1. Epidemiology of Dengue in Sri Lanka: past, present and future Hasitha Tissera MBBS, MSc, MD Consultant Epidemiologist Ministry of Health Epidemiology Unit Ministry of Health Sri Lanka Dengue Seminar September, 2011
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4. Transmission Modulating Factors Vector Host (human) Virus Dispersion Density Deposited eggs Vector’s competency Individual immnunity Herd immnunity Sequential Infections Individual factors Magnitude of the Epidemics (DF/DHF) Serotypes (Previous Circulation) Genetic differences Virulence Probability of Transmission Source: Prof. Maria Gloria Teixeira, London May 2008
5. Dengue: Global burden Dengue ploriferates from 20 th to 21 st century with increasing burden, despite a lot of hard work on control and prevention 1960 2004
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9. Temporal and Spatial Spread, 1996 - 2009 1996 2004 2005 2006 2009 N=1294 N=15463 N=5994 N=11980 N=35007 Reported Cases to National Epidemiological Unit
10. Dengue Trends in Sri Lanka 2009 CFR – 0.99% 2010 CFR – 0.71% 2011 CFR - 0.71%
18. Which Perspective Do We Take? SOCIETY PATIENT FAMILY GOVERNMENT ALL OTHER STAKE HOLDERS SCIENCE Slide courtesy of Dr. Ananda Amarasinghe
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22. Statistics LRH Ward 04 - 2009 Source: Infection Control Unit LRH + Ward 04 records Slide courtesy of Dr. Padmakanthi Wijesuriya, Consultant Paediatrician LRH DF DHF I & II DHF III DHFIV Total Dengue Patients : 333 (Jan-Aug 2009)
30. Major Breeding Habitats Urban Breeding Sites Rural Breeding Sites Discarded containers – plastic cups, tins, cans, bottles.… Discarded containers – coconut shells, clay pots, bottles …. Water Storage –tanks, barrels, buckets Water storage – tanks, barrels, buckets Used Tyres - domestic, workshops, depots Used Tyres – domestic, workshops, depots Roof Gutters - domestic, offices, high-rising building tops Roof Gutters – domestic, sun shades Other – ornamental items, blocked drains, construction sites, natural breeding -ornamental plants, underprivileged communities, bare lands Other – spare part yards, natural breeding sites -bamboo shoots, tree axills/holes, fallen tree leaves, plantations
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Hinweis der Redaktion
Being endemic for dengue with around 5000 cases per year since year 2000, epidemics have been reported during the rainy seasons once every 3-4 years. Along with the geographic expansion the incidence too has grown – with over 20 districts reporting more than 100 cases per 100,000 population in 2010. Reported national incidence has a marked upward trend. An incidence of 30/100,000 population in year 2000 has gone up to 170/100,000 population by 2009 (an increase of almost 6 times) and >200/100,000 in 2010.
Sri Lanka has both childhood & adult dengue
shows the number and percentage of children positive for flavivirus antibodies. Overall 51.4% (407) of children were seropositive. There was an increasing trend with age, from 7.4% (2) among infants between 6 and 12 months to 71.7% (38) by the age of 11 years. Among 25 infants <6 months of age, 33.3% were seropositive, indicating that there is substantial acquisition of maternal antibodies among infants in this population.
Dengue is a quintessential 20-21 st century emerging disease. By 1960, Aedes aegypti had been largely eradicated from the American tropics but after abandoning vector control programs, the mosquito quickly returned. Viral infections were accelerated by the demographic forces described in this slide.
We are experiencing more and more severe form of the disease.
Dengue has undoubtedly become the most important public health concern in Sri Lanka at present. And it has received the highest political commitment. Last week (on May 25 th ) a Presidential Task Force was set-up involving 8 ministries with a mandate to control dengue through strengthened intersectoral collaboration.