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The Financial Express

Dengue: children at greater risk in Bangladesh

| Updated: August 01, 2021 15:17:04


Dengue: children at greater risk in Bangladesh

A month ago, Moslehuddin Tarun’s life was marked by tragedy. A monitoring officer at Willes Little Flower School, Tarun lost his wife Fatema Begum to dengue. She was nine months pregnant.

“If it wasn’t for dengue, I would be holding my child in my arms right now,” said Tarun. “I could be spending time with my wife. Dengue has destroyed my entire life.”

It all happened so fast. On Jun 14, Fatema ran a sudden fever. She was diagnosed with dengue on Jun 16. By then her platelet count had dropped to 18,000, reports bdnews24.com.

She was then admitted to Ad-din Women’s Medical College Hospital, where she received an infusion of platelets. But her condition deteriorated and she was soon taken into intensive care. On Jun 20, Fatema died, along with the child she was carrying.

Tarun says the stagnant water in the trash heap next to their home in Shantinagar is a breeding ground for the Aedes mosquitos that spread the deadly disease.

“Many people are catching dengue here every day. One of the students at the school caught it too.”

“Dengue is far more dangerous than coronavirus. In just six days it has wrecked my family. If the area around my home was cleaned regularly and mosquito spray used to kill the pests, I may not have lost everything,” Tarun said.

Amid the COVID-19 pandemic, dengue poses a far greater threat to the children, experts say. As the entire health sector is working to combat the surge in COVID-19 cases, dengue patients are getting diagnosed later and suffering more.

Experts urged hospital authorities to take action to prevent an escalating death toll caused by dengue and COVID-19 and more work to be done to prevent mosquitos from breeding.

The health sector is facing a huge challenge as dengue spreads across the country, according to the Directorate of Health Services. The agency says it is sending emergency directives to the hospitals to combat the situation.

A total of 164 dengue patients have been admitted to Dhaka hospitals in the 24 hours to 8 am on Friday, the DGHS said.

The IEDCR reported four deaths this year that were most likely from dengue. In the first six months of the year, Dhaka hospitals recorded only 372 patients with dengue, but the number surged to 2,090 in July.

Bangladesh saw its worst dengue outbreak in 2019 when more than 100,000 cases were detected. The tally of hospitalised patients declined to 1,405 a year later.

But experts are worried about the massive pressure on public health as it tries to handle the dual challenges of the pandemic and the massive spike in dengue cases in July.

OVERWHELMED HOSPITALS

Doctors at government and private hospitals in Dhaka reported an increase in the inflow of dengue patients over the past few days, including children. Children manifesting dengue symptoms like fever, headache, pain in the eyes, body aches, bleeding from the mouth, swollen stomach, swellings and rash are visiting hospitals.

Central Hospital in Dhanmondi has reported 64 dengue patients as of Friday, the second-highest number of cases in the country, the DGHS said.

Ahona Binte Monir holds her mother’s hand as she girl lies inside a mosquito net at Islami Bank Central Hospital in Dhaka’s Kakrail on Thursday, Jul 29, 2021. She was admitted to the hospital with dengue fever three days earlier. Photo: Asif Mahmud OveThe actual number is over 90, as nearly half of the dengue patients are children, said Dr Sujit Kumar Roy, who is in charge of the paediatrics department at the hospital.

“The prevalence of dengue has increased over the past week. A week ago, we had around 12 dengue patients but in the last three days, more than 40 children were admitted with dengue. Another 50 adult patients are also receiving treatment,” he said.

Sir Salimullah Medical College Hospital has the highest number of dengue patients admitted, with 96, said Kazi Md Rashidunnabi, the director. Twelve of these patients are children. An eleven-year-old child with a dengue shock syndrome passed away at the hospital four days ago, before tests could be conducted, he said.

“Most of the patients are coming in with a fever and low platelet count. We’re providing treatment but the number of patients is increasing by the day.”

The actual number is far  bigger than the official data, he said, adding that the hospital is prescribing outdoor patients to stay home if their condition is not too bad.

Anyone with a fever must do a dengue test and follow advice from a doctor, Rashidunnabi said. They must be admitted to a hospital if they have stomach aches, oedema or vomiting.

