Dengue crisis: How many lives must be lost before action is taken?
It is heartbreaking to live abroad, work in a reputable North American public health laboratory and read about deaths due to dengue in Bangladeshi newspapers on a daily basis. The situation is unacceptable.
We all know that Dhaka, along with other parts of Bangladesh, are experiencing an alarming surge in dengue cases for the last few years, and that the current year is more serious than previous years, with this year having daily fatalities. Yet, the response from authorities remains insufficient. Dengue and mosquito-borne diseases in Bangladesh, much like floods or cyclones, are an issue that is not going anywhere. A long-term action is needed and it is needed urgently. Unfortunately, this has not happened as of now.
For all latest news, follow The Daily Star's Google News channel. A long-term Mosquito Control Program (MCP), similar to climate adaptation plans, could provide structured and consistent efforts to tackle mosquito populations and dengue outbreaks over the years. At the very least, we should try our best to avert deaths due to mosquito-borne illnesses using science-based formulas. This would involve education, ongoing surveillance, and a coordinated mosquito control strategy.
Community education and engagement: Raising awareness at all levels of society about how to reduce mosquito breeding sites is essential. This could include mass campaigns, engaging religious leaders, social workers, professionals and adding mosquito control education to school curriculums.
Ongoing surveillance: Regular mosquito population and pathogen monitoring would allow for proactive intervention. Surveillance data could help detect trends in mosquito species and breeding sites, guiding authorities in timely spraying and control efforts.
Larval mosquito control: Controlling mosquitoes of all stages is important; however, larval mosquito control must be a priority. To effectively control mosquito populations, particularly in urban areas like Dhaka, an integrated approach focusing on larval mosquito control can be extremely impactful. This method targets mosquito larvae in stagnant water sources before they mature into biting adults, which is the most effective stage to interrupt their life cycle and prevent mosquito-borne diseases.
Biological agents derived from naturally occurring bacteria such as Bacillus thuringiensis israelensis, Saccharopolyspora spinosa, and Lysinibacillus sphaericus. These agents are environmentally friendly and effective at killing larvae without affecting other organisms. They are available in liquid or solid forms. This can be applied directly to water through backpack sprayers, trucks, or aircraft. Solid forms are available as dunks, tablets, pellets, granules, or briquettes that are placed in water where mosquitoes lay eggs. This can be done using school students, social workers and religious leaders.
Given Dhaka's rapid and unplanned growth, large areas are inaccessible by trucks. A potential solution is the use of crop duster planes. These planes are affordable relative to the magnitude of the mosquito issue, and they can cover extensive areas quickly and effectively. Crop duster planes for spraying and more frequent, large-scale treatments could be part of the immediate response.
For Dhaka city, authorities could consider investing in crop duster planes for larvicide application, especially in hard-to-reach urban areas and implement weekly applications and regularly monitor water samples to ensure no larval presence, adjusting efforts until open water sources are mosquito-free.
Such measures, along with regular monitoring and targeted applications, can reduce mosquito populations significantly, aiding in the prevention of mosquito-borne diseases.
Government action and coordination: The government's MCP, backed by scientific input and coordination among city authorities, health departments, and communities is a necessity and need it NOW..
Short-term and for quick action: This should include immediate actions like spraying to kill adult mosquitoes using a crop duster plane and eliminating stagnant water sources in both public and private spaces.
Without consistent and coordinated action, the problem is likely to worsen as the environment for mosquito breeding improves with climate change. A plan focused on Coordination, Consistency, and Continuity (3Cs) would be key to success and should be implemented immediately to stop unwanted death.
My sincere hope is that authorities responsible for controlling dengue will take immediate action to avert these undesirable deaths immediately.
Dr Muhammad Morshed is clinical microbiologist and program head at Zoonotic Diseases and Emerging Pathogens, BC Center for Disease Control, Vancouver and Clinical Professor, Department of Pathology and Laboratory Medicine, University of British Columbia.
Views expressed in this article are the author's own.
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