Dengue fever- a mosquito-borne disease- has been tackled on a short-term basis in Tanzania for years, with interventions only scaled up against the disease when there is an outbreak. However, malaria, which is also transmitted by mosquitoes, has been tackled in the long term with well-established programs. In a new study, researchers say the “smarter approach” to fight mosquito-borne diseases is by combining efforts against dengue fever within the existing National Malaria Control Program (NMCP), in what we call an integrated approach.
The study, published in the Tanzania Medical Journal (TMJ), suggests that dengue fever control should be incorporated into existing programs like malaria control– known as Integrated Vector Management or IVM). The approach, according to the study, could make it easier to mobilize resources to prevent both diseases cost-effectively and potentially save more lives in Tanzania.
Over 6,800 cases of dengue fever and 13 deaths were recorded in Tanzania’s last outbreak in 2019. A year following the outbreak, the researchers studied how well Tanzania’s Malaria Control Program could also be used to fight dengue fever.
The researchers found that dengue control could be added to malaria programs, but there are challenges. The government’s political will is critical, but extra costs, different donor priorities, and more work for health workers are making it difficult. Dengue is seen as a Neglected Tropical Disease (NTD) in Tanzania. This means it lacks a dedicated national program.
“By integrating dengue in malaria control programs, the country can create a more efficient and effective system to protect public health,’’ says the study’s lead author, Dorce Lymo, a health administrator and the Health Secretary of Kibaha Town Council.
Lymo, who teamed up with researchers from Muhimbili University of Health and Allied Sciences (MUHAS) interviewed 15 key officials from the Ministry of Health’s National Malaria Control Program (NMCP), and Neglected Tropical Diseases (NTD) program.
They found that health workers are ready to handle both diseases simultaneously.
“Most of them expressed willingness to take on the extra workload [ in dengue], and the existing infrastructure could be leveraged for both diseases,’’ says Lymo. According to the study, the interviewed stakeholders appeared receptive to the approach.
“The Aedes mosquito continues to exist in our communities and transmits the viruses that cause dengue fever. This means that our interventions against this mosquito must be long-term,’’ says Lymo, adding: “By these findings, we are making a compelling case for a united front against mosquito-borne diseases in Tanzania.”
However, the study acknowledges potential hurdles. Concerns about additional costs and workload strain were found to be valid. The researchers propose a collaborative approach involving various government departments and non-government organizations to address these challenges.
In the face of diminishing public sector human and financial resources, the World Health Organization (WHO) recommends integrated vector management to equip countries better to meet the growing challenges of controlling vector-borne diseases.
Dr. Nathanael Sirili is the study’s co-author, a senior lecturer and health systems researcher at Muhimbili University of Health and Allied Sciences (MUHAS). He says the primary concern of many policymakers interviewed during the study was the availability of resources to effectively control dengue and malaria.
“Dengue has often been placed in a category of neglected diseases due to the lower fatality rates associated with it. However, when a family member dies from dengue, it becomes a 100% loss for the family,” says Dr. Sirili, emphasizing why Integrated Vector Management is a better approach.
He adds that “integration will allow the use of fewer resources but achieve greater results. Having two separate programs would require allocating resources for dengue and others for malaria,”
Where to find the study:
Tanzania Medical Journal(TMJ): Organizational Facilitators and Barriers for the Integration of Dengue into The National Malaria Control Program in Tanzania: A Case Study