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World Health Day

Vector borne diseases: Small bites can be a big threat

Globalisation of trade and travel, and environmental challenges such as climate change and urbanisation, are having an impact on transmission of vector-borne diseases and causing their appearance in countries where they were previously unknown.

M.A. Jabbar
WORLD Health Day is celebrated on April 7 every year to mark the anniversary of the founding of WHO in 1948. Each year, a theme is selected that highlights a priority area of public health. The Day provides an opportunity for individuals in every community to get involved in activities that can lead to better health. The topic of world health day for 2014 is "Vector-borne disease: Small bites can be a big threat."
Vector-borne diseases are infectious
diseases spread by intermediate organisms, such as insects and snails that transmit viruses, parasites and bacteria to humans. They are most commonly found in tropical areas and places where access to safe drinking-water and sanitation systems is problematic.
According to WHO, the most deadly vector-borne disease - malaria - caused an estimated 660,000 deaths in 2010. Most of these were African children. However, the world's fastest growing vector-borne disease is dengue, with a 30-fold increase in disease incidence over the last 50 years. About half of the world's population is now at risk from dengue, which is found in tropical and sub-tropical regions around the world, predominately in urban and peri-urban areas. Dengue haemorrhagic fever (DHF), a potentially lethal complication, was first recognised during the 1950s and is today a leading cause of childhood mortality in several Asian and Latin Americn countries. As such, the theme of the World Health Day this year is very timely and appropriate.
Dengue is a mosquito-borne viral infection which causes Ou-like illness and occasionally develops into potentially lethal complications called severe dengue. There is no specific treatment for den-gue/severe dengue, but early detection and access to proper medical care lowers fatality rates below 1%. Dengue prevention and control solely depends on effective vector control measures.
Over 2.5 billion people - over 40% of the world population - are now at risk from dengue. WHO estimates there may
currently be 50-100 million dengue infections worldwide every year. WHO data further shows that before 1970, only nine countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries. The American, South-east Asia and the Western Pacific regions are the most seriously affected.
The Institute of Epidemiology Disease Control and Research (IEDGR) and the Centre for Communicable Diseases, ICDDR,B conducted a hospital-based study measuring the prevalence of dengue and malaria in six districts (Rajshahi Medical College Hospital, Khulna Medical College Hospital, Barisal Sher-e-Bangla Medical College Hospital, Kishoreganj Jahurul Islam Medical College Hospital, Chittagong Bangabandhu Memorial Hospital,USTC and Sylhet Jalalabad Ragib-Rabeya Medical College Hospital) in Bangladesh from 2008 to 2009.
The study team confirmed four malaria and 69 ELISA positive dengue cases. Dengue was equally prevalent in urban (51%) and rural areas (49%), and most common (19%) during the post monsoon season (September-October). The study revealed that in Bangladesh dengue is common in urban and rural areas throughout the year. According to the study, physicians and health workers in rural areas should be trained in effective management of dengue patients with adequate rehydration and judicious use of antibiotics. Healthcare providers in Bangladesh should use malaria diagnostics to ensure accurate diagnosis of febrile illness and avoid inappropriate use of anti-malarial drugs.
Globalisation of trade and travel, and environmental challenges such as climate change and urbanisation, are having an impact on transmission of vector-borne diseases and causing their appearance in countries where they were previously unknown. In recent years, renewed commitments from ministries of health and regional and global health initiatives -with the support of foundations, nongovernmental organisations, the private sector and the scientific community -have helped to lower the incidence and death rates from some vector-borne diseases.
World Health Day 2014 will highlight some of the most commonly known vectors - such as mosquitoes, sandflies, bugs, ticks and snails - responsible for transmitting a wide range of parasites and pathogens and attacking humans or animals.
World Health Day 2014 campaign aims to raise awareness about the threat posed by vectors and vector-borne diseases and to stimulate families and communities to take action to protect themselves. A core element of the campaign will be to provide communities with information, as vector-borne diseases begin to spread beyond the countries where they currently thrive. The campaign programme also aims at informing the people how to protect themselves in areas where diseases are transmitted by vectors; telling travelers how to protect themselves from vectors and vector-borne diseases when travelling to countries where these pose a health threat; and putting in place measures for protection of populations in countries
where vector-borne disease are a public health problem.
In countries where vector-borne diseases are an emergency threat, health authorities must work with environmental and relevant authorities locally and in neighbouring countries to improve and integrate surveillance of vectors and take measures to prevent their proliferation.
Vector-borne diseases can be prevented by (i) wearing clothes that lessen exposure to bites (ii) using screens on doors, windows and eaves to keep vectors out of houses (iii) reducing breeding sites by covering water storage containers; eliminating places where water accumulates; and cleaning out refuse in yards and gardens.
The only method to control or prevent the transmission of dengue virus is through preventing mosquitoes from accessing egg-laying habitats by environmental management and modification; disposing solid waste properly and removing artificial man-made habitats; covering, emptying and cleaning water storage containers regularly; improving community participation and mobilisation for sustained vector control; applying insecticides by spraying during outbreaks; and active monitoring and surveillance of vectors to determine effectiveness of control interventions.
The government is determined to combat vector-borne diseases, which is reflected through various programmes undertaken by the Ministry of Health and Family Planning. WHO plays important role in this respect. It supports countries in the confirmation of outbreaks though its collaborating network of laboratories. The collaborating networks in Bangladesh are ICDDR,B, BIRDEM and NIPSOM.
WHO provides technical support and guidance to countries for the effective management of dengue outbreaks and improvement of their reporting systems. It also provides training on clinical management, diagnosis and vector control at the regional level with some of its collaborating centres; formulates evidence-based strategies and policies; develops new tools, including insecticides products and application technologies; gathers official records of dengue and severe dengue from over 100 member states; and publishes guidelines and handbooks for case management, dengue prevention and control for member states.
For effective vector-borne disease control we must work together. Green city/Green Bangladesh concept should be popularised. Along with government and WHO efforts, health personnel, public representatives, social workers, NGOs, health workers, religious leaders, school teachers and individuals must work to raise awareness about the threat posed by vectors and vector-borne diseases and to stimulate families and communities to take action to protect themselves from the dangers of the disease. The theme of World Health Day this year must be heeded in an appropriate manner. Working together, we shall certainly win over the disease and thus keep the community safe from the danger.
The writer is Executive Secretary, ADHUNIK.