Dengue deaths on the rise

A nurse provides treatment to a dengue patient at the Shaheed Suhrawardy Medical College and Hospital in Dhaka, Bangladesh, 26 July 2023.Reuters file photo

The number of dengue patients and deaths continues to rise in the country and what is more concerning is that the deaths are on the rise in Bangladesh at a higher rate than anywhere in the world.

Experts said the dengue situation is getting slightly complex in the country.

There are also allegations of lack of proper steps to tackle the situation; no countrywide dengue prevention campaign is seen, and there is no progress in treatment either.

The prevalence of dengue was first reported on a large scale in the country in 2000. Since then, the mosquito-borne disease has continued to break out every year except for 2020 during the coronavirus pandemic and no death from dengue was recorded that year.

A group of public health experts, however, argued two viruses cannot become active simultaneously and the dengue virus was somewhat inactive due to the presence of the novel coronavirus, but the dengue outbreak returned after the pandemic ended.

Dengue specialist and editor-in-chief of National Guideline for Clinical Management of Dengue Syndrome professor Quazi Tarikul Islam told Prothom Alo on Monday, “Fatality rate from dengue is 5 per cent in Bangladesh, which is even more than Brazil where the highest number of people suffers from dengue.”

Govt data on dengue

A year after the Covid-19 pandemic, a total of 28,428 dengue cases and 105 deaths were reported in 2021 with a fatality rate of 0.37 per cent. The following year, 62,382 cases and 281 deaths were reported with a mortality rate of 0.45 per cent. Dengue reached a record peak with 321,027 cases and 1,705 deaths (fatality rate 0.53 per cent) in 2023.

Taking experience from the previous years, public health experts, entomologists and government officials feared a widespread dengue outbreak this year. As of 5 May, a total of 2,288 dengue cases and 27 deaths were reported with a fatality rate of 1.18 per cent.

Situation getting complicated

According to public health experts, deaths from dengue will rise as many as dengue cases rise. Besides, other factors also contributed to more deaths.

Not all dengue cases in Dhaka have been reported by the government since 2000. Persons suffering from dengue disease for the second time face more complications and a growing number of people are suffering from dengue for the second time in Dhaka.

Quazi Tarikul Islam said, “Patients suffering from dengue for the second time develop immunity complex reactions, as well as more plasma leakages. Patients go on a shock, posing a major risk of death.”

Besides, many patients neglect the dengue fever at the beginning and come to the hospital late or after the situation gets complicated.

But what contributes to a high fatality rate is still unclear, but had a ‘death review’ been conducted, the matter would have been clarified. The Directorate General of Health Services (DGHS) took the initiative to conduct a death review last year, but they are yet to complete it.

DGHS director (disease control) Sheikh Daud Adnan told Prothom Alo, “We are going to publish the findings of the death review soon.”

Last year, 980 dengue deaths were reported in Dhaka city and 725 more outside the capital. Data on 94 patients, according to the DGHS sources, were collected from various hospitals in Dhaka to conduct the death review, but public health experts think more data should be collected on patients outside Dhaka.

Public health expert professor Be-Nazir Ahemd told Prothom Alo, “We have heard many patients in Dhaka are suffering from dengue for the second or the third time and the fatality rate will be higher among them, but the situation is different outside Dhaka where there is a lack of experienced physicians and necessary equipment."

"Besides, many problems occur while shifting patients to Dhaka. The cause of the death could be known once the death review is conducted. We could learn whether the patients suffered dengue before or arrived in the hospital lately; what organs of the patients were damaged and whether fluid management was okay. Unfortunately, we cannot learn about it. Had we learned about these issues, some lives would have been saved by bringing changes to patient management and launching campaigns,” he added.

*This report, originally published in Prothom Alo print and online editions, has been rewritten in English by Hasanul Banna