Dengue control: Big talk, little action

There is a lot of talk about controlling the dengue situation in the country, but little is being done. There are no visible effective measures being taken to bring the situation under control.

This is the state of affairs regarding dengue in the entire country, including Dhaka's two city corporations. The latest update given by the mayor of Dhaka South City Corporation, Sheikh Fazle Noor Taposh, has confused people further. He said the number of dengue patients in Dhaka in 2023 was 42,000 less than in 2019.

However, according to the Directorate General of Health Services, over the last 22 years, the highest number of dengue patients in Dhaka city was in 2023, totalling 110,008. In 2019 this was 51,810.

Reviewing the state of dengue contagion and control in the country, public health experts feel that the government officials have hardly learnt any lessons from the alarming dengue situation of last year. It is basically the responsibility of the local government, rural development and cooperatives ministry to prevent dengue. And the health ministry is basically responsible for the treatment of the dengue patients. But the two ministries are not carrying out duties with due importance.

The dengue situation was the worst last year. According to the health directorate, in the first five and a half months of last year, there were 1,292 dengue cases and 12 dengue deaths. In the corresponding period this year, there have been over double the number of dengue patients, and the deaths are almost more than triple.

From 1 January this year till yesterday, 16 May, a total of 2,569 persons were afflicted by dengue and 32 died.

The Aedes mosquito carries the dengue virus. Aedes aegypti transmits dengue in the cities and Aedes albopictus in the villages. The local government ministry is basically responsible for eradicating and controlling mosquitoes in the cities and villages. In recent years it has basically been the two Dhaka city corporations that have been taking initiatives and discussing the mosquito control. The issue is sometimes discussed by the Chattogram and Rajshahi city corporations too. Outside of that, what the local government ministry is doing in the rest of the country is not visible.

The ministry's local government division has created a total of nine tiers of committees for the 'prevention of dengue and other mosquito-borne diseases' from the capital city to the union level.

When asked yesterday, Thursday, about how active these committees were, additional secretary of the local government, rural development and cooperatives ministry Md Sher Ali told Prothom Alo, the temperature in the country for some days was above 35 degrees Celsius. Dengue cannot survive in such high temperatures and that is why the committees were a bit inactive. But with the change in temperature, the committees are immediately becoming activated again.

Additional deputy commissioner (general) of Chattogram, Rakib Hasan, said the dengue prevention committee held a meeting in the first week of April, presided over by the deputy commissioner.

According to the health directorate, till yesterday (16 May) thus year, 18 persons were diagnosed with dengue in Khulna. Of them, 17 have recovered and been released from hospital. Khulna's deputy commissioner Khandakar Yasir Arefin, however, said that dengue patients haven't been identified in Khulna as yet, adding that there had been no separate meeting for dengue. He said that the matter of dengue was discussed every month at the meeting of the law and order committee. For around one month, mikes have been used to increase awareness in this regard, he said.

Barishal deputy commissioner Md Shahidul Islam said, every year the district coordination committee has a meeting regarding dengue prevention. Decisions are taking at the meeting regarding dengue prevention. Based on that, awareness meetings are held at schools, leaflets are distributed, a mobile court initiative is taken up, and mosquito eradication insecticide is sprayed in the city corporation and municipal areas.

Researchers say, however, this year mosquito control programmes are not being carried on in accordance to the outbreak of dengue seen in the rural areas last year. Professor of zoology at Jahangirnagar University, Kabirul Bashar, carries out research on dengue and mosquitoes. He told Prothom Alo, "We have worked in Chattogram, Cox's Bazar, Barguna, Gazipur, Barishal and Chandpur district. We saw a higher incidence of mosquitoes in these areas compared to last year. I feel that the dengue outbreak will be even more extensive this year."

Dengue patients have been identified from the very outset of this year. Till yesterday, a total of 502 cases have been identified in Dhaka South City Corporation. Of them, 17 have died. In Dhaka North City Corporation, the number of dengue cases stood at 363, of whom 3 died.

From the last few years' experience, it has been seen that initially dengue spreads extensively in Dhaka and then spreads to the rest of the country. Many are of the opinion that if there are less dengue cases in Dhaka, there will be less dengue in the rest of the country.

The more dengue mosquitoes there are, the more likely people are at risk of contracting dengue and the more people may have to be admitted to hospital. The health department claims that there is adequate medical equipment at the hospitals. There is no difference in the treatment of dengue cases in Dhaka or outside of Dhaka. The officials say that dengue patients outside of Dhaka do not need to come to Dhaka for treatment.

The health directorate so far has reported 32 deaths of dengue patients. Experts say that the reasons behind these deaths are coming to hospital to late, lack of proper management, and elderly patients having other health problems. A review of the deaths reveals the reason behind the high number of deaths.

The health ministry, however, is not publishing the data from the death review reports. A committee of experts has reviewed information regarding 94 patients who died in 2023 in Dhaka hospitals. They have submitted their review report to the health directorate. The health directorate, however, is not publishing the report.

The health directorate's director (disease control) Sheikh Daud Adnan, speaking to Prothom Alo yesterday, Thursday, said a decision will soon be taken regarding the death review reports.

On the one hand the local government ministry has not taken any effective measures to control mosquitoes across the country, and on the other hand, the health directorate has taken no visible additional initiatives to bring down the deaths. As the rainy season approaches, people are growing more restless and concerned about the dengue situation.

Public health expert Be-Nazir Ahmed told Prothom Alo that there was need of evidence-based successful measures for dengue control and treatment. But the local government and health ministry have not taken such measures. They do not have the capacity, not do they make any effort to build up that capacity. The two ministries have taken the matter of dengue very lightly. The local government ministry should have strengthened the mosquito control programme in the big cities and all over the country. And all possible alternative measures should have been taken to reduce the number of dengue deaths.

[The staff correspondents of Chattogram and Barishal and correspondent of Khulna helped in preparing this report].