would have been lower.
Another aspect, which is quite worrying and intriguing, is the gender discrimination of those who died in the hospital. According to a recent briefing by the Department of Health, the death rate of women due to dengue is twice that of men. To explain this, some have pointed to society’s dismissive attitude towards women’s illnesses. This attitude contributesto delayed hospitalization of women and consequent death. The issue demands further investigation and due attention from all concerned.
The health department publishes daily information on patients admitted to 41 public and private hospitals in Dhaka city. According to their data, all the hospitals have dengue patients except the only Pongu hospital, and Dhaka Medical College Hospital has the highest number of patients. According to the data of the Directorate of Health, the districts where dengue infection is high outside Dhaka include Cox’s Bazar, Jessore and Pabna.
According to the government’s health department, dengue patients have been found in all districts except ten this year. Entomologists say that Aedes mosquitoes carry dengue in every city in the country. There is no mosquito control program in all cities and upazilas across the country, and many districts lack human resources, equipment and insecticides for mosquito control. Much is being discussed about the city corporation’s control of mosquitoes.
The mosquito breeding ground known as Aedes aegypti has spread across the country. Dengue outbreaks are no longer confined to the monsoon season only. Due to climate change, scattered rainfall is happening throughout the year. Therefore, it has become necessary to continue the dengue eradication campaign throughout the year.
At present, the mosquito control campaign is one of the responsibilities of the City Corporation or municipality. But experts say there is a need to set up an organization whose task is to kill Aedes mosquitoes and their larvae throughout the year.
So, apart from forming an independent and dedicated organization to fight dengue, it is also essential to check the methods of mosquito eradication and the type and quality of chemical agents. Other procedures on the market to kill Aedes mosquitoes should also be looked at, besides spraying insecticides. In this regard, other countries’ experiences can be shared and, if necessary, emulated.
Besides this, entomologists are also talking about establishing a national institute. This institute willresearch mosquitoes and other pests, work on pest control at the field level and monitor the situation.
According to experts, adopting a national plan to combat dengue is necessary. In 2017, the World Health Organization gave the government of Bangladesh an interim plan to control the Aedes mosquito-borne disease. Apart from the Ministry of Health, the Ministry of Local Government, the Ministry of Science and Technology, the Ministry of Road Transport, the Ministry of Railways, the Ministry of Agriculture, the Ministry of Defense, and the Ministry of Commerce were included in the plan. The roles and responsibilities of each ministry were also described in the plan.
Experts said that this plan did not work. One of the many functions of the disease control wing of the Department of Health is to develop strategies to combat the mosquito-borne diseases of dengue and malaria. However, no such strategy has been adopted for dengue diseases.
The government has no national strategy or plan to control dengue. The Ministry of Health is giving importance to the treatment of dengue, but they feel that it is not their responsibility to prevent dengue. In such a reality, public health experts believe that Aedes mosquito and dengue control is impossible without formulating an integrated national plan and strategy and implementing the plan involving all concerned parties.
All ministries and agencies, including local governments, must take action against the challenge that dengue-carrying mosquitoes have created for public health. Addressing the dengue problem through a concerted effort has become imperative.
(The writer is a researcher and development worker).
