Dengue – a persisting challenge

Health experts blame irresponsible behaviours, rapid urbanisation for spread of the mosquito-borne tropical disease

Emerging every year like a nightmare affecting thousands of countrymen, the deadly dengue fever remains an enormous challenge for the authorities concerned. Health experts have called out ‘irresponsible’ behaviors and ‘rapid’ urbanisation as main reasons for its outspread.

Persisting in our country since the past two decades, dengue commonly known as the ‘breakbone fever’ every monsoon hits the populace across country as by the time, no specific medicines have been discovered as ‘deterrence’ for this disease.

Experts opine that rapid urbanisation and stagnant water within and outside the houses provide as breeding points for the dengue mosquito exposing the immune compromised citizens to this disease.

Irresponsible attitude of citizens, non-availability of specific treatment and already over-burdened medical facilities aggravate the situation resulting in death of scores of people every year.

“Rapid urbanisation, unhygienic living conditions, co-morbidity, lack of strict vigilance and less awareness about preventive measures can be stated as main causes for mass spread of this disease,” stated Dr Mubashir Daha, medical expert and Secretary General Pakistan Medical Association (PMA).

He further said other major reasons of disease propagation in Pakistan, are poor sanitation, inflation in population, inadequate medical and pharmaceutical care facilities, high illiteracy rate and less knowledge regarding vaccination.

“Dengue has significant effects on our economy and social status along with its drastic consequences on public health,” Dr Daha said pleading that its damage could be reduced to large extent through preventive measures.

He suggested diverse studies to investigate different features of mosquito and dengue viruses that might be helpful in finding new efficacious techniques for improving treatment mechanism.

Moreover, the year 2019 has been the worst year in the country’s history when more than 44,000 cases were reported by early November. However, many healthcare professionals believe that these numbers could be much higher as majority of cases in rural areas and slums are seldom reported.

“Major areas of concern are control of vectors, management of disease and new community awareness programmes,” said Dr Wasim Khawaja, former Director, Pakistan Institute of Medical Sciences (PIMS).

“Therefore, we need proper education and training of health professionals to equip them for meeting the challenge,” he added pleading a vibrant role of electronic media in awareness raising.

He also said the dengue transmission can be limited through preventive strategies like spraying, fumigation, repellents and water coverings. “For this purpose, we need a combined effort by different organisations, health teams and the communities as a whole.”

Since, this disease repeats every year there is dire need for tightening belt each time to take preventive measures for averting its consequences.

“Dengue strikes the federal capital seasonally and several measures are taken to contain it,” said Director PIMS Dr Khalid Masood.

He elaborated that keeping in view the volume of disease, the PIMS every year make special arrangements to treat the patients. “We have decided to allocate three more wards for dengue patients 120 additional beds to handle the patients’ burden.”

He advised the people to take extra care during dengue season, particularly at the time of sunrise and sunset as dengue mosquitoes are more active during these hours. Moreover, people should wear full sleeve clothes and take extra while walking in the morning and evening. According to spokesperson Ministry of National Health Services, the Health Minister Abdul Qadir Patel has directed the health officials to take extra care for dengue patients by putting in place a comprehensive plan. The minister has also directed Drug Regular Authority of Pakistan (DRAP) team to take action against laboratories and pharmacies, charging high rates for dengue tests as well as medicines used to cure this disease.

He has also directed the civic bodies to undertake frequent fogging in vulnerable areas and appealed citizens to adhere to the directions for wiping stagnant water and observing SOPs to avoid from the disease.

Dengue is a self-limiting disease and recovery can take place between two to seven days. Since, there is no specific treatment for dengue, the doctors’ advice routine fever medicines and a ‘peculiar’ food intake mechanism with enhanced liquids usage to cure the disease.

Speaking about the symptoms, Dr Khawar Sultan, a medical expert at PIMS stated mentioned persistent vomiting, abdominal pain, loose motion, and drop in platelets, weakness and low blood pressure besides high temperature.

He recommended proper treatment is to prevent shock, provide basic supportive measures including fluids orally or intravenously throughout the illness.

As per official records, dengue is one of the fast-emerging diseases among humans and is among the most widespread vector-borne tropical viral disease in the world today. The current incidence of dengue infections around the world is more than 58.4 million cases per year with mortality between 10,000 and 20,000.

Countries in South Asia and South East Asia have the highest burden of this disease with its presence in more than 128 countries around the world. The World Health Organisation (WHO) has placed dengue among the top 10 global health problems.

Therefore, it is imperative for the policy makers and the communities to keep alert during the dengue season for containing its impacts to the minimum and ensuring better preventive and cure facilities for the countrymen. APP