Dengue becomes public health burden in Bangladesh

Dr. Tanzina Afroz :

Earlier, records of dengue were initially found in a Chinese medical encyclopaedia in 992 BC.

In addition, outbreaks of a particular disease that showed a significant resemblance to dengue were known to have appeared in both America and Asia at sporadic intervals before the middle of the 18th and 19th centuries.

Infection of dengue disease is caused by a virus (DENV). There are three different types of DENV, and it’s theoretically conceivable to contract the virus four times.

In several nations, especially in Asia and Latin America, dengue is one of the major causes of fatal disease and death. It is something that has to be managed by trained medical specialists.

Previously, World Health Organization (WHO) said, over 2.5 billion people are impacted by dengue fever in the world and 100 million incidences are detected yearly.

Bangladesh has one of the greatest burdens of dengue in the world and the disease has increased 30 times over the previous 50 years.

An estimated around 24percent of the population of Bangladesh gets infected with dengue at some point in their lives with 3 percent of those affected living in the rural village and 90 percent in urban areas.

In 2019, a total of 164 confirmed deaths from the dengue virus were reported in Bangladesh and about 100,000 thousand individuals were hospitalized as a result of the infection. Around 50 percent of patients came from the city of Dhaka.

According to a study, the incidence of dengue fever is higher in men than in women because men are more likely to be in environments that are favourable to the transmission of the virus, such as the office or other types of workplaces.

It has been found that adults are more likely to be affected by dengue, with studies in Saudi Arabia and Bangladesh findings that nearly (49.9 percent) of cases were in those aged 20 to 40 and 18 to 33 years old, respectively.

In the 1950s, the Philippines and Thailand experienced significant dengue outbreaks and then in 1964, Bangladesh faced its first-ever dengue outbreak, leading to the creation of the term “Dacca fever”.

Ever since 2000, when the first confirmed case of dengue fever was reported in Bangladesh, the number of people hospitalized due to the disease has increased by more than 600 percent to over 3000.

Dengue fever is widespread in Bangladesh, but since May 2022, the Rohinga refugee (forcibly displaced Myanmar nationals) camps in Cox’s Bazaar have seen a sharp increase in dengue cases.

The report indicates that the months of August and September account for 92% of all dengue incidents in Bangladesh with 94% of those reported in the country’s capital Dhaka.

Though Bangladesh has made significant progress toward improving population health by reducing child mortality through MDG 4 implementation, however considerable difficulties in the area of health still exist.

There are challenges for Bangladesh. Firstly, there is a lack of a standardized method of delivering primary healthcare to people in both urban and rural areas.

Secondly, there is a significant shortage of skilled healthcare providers to meet the growing demand for healthcare alternatives.

Thirdly, there is a lack of fair and equal medical care access in rural areas, and also a better method of financing these services.

Bangladesh’s biggest challenge in preventing dengue is not only the availability of a dengue vaccine but also because there is still no treatment for dengue in Bangladesh.

Despite vaccine unavailability, there are other factors that cause an increased risk of infection, such as, lack of public awareness of the reduction of mosquito breeding.

There is a lack in increased immunization programme and inability to take active preventive measures against dengue.

There is also the inadequate urban planning, which can potentially enhance the rates of viruses spread.

The risk of dengue fever will rise with the mobility of the population and the impact of economic variables.

Lack of reliable methods for detecting the dengue virus in a routine blood screening and management of solid waste is also contributing too increased cases of dengue infection.

The government of Bangladesh should implement measures to guarantee that people living in both urban and rural areas have access to effective dengue treatment.

Since there is currently no dengue vaccine available in Bangladesh, the government should implement other effective measures to prevent the disease’s spread, such as proper garbage disposal, spraying all across the suspected areas, and spraying the region of the country that has been reported to have dengue cases.

Besides, the government should prioritize introducing a vaccine programme as soon as possible, providing inexpensive treatment for those already infected by dengue to reduce inequities and fulfill the 2030 WHO elimination target.

(The writer is BDS (Bangladesh), MPH (UK), FRSPH (London).)