By Danilo P. Padua, PhD
Dengue fever incidence is causing a lot of alarm in almost all regions of the Philippines, including CAR. But being alarmed is not a guarantee that something is being done to contain the problem. I mean, measures to control it maybe in place but it is not providing the right solution to such scourge.
According to reports, the first epidemic of dengue in the world happened in Manila way back in 1953. It was called dengue hemorrhagic fever precisely because it results in blood oozing out of the nose by an afflicted individual. Two decades later, the disease became a leading cause of hospitalization and death among children in some regions in the country.
Because of this, the National Dengue Prevention and Control Program (NDPCP) was instituted in 1993. Despite this, dengue incidence showed an increasing trend, especially on the first half of this year. That means that after about 23 years of the program, the dengue problem was not mitigated but escalated to unprecedented proportions. The NDPCP itself was not apt to the task.
While CAR is not among the top 6 regions with dengue, the recorded cases in Baguio alone was more than 1,200 from January up to July this year. La Trinidad is not far behind. Six have died in the Baguio-La Trinidad area during the period because of the disease.
Data had shown that from 2011-2015, the average dengue cases in the country was 220 per day affecting people aged 1 to 91 years old. The approximate average direct medical cost is a staggering PhP15.87 billion annually. Definitely, this has a substantial economic impact locally.
What is worrisome is the prediction that increasing trend of dengue cases will continue because this year, the rainy season is forecasted to be longer and wetter than last year.
The NDPCP did a commendable job in bringing out the foregoing data. Unfortunately, it was not subsequently accompanied by an appropriate program to prevent or control dengue. What was the problem? The program apparently had good enumerators, compilers and maybe medical doctors. Intra-unit communication and cooperation may not have been much of a problem. What was lacking I guess is the lack of entomologists committed to the program who can provide the basic research imperatives as basis for practical strategies in combatting the diseases. Five years would have been sufficient for the purpose.
The main dengue vector in the Philippines is the mosquito Aedes aegypti, which is identifiable by its white dots on its back and head regions and white stripes on its legs. Another one that transmits the disease is Aedes albopictus. Let entomologists do something about them.
The cooperation of everyone was not engaged early on. Control programs were only recommendatory such as the 4S strategy of search and destroy mosquito breeding places; use self-protection measures; seeking early consultation for fever lasting more than 2 days; saying no to indiscriminate fogging. These were not concrete enough to have a viable and effective prevention or control program.
Maybe there is insufficient fund backing for the NDPCP. More funding therefore should be poured into the program for formulating prevention and control strategies, not just for data gathering. The huge direct medical costs and the attendant economic losses due to reduced productivity are reasons enough to increase funding support.
It is said that climate change have made dengue a year-round threat in the Philippines. Some researches suggest that dengue cases are prevalent one to two months after the rainy season sets in with a resulting peak between July and November. That means we have a peak of dengue occurrences at this time of the year. Also, researches show that dengue epidemics are exacerbated by elevated temperatures due to El Niño. These are important research information that should be taken into consideration in crafting a meaningful control strategy.
The following had been suggested to effectively prevent dengue: 1)stop its mosquito vector from breeding and by protecting people from getting bitten by the mosquito (here, the search and destroy activity should be a prime consideration); 2) Screen your house; 3)Alternately, use mosquito nets, mosquito repellants or mosquito coils (katol) and mats; 3) Isolate persons with dengue fever in a screened room for at least five days from the onset of symptoms. This will prevent mosquitoes from biting the patient and acquiring the virus; 4) Eliminate all possible breeding places of mosquitoes in your neighborhood; 5) Fill potholes; 6) Cover water containers and septic tanks; do not allow empty cans, soft drink bottles, spare tires, etc. to accumulate water; 7) Ensure that drains and gutters are not clogged and that water flows freely in sewage lines; and 8) Dispose garbage properly and regularly.
When our son was afflicted by dengue, we gave him barley juice and trace mineral drops. His platelet count never plummeted and he recovered very quickly. He was attended to at the Benguet Gen but stayed there only for two nights. That was about two years ago.
Baguio City had come up with a new program called, “Oplan alis kiti kiti, goodbye dengue”, to combat the disease. It mandates practically everyone from schools, government and private offices, churches, barangays, etc. to be actively involved. This is very good but it needs more teeth, more concrete plan of implementation. Maybe it would be good to organize barangay residents (e.g. cluster them into 50 or 100 houses each) into barangay brigades and do something similar to Brigada eskwela. It could be called Brigada dengue. Let each cluster select their leaders so they can perform what are needed to be done. The brigades will be the one to pursue the 4S strategy or whatever new and appropriate measures they will come up with. Others (schools, churches, offices, etc) could follow a similar tack.
Dengue is everyone’s concern. Together, we can lick it. **
