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Strengthen health systems to control Dengue: WHO

Strengthen health systems to control Dengue: WHO

By Bobby Ramakant

"It is critical for countries to strengthen their health systems for prediction, early detection, preparedness and early response to dengue outbreaks," said Dr Samlee Plianbangchang, WHO South-East Asia Regional Director, at a WHO meeting to review and endorse the 'Strategic Framework for the Prevention and Control of Dengue' in the Asia-Pacific region.

In India Dengue is the leading cause of hospitalization and death among children. Increasingly every year, regular outbreaks of mosquito-borne diseases across India leave scores of people dead and swamped hospitals and clinics, exposing the country's appalling public health system. Last year in 2006, three members of the Prime Minister's family were taken to hospital suffering with high fever, a dengue symptom, sparking grave concern and media spotlight.

"The fever is not always fatal but in extreme cases patients might need a blood transfusion to replace platelets and stabilise internal organs. When a patient's platelet count drops the blood's clotting property diminishes and this raises the possibility of continuous bleeding and eventual death. The cost of hospitalisation and treatment is high, especially when a blood transfusion is required," said Dr Rishi Sethi, MD, DM, of King George's Medical University.

Dengue fever is an infectious disease, transmitted by mosquitoes and found in hot and humid climates. Dengue transcends international boundaries and is an acute problem, with about 75% of the population in the Asia-Pacific region at risk.

WHO appealed to governments of Asian countries to accelerate key interventions in the control of dengue, which include policy and regulatory support and partnerships within the health sector and with other ministries such as the environment, education, law and tourism.

Several countries in the region are already facing an unprecedented increase in dengue cases this year. Indonesia is reporting over one hundred thousand cases, which is a 10% increase from the numbers reported last year. Myanmar has seen a 33% increase reporting 11,577 cases so far this year and Thailand has 40,258 cases this year, an increase of 27%. Bhutan reported its first case in 2004 and has seen a gradual increase in the numbers; and Nepal reported its first case in 2006.

Countries must implement a national strategy that will eliminate breeding places of the mosquito vector.

Deaths due to dengue hemorrhagic fever can be reduced by seeking early care and the provision of standard case management in health facilities and hospitals.

Dengue is a man-made problem which is linked to globalization, rapid unplanned and unregulated urban development, improper water storage and unsatisfactory sanitary conditions, which provide breeding grounds for the mosquito. Movement of people to and from urban areas is another major factor.

The dengue virus spreads through the bite of the infectious female Aedes mosquito, primarily Aedes aegypti, which breeds in artificial containers and improperly managed garbage where clean or clear water accumulates. Because dengue is an ecological disease, prevention is the key to effective control.

Individuals can take simple steps such as emptying all water containers at least once a week and ridding their surroundings of containers that collect rain water, which will help to prevent the laying of eggs by the mosquitoes that are the dengue vector.


(Bobby Ramakant is a health and development journalist writing for newspapers in Asia and Africa,, and can be reached at:

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