Containment of dengue: A losing battle?

That the incidence of the vector-borne disease, dengue, has reached alarming proportions this year is to say the least when a record 928 deaths and 190,758 cases were reported till the morning of September 25. Given that the responsible government agencies including the local government bodies and the health ministry have so far failed to effectively combat dengue and destroy its carrier, Aedes mosquito, its larvae and the breeding grounds, it is anybody's guess what the final count of the infections and fatalities from the disease will come to in the end.

Doctors, however, have attributed this year's high death toll to delayed hospitalisation, reinfections and the existence of Den-2 and Den-3, the two of the four dengue virus serotypes among the patients. But early hospitalisation becomes an issue when overflowing with patients, the existing dengue-dedicated hospitals miserably fail to do justice to all those seeking inpatient service. So, with the caseloads of dengue and fatalities from it being on a steeply rising curve since 20018 and 20019 when the number of infections crossed the 100,000 mark, the authorities should have taken that as a wake-up call.

Now it appears too late when the total number of cases so far this year is close to 200,000. Had the government given due importance, for instance, to the warnings by WHO that Bangladesh was becoming an ideal ground for dengue vector, thanks to climate change, the preparedness to fight the menace should have meanwhile been on a war footing. But nothing like that happened. Rather, the traditional approach to kill the mosquito and fogging at its suspected breeding spots continued. All seems to be quiet on the dengue front now, though the disease has been wreaking havoc on the populace in the capital as elsewhere in the country. One often hears of those supposedly in charge blaming the lack of the public's awareness for the ever-deteriorating dengue situation. But it is like the proverbial bad workman who blames his tools for any failure. To be frank, what has been lacking from the very beginning is a sharply defined policy to address the dengue menace. It is said that there is such a policy in the making, styled, Bangladesh's Vector Management Policy and that it is being drafted by the local government ministry. No doubt it sounds big. But then whose purpose is such a yet-to-be-born policy going to serve if it is not available when the war is practically over with the enemy, dengue, practically, the victor?

The ministry of health, though not an agency to contain the dengue vector, does still have a role to play by informing the public about the scale of infection by the disease across the nation. In absence of a database to do the job, the bulletins it publishes for the purpose are also not exhaustive. In fact, the Directorate General of Health Services (DGHS) gets its data from only 57 public and private hospitals in Dhaka and 81 district and divisional hospitals. But it is important to note that some 16,000 public and private hospitals, clinics and similar other health facilities are extending dengue-related services across the country. So, it is urgent that as a vital tool to contain the dengue vector, the health ministry should at least have a database updated regularly with all the dengue-related information from the existing nationwide health facilities.