No national plan for dengue control

The government doesn’t have a national strategy or plan in dengue control. The health ministry is stressing on the treatment of dengue.

Health minister Zahid Maleque said, it is not the health division’s job to control Aedes mosquito, the carrier of dengue.

Public health experts say the situation at hand is the result of Bangladesh failing to learn from past experiences.

According to the Directorate General of Health Services (DGHS), this year dengue patients have been found in every district except ten.

Entomologists say that dengue-carrying Aedes mosquitos can be found in every city of the country.  However, no mosquito control activities can be noticed on the city and upazilas level across the country

Many of the districts also lack the workforce, equipment and insecticides needed for mosquito control. When it comes to mosquito control, what the city corporations are doing becomes the most discussed topic.

The number of dengue-infected patients and dengue-induced deaths is mounting every day. DGHS reported four more deaths this Thursday.

With this, the death toll of the year rose to 110.

The toll was higher in 2019 with 179 deaths. A total of 28,698 patients have been hospitalised this year. More patients were hospitalised in 2019 and the exact number was 101,354.

Public health expert and former director of DGHS’s disease control wing professor Be-Nazir Ahmed told Prothom Alo, “Past experiences haven’t been put into use and expert opinions have been ignored.”

He added that no national plan has been introduced to control Aedes mosquito. As long as this mosquito exists, dengue patients will be there. The ongoing outbreak was indeed inevitable.

Capital’s Shaheed Suhrawardy Medical College and Hospital has allocated three separate dengue wards for male, female and child patients.

Ward no. 634 on the fifth floor of the hospital has been reserved for the male dengue patients. Visiting the ward on Thursday, mosquito nets were found strung above all the beds.

All the patients were within nets there. Some patients took treatment on the balcony as well.

College student Abul Kalam found a place for himself on bed no. 43 of the ward.

Kalam said, his family lives on the ground floor of a multi-storied building in Mohammadpur’s Banshbari area.

Mosquito infestation is significantly high in the area. He said he was admitted to the hospital on 15 October.

Director of the hospital Khalilur Rahman told Prothom Alo, 19 patients returned home upon recovery on Thursday. But, 29 new patients replaced them. 129 dengue patients hospitalised there till 1.00pm.

He added, “Pressure on the hospital’s medicine department has increased. If the number of patients keeps mounting, it might be necessary to open a new ward.”

The pressure of patient is on the rise at Bangladesh Shishu Hospital and Institute. There were 70 dengue-infected children admitted in this hospital on Thursday.  

According to hospital officials, dengue-infected children are being treated in several wards. The 24-bed ward no. 14 on the third floor is reserved for breast-fed children only.

12 of those beds are now reserved for children with dengue while, the remaining 12 are for children with other ailments. No empty bed was found at the ward, during a visit to the ward at 11.00am Thursday.

Hospital officials said as many as 24 beds of ward no. 2 are occupied by dengue patients. Six children are in ICU. The remaining 28 children are in different wards. This year 10 children died of dengue in the hospital.

Health minister Zahid Maleque inaugurated ‘Abul Hossain Respiratory Center and Pneumonia Research Centre’ at the hospital Thursday.

Later in reply to journalists’ questions the minister said that five to six people are dying of dengue every day while a thousand new patients are being hospitalised.

It is the job of the city corporations and municipalities to spray anti-mosquito pesticides. The health ministry is not responsible for the spraying, he added further.

DGHS publishes the data of patients getting admitted to 41 public and private hospitals of Dhaka city every day.

Thursday’s data shows, there are dengue patients admitted in every hospitals, except for only National Institute of Traumatology and Orthopaedic.

Dhaka Medical College Hospital has the highest number of patients. There were 201 patients admitted in the hospital on Thursday. So far, 12 dengue patients have died in this hospital.

DGHS said that Cox’s Bazar, Jashore and Pabna are among the districts with a high dengue infection rate outside of Dhaka. Till now, 460 infected people have been hospitalised in Jashore.

Meanwhile, Jashore civil surgeon’s office told Prothom Alo on Thursday that more than 354 of the patients are from Abhaynagar upazila. And, most of these patients are residents of villages under Challisha union of the upazila.

On the other hand, 523 people have been hospitalised with dengue in Pabna district. 500 of them are from Rooppur Nuclear Power Plant.

Till Thursday, no patients were hospitalised in 10 districts. These ten districts are Kurigram, Nilphamari, Gaibandha, Thakurgaon, Sunamganj, Habiganj, Rangamati, Bandarban, Noakhali and Brahmanbaria.  

Mosquito expert and professor at the zoology department of Jahangir University Kabirul Bashar told Prothom Alo, “It’s not like that Aedes mosquitoes are found only in cities.

“There are mosquitos almost everywhere in the country now. The risk is no more limited to big cities only. The initiative of dengue-control has to be spread beyond Dhaka, across the country,” he added.

In 2017, World Health Organization consultant K Krishnamurthy provided Bangladesh government with a mid-term plan to mitigate Aedes mosquito-borne diseases.

It recommended bringing local government ministry, science and technology ministry, road transport ministry, railways ministry, agriculture ministry, defence ministry and commerce ministry together in the plan along with the health ministry.

The roles and responsibilities of the ministries were also stated in the plan briefly.

No work has been done on this plan. DGHS said, one of the many tasks of their disease control wing is to deal with the mosquito-borne diseases, dengue and malaria.

Deputy programme manager of DGHS’s disease control wing Ekramul Haque told Prothom Alo, there are national strategies for controlling several diseases including tuberculosis and HIV/AIDS. However, there’s no such document on dengue.

The disease control wing conducted mosquito surveys in Dhaka twice this year and trained about a 1,000 physicians. Plus, they have sent dengue treatment guidelines to 2,000 physicians.

Public health expert Be-Nazir Ahmed deems it impossible to control Aedes mosquito and dengue without the formation of a national plan and strategy along with the implementation of the plan bringing all the concerned parties together.

Entomologist Kabirul Bashar has opined in favor of building a national institution alongside.

He said the organisation will be responsible for conducting research on mosquitoes and other pests, working on field level pest control, and monitoring the situation.