Some 919 dengue patients have been admitted to hospitals daily on average this year. The average daily dengue-related casualties stand at 5. The number of dengue patients aged below 15 who died last year was 166. This figure was obtained by analysing the daily updates from the Directorate General of Health Services (DGHS) throughout the year.
However, this data does not represent the entire scenario. The government's data exclude information about many people diagnosed with dengue. Some of these patients received separate home treatment, while many did not undergo any treatment at all. Therefore, obtaining accurate information about patients excluded from the government data is challenging.
According to public health experts, the actual number of dengue patients is estimated to be four to five times higher than the number of patients admitted to hospitals. Therefore, the projected total number of dengue patients this year is around 1.2 million to 1.5 million.
With 19 days still remaining in this year, the number of dengue patients admitted to hospitals has already reached 317,956, with 1,667 reported deaths.
Such a high number of dengue patients and subsequent casualties are unprecedented in the history of the country. Although the number of dengue patients is higher in the South American country Brazil, the casualties there remain below 1,000.
Public health experts and entomologists have consistently expressed concern that the government has not given adequate attention to the dengue situation. There is a lack of long-term planning or programmes addressing this issue.
The government becomes a bit proactive when the number of dengue patients rises every year during the monsoon. However, all these promptness disappears as soon as dengue related indicators fall in winter. This pattern has persisted for years.
Speaking regarding this, public health expert professor Be-Nazir Ahmed told Prothom Alo, “This year we have seen that dengue has been persisting throughout the year and it has spread across the country. Bangladesh is facing a complex and difficult health situation at the moment. If the government doesn’t work throughout the year and across the country, both the number of patients and casualties will increase in the coming days. The costs of related medicines and treatment will increase at the same time.”
Despite the delay, the government is going to take up a long term plan to control the dengue situation. Speaking to Prothom Alo on Tuesday, professor Md Nazmul Islam, director of the disease control unit of the DGHS, said, “The draft of the national guidelines to contain dengue has been prepared. The draft will be finalised after taking opinions of the stakeholders. A national workshop is going to be held within a week.”
Dengue outbreak across the country throughout the year
The country has been experiencing the outbreak of dengue regularly from 2000. The outbreak of dengue was mainly Dhaka-based in the past. Although there were reports of dengue cases in big cities like Khulna and Chattogram, the number of affected people wasn’t that much. However, there were reports of dengue cases from several districts in 2019.
People from all the 64 districts have been diagnosed with dengue this year. According to the government figures, some 66 per cent of the patients were from outside Dhaka. The number of dengue patients is 43,000 in the Chattogram division, 37,000 in Barishal division and 34,000 in Khulna division.
The number of dengue patients is the lowest in Sylhet division. A total 1,426 people were diagnosed with dengue in the four districts of the division and only one of the patients has died.
A large portion of the Chattogram, Barishal and Khulna divisions are coastal areas. The DGHS hasn’t come up with any explanation as to why the number of dengue affected people is so high in these coastal divisions and low in Sylhet division.
In addition to the existing dangers, the fact is that people are being diagnosed with dengue even in the winter and there have been reports of subsequent casualties as well.
According to the regular bulletin of the health emergency operation centre and control room of the DGHS on Tuesday, a total of 311 dengue patients were admitted to different hospitals in the 24 hours from 8:00 am Monday to 9:00 am Tuesday across the country. Two of the patients died at that time. With the number of new dengue patients in December rose to 6,065. Of them, some 45 died.
The public health experts fear that the outbreak of dengue is likely to continue throughout the entire winter across the country and it may rise further in case of any untimely rain. The number of mosquito population will increase as there is no effective programme to contain the growth of mosquito population anywhere in the country. The dengue situation will turn severe with that. There are chances of the dengue situation getting worse after winter.
Casualties among the women and children are high
According to the government figures, some 60 per cent of the dengue patients are male and 40 per cent are female patients.
However, the dengue-related casualty is the highest among women. Of the 1,667 dengue patients who have died so far, 954 were women, which is 57 per cent of the overall casualties.
There has been no acceptable explanation yet as to why the casualties among the female dengue patients are higher than the male patients.
The number of casualties among the patients aged below 15 years is 166. Such a high number of casualties among the children is unprecedented in the country.
According to the officials of the Bangladesh Shishu Hospital & Institute, there are not enough arrangements to treat the children diagnosed with dengue in many districts of the country. Children were admitted to hospitals in more than 30 districts at different times this year.
A feasible planning is required
There is no such instance of completely eradicating dengue from any place after its outbreak. However, there are many cases where dengue has been controlled effectively. The first cases of dengue were reported almost at the same time in Kolkata in India and Dhaka. The dengue situation is completely under control in Kolkata now, where the situation has become severe in case of Dhaka. The people in Kolkata are enjoying the benefits of implementing yearlong planning. However, the residents of Dhaka are suffering due to a lack of planned programmes.
Two specialists from the World Health Organization made some recommendations to contain dengue in 2017 and 2019. However, the DGHS didn’t pay attention to those recommendations.
Speaking to Prothom Alo, several DGHS officials told Prothom Alo that they are going to take up a 10-year work plan, which stressed involving people apart from activities to contain the growth of mosquito population throughout the year.
Speaking to Prothom Alo regarding this, public health expert Be-Nazir Ahmed told Prothom Alo, “Residents in the cities and rural areas are equally important just as the entomologists for drafting a plan and its implementation. We must keep it in mind that this is not a task of any single ministry. The work should be done throughout the year across the country and it should be continued for years. The benefits will be realised a few years after starting the process."
*This report appeared on the print and online versions of Prothom Alo and has been rewritten in English by Ashish Basu