OPINION: Why it is virtually impossible to defeat dengue fever through ad hoc strategies

Monday April 15 2019



Syriacus Buguzi

Syriacus Buguzi 

By Syricus buguzi

You may have slept under an insecticide-treated bed-net, believing you were safe from mosquito-borne infections. Yet, as soon as you get out of bed at dawn, a tiny insect with white markings on its legs and lyre-like markings on its upper surface of the thorax keep nagging you as you walk around, perhaps brushing your teeth, et cetera, et cetera...

Then the insect softly land on your bare shoulder, stretch out its proboscis and pierce your skin and into a blood vessel, suck your blood – and flow away.

Then it dawns on you that a mosquito has just been following you around. But then, you ask yourself: “I slept under a bed-net because mosquitoes which transmit malaria parasites are active at night. How come they were also active in the morning?”

Well, Tanzania is inhabited by various mosquito species, including the common night-biting Anopheles which transmit malaria parasites. Then there are largely-unknown varieties, such as the Aedes aegypti that bite especially in the morning and evening.

Aedes aegypti has recently become notorious in Tanzania for the increasing cases of dengue fever it causes. Indeed, the Health ministry announced recently that 307 cases of dengue fever had been diagnosed in Dar es Salaam and Tanga.

But there was virtually no mention of long-term plans by public health institutions to rid the country of the mosquitoes.

Indeed, the announcement by the Health deputy minister, Dr Faustine Ndugulile, was mainly on how to avoid the mosquitoes, and procedures to follow in case one develops dengue symptoms.

Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to 14 days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash.

There is no specific medicine to treat dengue infection. In other words, it has no known cure, no vaccine – and prevention remains the only option.

We, therefore, need to focus on the long-term strategies of dealing with the mosquitoes instead of waiting until another round of cases occurs.

Generally, dengue fever can be relieved by using painkillers with acetaminophen, and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids and see an accredited doctor.

More often than not, when dengue fever cases are diagnosed in Tanzania, the government and the media tend to react, virtually screaming ‘dengue fever has resurfaced’.

Indeed, there are dengue epidemics. But I remain convinced that the scourge of dengue fever has always been with us because the Aedes aegypti mosquitoes have always been with us as well, from time immemorial. They don’t disappear and resurface.

Evidently, dengue fever is sometimes misdiagnosed because of its symptomatic semblance with malaria – including high fever. It is only when a medic decides to go the proverbial extra (diagnostic) mile that a dengue fever patient can be positively identified.

That’s why there’s an ongoing malaria treatment campaign in Tanzania dubbed ‘Not every fever is malaria’.

While medics must always go the extra mile, at the heart of effectively tackling dengue is the eradication of breeding habitats of the main culprit, the Aedes aegypti – thus eliminating the vector.

The government must not end this season’s epidemic with another ad hock approach: giving a statement, spreading social media tips and waiting for when people and media organs will react again. Long-term Larvae Source Management (LSM) and indoor residual spraying (IRS) are key.