Around eight children suffering from dengue are admitted to Dhaka Shishu Hospital, said Dr Shafi Ahmed, the director of the hospital. At least two of the 25 dengue patients at the hospital are now in the intensive care unit, he said.

“The patients are coming with dengue fever and dengue shock syndrome. These diseases worsen the medical condition of patients. Four children have already died. Those with comorbidities and those who have meningitis or leukaemia are dying.”

“We are getting many outdoor patients as well. In August and September, we will be able to determine if the dengue outbreak will intensify further.”

For children, dengue is more dangerous than coronavirus, he said, adding that children with a fever are administered both COVID-19 and dengue tests. “Sometimes they have both and we treat both diseases.”

“Children have mild COVID symptoms and they are less vulnerable to it, but dengue can be fatal for them.”

Due to the lockdown, the number of general patients visiting the hospital has dropped, but the intensive care unit is always full, the director said.

Children with dengue must consume enough water and fluids, said Dr Ahmed Shafi. “When the fever recedes, we feel that the patient has recovered. But in fact, complications arise after the fever is gone. Therefore, they should be monitored for the next 72 hours.”

A nurse cares for patients at Dhaka Shishu Hospital on Wednesday, July 28, 2021. Rising dengue cases have given rise to additional concerns among the COVID pandemic. Photo: Asif Mahmud OveChildren must wear full-sleeved clothes and use mosquito nets to prevent dengue, the doctor said.

One must do a dengue test in 24 hours if they have a high fever, or loss of appetite, said Dr Sujit of Central Hospital.

“No medicine should be taken without consulting a doctor. Many people use Clofenac suppositories if the fever doesn’t come down after taking paracetamol. These medicines can worsen the health of a dengue patient. It is better to get admitted to a hospital if one catches dengue.”

He suggested using mosquito repellents and keeping household surroundings clean.

THREAT TO PUBLIC HEALTH

People are suffering more as hospitals are struggling to cope with the COVID and dengue caseload, say public health experts.

“The coronavirus is foremost in mind, so they take a test for that when they have a fever. After they test negative, they opt for a dengue test, meaning it takes more time to diagnose the patient and their health deteriorates by then,” said public health expert Lenin Chowdhury.

Many patients are suffering from both.

“Most of the hospitals are out of beds for dengue patients as the COVID-19 has spread further. They are not receiving proper treatment. Public health is in grave danger. We are worried about what to do if the dengue spreads further,” he said.

Authorities should initiate a cleaning drive with support from local government and citizens, he said.

“Otherwise, the death toll will skyrocket due to a joint attack of COVID and dengue. Many people will be deprived of proper treatment.”

“Some hospitals have been dedicated to COVID-19 while others are specialised in dengue. What will a patient do if they suffer from both? Therefore, every hospital should have provision to treat dengue and COVID.”

EACH HOSPITAL TO HAVE DENGUE CORNER: DGHS

The dengue menace ‘reached its peak’ before the season arrived, as people were not sufficiently aware despite continuous campaigning, said Dr Afsana Alamgir, deputy programme manager of the Malaria and Aedes Mosquito-Borne Disease Control Programme at the DGHS. “The dengue outbreak amid the COVID-19 pandemic has added to our woes,” she said.

A doctor checks the blood pressure of Fardin Shahriar, a 7-year-old boy who has dengue fever, at Holy Family Red Crescent Medical College Hospital in Dhaka on Thursday, Jul 29, 2021. His younger brother Rahil Shahriar died from the mosquito-borne viral disease at the hospital two days ago. Photo: Asif Mahmud OveAuthorities started the monsoon survey on Thursday and found larvae in six among ten households they visited in the DOHS area, she said. They were all found in rooftop gardens, flower pots or stagnant water, she said.

“On Friday, our team found millions of Aedes larvae in the stagnant rainwater in a closed-down factory.”

She hoped the spread of dengue will be constrained by the second week of August as the City Corporation has started its mosquito-killing drive.

While six hospitals have been dedicated to the treatment of dengue patients, all government and private hospitals have been directed to set up a dengue corner, Dr Afsana said.

“We asked them to dedicate a team for treating dengue patients, which we did in 2019 too. No one should go back without receiving treatment and at least have the chance to do a free NS1 test.”

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