By Alfred
Zacharia
Da es -Salaam. Dengue fever- a
mosquito-borne disease- has been tackled on a short-term basis in Tanzania for
years, with interventions only scaled up against the disease when there is an
outbreak. However, malaria, which is also transmitted by mosquitoes, has been tackled
in the long term with well-established programs. In a new study, researchers
say the “smarter approach” to fight mosquito-borne diseases is by combining
efforts against dengue fever within the existing National Malaria Control
Program (NMCP), in what we call an integrated approach.
The study, published in the Tanzania Medical
Journal (TMJ), suggests that dengue fever control should be incorporated into
existing programs like malaria control– known as Integrated Vector Management
or IVM). The approach, according to the study, could make it easier to mobilize
resources to prevent both diseases cost-effectively and potentially save more
lives in Tanzania.
Over 6,800 cases of dengue fever and 13 deaths were
recorded in Tanzania’s last outbreak in 2019. A year following the outbreak,
the researchers studied how well Tanzania's Malaria Control Program could also
be used to fight dengue fever.
The researchers found that dengue control could be
added to malaria programs, but there are challenges. The government’s political
will is critical, but extra costs, different donor priorities, and more work
for health workers are making it difficult. Dengue is seen as a Neglected
Tropical Disease (NTD) in Tanzania. This means it lacks a dedicated national
program.
“By integrating dengue in malaria control programs,
the country can create a more efficient and effective system to protect public
health,’’ says the study's lead author, Dorce Lymo, a health administrator and
the Health Secretary of Kibaha Town Council.
Lymo, who teamed up with researchers from Muhimbili
University of Health and Allied Sciences (MUHAS) interviewed 15 key officials
from the Ministry of Health’s National Malaria Control Program (NMCP), and
Neglected Tropical Diseases (NTD) program.
They found that health workers are ready to handle
both diseases simultaneously.
“Most of them expressed willingness to take on the
extra workload [ in dengue], and the existing infrastructure could be leveraged
for both diseases,’’ says Lymo. According to the study, the interviewed
stakeholders appeared receptive to the approach.
“The Aedes mosquito continues to exist in our
communities and transmits the viruses that cause dengue fever. This means that
our interventions against this mosquito must be long-term,’’ says Lymo, adding:
“By these findings, we are making a compelling case for a united front against
mosquito-borne diseases in Tanzania.”
However, the study acknowledges potential hurdles.
Concerns about additional costs and workload strain were found to be valid. The
researchers propose a collaborative approach involving various government
departments and non-government organizations to address these challenges.
In the face of diminishing public sector human and
financial resources, the World Health Organization (WHO) recommends integrated
vector management to equip countries better to meet the growing challenges of
controlling vector-borne diseases.
Dr. Nathanael Sirili is the study's co-author, a
senior lecturer and health systems researcher at Muhimbili University of Health
and Allied Sciences (MUHAS). He says the primary concern of many policymakers
interviewed during the study was the availability of resources to effectively
control dengue and malaria.
“Dengue has often been placed in a category of
neglected diseases due to the lower fatality rates associated with it. However,
when a family member dies from dengue, it becomes a 100% loss for the family,”
says Dr. Sirili, emphasizing why Integrated Vector Management is a better
approach.
He adds that “integration will allow the use of
fewer resources but achieve greater results. Having two separate programs would
require allocating resources for dengue and others for malaria,"