Detrimental Effects of Dengue on Health Care


Dengue Fever Causes and Symptoms

Dengue is a mosquito-borne viral disease, female mosquito species known as “Aedes aeqypti” is the vector which causes Dengue fever; species named “Ae. Albopictus” also transmits Dengue fever on a smaller scale. Dengue is widespread in tropical and subtropical regions, causing severe illness or death in some Asian and Latin American countries.390 million infections of Dengue are estimated each year in more than 100 countries which is a strain on the healthcare system of the affected countries. Asia is the worst-hit region bearing 70% affliction from Dengue and increasing incidence in the Americas, Africa, and Thailand. With no specific Dengue fever treatment, its impact on the health care system and Global or national economies is consequential.

Dengue virus has four closely related stereotypes (DENV-1, DENV-2, DENV-3, and DENV-4). The World Health Organization classifies Dengue into two categories; Dengue and severe Dengue. Symptoms of Dengue are fever, nausea, vomiting, aches, and excruciating pain in muscles or joints whereas, severe Dengue symptoms are internal bleeding, organ failure, shock, and a substantial risk of death. Recovery from Dengue is likely to provide lifelong immunity from the stereotype which affected the individual however, cross-immunity from other stereotypes is only partial, and a second-time infection from a different stereotype can develop Severe Dengue.

Dengue Fever Patterns – Global Out Breaks and Risks

The world has experienced an exponential surge of Dengue in the last couple of decades. Though a proportion of Dengue cases is Asymptomatic or mild and self-managed yet, World Health Organization has recorded an increase of 8 times in Dengue cases reported in the last two decades. A total of 96 million cases of Dengue manifest clinically out of 390 million each year. Unreported and self-managed cases result in inaccurate estimates and consequent uncertainty over the cost of health care for implementing preventive and control strategies.

Dengue is endemic in more than 100 countries of Africa, the Americas, the Eastern Mediterranean, South East Asia, and the western Pacific. The threat of a Dengue outbreak also looms over Europe. 2019 experienced the highest number of Dengue cases and the first-ever transmission in Afghanistan. Outbreaks of Dengue caused 3.1 million cases in the American region, 101,000 cases in Bangladesh, 131,000 in Malaysia, 420,000 in the Philippines, and 320,000 in Vietnam. The countries most affected by Dengue are Brazil, India, Vietnam, Philippines, Cook Islands, Columbia, Fiji, Kenya, Paraguay, Peru, and Reunion Islands.

Dengue Fever Causes

Unplanned urbanization is a driving factor that amplifies various social and environmental aspects contributing to the transmission of Dengue. Population density, human mobility, water source, lack of sanitization, and poor living conditions in urban centres complement the breeding of Dengue vectors, Aedes Aegyptus and Ae. Albopictus. Climate change has created conducive conditions for vector habitats through changing rainfall patterns, humidity, and temperature. Rising temperatures attributed to climate change will increase mosquitoes’ survival, reproduction, and biting rate. Rapid urbanization, Climate change, and population growth are the major factors that threaten the food and health security of the world. The same factor enhances the endemic characteristics of Dengue and is estimated to affect 60% of the world population by 2080.

The strain on Health care

The cost of Dengue, like any other disease, has various direct and indirect impacts. Direct cost encompasses the expenditures incurred on Dengue Fever diagnosis, Dengue fever treatment, and prevention. The indirect cost amounts to economic value lost by households and society due to illness, morbidity, and mortality. Dengue is dangerous, and endemic thrives in urban centres, transmits exponentially, and has no specific treatment. Albeit, Governments have to mainly focus on preventive and control strategies which boost the direct cost and burden the health care system. The global economic burden of Dengue is estimated to be more than US$ 9 billion per year, exceeding several other infectious diseases. Dengue fever is a resource-heavy outbreak due to increasing cases vis-à-vis inadequate space to accommodate all arriving patients in hospitals. In Pakistan average direct cost per patient is estimated to be 358 US$, much higher than the average monthly income per household.

One of the peculiar aspects of Dengue is its unparalleled productivity cost which amounts to 40% of the total economic burden of Dengue. Dengue outbreak renders a sizeable part of affected individuals ineffective or unproductive due to illness which complements the productivity cost of Dengue. Around 18% of symptomatic patients are hospitalized, 43% are treated in ambulatory settings, and 48% are treated in non-medical settings all over the world. 11% of US$ 9 billion is attributed to fatal cases, 46% to hospitalized nonfatal, 33% to ambulatory nonfatal, and 8% to non-medical cases.

Vaccination is a proactive preventive and control strategy and curbs the direct, indirect, and productivity costs in terms of reduced hospitalization, minimal impact on the efficiency of the population, and less expenditure on community control to avoid the spread of an outbreak. In the absence of specific Dengue treatments and vaccines, the direct cost tends to multiply manifolds.

Common Strategies for the World to fight Dengue

Personal preventive measures rely on avoiding mosquito bites which are ensured through distance from the proximity of the breeding habitat, wearing full clothes to minimize the exposure of skin, and using repellants, etc. However, it is high time that the world acts decisively to hold the bull by the horn. The first and foremost thing which is instrumental in the outbreaks of Dengue is unplanned urbanization. It leads to population density, poor sanitization, and stagnant water – creating an ideal environment for the habitat and reproduction of Dengue vectors. Dengue is dangerous, World Health Organization must put its weight on and force the Dengue-affected countries to have well-planned urbanization to reduce Dengue fever causes, the direct cost and the productivity cost affiliated with Dengue.

The second most important factor which impacts the transmission, breeding and Dengue fever pattern is Climate Change which requires the collective resolve of the world. The rising temperature, population growth, and ill-planned urbanization facilitate the reproduction and survival of Dengue vectors. Though Dengue may not be the leading concern, World leaders have to come together to avoid the devastating and ruinous cataclysm of Climate change.


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