The Philippines, a constituent of the Association of South East Asian Nations (ASEAN), joins fellow country members in urging the public to strengthen forces in our continuous pursuit to defeat dengue as we commemorate the ASEAN Dengue Day for its 7th year. This is observed every 15th of June per declaration of ASEAN Health Ministers during their meeting held in Singapore on July 22, 2010.

Image/Broesis via pixabay
Image/Broesis via pixabay

This year, the Department of Health (DOH) Regional Office V (Bicol Region) is leading the efforts to promote the local ASEAN Dengue Day with its theme focusing on “Search (and destroy mosquito breeding places) and Seek (early consultation).” This event aims to focus on the two (2) core actions of the 4S strategies as our shared responsibility for effective dengue prevention and control program.

The 4S implementation calls for everyone to become prime movers in achieving substantial change and positive influencers to others within the community. “The significance of addressing dengue at the barangay level is to overcome its detrimental impact of instigating economic burden and hindering our development goals. The first step to prevent dengue is within our homes, it is important to instill cleanliness in our surroundings and empty containers with stagnant waters to eliminate the breeding places of mosquitoes. If fever is persistent, with or without rashes, it is imperative to seek early consultation in the health facilities for proper medical management and to avoid serious complications,” DOH Secretary Paulyn Jean Rosell-Ubial emphasized.

“Our fight against this dreaded virus needs a multi-sectoral approach towards a sustained integrated vector management. We need everyone’s support, the DOH together with the local government unit, other government agencies and private sectors will visit households and educate the residents on the importance of preventing the spread of dengue,” the Health Chief added.

The challenge to adhere an enhanced 4S implementation is doing them consistently and regularly. A great example is the reactivation of the 4 o’clock habit, a once a week search for key containers and other breeding sites of mosquitoes and eventually destroy them at 4 o’clock in the afternoon in every household. To institutionalized this “Search and destroy breeding sites” in the locality, the passage and implementation of an ordinance is hereby recommended.

Meanwhile, there is a decreasing trend of reported dengue cases to the Epidemiology Bureau. Statistics from January 1 to May 20, 2017 show a total of 35,973 dengue cases nationwide, 31.8% lower compared to the same time period last year (52,780). Secretary Ubial, however, reiterates that we cannot be complacent in our efforts against dengue and we strive harder to eventually make Philippines a dengue-free country.

Most of the cases from 2017 were from the following regions: Central Visayas Region (15.5%), Central Luzon Region (13%), National Capital Region (12.2%), CALABARZON Region (11.4%) and SOCCSKSARGEN Region (11.1%). Ages of cases ranges from less than 1 month to 98 years old (median = 13 years). Majority of the reported cases are males (54%). Most (21.5%) of the cases belongs to the 5 – 9 years age group. There are 207 reported deaths with a Case Fatality Rate (CFR) of 0.58%. The age group that has the highest CFR is 0-4 years old (0.86%).

The National Dengue Prevention and Control Program (NDPCP) highlights the reinforcement of its Integrated Vector Management (IVM) strategy by letting the public know the vector itself, Aedes aegypti. In Bicol, our host region for this year, these mosquitoes are cultured at the Regional Insectary for research and other educational purposes while dengue virus can be further studied at the Public Health Laboratory for Dengue. In this regard, it is necessary to improve and upgrade the facilities of both the Regional Insectary and the Public Health Laboratory for Dengue.

Also, scaling-up interventions against dengue is the national roll-out of Dengue NS1 Rapid Diagnostic Test (RDT). An administrative order No. 2016-0043 entitled “Guidelines for the National Implementation of Dengue Rapid Diagnostic Test RDT” was signed on December 21, 2016. A nationwide orientation was done on the use of Dengue NS1 RDT and capacity building for peripheral health care workers in cooperation with Research Institute for Tropical Medicine. Updating the clinical management guidelines and surveillance flow as well as diagnostic tools like the RDT NS1 antigen for Dengue has been introduced. More so, the operating guidelines for the use of Loop Mediated Isothermal Amplification (LAMP) technology to complement the dengue NS1 RDT is near finalization and will be applied at hospital level. (RDT at RHU level, LAMP at hospital level).

The prick-drop-wait procedure test kit contains a finger lancet to draw blood and promises results in 15 minutes. Like a pregnancy test kit, the Dengue NS1 RDT yields positive result for dengue by displaying two lines. Qualitative detection of NS1, released with high concentration in human serum during the acute phase of dengue infection, may help predict the risk associated with the disease. Thus, this NS1 test is relevant during the acute or early phase of infection. Seeking early consultation will substantiate the result of the Dengue NS1 RDT.

Early case detection, diagnosis and correct fluid management are key factors in reducing dengue morbidity and mortality shall be facilitated by: early seeking behavior; reiteration of the nationwide implementation of the Dengue NS1 Rapid Diagnostic Test (RDT) under administrative order 2016-0043; appropriate fluid replacement for children and adults to prevent dehydration and avoid overhydration; implementation of the guidelines for case management and referral based on clinical judgement and local context and ; conduct of formal systematic mortality reviews.

“Dengue prevention should start from us. Make 4S a habit so that together, we can fight and eliminate dengue-carrying mosquitoes and protect ourselves and loved ones against dengue. Let us unite in one goal of all for health towards health for all, ACHIEVE!” Health Secretary Ubial concluded.

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