CHAPTER 2: DENGUE FEVER IN MALAYSIAi. LOCATION OF MALAYSIA & THEIR PEOPLEii. WHY DENGUE IS IN ASIA, PARTICULARLY MALAYSIA?iii. IMPACT OF DENGUEiv. STATISTICAL DATA
Where is Malaysia?o Malaysia is situated in Southeast Asia, bordered by Thailand in the north, Indonesia in the south, and the Philippines in the east.o The country has an area of 329,758 square kilometers (127,320 square miles).
Who are we? Malaysia is the ONLY country in the world consist of multiracial people with different culture and religion, living together in the same community. The population of Malaysia was estimated at 21,793,000 in July 2000. Now app. 30 million.
•The Malay areMalaysias largest ethnicgroup, accounting forover half the populationand the nationallanguage.•With the oldestindigenous peoples theyform a group calledbumiputera, whichtranslates as "sons" or"princes of the soil.“• Almost all Malays areMuslims.
The Chinese traded withMalaysia forcenturies, then settled innumber during the 19thcentury When they firstarrived, however, Chineseoften worked the mostgrueling jobs like tinmining and railwayconstruction. Most Chinese are TaoBuddhist and retain strongties to their ancestralhomeland.They form about 35
Indians had been visitingMalaysia for over 2,000 years,but did not settle until the 19thcentury. Most came from South India,fleeing a poor economy.Arriving in Malaysia, manyworked as rubber tappers, whileothers built the infrastructure orworked as administrators andsmall businessmen.Today ten percent of Malaysiais Indian.Their culture -- with itsexquisite Hindu temples,cuisine, and colorful garments --is visible throughout the land
The oldest inhabitants of Malaysia are its tribal peoples. They account for about 5 percent of the total population, and represent a majority in Sarawak and Sabah. Though Malaysias tribal people prefer to be categorized by their individual tribes, peninsular Malaysia blankets them under the term Orang Asli, or "Original People."
The transmission of dengue illness is associated with the geographic expansion and distribution of mosquito vectors and viruses There are many factors that have created the ideal conditions for this expansion, especially in low- and middle-income countries, including Malaysia.
Factors favoring the dengue spread high rates of population growth, unorganized urbanization the proliferation of slums, crowding, poor water, sewer, and waste management systems, global warming, rise in global commerce and tourism, changes in public health policy, decreasing resources for vector prevention and control, and the development of hyperendimicity among other factors
1) Individual & family level People are not capable of bearing the cost of treatment to disease (most of the involved country, including Malaysia are still developing countries) Absence from work during the duration of illness (7-10 days), more in case of hemorrhagic dengue fever, and thus decreasing in the total family income. The illness caused significant stress: a psychological burden shared by patients and families.
2) Impact on health sector & government of Malaysia Mortality & morbidity burden: leading number of incidence rate among vector-borne disease (63.75%) The health sector could not cope with the expanding population which worsens the situation; rapid growth of population & migration to area with infection Strain on health care services due to sudden, high demand during epidemic Treatment of the disease is very costly & most of the action taken so far are not so effectively control the disease Confusion of the control of the disease; public assuming the disease is well controlled by the increasing frequency of spray etc.
3) Impact on economy of Malaysia Medical expenditures for hospitalization of patients & treatment of infected cases, add to the burden. Control activities themselves are also of course costly. Loss of productivity of affected work force resulting from those suffering from the illness Most people with dengue fever do recover but when, at the height of an epidemic, so many of the workforces are sick and unable to work, the cost to the national economy will be high.
It was estimated in 2005 that dengue typically costs Malaysia $13 million in treatment and vector control efforts annually, and that the output of 940,000 days of work is lost to the nation. From this study, it was concluded that: “One hospitalized case of dengue fever costs one-fifth of Malaysia’s per capita gross national product (GNP)”. A study by the Indian Institute of Management (IIMA) conducted in 2009 on the comparative costs to economies in the region put the financial burden of the virus on Malaysia at $5.30 per person, with total lost more than $153m every year!!!
Considerable expenditures for scale emergency control actions incur and also the loss of national income from tourism as a result of negative publicity Many areas with a dengue problem are tourist destinations and visitor numbers are likely to decline as media coverage of dengue outbreaks reaches those who might be considering holidaying in the countries concerned.
1902 - The earliest recorded case of dengue fever in Malaysia in Penang 1962 – The first documented major outbreak of dengue fever occurred in Penang in 1962. 1973 – A nationwide outbreak in Kuala Lumpur Since then dengue has become a major public health problem in the country.
Statistic showing incidence of dengue cases & death from 1998 to 2012 (up to 15 September 2012) in Malaysia:
Number of reported cases of dengue fever in Malaysia from 1998 to 2012 (up to 15 Sept. 2012) 60000 48846 49355 50000 46171 39654 40000Number of reported cases 41486 31545 34386 30000 27381 33895 20000 15606 16386 15493 10146 10000 13743 7103 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Year
Number of death from dengue fever in Malaysia from 1998 to 2012 (up to 15 Sept. 2012) 160 140 134 120 112 107 98 100Number of death 102 82 80 72 88 70 60 50 54 37 40 45 27 20 22 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Year