Presentation for Research & Student Activities in our Urosurgery Round

1. CHAPTER 3:
HOW DO WE DEAL WITH IT?

2. WHAT WILL WE LEARN THROUGHOUT THE
CHAPTER 3?
CHAPTER 3: HOW DO WE DEAL
WITH IT?
i. ACTION!
ii. THE CONSTRAINTS
iii. MANAGEMENT (MEDICALLY)

3. CHAPTER 3: HOW DO WE DEAL WITH IT?
I- ACTIONS!
1) Action of People and Community
against Dengue (Prevention and Control)
At present, there is no vaccine for preventing dengue.
Therefore,
the best preventive measure is to combat the mosquitoes.

4.  Removal of stagnant
water  Always clean and
 Get rid of sources or check drains to ensure
areas where they are not blocked
mosquitoes breed, especially during the
such as standing water rainy season.
in flower pots, tins,
bottles or discarded
tires

6.  Appropriate
insecticides, such as
larvicide's can be
added to water
containers. The
insecticides can
prevent mosquitoes
breeding for several
weeks.
 Top up uneven
surfaces of the floor to
prevent water from
accumulating

7. In addition to the above, here are some ways to
help prevent the mosquitoes being attracted to
human prey.
 Wear loose, light coloured clothing that
covers the whole body
 Apply mosquito repellents.
 Sleep under mosquito nets or in a room
which has mosquito screens on the doors
and windows.
 Avoid outdoor activities during morning and
late afternoon

9. 2) Action of Health Personnel against
Dengue (Primary Health Care and
Dengue Prevention and Control)
The ultimate goal of controlling dengue is
to prevent its transmission and contain the
spread of the disease as soon as possible

10.  Community participation
 Community participation involves active
voluntary engagement of individuals and
groups to change problematic conditions
and influence policies and programmes that
affect the quality of their lives or the lives of
others.

11.  This entails several tasks:
• Raising community awareness:
• Initiating community dialogue
• Identifying and involving community
health volunteers/workers
• Identifying key stakeholders for local
planning and actions
• Empowering stakeholders by building
capacity

13.  Baseline data collection
 health workers and supported by technical
experts to collect baseline data on the
nature and extent of vector problems,
breeding sites, location of human habitats,
disease outbreaks, the number of dengue
cases which turned severe and
complicated within a certain period, and
sociobehavioural
 data related to disease transmission,
treatment-seeking, etc

14.  Comprehensive Guidelines for Prevention
and Control of Dengue and Dengue
Haemorrhagic Fever
 (a) Promotion and prevention activities:
-Health education and empowerment:
-Campaigns
-Integrated programmes
 (b) Surveillance (vector and disease) and
treatment
 (c) Containment of disease
 (e) Social support and social network
 (d) Monitoring and evaluation

16.  Action by The Government Against
Dengue
 ASEAN Dengue Day was launched on 16
June 2011 by Deputy Prime Minister The
Most Honourable Tan Sri Muhyiddin bin Hj
Mohd Yassin. The event, held at the HGH
Convention
Centre Kuala Lumpur, was also attended by
Dr Corinne Capuano, WHO Representative
for Brunei Darussalam, Malaysia and
Singapore and Dr Harpal Singh. Both were
there to
demonstrate WHO’s commitment against

19.  anti-dengue campaign, the Health
Ministry also enlisted Malaysian celebrity
and TV host Aznil Haji Nawawi to be the
Ministry’s anti-dengue ambassador and to
headline its anti-dengue campaign, called
Jom Ganyang Aedes (Let’s Crush
Aedes)

20.  “gotong-royong’’ (cooperative action to
attain a shared goal) programme, as well
as other
general dengue awareness campaigns,
such as buses with advocacy body wraps
placement of advocacy billboards in
communities, schools, bus stations and
mobile exhibitions at hot spot areas.

22. CHAPTER 3: HOW DO WE DEAL WITH IT?
II- THE CONSTRAINTS
Several problems facing us lead to
decrease effeciency to counter the
problem.

23. 1. Geography
- The disease itself is endemic in Malaysia as
one of the tropical countries
2. Climate and Weather Pattern
- Average temperature and rainfall (high
humidity) are the most suitable for
mosquitoes breeding
- High temperature also will increase biting
and feeding frequency
3. Population
- Population growth and poor urban planning
where there is over crowding resulting in poor
sanitation and limited water resources to it

24.  4. Awareness
- Lack of knowledge among the community
about dengue fever
- Insufficient practice of the disease control
- Misconception: a thought of having a virus
that the body will build immunity to it
 5. Legislative control
- Incomprehensive legislative control on
Aedes breeding through inspection and
destruction of breeding habitats as in housing
area, premises, dumping area, factories and
construction sites

26.  6. Management
- Doctors have low threshold to diagnose
dengue during interepidemic period
- There is no vaccine approved yet for use
and no specific medication for treatment
- Lack of neither expertise nor the political will
to implement sustainable and effective vector
control measures
 7. Economic
- Constraint in funding lead to loss of
technical expertise and limitation in health
resources either for treatment or research

27. CHAPTER 3: HOW DO WE DEAL WITH IT?
III- MANAGEMENT (MEDICALLY)
 Dengue fever is usually a self-limited illness.
 The management of dengue is symptomatic
and supportive.
 There is no specific antiviral treatment
currently available for dengue fever.

28.  Supportive care with analgesics, fluid
replacement, and bed rest is usually
sufficient.
 Acetaminophen may be used to treat fever
and relieve other symptoms.
 Aspirin, nonsteroidal
anti-inflammatory drugs (NSAIDs),
and corticosteroids should be avoided.
 Management of severe dengue requires
careful attention to fluid management and
proactive treatment of hemorrhage.

29.  Patient who does not require admission
must be advised to take adequate fluids
(minimum of five glasses
of isotonic drinks or juice).
 Intravenous (IV) fluid is
indicated in patients who are vomiting,
unable to tolerate oral fluids or having an
increasing HCT (indicating on-going
plasma leakage) despite increasing oral
intake.

30.  All patients with
warning signs should
be considered for
monitoring in
hospitals. Patients can
be started with IV fluid 5-
7 ml/kg/hour for 1-2
hours, then reduce to 3-5
ml/kg/hour for 2-4 hours,
and then reduce to 2-3
ml/kg/hour or less
according to the clinical
response.
 Crystalloid (such as 0.9%
saline) is the fluid of
choice for non-shock and
Dengue Shock
Syndrome patients.