Rising dengue, chikungunya cases haunt Karachiites

KARACHI: Rising cases of dengue and chikungunya continue to haunt the citizens of the port city and public health authorities are clueless how to control mosquitoes, the main vector of these diseases.

The city has witnessed a rising trend of dengue and chikunguya at both government and private hospitals and clinics. Both diseases require a lot of money for proper treatment which many poor and low income families could not afford easily.

There is no specialized dengue and chikunguya wards in the government hospitals and the laboratory tests of both viral diseases are pretty costly and not available free of cost in many government hospitals.

Sindh health, public health departments and the KMC are not able to control mosquitoes and overflowing gutters in almost areas of the city are favorable breeding grounds for the disease-carrying vectors, especially houseflies and mosquitoes.

Karachi Mayor Waseem Akhtar says that the hospitals and dispensaries run by the Karachi Metropolitan Corporation (KMC) are providing treatment facilities to patients of dengue and chikungunya. He said fumigation process has already been under way in the city. However, he complained that the KMC is facing severe fund crunch as the port city is not getting a judicious share of financial resources from the provincial government of Sindh.

Treatment of dengue and other viral diseases in private hospitals is a very costly affair and only well-to-do families could afford visiting the private hospitals if any family member catches the viral diseases. To facilitate low income people of Karachi, it needs setting up of special viral disease treatment wards in major government-run hospitals like the Jinnah Postgraduate Medical Center (JPMC), Civil Hospital Karachi (CHK) and Abbassi Shaheed Hospital (ASH).

A doctor in a reputed private hospital, on condition of anonymity, said dozens of cases of dengue and chikungunya are reported to them every week, but they often provide the data of these patients to the government agencies very late. He said malaria, dengue and chikungunya are widespread in coastal localities of Karachi including Lyari, Gizri, Korangi, Ibrahim Haideri, Landhi and some parts of Malir, adding hundreds of patients suffer in poor slum areas but they do not visit private hospitals and clinics.

However, according to the Prevention and Control Program for Dengue in Sindh this year up to August 07, 2017, a total 422 dengue fever cases were reported in Sindh province, out of them 410 were reported from Karachi, five from Hyderabad, five from Tharparkar/ Mithi and two from Umerkot. However, this program does not release the data of reported cases of chikungunya.

Munawar Ali, a retired government employee, told that he and his wife caught the chikungunya two weeks back. He said they are still under treatment and not fully well as yet. He said the chikunguya is a very agonizing ailment and he could not ever offer his prayers due to the severe joint pain.

Pakistan Medical Association (PMA) general secretary Dr Qaiser Sajjad has said that the PMA has been raising voice over the rise in viral diseases in Karachi for a long but the government is yet to take serious steps to mitigate the situation. He said Karachi needs a modern viral laboratory for early diagnosis of the viral diseases as presently blood samples of the suspected patients are sent to Islamabad for lab analysis, which is a time consuming process.

WHO says that the incidence of dengue has grown dramatically around the world in recent decades. The actual numbers of dengue cases are underreported and many cases are misclassified. One recent estimate indicates 390 million dengue infections per year (95% credible interval 284-528 million), of which 96 million (67-136 million) manifest clinically (with any severity of disease). Another study, of the prevalence of dengue, estimates that 3.9 billion people, in 128 countries, are at risk of infection with dengue viruses.

Member States in 3 WHO regions regularly report the annual number of cases.. The number of cases reported increased from 2.2 million in 2010 to 3.2 million in 2015. Although the full global burden of the disease is uncertain, the initiation of activities to record all dengue cases partly explains the sharp increase in the number of cases reported in recent years.

Other features of the disease include its epidemiological patterns, including hyper-endemicity of multiple dengue virus serotypes in many countries and the alarming impact on both human health and the global and national economies.

Before 1970, only 9 countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries in the WHO regions of Africa, the Americas, the Eastern Mediterranean, South-East Asia and the Western Pacific. The America, South-East Asia and Western Pacific regions are the most seriously affected.

An estimated 500 000 people with severe dengue require hospitalization each year, and about 2.5% of those affected die, says WHO.

However, Sindh health minister Dr Sikander Mandhro has taken notice of the situation and ordered to provide all required medicines to the government hospitals for treatment of vector diseases including dengue and chikungunya.

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