Jakarta, IO – Global Health Sustainable Development Goals (SDG) for 2030 include ending tuberculosis, malaria, HIV/ AIDS and neglected tropical diseases epidemics, as well as battling hepatitis, water-borne diseases and other communicable ailments. In the specific case of dengue fever, formerly known in Indonesia as the “dengue bloody fever” (demam berdarah dengue–DBD), the purpose is not to end the epidemic, but rather to achieve a zero death rate from the disease by 2030, as more than half the patients show no symptoms and it is too late to administer treatment by the time their disease is diagnosed.
Anybody may suffer from dengue fever. It is an infection caused by a virus transferred by the bite of the Aedes aegypti and Aedes albopictus mosquitoes. Up to now, there is no specific medication for dengue fever – only supportive therapies that will mitigate the symptoms, not cure the disease.
“We found out more things about the disease as it lasts, including the fact that bleeding does not have to occur. Therefore, it is no longer DBD, but just ‘dengue fever’ now. We are setting a target of zero dengue deaths because more than half the cases show no specific symptoms. Thankfully, because of technological advances, we can now check for the presence of the disease using blood antigen tests. With everyone’s support, the Ministry of Health continues its efforts to prevent dengue infection. To achieve zero deaths, we need to ensure that a patient gets into healthcare facilities on time, so don’t be late. If they are already in shock, their hearts will not be able to pump blood and they might die,” explained dr. Imran Pambudi, MPHM, Ministry of Health Director for the Prevention and Control of Communicable Diseases, in the “Joint Efforts to Prevent DBD: Towards Zero Dengue Death in Indonesia by 2030” press conference held by Takeda Innovative Medicines on Sunday (5/11/2023).
According to 2023 records, dengue fever incidence in Indonesia has subsided dramatically, as per November there were “only” 70,600 incidents, with 506 deaths recorded. This is fewer than half the 143,184 incidents and 1,236 deaths recorded in 2022.
“However, we need to be alert, as Indonesia has finally entered the rainy season. Do the 3M’s (drain, cover, and bury items that might serve as mosquito breeding grounds) and maintain your stamina and immunity. Improve the latter by consuming sufficient nutritious foods and having sufficient and regular sleep; don’t stay up all night. According to research, during the transitional season, the hotter the ambient temperature, the more frequently mosquitoes will bite. For example, if the temperature is 20 degrees Celsius, mosquitoes will generally bite only once every five days. However, if the temperature rises even slightly, say 25 degrees Celsius, they will bite more frequently – once every two days. If they bite a person whose blood contains the dengue virus, they will transfer that virus to the next person they bite,” dr. Imran said.
Up to Four Iterations
During the same event, both dr. Kanya Ayu Paramastri, Sp.A, member of The Indonesian Pediatric Society (IDAI), and dr. Dirga Sakti Rambe, Sp.PD, M.Sc, from the Indonesian Society of Internal Medicine (PAPDI), reiterate the importance of DBD vaccine as an effort to avoid dengue fever infection. “Three out of every four dengue fever deaths occur among children aged 0-14. IDAI recommend that children aged 6-18 years old be given two doses of dengue vaccine with an interval of 3 months between injections, whether they have previously contracted dengue fever or not. They may be inoculated with the dengue vaccine, as they are given other vaccines, as long as they are healthy. The vaccine causes mild side effects, and no fever. Children generally can return to their normal activities immediately after vaccination,” dr. Kanya said.
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PAPDI, according dr. Dirga, recommends that adults aged 19-45 also get the dengue vaccine. “Dengue fever is indiscriminate. We recently found that the number of dengue cases among the productive age population has increased. Even when healed, they cannot go back to work, because of fatigue. Why get a vaccine? Because there are four types of dengue viruses, and anyone has the chance to get infected with the dengue up to 4 times their whole lives, and the subsequent infections tend to worsen each time. The vaccine is meant for long-term protection. And adults aged 19 to 45 can also get it.
A caveat, though, before taking the vaccination: if they have any co-morbidity, it should be under control,” he warned. Apart from the application of Wolbachia technology in Bandung, Jakarta, Semarang, Denpasar, Bontang, and Kupang, dr. Imran reminds us that the Ministry of Health strongly encourages the “3×10 Program”, wherein we all take 10 minutes’ time to perform 3M every Sunday at 10.00 a.m. for 10 consecutive weeks. Places to check include water in the catching tray under the fridge and water dispenser, clothes that are hung. This effort is expected to eliminate mosquitoes properly, as their egg-laying and breeding cycle is some 3-4 weeks long. (est)