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Vigilance key to avoiding healthcare battle on two fronts

The government, with much of its focus now on battling the COVID-19 outbreak, should remain vigilant in anticipation of dengue fever cases to ease the strain on medical facilities in the country, a health expert has said

Marchio Irfan Gorbiano (The Jakarta Post)
Jakarta
Mon, March 30, 2020

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Vigilance key to avoiding healthcare battle on two fronts

T

he government, with much of its focus now on battling the COVID-19 outbreak, should remain vigilant in anticipation of dengue fever cases to ease the strain on medical facilities in the country, a health expert has said.

A total of 34,451 dengue fever cases were recorded in Indonesia from January to March 24, with West Java having reported the highest number of cases at 5,894, followed by East Nusa Tenggara with 3,595 cases and Lampung with 3,408 cases, according to Health Ministry data. Dengue fever claimed 212 lives during the same period.

The nationwide figure was around half of 69,424 cases reported in the same period last year. The nation saw 536 fatalities in the same period in 2019.

Despite the lower number of cases so far this year, Budi Haryanto, a professor at the University of Indonesia’s (UI) School of Public Health, urged the government to exercise vigilance, given that more people were staying home now under the government’s instruction to contain the spread of COVID-19. He said this might expose them to a higher risk of encountering the Aedes aegypti mosquito, a host of numerous viruses, including the dengue virus.

“Many people are staying home right now, which means the risk of [contracting dengue fever] would be increased,” Budi said.

Aedes aegypti mosquitoes tend to live near humans and hide inside houses, particularly in dark places. They tend to only go outdoors in search of breeding grounds, according to Budi.

Occasional fogging, a well-established measure to kill adult mosquitoes by spraying insecticides around houses and residential areas, could be less effective now, considering the longer people stay at home during daytime, he said. He, instead, recommended people to regularly spray mosquito repellents around their premises early in the morning, before the mosquito’s active hours later in the day.

Currently no province has raised its alert status to that of an extraordinary occurrence (KLB) for dengue fever, said Siti Nadia Tarmizi, the Health Ministry’s director of vector and zoonotic infectious diseases.

Six cities and regencies, meanwhile, have declared the KLB status so far this year. East Nusa Tenggara’s Sikka, the regency with the highest number of dengue fever cases in the country this year at 1,480 cases, revoked its KLB status on March 18, indicating that the situation there had already improved, said Siti.

However, she called on the public to keep their environment clean and remove stagnant water to deprive the Aedes aegypti mosquitoes of breeding spots, considering that, according to previous data, dengue fever cases usually peaked between March and April.

“We keep reminding the public to stay vigilant, because this is the period of dengue transmission,” Siti said. “People are urged to actively clean their houses and surroundings from mosquito nests, particularly since most people are staying home now.”

The central government, she said, continued to update regional administrations with the latest available data and analysis to ensure they remained alert in anticipation of the dengue fever outbreak.

With more than 1,000 dengue fever cases reported, questions remain as to whether Jakarta, which is the epicenter of the COVID-19 outbreak in Indonesia, will be able to handle two epidemics simultaneously.

As of Sunday afternoon, Jakarta recorded 675 COVID-19 cases — or around 52 percent of the 1,285 cases recorded across Indonesia — and 68 deaths, according to government data published on covid19.go.id.

Jakarta Health Agency’s data, information and report management head Verry Adrian said that, as of Thursday, no hospitals in Jakarta had reported disruption of their services because of treating dengue fever patients.

He said that the Jakarta administration routinely conducted public campaigns on dengue prevention and putting healthcare facilities on standby to treat the cases.

To curb the spread of dengue fever, the Jakarta Health Agency has also been encouraging households to appoint a member who can monitor larvae inside the house, called a jumantik. The agency is also working with one jumantik for every community unit (RW).

The Jakarta administration, in collaboration with the Meteorology, Climatology and Geophysics Agency (BMKG) and the Bandung Institute of Technology (ITB), provides an early warning system for dengue fever on dbd.bmkg.go.id. The online platform provides estimates on the number of dengue fever cases in each municipality in Jakarta, with rainfall and humidity used as the main predictors.

According to the website, the rate of dengue fever cases in April was estimated to be higher than the rate in March, based on its prediction on March 16. It projected South Jakarta to have the highest rate of dengue fever cases with 12.8 cases per 100,000 people in April, compared to 12.5 cases per 100,000 people in March.

The administration urges people to stay alert for rates above three cases per 100,000 people.

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