Dr. Tanzina Afroz
BDS (Bangladesh), MPH (UK), FRSPH (London)
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.
Infectious of dengue disease is caused by a virus (DENV). There are three different types of DENV and its 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.
Earlier, World Health Organization 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 3percent of those affected living in the rural village and 90percent in urban areas. Previously in 2019, total of 164 patients confirmed deaths from the dengue virus were reported in Bangladesh and about 100,000 thousand individuals were hospitalized as a result of the infection. Where around 50percent 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 (49.9percent) 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 in 1964, Bangladesh faced its first-ever dengue outbreak, leading to the creation of the term “Dacca fever”. 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 state 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, howeverconsiderable difficulties in the area of health still exist.
The challenges are;
First, 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.
- Lack in increased immunization programme.
- Unable to take active preventive measures against dengue.
- 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.
- Management of solid waste: inadequate efforts made toward waste collection and disposal.
DENGUE ELIMINATION ROADMAP IMPLEMENTED BY WHO (WHO, 2019)
The morbidity and mortality of dengue in Bangladesh are terrifying, and the country is working to combat new infections by strengthening its prevention measures. On the other hand, there are additional issues such as socioeconomic determinants, inadequate policies and strategies towards dengue, which is the greatest hurdle in the way of attaining dengue prevention.A disproportionately large number of affected people are concentrated in the village or other nearby communities, which only have access to primary healthcare services. The government of Bangladesh should implement measures to guarantee that people living in both urban and rural areas have access to effective dengue treatment.World Dengue Day should be established more frequently by governments, non-governmental organizations, and NGOs in order to raise awareness of the disease worldwide, encourage the widespread dissemination of images related to dengue, and make the fight against the disease a top priority.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.Thailand serves as a model for other countries looking to successfully implement a mass paediatric dengue vaccination programme. Nevertheless, local bodies must conduct regular evaluations and inspections, such as retaliatory sanctions and penalty fees for violating recommended procedures.However, there is not enough surveillance of the illness trend in the country to acquire the data necessary to develop evidence-based strategies and make decisions promptly.The government should prioritize introducing a vaccine program as soon as possible and providing inexpensive treatment for those already infected by dengue to reduce inequities and fulfill the 2030 WHO elimination target.
