Country's dengue death rate hits highest in 22 years

Infograph: TBS

Reasons behind high mortality rate:

• Repeat infections increasing complications
• Patients treating fever at home, delaying hospitalisation
• Collapse of dengue prevention efforts
• Most affected age group 16 - 35 years
• Almost all 64 districts have been affected

This year, the country is witnessing the highest dengue death rate since 2003 as a total of 34,121 dengue patients have been hospitalised with 177 deaths recorded across the country until yesterday.

The death rate reached 0.52%, surpassing last year's 0.49%. In 2023, Bangladesh saw a staggering 211,683 hospitalisations and 1,030 deaths from 1 January to 3 October.

While 2024 has seen fewer cases overall, the death toll until yesterday is the second highest on record, according to the Directorate General of Health Services (DGHS) Health Emergency Operation Center and Control Room data.

Expressing concern over the rising mortality rate, public health experts said repeat infections was one of the main reasons behind the high mortality rate.

They said that for the past few years, dengue has persisted in Bangladesh, causing many people to be infected at least once. The risk of death significantly increases when a person contracts dengue a second or third time, they added.

Entomologist and Professor Dr Kabirul Bashar pointed to three main reasons for the higher mortality rate.

He said, "First, many people who were previously infected, even outside their knowledge, and are now being reinfected for the second or third time, are at a greater risk of severe complications, leading to more deaths.

"Second, many patients are treating their fever at home and delaying hospitalisation until it's too late, which raises the risk of death."

"The third reason is that the health services and dengue prevention efforts at city corporation and local government level in the country have collapsed. Many hospitals are referring patients to other medical facilities, leaving patients to move from one hospital to another, increasing their risk," he added.

Data from the DGHS shows that dengue fatalities have been reported every month this year, with the highest number of deaths, 80, occurring in September. As per the DGHS record, 14 people died in January, three in February, five in March, two in April, 12 in May, eight in June, 12 in July and 27 in August.

In the first three days of October alone, 16 deaths were recorded. In the 24 hours until yesterday morning, 1,022 new patients were admitted to hospitals, with most cases in Dhaka, and three deaths were recorded, two occuring in Dhaka South City Corporation (DSCC) areas, and one is Barishal Division.

According to hospitalisation data, though 37% of hospitalised patients are female and 63% male, the death rate shows 51.4% of deaths are among females and 48.6% among males.

The age group most affected by deaths is between 16 to 35 years, with 40% of fatalities occurring within this range.

The World Health Organization in a statement yesterday said the number of reported dengue cases has approximately doubled each year since 2021, with over 12.3 million cases, including more than 7,900 deaths, reported in just the first eight months of 2024.

Dr MH Chowdhury Lenin, a public health expert, criticised the city corporation and local government efforts to control the spread of Aedes mosquitoes.

"We anticipated a rise in dengue cases from the start of the year, yet city corporations and local governments failed to take effective measures against Aedes mosquitoes. The mosquito control programmes by city corporations and local governments have almost come to a halt," he said.

He also pointed out the lack of research into the dengue virus this year.

"The Directorate General of Health Services has not provided any research findings on the current strain of dengue. As the monsoon season has been prolonged, water is gathering in places, leading to increased mosquito breeding," Lenin said, adding that, "An integrated plan from the central government is needed to control the spread of Aedes mosquitoes."

He further said, "If for three consecutive days, we could clean all residential areas, public spaces, and surrounding water bodies and eliminate mosquitoes, we could significantly reduce the mosquito population."

In the whole of last year, 1,705 people died from dengue in Bangladesh, making 2023 the deadliest year on record with 321,179 reported cases.

However, public health experts believe without stronger preventive measures, this year's fatalities could continue to rise.

They fear that while the number of dengue cases increased from 6,500 to over 21,000 in September, the number of infections could rise even further in October. The outbreak is expected to persist into November as well.

Entomologist Kabirul told TBS, "This year, due to limited activities and research on dengue, the disease has spread across the country. There has been a higher number of dengue cases in Cox's Bazar, Barguna, Chandpur, Mymensingh, and Narsingdi compared to previous years."

The DGHS data shows that this year's dengue outbreak has already spread to all 64 districts of the country. However, an analysis of past data from the DGHS shows that in previous years, dengue had never spread to all 64 districts during this period.

The directorate's data further shows that the highest number of dengue cases has been reported in Dhaka South City Corporation, with 7,651 patients. Dhaka North City Corporation has recorded 6,798 cases, while 4,849 cases have been reported in areas outside Dhaka within the Dhaka division.

Additionally, 7,055 patients have been admitted to hospitals in the Chattogram division, 2,983 in the Barishal division, and 2,667 in the Khulna division.

In terms of fatalities, DSCC recorded the highest number of dengue deaths, with 95 people losing their lives. Additionally, 25 people died in the DNCC area, 21 in the Chattogram division, 18 in the Barishal division, and 10 in the Khulna division.