Comprehensive drive against dengue needed

Of late, a lurking public health emergency, dengue, does not hit the headlines, since the media is now obsessed with absorbing or exciting political news. Despite the relative public as well as official inattention, the vector of the disease, the Aedes mosquito, has not stopped breeding, if only due to the ideal condition being created by the frequent  spells of rain often accompanied by downpours across the country this rainy season. Also, the ongoing construction works with more and more urban sprawl around providing the aedes mosquito with numerous holes at the construction sites creating puddles for the dengue mosquitoes to lay eggs, develop those into larvae, which are quietly undergoing metamorphosis and becoming adults in greater numbers. Is this process of growing aedes mosquito population facing any mortal challenge from the local government bodies, the city corporations and municipalities tasked with eradicating the deadly insect?

As late as last Friday, July 18, the Directorate General of Health Services (DGHS) informed that to date, 61 persons have died of dengue across the country this year. On that particular day (Friday), one dengue patient died in the country and the patient in question was under treatment in a hospital within the Dhaka South City Corporation (DSCC) area. Consider that, of all places in the country, it was from a city hospital that a dengue-related death was reported. The number of dengue patients admitted to hospitals was 114 on that day. In the 18 days of the current month,  6,099 dengue   patients with fever were admitted to different hospitals across the country. If the number of hospitalisation of dengue patients since the beginning of 2025 till July 18 are counted, the total figure will stand at 16,395. 

Notably, the highest number of deaths from the disease was recorded in June. Also, the highest number of hospitalisation from dengue cases at 288, according to DGHS, was reported last month since January 2025. The broader trend was that, unlike in the past years, 75 per cent of the dengue cases were being reported from different districts outside Dhaka.  Last month, the highest number of dengue cases were reported from the coastal district of Barguna. Entomologist GM Saifur Rahman was of the view that the district's coastal geography has a role to play in this regard. Since, according to him, in coastal areas people usually store water, the practice provides an ideal ground for the aedes mosquito to breed. Improved connectivity throughout the country is yet another reason for faster spread of the vector-borne disease in the districts.   This development challenges the previously held belief that dengue is primarily a Dhaka-centric public health issue. In consequence, activities like adopting the required dengue prevention measures were largely conspicuous by their absence in the districts. The obvious answer to this lacking is strengthening surveillance and actions to eliminate mosquito breeding grounds. Experts attributed the surge in dengue cases outside Dhaka to inadequate mosquito control measures, low level of public awareness and the presence of multiple dengue serotypes.    The dengue serotypes are closely related dengue viruses, namely, DEN-1, DEN-2, DEN-3 and DEN-4. In this connection, entomologist, Professor Kabirul Bashar  of Jahangir Nagar University, for instance, identified  Barishal, Barguna, Chattogram and Cox's Bazar as the most dengue-affected districts. However, the capital city's exposure to the different dengue serotypes since 2000,  has given some level of immunity to dengue among its residents. But in the districts outside Dhaka, the situation is different. They are more vulnerable to dengue. According to the European Centre for Disease Prevention and Control (ECDPC), Bangladesh has been experiencing more dengue cases in 2025 than during  the same period last year. For, as ECDPC report showed, till May 25 this year, Bangladesh had recorded 3,972 cases and 23 deaths from dengue compared to 2,853 cases by the same period in 2024. However, the number of dengue-related deaths during the same period last year was higher at 41.  Another development worth noting is the sharp rise in the so-called Breteau Index (BI), which is a measure of aedes mosquito density, across  the country. The method used by entomologists to measure BI is taking a count of the number of households that have at least one positive water container marked positive,  i.e., have mosquito larvae or pupa, out of 100  such households inspected. Entomologists involved in the related research showed that  April's count  for BI that exceeded 10 was higher than the average of the previous year. If the BI count crosses 20 or more, that would be bad news for the country's public health issue. If the rise in MI remains unchecked, 2025 may experience an even severer form of dengue outbreak than last year's that witnessed some 101,214 dengue cases and 575 deaths.

This should be a cause for concern. That is because  hospitals outside Dhaka are not adequately equipped with the required facilities to treat dengue patients. 

That calls for due attention from  the health ministry and all other government agencies concerned to launch a concerted programme of building dengue awareness among the population so they keep the surroundings of their residences clean and free from any potholes or containers that can hold rainwater. At the same time, comprehensive dengue eradication drives have  to be launched in the districts. Especially, after every rainfall, a drive should follow to destroy the potential breeding places and the mosquito larvae. 

To enable proper tracking of the dengue cases and ensuring effective surveillance and response, some experts have suggested that dengue be declared a reportable disease. In that case, a database for dengue based  on the case reports from the hospitals and diagnostic centres of the country could be created. 

So far, the  government failed to adopt an integrated  dengue control strategy. The Integrated Aedes Management (IAM) approach tested and approved by the World Health Organization (WHO) and implemented across the globe should also be applicable here. It  is a data-driven and evidence-based  action plan tailored to local contexts. Its  components include: environmental management, biological control, application of  chemicals, community participation and education. Such approach is also aligned with WHO's Integrated Vector Management (IVM) strategy, which stresses the application of a combination of different kinds of interventions rather than a single method. 

The government should also take a more innovative and integrated strategy to fight the dengue vector. Otherwise, the growth of Aedes mosquito population, which is becoming resistant to a particular type of adulticide, may go out of control.

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