EIACP Programme Centre on Climate Change & Public Health

Dengue is regarded as one of the most important arboviral infections in the world. Dengue is caused by infection with dengue viruses, all 4 types of which are circulating in South-East Asia Region, and has rapidly spread to 10 out of the 11 Member States. About half of the world’s population is currently at-risk of dengue. Globally, every year, an estimated 50 million dengue infections occur, with half a million severe cases requiring hospitalization and over 20 000 deaths. About 52% population in WHO South East Asia Region is at risk of dengue. In 2012, a total of 257 204 cases and 1229 deaths were reported from the Region. Dengue is transmitted by Aedes aegypti and Aedes albopictus mosquitoes– the population of which is influenced by demographic, socio- economic and behavioural factors such as rapid urbanization, human activities, increased air travel.

 

Dengue fever (DF) is typically acknowledged to be a disease of early childhood but now there is evidence of increasing dengue incidence in older age groups. Dengue infection causes flu-like illness, but occasionally develops into a potentially lethal complication called severe dengue. Recovery from infection by one serotype of the virus provides lifelong immunity against that particular serotype. However, it does not provide adequate immunity to the other serotypes and subsequent infections by other serotypes increase the risk of developing severe dengue including dengue hemorrhagic fever (DHF). Several factors attributing to the spread of dengue are beyond health sector. Therefore, an effective dengue control programme requires high level political commitment and strong multisectoral partnership. Dengue control requires ongoing and continuous efforts on vector control through integrated vector management approach. Social mobilization and community participation is crucial for this to be successful and sustainable.

–        National Dengue Strategic policy and plan including integrated vector management (IVM) plan

–        Well organized, nationally coordinated dengue inter-sectorial activities.

–        Trained health staff; health workers, clinicians, nurses, laboratory and insecticides spray workers

–        Efficient referral system (hospital, laboratory)

–        Adequate resources

 

–        Comprehensive Guidelines for Prevention and Control of DF and DHF (Clinical, laboratory, surveillance, vector control/ management, communication for behavioural impact)

–        Standardize clinical diagnosis and case management and surveillance form

–        Information about dengue signs, symptoms, early precaution and preventive action for community

–        Guideline and training modules for medical, public health officer, field staff and community volunteers

 

–    Training of health staff for surveillance and IVM

–    In-service training for clinician, nurses, laboratory technician

–    Education for

–        Undergraduate and postgraduate medical programmes

–        Continuing medical education

 

–        Policy and guideline during outbreak

–        Outbreak communication plan and strategy

–        Training of staff at every level

–        Standard case investigation

–        Logistic availability

–        Reporting, Monitoring and Evaluation at Health Center level

–        Good and effective referral mechanism

Monitoring involves the continuous collection of information during program implementation

–        Surveillance data (human, virus, mosquito)

–        Compliance of clinical management with dengue case management guidelines

–        Supplies and equipment

–        Community participation

 

Evaluation systematically assesses the programme effectiveness and efficiency. It evaluates the program plan and design, valuation of implementation, evaluation of outcomes or impact

 

–        You can get dengue through the bite of an infected mosquito. The dengue mosquito breeds in clean, stored, uncovered water.

–        Remove stagnant water from your surroundings

 

–        Empty and clean water storage containers weekly

 

–        Wear long-sleeved, full length clothing and use mosquito repellent.

 

–        Seek early treatment if you have high fever, nausea and body ache.

 

Source:  World Heath Organisation