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Bangladesh awaits a dengue blow

The dengue situation in Bangladesh might worsen further in the coming days devastating the country’s fragile healthcare system already battered by the Covid-19 pandemic, said experts.

Bangladesh started seeing an uptrend in dengue cases from June with the advent of monsoon. Since August 1, the country has been seeing over 200 dengue cases every day.

DGHS spokesperson Prof Nazmul Islam told UNB that there is a possibility that the number of dengue cases will rise further in August due to suitable breeding conditions. “Aedes mosquito breeding increases in stagnant water due to heavy rains in August,” he said.

Some 2,286 dengue cases were reported in the month of July alone, according to the Directorate General of Health Services (DGHS).

The outbreak of dengue fever with over 100 dengue patients reported daily for more than a week has sparked new worries as the country’s healthcare system is facing an unprecedented situation with rising Covid patients and limited capacities.

Just like the Covid-19 pandemic, Dhaka is the worst hit by the dengue outbreak as almost all the cases were recorded in the capital, a home to about 17 million people.

Of the new dengue cases reported on Saturday, 194 were reported in Dhaka while only two from outside the capital, the DGHS said.

According to the (DGHS), 777 patients are currently receiving treatment at different hospitals across the country.

The majority of the dengue patients are from Dhaka as only 30 of them were being treated in hospitals outside the capital.

Some 2,658 patients have been admitted to different hospitals with dengue since January and 1,877 of them have been released after they recovered.

Doctors are advising the patients who have been suffering from fever to undergo both Covid and dengue tests, creating financial burden and sufferings for many.

According to official statistics, 101,354 dengue cases and 179 deaths were recorded in Bangladesh in 2019, the worst the country has ever experienced.

About 50,974 people were infected with dengue in August 2019 though only 50,166 dengue cases were recorded in the previous 18 years from 2000 to 2018.

If the similar scenario repeats, the health system, which is already on the brink, might completely collapse and create a catastrophic situation in the country in addition to the Covid-19 pandemic, experts warned.

Prime Minister’s personal physician Prof Dr ABM Abdullah told UNB that dengue cases may increase further in the future.

“The breeding season of Aedes mosquitoes begins in May and continues under winter. So, there must be measures to control the outbreak before the Dengue season begins,” he said, adding that mosquito control is not the sole responsibility of the two city corporations.

He urged other government agencies, including Wasa and PWD, to put their best foot forward as soon as possible over the matter.

“Destroying Aedes breeding grounds isn’t a tough task. If everyone, including the citizens, regularly cleanse stagnant water from residential premises and the service providers do their duty, we don’t need to worry about an outbreak,” Abdullah added.

Besides, Prof Nazmul of the DGHS said they are currently in the middle of conducting a 10-day survey to have a clear idea about the overall dengue situation in the country.

The DGHS will take further actions to control dengue outbreak after understanding the ground situation upon completion of the survey, he said.

He added that citizens can undergo free dengue tests at government hospitals and there are adequate kits available for this purpose.

Nazmul recommended using mosquito nets even for sleeping in the morning as it is when aedes mosquitoes mainly bite.

“If someone has a fever, they should be tested immediately for dengue and corona. And in the case of taking treatment, the medicine must be taken as per the advice of a registered doctor. If necessary, take treatment by contacting the hot line or health window of the health department,” Prof Nazmul added.

Contacted, Local Government Minister Tajul Islam said many city dwellers are still reluctant about destroying the Aedes breeding sources despite conducting mobile courts regularly.

Tajul Islam warned of stringent punitive action if Aedes larva is found on residential premises. “Anti-mosquito drives and cleansing activities of the two city corporations have already been strengthened in Covid hotspots,” he added.

Besides, the mosquito eradication teams would immediately reach out if residents need help in cleaning stagnant water or other breeding gounds, he added.

DNCC Mayor Atiqul Islam told UNB that a 10-day mosquito eradication campaign was carried out simultaneously in 54 wards of Dhaka North from July 26.

He said citizens can reach out to them anytime through ‘Shobar Dhaka’ (Everyone’s Dhaka) mobile app, emergency number 333 and DNC hotlines 09602222333 and 09602222334.

Dhaka South City Corporation (DSCC) mayor Sheikh Fazle Noor Taposh urged the city dwellers to inform municipality authorities about Aedes larvae so that they can take necessary steps to clean that. “We cannot reach the rooftops of your (city dwellers) buildings. So, if you (residents) watch stagnant water, either clean it by yourselves or inform us and we will clean it.”

He went on saying, “Inform us if you know the breeding sources of Aedes mosquitoes in your surroundings as it is impossible for us to locate and destroy them all by going home to home.”

Dengue fever was first reported in Bangladesh in 2000, claiming 93 lives that year. In the years that followed, the country learned to deal with the disease much better.

The fatalities had almost fallen to zero at one stage, before surging again in 2018, leading to the severe outbreak the following year.

Global burden of dengue

The incidence of dengue has grown dramatically around the world in recent decades. A vast majority of cases are asymptomatic or mild and self-managed, and hence the actual numbers of dengue cases are under-reported, according to the World Health Organization (WHO).

The number of dengue cases reported to WHO increased over 8 folds over the last two decades, from 505,430 cases in 2000, to over 2.4 million in 2010, and 4.2 million in 2019. The reported deaths between the year 2000 and 2015 increased from 960 to 4032.

Before 1970, only nine countries had experienced a severe dengue epidemic. The disease is now pandemic in more than 100 countries in the WHO regions of Africa, America, the Eastern Mediterranean, South-East Asia and the Western Pacific.

The America, South-East Asia and Western Pacific regions are the most seriously affected, with Asia representing – 70% of the global burden of disease.

The largest number of dengue cases ever reported globally was in 2019. All the regions were affected, and dengue transmission was recorded in Afghanistan for the first time.

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