Abstract

BackgroundThe frequency and magnitude of dengue epidemics has increased dramatically throughout the tropics in the past 40 years due to unplanned urbanization, globalization and lack of effective mosquito control. The commercial capital of Tanzania, Dar es Salaam, is now experiencing regular dengue outbreaks. Three dengue serotypes have been detected in Dar es Salaam (DNV 1, 2 and 3). Without adequate vector monitoring and control, further outbreaks will certainly occur.Methods/FindingsA case series study followed 97 individuals with confirmed dengue fever (NS1 and/or IgM on rapid diagnostic test and/or PCR positive) to their households in Kinondoni, Dar es Salaam during the 2014 outbreak from a random sample of 202 confirmed cases at Mwananyamala Hospital. Kinondoni wards of Manzese, Mwananyamala, Tandale and Mabibo had the highest number of confirmed cases: 18, 13, 13 and 9 respectively. Individuals were interviewed by questionnaire on dengue prevention practices and houses were inspected for mosquito breeding sites to validate a Habitat Suitability Score (HSS). This is a tool devised to predict the productivity of any potential breeding habitats (PBHs) before the rains begin.There were 12 /312 positive Aedes breeding habitats. Drums/barrels, flowerpots and tyres were the most common breeding habitats. The HSS correctly identified 9/12 of Aedes breeding habitats. Larviciding is already conducted in urban Tanzania for malaria control and the HSS may be a useful means to train individuals on productive Aedes aegypti breeding sites should this program be extended to include dengue control.The population remains poorly informed about dengue transmission and prevention: 22% of respondents said dengue is spread from one person to another and 60% first heard about dengue when already sick. Less than 20% of respondents used personal protection and >80% thought bednets protected against dengue. Mobile phones were owned by almost all individuals followed up and have the potential of being the prime medium for dissemination of information on dengue prevention.

Highlights

  • In 2014, a Type 2 dengue fever outbreak in Tanzania spread to seven regions on the mainland and two regions in Zanzibar [1]

  • Descriptions refer to adult cases only and may not be generalizable to children

  • A simple tool such as Habitat Suitability Score (HSS) may be used by to inform vector control teams and communities even when there are no rains to identify potential breeding habitats (PBHs), which can be removed or covered to prevent the breeding of vectors. Such tools with further testing and improvements may become very useful for the control of arboviral infections at the household level and require no special skills

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Summary

Introduction

In 2014, a Type 2 dengue fever outbreak in Tanzania spread to seven regions on the mainland and two regions in Zanzibar [1]. On mainland Tanzania, there were 1,017 confirmed cases from a total of 2,121 suspected cases including 4 deaths. The frequency and magnitude of dengue epidemics have increased dramatically in the past 40 years as both the mosquito vectors and the four dengue virus serotypes have expanded geographically throughout the tropics and subtropics. The frequency and magnitude of dengue epidemics has increased dramatically throughout the tropics in the past 40 years due to unplanned urbanization, globalization and lack of effective mosquito control. The commercial capital of Tanzania, Dar es Salaam, is experiencing regular dengue outbreaks. Without adequate vector monitoring and control, further outbreaks will certainly occur

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