The World Health Day this year brought into sharp focus a set of diseases that are water-borne. In a country like Bangladesh which is dotted with countless rivers, rivulets and canals full of water, the incidence of such diseases is to be otherwise considered menacingly high. But thanks to ceaseless efforts of the government and the World Health Organisation, its magnitude has been brought down to a minimum.
The top 10 vector-borne diseases that contribute to increased morbidity and mortality are malaria, Kala Azar, dengue, plague. filariasis, chickungunya (common symptoms of the disease are similar to dengue), lyme disease, yellow fever, Chagas' disease and Japanese encephalitis. The first three diseases are common in Bangladesh but low in intensity. These are diseases caused by pathogens that are transmitted to humans through insects and ticks carrying the pathogen. They are difficult to prevent because of several challenges facing the control of vectors and transmissibility of the pathogens.
The ministry of health in particular deserves kudos for greatly reducing the incidence of dengue, a fever that is caused by mosquito bites. When it broke out in an epidemic form in different districts years ago, doctors appeared to be at their wit's end. But it was due to timely intervention by the World Health Organisation (WTO), special kits were brought in from abroad and adequate training was given to the country's doctors by foreign specialists. And today Bangladesh's doctors are capable enough to deal with it themselves.
There have been mass awareness programmes initiated by the Department of Heath Education under the Heath Directorate. Common people in urban centres have been enlightened with do's and don'ts. Most of them now know that vector-borne diseases can be prevented by wearing clothes that lessen exposure to bites, using screens on doors and windows to keep vectors out of houses and reducing breeding sites by covering water storage containers. Moreover, residents of different localities now eliminate places where water accumulates and cleans out refuse in yards and gardens.
In fact, the only method to control or prevent the transmission of dengue virus is through preventing mosquitoes from accessing egg-laying habitats by environmental management. Solid wastes need to be disposed of properly and artificial man-made habitats are to be removed; water storage containers need to be covered, emptied and cleaned regularly. We have to improve community participation and apply insecticides by spraying during outbreaks. There must be active monitoring and surveillance of vectors to determine effectiveness of control interventions.
Bangladesh is indebted to the WHO for technical support and guidance for effective management of dengue outbreaks and improvement of their reporting systems. The global agency also provides training on clinical management, diagnosis and vector control at the regional level with some of its collaborating centres. The WHO develops new tools, including insecticides products and application technologies and gathers official records of dengue and severe dengue. It also publishes guidelines and handbooks for case management, dengue prevention and control for member states like Bangladesh.
But then common people have to be involved with mass awareness programmes as they live in places close to breeding grounds of vector diseases. For effective vector-borne disease control, all must work together.
Along with the government and WHO efforts, health personnel, public representatives, social workers, NGOs, health workers, religious leaders, school teachers and individuals must work to raise awareness about the threat posed by vectors and vector-borne diseases.
As urban centres are being looked after by municipalities with elected representatives and health departments, incidence of vector-borne diseases is relatively low there than in the rural areas. The upazila parishads should make efforts to involve the union parishads in taking up motivational and awareness programmes as villages virtually remain outside the government's coverage.
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