Dear Editor,
Understanding that the incidence of Dengue has increased over the past four decades and that the highest number of cases has been noted in the Americas. According to PAHO (2024), the Americas had recorded the largest proportion of the global burden in 2023, registering more than 4.1 million new infections. The Guyanese population notes the valiant efforts being made by the Ministry of Health to secure vaccines to arrest the dengue transmission and the engaging of technical partners and stakeholders such as PAHO to build the capacity of health care professionals to manage clinically the Aedes aegypti mosquito, the primary vector of dengue.
However, is the Health Sector prepared to avert a major public health crisis, this vector borne disease, in a climate changing world? Dengue is a common tropical infection transmitted to man by the Aedes mosquito and occurs from dawn to dusk. There is Dengue Fever and the Dengue Hemorrhagic Syndrome which can progress to Dengue Shock Syndrome. The general symptoms of Dengue include high fever, severe headache, retro-orbital pain, myalgia and arthralgia (muscle and joint) and a rash to the face or thorax-chest. However, Dengue Hemorrhagic fever manifests itself with vomiting- hematemesis or as hematochezia (blood or blood in the stool), abdominal pain and difficulty in breathing. The Dengue Shock Syndrome occurs when the circulatory system fails, and is usually accompanied by tiredness, restlessness, irritableness, shock, organ impairment and death.
With 2, 852 cases being positive and 265 persons needing hospitalization, with two deaths recorded eight weeks ago, and with 60 percent of the regions affected by the vector borne disease are cause for concern. With the recent death of an eleven-year-old child in Bartica, as reported 72 hours ago, seventy percent of our administrative regions have now been placed on the dengue alert. A collaborative effort among the relevant stakeholders must be quickly undertaken. With the advent of climate change, there must be strategic efforts to involve the meteorology department to inform us of the meteorological factors such as temperature fluctuations, the pattern of rainfall, and the vector ecology. The One Health Concept, which recognizes the intrinsic link that connects human health directly to the health of animals and the environment, must not only be adopted but practiced.
It has been well established that the Dengue mosquitoes are susceptible to temperature changes and rises- a range between 20 to 35 degrees Celsius. Hence owing to the vectorial capacity, there are now higher biting rates, more transmission, and more feeds. Other drivers that can affect the vector competence will include land use changes and agricultural practices in urban settings, and a breakdown of public health. These players provide conditions for a wider spatial distribution, increase frequency, intensity, severity, and create the dynamics for increasing contact rates. It will be foolhardy to think that the recent floods in Linden in Region 10, and in Region 5, will not create the opportunity for the vector- borne disease.
There must be better prevention and control that is intersectoral and involve the family and the community. There must be a focus on Public Education and Awareness of this Vector – Borne Disease to include the reduction of breeding sites and on personal protection. Make repellants and mosquito nets free to the populace. There should be One Health Surveillance. The country may also need to relook the legislation on legal and illegal trade of wildlife and the legislation to protect wildlife. There must be sustainable vector control. There must be scheduled fogging. The environmental units of all Municipalities should have access to chemicals and fogging machines. Where is the action plan to help curb this mosquito -borne disease, Health Minister, Dr. Frank Anthony?
Interestingly, while the Minister of Health was taking a photo opportunity as he handed out certificates to 35 Community Health Care Workers in Mahdia, Region 8, the goodly Minis-ter must have been unaware that the fogging machine was not working in the same mining community and Region. The clarion call goes out for the PPP/C Government to make a concerted effort to reduce morbidity by 25 percent and the mortality of Dengue by 50 percent long before 2030. What is the burden of the disease in Guyana? The populace awaits the impact of the dengue vaccine roll out. Is there still no need to panic, Dr. Anthony? Could Guyana avert a health crisis?
Sincerely,
Dr Karen Cummings, MP
Shadow Minister of Health
APNU+AFC Coalition
