JOHOR BARU: Malaysia is facing a public health crisis as dengue fever cases surge, putting additional pressure on the already overwhelmed healthcare system.

Gleneagles Hospital Johor chief executive officer Dr Kamal Amzan has urged for immediate action to address the escalating dengue problem and mitigate its impacts.

Dr Kamal, who is also the IHH Hospital Malaysia regional (southern and eastern) chief executive officer, said the multifaceted crisis is fuelled by climate change, social inequalities, and public health challenges.

If the crisis is not managed swiftly, it will put a strain on the already overburdened healthcare system.

He said during dengue peak seasons, public hospitals in urban cities like Kuala Lumpur are often overcrowded due to medical staff shortages, causing long wait-times for patients.

This translates to the urgent need for more resources and improved healthcare infrastructures.

Malaysia urgently needs a comprehensive and proactive approach to reduce dengue impact and protect the people from future outbreaks.

Dr Kamal said it is crucial for effective policies, community involvement, and international cooperation to be taken immediately to address the challenges posed to public healthcare system.

"Combating dengue is not just fighting the virus, but also about improving living conditions, adapting to climate changes, and ensuring access to quality healthcare.

Climate Change and Emerging Diseases

Climate change is a major factor driving the rise of dengue in Malaysia.

Warmer temperatures accelerate mosquito life cycles, increasing its population and bite frequency.

Additionally, altered rainfall patterns create more breeding grounds for mosquitoes, especially in urban areas with stagnant water.

Globally, climate change contributes to the spreading of infectious diseases.

In Southeast Asia, countries like the Philippines, Vietnam, and Laos have reported significant increases in dengue cases.

Laos has experienced a 20-fold increase in cases, while the Philippines and Vietnam have seen their cases double and quadruple, respectively.

This underscores the dramatic impact of climate change on mosquito-borne diseases.

Public Health Challenges

Dr Kamal says the country's public healthcare is struggling to control dengue fever, despite vector control and public awareness efforts.

Malaysia's rapid urbanisation growth but poor waste management systems have created areas conducive to mosquito breeding.

Selangor is the country's worst affected, with the highest number of cases reported in the state.

According to the Health Ministry, 123,300 dengue cases were reported last year, compared with 66,102 the previous year.

Dengue outbreaks tend to happen every three to five years.

The cyclical nature of dengue outbreaks poses challenges and makes the issue harder to manage.

Based on experts' dengue trend projections, Selangor's cases will continue to surge this year and the next.

Socioeconomic Disparities and Dengue Prevalence

Based on the Statistics Department's records, about 30 per cent of the urban population lives in low-cost housing or squatter settlements which often lack proper sanitation and waste disposal, making them ideal for mosquito breeding.

Studies have shown that low socioeconomic status significantly correlates with higher dengue incidence.

Basically, lower-income communities with poor education and bad living conditions are at risk and are linked to higher dengue rates.

They are less likely to get timely medical help, leading to severe cases and more dengue-related deaths.

In highly populated areas, once the Aedes mosquitoes breed, they can spread rapidly.

The foreign worker group in the country is another demographic heavily affected by dengue.

Many live in crowded, poorly maintained accommodations with inadequate mosquito control, increasing their risk of contracting and spreading dengue.

Strengthen Public Health Infrastructure

Dr Kamal said although the country's dengue crisis is at a critical stage, a multifaceted approach could still be adopted by policymakers.

There should be better control measures taken by policymakers, which includes regular fogging, frequent exercises to destroy breeding grounds, and setting up mosquito traps.

The government should educate the public to keep their homes and neighbourhoods free of stagnant water.

The public healthcare service should be improved, with increased funding to enhance hospital and clinic facilities, especially in rural areas.

Healthcare workers should be equipped with proper training enabling them to manage dengue cases efficiently.

Policymakers should consider using advanced surveillance systems to detect and respond to dengue outbreaks quickly.

Decant Patients to Private Hospitals

To alleviate the pressure on public hospitals, the government could collaborate with private healthcare providers to decant non-critical patients to private hospitals. 

This allows public hospitals to focus on dengue and other infectious diseases. 

Public-private partnerships can facilitate this process by establishing clear protocols and funding mechanisms to ensure seamless patient transfers. 

Private hospitals can offer their bed capacity and medical staff to treat less critical cases, thereby optimising the use of resources across the healthcare system.

Climate-adaptive Strategies, Socioeconomic Development

Policymakers should integrate climate-adaptive strategies into public health planning.

For instance, weather forecasts could be used to predict dengue outbreaks and prepare in advance.

The government should develop plans that take into consideration the impact of climate on the spread of dengue in order to mobilise resources and implement effective control measures.

It should also invest and boost community development by improving living conditions.

This will be beneficial in the long-term as better housing facilities with proper sanitation will significantly reduce mosquitoes breeding grounds.

Research and Innovation

Policymakers should support and fund research on dengue vaccine and new sustainable ways to control mosquito breeding.They should collaborate with international health organisations to facilitate access to the latest technology and treatments.

Recent mosquito genetic modification advancements and the development of Wolbachia-infected mosquitoes are promising areas that warrant further exploration and investment.

Dr Kamal said efforts taken by the country in combatting the dengue surge could serve as a model to other countries facing similar issues.

It also demonstrates that integrated and well-rounded strategies are key to controlling mosquito-borne diseases globally.

https://www.nst.com.my/news/nation/2024/06/1063812/proactive-approach-needed-reduce-dengue-impact