Dengue Fever: A Drain on Health Resources

Abstract

Dengue fever is a very hot topic nowadays, not only among health professionals but among politicians as well. And it is rightly so because since 2010, Pakistan has been experiencing an epidemic of dengue fever that has caused 16 580 confirmed cases and 257 deaths in Lahore and nearly 5000 cases and 60 deaths reported from the rest of the country. The three provinces facing the epidemic are Khyber Pakhtunkhwa, Punjab and Sindh. This year Punjab has reported 2300 cases, of which 50% alone are from Rawalpindi District. In spite of allocation of additional funds it has resulted in drainingmuch of the already meager health resources. While handling the epidemic a lot of emphasis was on providing indoor treatment facilities including platelet transfusions to as many patients as possible. While doing so important principals of community medicine for dealing with epidemics were largely ignored because of the political pressure on the hospital administrators and doctors. It is not only Pakistan facing this menace, it is estimated that about 2.5 billion people (over 40% of the world population) are at risk. There are about 50-100 million cases occurring in the population at risk every year. Dengue is transmitted by an Arthropod (mosquito Aedes aegypti ) and caused by a Flavivirus infection, the primary host of which are human. Therefore the emphasis for controlling the disease should be on the vector control(mainly Aedes aegypti mosquito) and protection from mosquito bite. This is what the WHO recommends. Obviously the responsibility for vector control rests on Civic bodies and the society itself. In a country where leaking fresh water pipes, broken roads and ditches holding rain water, tyres and pottery shops are abundant with no sense of responsibility for regular garbage disposal and mosquito control, there is abundant space for breading of vector. This is added by underground fresh water tanks, most favorite site for Aedes to breed is in almost every house. The money which is spent upon providing treatment facilities, which are expensive, should be diverted towards improving civic services and creating awareness about the preventive measures, which are far less expensive. Prevention is better than treatment as it also reduces morbidity whereas treatment will only reduce mortality.