Rapid progress in fight against dengue
Sri Lanka is making progress in the battle against mosquito-borne
dengue fever, say health officials.
"Over the last two years we have gone all out to stop the spread of
dengue," Pabha Palihawadana, head of the Health Ministry's Epidemiology
Unit, told IRIN. "Now we are seeing some of the results."
In 2011, 26,722 cases were reported - down from 34,105 cases in 2010
- the Health Ministr reported. The number of deaths dropped from 246 to
172.
Dengue infections rose suddenly in 2009, when 35,000 infections were
reported - an almost six-fold rise on 2008 when there were 6,607 cases.
This prompted the authorities to take action, but the number of
infections continued at a high level. "That is when we knew we needed
help," Palihawadana said.
In May 2010, an anti-dengue Presidential Task Force- involving the
ministries of health, defence, the environment, education, and local
government, and headed by President Mahinda Rajapaksa - was set up and a
massive community prevention campaign launched using billboards, TV
advertising and even schoolchildren to raise awareness.
At the same time, military and civil defence forces began cleaning up
areas suspected of being mosquito breeding grounds. Dumping rubbish in
unauthorized locations became a criminal offence with fines of up to
Rs.4,000; and public health inspectors began visiting homes in search of
potential breeding places.
"It was with the fines and the environmental police that we saw the
tide beginning to shift," Palihawadana explained. Urban areas have been
particularly susceptible to dengue: In 2011, nearly 15,000 infections
and 115 deaths were reported in Western Province, the island's most
populous region and home to the country's largest city, Colombo. Other
urbanized districts with high rates of infection include Kandy (1,553),
Galle (831) and Rathnapura (1,078).
The Presidential Task Force has so far set up over 15,300 committees
at district and village level dedicated to dengue eradication.
Health Ministry spokesman W. M. D. Wanninayake explained that until
the task force was set up dengue was considered a medical problem, but
"with the task force it is now a national priority".
Imports, and local production, of Bacillus Thuriengiensis (BTI), a
bacteria used to control dengue vector larvae, were stepped up. BTI was
released in breeding grounds in high-risk areas, while at the same time
efforts were made to boost training for health workers, and set up
dedicated dengue treatment facilities in at least 50 hospitals.
Health experts from Thailand were brought in to train senior health
professionals who then cascaded the training down to district level.
Speedier referrals for patients with haemorrhagic fever have helped
reduce the number of fatalities.
"We have to commend the government of Sri Lanka for adjusting the
national management guidelines for dengue patients when admitted to
hospital," Kumari Navaratne, a public health specialist at the World
Bank said. "This has drastically reduced the complications of dengue
patients while in hospital and therefore reduced the case fatality
rate."
The government is currently drafting a National Dengue Prevention
Act, due to become law in mid-2012, Wanninayake said.
Under the new legislation, the authorities will be allowed to impose
spot fines and jail terms of six months on anyone who fails to clean up
potential breeding areas.
According to the World Health Organization, there is no effective
vaccine against dengue, or drug treatment for those who become infected
- and there are an estimated 50 million dengue infections worldwide each
year.
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