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DENGUE FEVER IN THE PHILIPPINES
Roberta Howard, Jaleel Arnado, Kat Fajardo
University of San Francisco
Most rapidly spreading mosquito-borne viral disease
Estimated 50 million dengue infections annually worldwide
Approximately 2.5 billion people live in dengue endemic countries
Philippines is one of four countries that has the greatest number of cases and deaths from dengue
(Cambodia, Malaysia, Vietnam)
In 2010, there were 62,503 total cases of Dengue Fever and 465 deaths (CFR 0.74%)
Risk factors: living in tropical or sub-tropical areas, increases in rainfall, suppressed immunity,
environment (water containers), traveling
(WHO, 2010)
Diseases of the heart (83.3)
Diseases of the vascular system (63.9)
Malignant neoplasms (48.4)
COUNTRY BACKGROUND EPIDEMIOLOGY OF DENGUE FEVER
TOP THREE HEALTH CONCERNS
RN/CNL ROLE
POLICY RECOMMENDATIONS
IMPACT OF DISEASE
SURVEILLANCE MEASURES
HEALTH PROMOTION /TREATMENT
Population (2012): 96,471,460
Considered to have low to mid-socioeconomic status (SES)
Official Languages: Tagalog and English
Religion: Catholic, Muslim, Evangelical, Iglesia ni Kristo,
other Christian (2000 census)
Government: Republic; mixed legal system of civil, common,
Islamic, and customary law
National Health Insurance Agency: PhilHealth
2010 - Reform to achieve Universal coverage; Private
health care also available
Health Care Beliefs: No symptoms means no disease,
exercise is important in preventing hypertension, sometimes
ashamed to ask for help regarding health issues
Educate nurses and medical staff of WHO standard clinical
management guidelines of Dengue Fever
Encourage health promotion education and prevention with
patient, family and community members
Ensure cases are being reported for surveillance ot track
outbreaks and notify communities of outbreaks
Educating communities about dengue fever, how to prevent
outbreaks and when to seek medical assistance highly
effective in reducing incidence. CNL role would be most
strongly utilized as liaison between community member,
medical staff, and public sectors.
Aggressive research into vaccinations
Continued research on disease surveillance,
economic burden of dengue, cost-effectiveness of
vaccinations
Continued education about prevention in cities and
in provinces
PREVENTION - Prevent getting mosquito bites Primary
Reduce mosquitoes by eliminating places where mosquitoes
lay their eggs
Artificial containers that carry water in and around the
house
Use of chemicals to control vector population
Insecticides, Space spraying
Change water in vases, pet/animal water containers
at least once a week
Wear insect repellant, long sleeves and pants
Make sure windows and doors are closed, mosquito bed net
Properly dispose of solid waste
No vaccine currently available
SCREENING - Identify People with Risk Factors - Secondary
Providing accelerated training and the adoption of WHO
standard clinical management guidelines for Dengue Fever
Promoting behavioral change at individual, household and
community levels to improve prevention and control
FIGHT the Disease - Treat Those with the Disease - Tertiary
No cure or medicine to treat Dengue Fever
Most effective: early medical intervention
Treat symptoms with analgesics with acetaminophen
except those containing ibuprofen or aspirin
Rest, plenty of fluids to prevent dehydration, may need
IV for fluid replacement therapy
Avoid mosquito bites while febrile
World Health Organization (WHO)
Vector management, case management
Social mobilization and communication
Outbreak response
Philippine Integrated Disease Surveillance
System and Response (PIDSSR)
Implemented 2007
Monitors incidence and notifies regions of
potential outbreaks to implement control
measures
Philippines Department of Health (DOH)
National Dengue Prevention and Control
Program
Becoming dependent on relatives/caregivers while the
symptoms last - workdays lost, school is missed, patients
travel long distances and pay heavy sums to get treatment.
Cost of treatment - cost can be double, or even triple average
monthly income, patients from the poorest households are
often reluctant to seek medical attention, no matter how ill
they feel
Fear of contagion spreads quickly through community and
patients seeking treatment for other conditions need to wait
longer for medical attention and receive shorter consultations
CULTURAL PRACTICES
Exacerbating the situation
Reuse of containers such as plastic jars, bottles,
cans, jars, tires, and buckets
http://www.eliminatedengue.com/our-research