The burden of dengue, source reduction measures, and serotype patterns in Myanmar, 2011 to 2015–R2

Oo, Pwint Mon; Wai, Khin Thet; Harries, Anthony; Shewade, Hemant Deepak; Oo, Tin; Thi, Aung; Lin, Zaw

doi:10.1186/s41182-017-0074-5

Cited by 23 publications

(33 citation statements)

References 28 publications

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“…However, a recent report of increasing resistance of two important JE vectors (Culex tritaeniorhymchus and Culex vishnui) to DDT, malathion, and deltamethrin in India is of concern to the region [31]. Case fatality was higher in the hills, similar to what was found 2 years ago with dengue [21]. This may be because health facilities are not as well-resourced in these areas, health care workers are less experienced in providing supportive care for encephalitis, and there is poor immunity of the population to the JE virus.…”

Section: Discussionsupporting

confidence: 53%

“…This was an ecological study, and we therefore did not capture any information about morbidity after recovery from the infection. Previous reviews point to significant neurological sequelae being present in up to 50% of survivors [3,23], so while this disease is less common in the country than dengue [21], it may nevertheless be very demanding on health service care and resources. While care is currently supportive, there is an ongoing work exploring the prospects for direct-acting antiviral treatment, especially with the use of nucleoside and nucleotide reverse transcriptase inhibitors [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Variables, data sources, and data collection Data variables for the study included the following: for hospital-recorded cases of JE and deaths-year, month, age group, gender, urban/rural residence, season, and ecological area of the country for each case. The definition of ecological areas was adapted from Oo et al [21] and is shown in Table 1. The source of data was the VBDC electronic EXCEL database for national aggregate data; for vaccinated children-ecological region, children eligible for vaccination, children vaccinated, children vaccinated during the school-based campaigns, and children vaccinated during the community-based campaigns.…”

Section: Study Populationmentioning

confidence: 99%

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The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

et al. 2020

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Background: Myanmar is endemic for Japanese encephalitis (JE) and has experienced several outbreaks in recent years. The vector-borne disease control (VBDC) program has collected hospital-based surveillance data since 1974. There is an urgent need to collate, analyze, and interpret the most recent information. The study aimed to describe (i) hospital-based JE cases and deaths between 2012 and 2017, (ii) a catch-up vaccination campaign in children in 2017, and (iii) health service provider perceptions about JE in one township in 2018. Methods: This was a cross-sectional study of cases, deaths, and catch-up childhood vaccinations using secondary data from program records and a survey database of health service provider perceptions. Results: Between 2012 and 2017, there were 872 JE cases and 79 deaths with a case fatality rate of 91 per 1000; 2016 was the year with most cases and deaths. Most cases (n = 324) and deaths (n = 37) occurred in children aged 5-9 years. Large case numbers were reported in delta and lowland regions (n = 550) and during the wet season (n = 580). The highest case fatality rates were observed in the hills and coastal regions (120 and 112 per 1000, respectively). Nationwide coverage of the catch-up JE vaccination campaign among 13.7 million eligible children was 92%, with coverage lower in the hills and coastal regions (84%) compared with delta and lowland regions and plains (94%). More vaccinations (65%) occurred through school-based campaigns with the remainder (35%) vaccinated through community-based campaigns. Structured interviews in one township showed that service providers (n = 47) had good perceptions about various aspects of JE, although perceived benefits of specific vector control measures were poor: spraying/fumigation (38%), garbage removal (36%), larvicide use (36%), and drainage of standing/stagnant water (32%).

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

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The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

et al. 2020

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“…Myanmar is a high dengue burden country in the Asia Pacific Region. Between 2011 and 2015, of the 89,832 dengue related admissions, 97% were children 13 . There is limited published literature on diagnosis delays after fever onset among children or adults who died due to dengue.…”

Section: Introductionmentioning

confidence: 99%

Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays

et al. 2020

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Background: Complications in dengue usually occur between day four and day six after fever onset. Hence, early diagnosis and haematological monitoring are vital. Among all hospital reported dengue deaths in Myanmar in 2017-18, we assessed the i) patient profile, ii) proportion of patients who arrived with a dengue diagnosis at admission and iii) delays in diagnosis after fever onset. Methods: This was a descriptive study involving secondary data. For all the notified deaths, death investigation forms were not available in prescribed format and therefore, data were extracted from hospital case records. Results: Of 304 deaths, 184 (60.5%) were female and 233 (76.6%) were less than 10 years old. Township level hospitals or below reported 36 deaths (11.8%) and the remaining deaths were from higher level facilities. Dengue was diagnosed before admission in 26 (8.5%) people and 169 (55.6%) were in shock at admission. Of 208 with date of fever onset recorded, the median diagnosis delay was four (interquartile range-IQR: 3, 5) days. Patient level delay (median three days) was a major contributor to the diagnosis delay. Conclusions: Most of the patients who died did not have a diagnosis of dengue before admission. This calls for an urgent review of health system preparedness in peripheral health facilities to suspect, diagnose, monitor, refer and treat dengue in children and patient level factors for better understanding of the reasons of delay. Timely filling of death investigation forms in a prescribed format and quarterly death reviews based on these is recommended.

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“…Dengue fever outbreaks routinely and progressively happen each year in South and Pacific Asian countries including India, Bangladesh, Sri Lanka, Indonesia, and Malaysia [8]. India and Myanmar have also been severely affected by dengue outbreaks in recent years with 21,000 cases in 2015 and 89,832 cases in 2011-2015, respectively [9,10].…”

Section: Introductionmentioning

confidence: 99%

Dengue Outbreak Response and Control in Khyber Pakhtunkhwa, Pakistan: A Mixed Methods Study

Mohamud¹,

Qazi²,

Latif³

et al. 2019

JEGH

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Background: Since 2008, dengue fever outbreaks had occurred repeatedly in various districts of Khyber Pakhtunkhwa (KP) province of Pakistan. Most importantly the outbreak of 2017 caused 70 deaths, about 121,083 suspected and 24,938 confirmed cases in 23 districts of KP. In 2018, an abrupt decline in suspected and confirmed dengue cases was observed and 2018 was declared as dengue outbreak free. This study characterizes and explores the control and response measure activities of the outbreak. In addition, we explored the challenges faced and lessons learned for control of future dengue outbreaks from the perspectives of health authorities and dengue response staff in the KP province of Pakistan. Methods: This was a mixed methods study with quantitative data on dengue outbreaks obtained from health department in KP followed by qualitative study to explore activities and responses that enabled the Dengue Response Unit (DRU) for a successful dengue outbreak control in 2018. In-depth interviews were conducted with the key informants from the department of health and the dengue response unit. Results: The quantitative data analysis revealed a huge decline of suspected and confirmed dengue cases in comparison with the previous year in most of the KP districts. A similar decline in dengue reported cases was also observed from previously high dengue burden 14 union counsels of Peshawar district. Among the 70 verified deaths in 2017, 44 (63%) were males and 26 (37%) were females. The cases were about 20% each from age groups of 21-30, 41-50, and 51-60 years. The qualitative study findings showed four prominent major themes for successful control: (1) control and response strategy; (2) organizing specific dengue control and response intervention activities; (3) addressing dengue control and response challenges; and (4) generating lesson for future dengue control and response.

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The burden of dengue, source reduction measures, and serotype patterns in Myanmar, 2011 to 2015–R2

Cited by 23 publications

References 28 publications

The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays

Dengue Outbreak Response and Control in Khyber Pakhtunkhwa, Pakistan: A Mixed Methods Study

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