Dengue deaths up 12-fold, cases over 15 times in 7 years

Bangladesh has recorded a sharp rise in dengue deaths and cases in recent years compared with the 18-year period from 2000 to 2018.

From 2000 to 2018, the country recorded 296 dengue deaths and 50,208 cases. In the following seven years and nine months, the figures rose to 3,466 deaths and 7,86,091 cases. The death toll was about 11.71 times the earlier figure, while reported cases were about 15.66 times higher.

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Meanwhile, at least six dengue patients died and 1,868 others were hospitalised in the 24 hours till 8:00am yesterday, taking this year’s death toll to 201 and reported cases to 67,367, according to the Directorate General of Health Services (DGHS).

Experts said poor control of Aedes mosquito breeding, underreporting of infections, delayed hospitalisation and repeated infections were among the factors behind the rise.

Public health expert Mushtuq Husain said sustainable dengue control required a long-term, coordinated and people-centred public health programme.

Husain said Aedes mosquitoes had adapted to different environments and could breed even in small amounts of stagnant water, including inside discarded small containers.

Their spread was also no longer confined to urban areas and was increasingly reaching rural communities, he said.

Population growth and repeated infections were further complicating the situation. People who have previously contracted dengue can become infected again, while communities with little or no previous exposure are now also experiencing infections, he added.

Husain also questioned how the effectiveness of dengue-control activities was measured.

He called for a centrally coordinated mosquito-control programme sustained for several years rather than short-term campaigns, with priority given to areas where garbage accumulation, stagnant water and mosquito breeding are most prevalent.

“Dengue should no longer be treated merely as a seasonal disease,” he said.

Husain also called for a three-tier dengue management system. Dengue detection and initial testing should be available free or at low cost at community-level primary-care facilities, while patients requiring closer monitoring should be referred to secondary-care facilities such as upazila health complexes and district hospitals. Medical colleges and specialised hospitals would treat severe or complicated cases.

For Dhaka, he suggested using existing city corporation, railway, bank and other autonomous organisation-run hospitals as secondary-care facilities and upgrading primary health centres with additional beds and necessary facilities for dengue patients. This, he said, would ease pressure on tertiary hospitals and help ensure specialised care for critically ill patients.

Prof Kabirul Bashar of the Department of Zoology at Jahangirnagar University said underreporting and repeated infections may be contributing to the high number of deaths.

Dengue deaths have remained high in most years since 2019 instead of following the earlier pattern of rising and falling in distinct waves, he said.

One possible reason is that the actual number of infections may be considerably higher than official figures because many cases go unreported, Bashar said.

Bangladesh has a huge number of hospitals and clinics, but only a small proportion regularly report dengue cases, he noted.

Underreporting is particularly significant when calculating the case-fatality rate because hospitalised patients are often those in critical condition, while a significant proportion of dengue deaths occur within 24-48 hours of admission, he said.

Repeated infection is another factor, as subsequent infections may increase the risk of death, Bashar said.

With dengue circulating in Bangladesh for more than two decades, an increasing number of people may already have been infected once or multiple times, sometimes without being diagnosed, he added.