Researchers Propose Integrating Dengue and Malaria Control Programs in Tanzania to Save Lives
July 19, 2024
By Adonis Byemelwa
Dengue cases have surged globally over the past two decades, creating a major public health crisis. Photo Courtesy
For many years, dengue fever, transmitted by mosquitoes, has been controlled through short-term measures in Tanzania, with actions taken only during outbreaks. In contrast, malaria, also spread by mosquitoes, has been managed through long-term, robust plans. In a recent study, researchers in Tanzania have proposed that dengue control measures be incorporated into national malaria control programs.
The study, published in March 2024 in the Tanzania Medical Journal (TMJ), highlights the importance of including dengue in existing malaria control programs. Researchers argue that this approach could streamline the allocation of financial resources, making it more cost-effective to prevent both diseases and increasing the likelihood of saving more lives in Tanzania.
During the last dengue outbreak in Tanzania in 2019, over 6,800 people were infected with the dengue virus, and 13 deaths were recorded. A year after the outbreak, researchers investigated how the Tanzania Malaria Control Program could also combat dengue.
They found that integrating dengue control into malaria programs is feasible, but they identified challenges such as political will, concerns about increased costs, and differing priorities among donors. Dengue is classified as a neglected tropical disease (NTD) in Tanzania, meaning it lacks a dedicated national plan.
"If we decide to include dengue control in malaria control programs, the country can build a more efficient and effective public health protection system," said Dorice Lymo, the lead researcher of the study, a health management expert, and Secretary of Health for Kibaha Town Council.
Lymo, in collaboration with researchers from Muhimbili University of Health and Allied Sciences (MUHAS), conducted interviews with 15 officials from the National Malaria Control Program (NMCP) of the Ministry of Health and the NTDs program. They discovered a readiness among employees in these institutions.
"Many showed a willingness to take on the additional burden of dengue, and existing infrastructure could be used for both diseases," said Lymo. The study found that stakeholders interviewed agreed with this integrated approach to control.
"The Aedes mosquitoes are still present in our communities, transmitting the dengue virus. This means our measures against these dengue mosquitoes should be long-term," Lymo added. "Our specific argument is that we should integrate the control of these mosquito-borne diseases in Tanzania."
However, researchers noted concerns about operational costs among interviewees, which they considered fundamental. They recommended collaboration between various government departments and non-governmental organizations to address potential cost challenges. Due to the shortage of human and financial resources in the public sector, the World Health Organization (WHO) recommends an integrated management approach for such diseases to enable countries to better tackle challenges arising from controlling vector-borne diseases like those spread by mosquitoes.
Dr. Nathanael Sirili, a senior lecturer and health systems researcher at MUHAS and a co-researcher of the study, stated that if dengue continues to be categorized as a neglected disease, it will remain inadequately controlled and cause more harm. "Dengue is often placed in the category of neglected diseases due to its low mortality rates.
However, when a family loses a member to dengue, it is a 100% loss for that family," said Dr. Sirili. "Including dengue in an integrated control with malaria will allow the use of fewer resources but yield greater results. There is no need for two separate programs. Having two different programs (for dengue and malaria) means allocating resources separately for dengue and malaria."
Dengue fever is caused by the dengue virus, transmitted primarily by Aedes mosquitoes, particularly Aedes aegypti. Symptoms of dengue include high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, and mild bleeding. Severe dengue, also known as dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure, and death.
There is no specific treatment for dengue, but early detection and proper medical care can significantly reduce mortality rates. The disease is prevalent in tropical and subtropical regions around the world, with an estimated 390 million dengue infections occurring each year. The integration of dengue control into existing health programs is seen as a crucial step in managing the disease more effectively and preventing outbreaks.
