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Development
of National Dengue Prevention and Control Programme
In response to the resolution accepted by
the World Health Assembly in 1993, WHO/ SEARO developed a regional strategy
for control of DF/DHF in 1995 and revised it in July 2001 with the following
major components:
 Establish an
effective disease and vector surveillance system based on reliable laboratory
and health information systems.
Ensure early
recognition and effective case management of DHF/DSS to prevent case
mortality.
Undertake disease
prevention and control through integrated vector management with community
and intersectoral participation.
Undertake activities
to achieve sustainable behavioural changes and
partnerships.
Establish emergency
response capacity to control outbreaks with appropriate medical services,
vector control, communications and logistics.
Strengthen regional
and national capacities to undertake prevention and control of dengue and
research related to epidemiology, disease and vector management and behavioural changes.
Different countries
formulated control programmes as per their
priorities, availability of infrastructure, and resources, etc. Consequently,
Thailand, Indonesia and Myanmar established National
Dengue Prevention and Control Programmes followed by Sri Lanka which has
established a National Task Force for control of DF/DHF. India, Bangladesh and Maldives do not have National
Dengue Control Programmes but undertake
vector-borne disease control/malaria control activities for emergency control
of epidemics.
 Major
activities under Dengue/DHF Control Programme
Disease Surveillance
A strong surveillance
system is crucial for priority setting, policy decision to reduce disease
burden, prediction and early detection of epidemics. All the countries in the
Region have passive surveillance systems, which do not help in predicting
epidemics.
Emergency Response
Practically most of
the dengue-endemic countries do not have the necessary infrastructure to
respond early and effectively to control epidemics. Emphasis is always on
fogging and larvicide application. There
has been an attempt to mobilize communities to undertake source reduction
methods to prevent transmission. In most of the cases, the community will
rely almost exclusively on government services to address the problem.
Clinical Diagnosis
and Management
Prompt diagnosis and
standardized treatment is a key to case management and for reducing the case
fatality rate. In the South-East Asia Region clinicians and physicians in Thailand have provided the
leadership in this direction. Seminal studies on the pathogenesis and pathophysiological changes in DHF
patients were carried out in 1960 at the Queen Sirikit Institute of Child Health, the WHO Collaborating Centre for Clinical Management of DF/DHF, which resulted
in development of guidelines for clinical diagnosis and management of severe
cases to bring down the CFR below 0.5%. These guidelines were adopted by WHO in 1975 and have also been incorporated into the IMCI protocols
of Indonesia, Vietnam and Philippines.
Vector Surveillance
Larval Surveys: Specialized ecologies
of Aedes mosquitoes, limited
dispersal and container breeding habitat and preference for human blood,
enable the species to stay within human settlements. Vector surveillance is
largely based upon sampling larval population for estimation of appropriate
indices for planning, monitoring and evaluation of control programmes.
Vector Control
The Regional dengue
control strategy envisages a "selected, sustainable and integrated
control approach with community and intersectoral participation".
The
countries of the Region have developed various models of community-based
control programmes based source reduction and have met with varying
degrees of success.
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