Dengue cases shoot up outside Dhaka, no one knows why

Discussions concerning dengue are mostly urban-centric, basically focused on the capital Dhaka although in actuality, the number of dengue cases is much higher outside of Dhaka.

Epidemiologists say no one has an idea of the actual state of dengue outside Dhaka.

This observation was made yesterday, Sunday, at a meeting to review the dengue situation. The meeting was jointly organised by the health ministry, the disease control wing of Directorate General of Health Services (DGHS) and UNICEF.

Experts at the meeting highlighted the shortcomings in preventing dengue. They said special attention must be paid to the villages in the prevention of dengue. The people outside of Dhaka are being affected by a different type of mosquito.

At the meeting held at a hotel in Dhaka, health minister Zahid Maleque said the government is spending Tk 50,000 behind each dengue patient on average. So far this year Tk 4 billion (Tk 400 crore) has been spent on dengue.

A little while after the health minister gave these figures, the DGHS health emergency operation centre and control room informed the media that in the latest update (8:00am Saturday till 8:00am Sunday), another 11 persons had died of dengue. That brings this year’s dengue death toll in the country up to 548. Of them, 404 died in Dhaka hospitals and 144 outside of Dhaka.

In the last 24 hours, another 2,327 dengue patients were admitted to hospital all over the country. Of them, 920 were admitted to government and private hospitals in Dhaka and 1,407 in various districts outside of Dhaka.

According to the control room, till now 114,511 dengue patients have been admitted to hospitals in the country, with 60,102 being admitted to hospitals outside of Dhaka and 54,409 to hospitals in Dhaka city. In other words, there is a higher number of cases outside of Dhaka. Epidemiologists say this is the first time that so many dengue cases have been observed outside of Dhaka.

At Sunday’s meeting, former director of the Institute of Epidemiology, Disease control and Research (IEDCR), Meerjady Sabrina said that in 2019, dengue cases were detected in several villages of Kushtia and Jashore. At the time, IEDCR studies showed that dengue had been spread in those villages by the aedes albopictus species of mosquito.

Epidemiologists and entomologists say that aedes mosquitoes spread dengue. There are two types of aedes – aedes egyptus and aedes albopictus. Aedes egyptus is mostly found in the cities and aedes egyptus in rural areas. They lay eggs in the water that gathers in plant pots, in the outer covering of banana trees, on arum (kochu) leaves and so on.

Professor Meerjady Sabrina went on to say that, “This year dengue has spread to 64 districts. We do not know which mosquitoes are spreading the disease more.” She said the people in the cities are asked not to let water collect in any place. But in the villages the people don’t have any choice but to collect water. So what message will be given to the village people to tackle dengue?

Also speaking at the meeting, additional director general (planning and development, DGHS and secretary general of Bangladesh Medicine Society, Ahmedul Kabir, said that people are being afflicted by various types of dengue. The dengue symptoms that are appearing this year, indicate that next year there is risk of the dengue cases will be even more complicated.

Meanwhile, head of the entomology department of DGHS’ National Institution of Preventive and Social Medicine (NIPSOM), Md Golam Sarwar, said that if the insecticides are not applied correctly, mosquitoes will not be controlled. Mosquitoes will not die if the size of the water drops mixed with the insecticide is not correct. Addressing the health minister and the health secretary, he said, “There needs to be regular study on the biochemical character of the mosquitoes and their behaviourial changes.”

Some of the country’s top epidemiologists, entomologists and public health experts were not present at the Sunday’s meeting. They had not been invited. Meanwhile, the main task of controlling mosquitoes has been given to the local government ministry. While representatives of Dhaka North and South city corporations were present at the meeting, there were no officials or representatives of the local government ministry.

Other than health ministry representatives, the meeting was attended by representatives of the education, public works and information ministries as well as the ICT division and business organisations. Health minister Zahid Maleque conducted the main discussion.

Participants at the meeting came up with many recommendations. They recommended that work on dengue must be carried out the year round, the main thrust must be on prevention, various ministries must be involved in tackling dengue, a national committee for dengue must be formed headed by the health ministry, regular tests must be conducted to see if the insecticides being used to eradicate mosquitoes are effective, the application of the insecticide must be scientific, and the workers spraying the insecticide must be provided with proper training. At the start of the meeting, the disease control wing made a presentation on the present state of dengue in the country.

Taking part in the discussions, Professor Syed Abdul Hamid of Dhaka University’s health economics department said that there was no regular fund allocation for the health department to deal with any sudden outbreak like that of dengue. There needs to be a regular allocation otherwise during an emergency, various institutions in the health sector have to wait for funds.

Health secretary (health services) Anwar Hossain Howladar said that according to their records, so far all over the country 27 children aged between 6 to 10 years have died of dengue. This included 15 boys and 12 girls.

World Health Organisation (WHO) representative Bardan Jung Rana told the meeting that WHO came forward with assistance every time that dengue had appeared in Bangladesh.

UNICEF representative Sheldon Yett said, UNICEF provided the government with USD 1.2 million (Tk 24 crore) to tackle dengue.

Representative of the apex body of businesspersons FBCCI, Priti Chakraborty, highlighted how two children of the same family had died of dengue. He said that only that family could understand the pain.

The event was presided over by the director general of DGHS Abul Bashar Mohammed Khurshid Alam.