A determined campaign vs the dreaded dengue

MANILA, Philippines - The fight to eradicate dengue continues and the government and its health agencies are relentless in its determined drive to rid the country of this dreaded disease once and for all.

And the Infectious Diseases Office (IDO) of the National Center for Disease Prevention and Control of the Department of Health (DOH) is one of those agencies. Through the National Dengue Prevention and Control Program, one of the IDO’s 11 health programs, it is unwavering in its objective of helping save more lives against dengue — now and in the future.

From Jan. 1 to July 31 this year, the total number of dengue cases nationwide dropped to 76,354 from 81,509 registered during the same period last year for a 6.32 percent decease, according to the Disease Surveillance Report issued by the Public Health Surveillance and Informatics Division of the DOH’s National Epidemiology Center.

Most affected were Regions 4-A (Calabarzon), 6 (Western Visayas), 7 (Central Visayas-Cebu), 11 (Davao) and 12 (Socsksargen), affecting mostly infants and majority males.

The National Capital Region (NCR) registered the most significant decline though from 15,849 to 4,719 cases so far this year for a 70.23 percent reduction, followed by Region 3 at 56.87 percent and Region 1 at 32.53 percent.

“These are good numbers that say we are on the right track, but we still got a long way to go,” says IDO-OIC director Dr. Mario Baquilod, “especially now that dengue is happening year-round instead of being cyclical.”

To combat this trend, Baquilod said they continue to focus on the “preventive” aspects. Prevention is where the DOH augments the current resources of local government units like equipment, insecticides, insecticide-treated materials (curtains), plus technical assistance so that program guidelines are followed.

However, Baquilod lamented that there is still a need to intensify community cost-effective interventions such as “source reduction,” a campaign to help kill mosquitoes that breed in both natural and artificial water containers, mostly in urban districts with informal settlers and poor waste management.

These include plastic cups, tires on roofs, and water containers where people store clean water because of inadequate water supply in their area, and other possible places, especially during the rainy season.

Baquilod mentioned program tools like the “Ovitrap,” a small black container that attracts mosquitoes and comes with a small piece of wood where mosquitoes land and lay their eggs.

These traps are then placed in possible breeding grounds in the house.Though not really a brand new tool (used for monitoring and surveillance to determine presence of mosquitoes), these traps were enhanced by placing an organic solution in the water that kills the egg and the larva once it comes into contact with the water.

However, based on reports from regional program coordinators, the organic solution needs to be replaced every seven days, plus other operational problems emerged like what if it tips over when accidentally bumped or who will take charge in replacing the organic solution every seven days.

Recognizing that the Ovitrap remains an effective tool, the DOH decided to use instead a chemical solution called “pyriproxyfen” which, according to Baquilod, prevents or “retards” the growth of the egg from becoming a larva or prevents the larva from becoming a pupa until it eventually dies.

“You don’t have to change it every week because a small pinch lasts for 45 to as long as 150 days. It proved to be very economical in the long run for our ‘source reduction’ efforts,’” Baquilod said.

In other areas, Baquilod said they use insecticide-treated curtains, particularly in schools since the most affected age groups are schoolchildren. The curtains drive away or kill mosquitoes upon contact so these were put in windows in schools to protect the kids.

He also mentioned “fogging,” but this is only done to immediately reduce the number of adult mosquitoes in an area during dengue outbreaks and is not a long-term solution.

“The larva and pupa are not affected so they will just grow to become adult mosquitoes. Plus it’s expensive in terms of supply and manpower costs,” he said.

It also helped that the health education program of the DOH against dengue is in full swing like the “4 o’clock habit” campaign. The DOH is reviving it, Baquilod said, to make more people aware of the need to clean their areas and serve as a rallying point to rid their houses of possible mosquito-breeding sites, which include damp clothes in their clothesline where adult mosquitoes also land.

Admittedly, Baquilod said the DOH needs enough budget to effectively and sustainably combat dengue nationwide. But more than the budget, he said everyone should be involved. 

Fighting dengue is not the DOH and the national government’s concern alone, it should involve everybody, from families in a barangay, the community, to even the media in terms of disseminating information. “Eradicating dengue should be everybody’s business,” Baquilod said.

“Families and communities should take care of cleaning their area dutifully and not just rely on barangay health workers. All houses have their own share of mosquitoes so it’s up to them to take care and clean their surroundings, especially in areas with poor sanitation. Immediate action is also important once a family member is suspected of having dengue, that’s why we continue to inform people about dengue symptoms through our info drives,” he added.

With the proper combination of consistent source reduction efforts, health education campaigns, budget, and unfailing — not “ningas cogon” — cleaning efforts of households and communities, Baquilod believes the Philippines can be dengue-free in no time.