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Dengue shakes health system in Bangladesh

The weakness in the health system of Bangladesh came in the spotlight as the country endured the worst dengue outbreak in history in 2019.Since May, the media had abounded with stories and images of hospitals overrun with dengue patients.

There were also countless news stories of private hospitals cashing in on the situation, ineffective mosquito killing medicines, untackled mosquito-breeding habitats, the spreading of the dengue menace all over the country and denial of dengue death cases.

Primarily dubbing the dengue situation as a rumour, the government later responded with ordering more beds at government hospitals, limiting patient care charges, cancelling doctors’ leave, importing mosquito-killing medicines and dengue-test kits alongside conducting mosquito-killing drives.

The Directorate General of Health Services reported a total of 101,354 dengue cases up to December 31, which was unprecedented in the country’s dengue history since 2000 when dengue infection was first reported in Bangladesh.

Until 2018, the number of dengue cases hospitalised in the country crossed the 6,000-mark three times since 2000 with at least 6,232 getting hospitalised in 2002, at least 6,060 in 2016 and at least 10,148 in 2018.But the 2019 official figure hit nearly 10 times the official number in the previous year.

The number of dengue patients hospitalised in June of 2019 was 1,884, in July 16,253, climaxing in August to 52,636. The figure then started falling, with 16,856 patients hospitalised in September, 8,143 in October, 4,011 in November, and 1,237 in December.

Although the number of dengue cases generally peaks in October after the monsoon but the surge in dengue patients started from May, apparently because of substantial increases in rainfall, creating a favourable breeding condition for Aedes aegypti mosquitos, the primary vector of the infection.

The DGHS Communicable Disease Wing in its surveillance in February found high number of aedes mosquitos in the capital but the city corporations paid no heed to the wing’s warning.

Although dengue infections were initially confined to the capital, as had been the case since 2000, in 2019 the menace started spreading outside the capital, for the first time, in the fourth week of July.

Just in a week the menace spread to the whole country and its severity in the outlying districts overtook that in the capital.

As the district and upazila health facilities were not prepared for the situation, the number of fatalities from the fever increased in the rural areas at a fast pace, and critical patients were referred to the capital and many of them died on the way.

Bangladesh’s poor surveillance system led to huge under-reporting of its cases as experts estimated that the number of the cases could be several times higher than officially reported.

The reports of the hospitalisation of its patients and of the deaths caused by the disease were sent to the DGHS by 12 government and 29 private hospitals in the capital and by 64 civil surgeons and the medical college hospitals elsewhere in the country.


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