A worrying either-or proposition of dengue detection

Published: 00:00, Nov 17,2019 | Updated: 00:24, Nov 17,2019


THE Institute of Epidemiology, Disease Control and Research coming up with a figure of death from dengue which is lower than what the physicians have confirmed this year is largely construed to be government efforts to deflate the number of dengue death and, thus, to make the gravity of the situation appear less concerning. This appears so as the government had been in denial of a sort of the dengue reality when the disease broke out in June and in the fourth week of July when the infection became almost epidemic, the authorities concerned said that media reports on dengue infection were ‘rumours.’ The government has prepared its statistics, initially, based on admission records of 12 public and 29 private hospitals in the capital city and, then additionally, on records prepared by the 64 civil surgeons and public and private medical college hospitals in outlying districts. The hospitals have so far reported 251 cases of dengue death to the government but the institute, which could analyse 179 of the cases, has confirmed dengue as the reason for the death in 112 cases. The institute has, however, failed to establish the cause of the death of 67 people in the cases that the institute reviewed.

Such a deflation of the dengue death figure, if wilful, could harm plans to better government preparedness to fight the menace in future. A situation like this also calls into question the treatment of dengue that physicians across the country have administered to patients. Dhaka Medical College Hospital reports 40 patients to have so far died of dengue, but the institute has confirmed only 11 deaths from dengue on review of 23 of the 40 cases. In the remaining 12 of the 23 cases, physicians, who have confirmed the death to have been caused by dengue, have treated dengue infection in the patients. The institute’s coming to say that the 12 patients have not died of dengue also sets aside the diagnosis, and treatment of, dengue that the physicians in the hospital have done in the cases. The hospital says, as New Age reported on Saturday, that it has reported the death from dengue to the institute after having the cases thoroughly reviewed by its own death review committee composed of senior professors. This creates an ‘either-or’ proposition: if the institute is correct in its reviews, physicians have largely made mistakes in their diagnosis and treatment of the disease, which in turn could question the quality of medical education and training; and if the physicians are correct in their diagnosis and treatment of dengue, the disease research institute is incorrect in its review of dengue death cases, which in turn could question its research protocol. While both of the parties cannot be correct at the same time, either of the propositions being true could be disastrous for public health.

The government must, therefore, make a course correction if it has employed the institute to deflate the dengue death figure. If it has not employed the institute to do so, it must look into why the institute refuses to acknowledge dengue that the physicians have established as a reason for such death and resolve the either-or proposition.

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