Jessica Ang MPH Capstone Project August, 2011 Capstone Advisor:
Dr. Randall Packard Recommendations to Improve Dengue Control in
the Philippines
Slide 2
Agenda: Background Dengue in the Philippines Ecological Model
of Dengue Disease in the Philippines Current Control Strategies in
Philippines Potential Interventions Decision Matrix Conclusion
Slide 3
Background on Dengue Dengue is one of the fastest- emerging
infections in the world 4 viruses that can cause dengue Viruses do
not provide cross-immunity from one another Main Vector - Aedes
mosquitoes Aedes aegypti Causes severe flu-like illness Dengue
haemorrhagic fever Dengue Shock Syndrome Symptoms appear 314 days
after the infective bite
Slide 4
Dengue in the Philippines Dengue is endemic in the Philippines
Economic and social impact on the Philippines Dengue case rates
increase one-to-two months after the onset of the rainy season in
June Incidence of dengue fever in the Philippines has increased
rapidly in the last ten years No vaccine and no antiviral
medications to treat dengue fever. Evidence that sequential
infection of dengue fever increases the risk of developing DHF(WHO,
2009) Philippines needs focus on vector management approaches to
prevent transmission of the dengue virus to humans.
Slide 5
Dengue cases in the Philippines from 2000-2010 Data taken from
http://www.wpro.who.int/health_topics/dengue/data.htm
Slide 6
Current Methods to Control Dengue Global Strategy for
Prevention and Control of Dengue Fever and Dengue Haemorrhagic
Fever Decentralization of Vector Control services Centered on
community-based approaches use of internet, newspaper, radio &
television Dengue cases and deaths are reported from hospitals
through the National Epidemic Sentinel Surveillance System.
Insecticide fogging Community participation (e.g. rotary club )
From http://www.rotarymetrolipa.org/news/rcml-armed-and-
dangerous/
Slide 7
4-S Strategy i) Search and destroy; (ii) Self-protection
measures; (iii) Seek early consultation; and (iv) Say no to
indiscriminate fogging June Dengue Awareness Month Four-oclock
Habit D.E.N.G.U.E. strategy educate the public on home treatment of
mild dengue cases Ovicidal/Larvicidal (OL) Trap system No regular
program monitoring and evaluation process for dengue control
Current Methods to Control Dengue
Slide 8
Ecological Framework of Dengue Disease in the Philippines
Slide 9
Potential Interventio ns: Insecticide-treated Materials
Biological control - Mesocyclops Geographical Information System
Excerpt from (WHO, 2009) Excerpt from http://www.rams-
aid.org/DDSS/casasegura.php#
Slide 10
Intervention: Decision Matrix CRITERIA APPLIED TO DECIDE
PRIORITIES Biological ControlsInsecticide- treated materials GIS
Surveillance Do Nothing Potential impact (x3) Reduce # of cases of
dengue 3x3= 9 1x3 = 3 Administrative Feasibility 2333 Affordability
2123 Sustainability 2233 Political acceptability 3331 OVERALL
PRIORITY RATING*** (Example: High = 3, Medium =2, Low =1) 18
2013
Slide 11
Conclusion: The highest scoring intervention is implementing a
GIS system for dengue control in the Philippines. Recommended that
DOH partner with the Department of Science and Technology to
perform a pilot study on the use of GIS system with dengue.
Philippines needs to continuously monitor and evaluate program
strategies to help assess the effectiveness of the different
approaches Additional research is needed to address the broad root
causes of dengue disease (e.g. solid waste disposal)
Slide 12
Works Cited: Capuloy, P. A. (2010, September 20). RCML Armed
and Dangerous. Retrieved June 21, 2011, from Rotary Club of Metro
Lipa: http://www.rotarymetrolipa.org/news/rcml-armed-and-
dangerous/http://www.rotarymetrolipa.org/news/rcml-armed-and-
Sanika, C. (2011). Risk Assessment and Management Solutions for
Arthropod-borne and Infectious Diseases. Retrieved July 20, 2011,
from RAMS-AID Research - Dengue Decision Support System Project:
http://www.rams-aid.org/DDSS/casasegura.php#http://www.rams- World
Health Organization. (2009). Dengue: Guidelines for Diagnosis,
Treatment, Prevention and Control. Geneva: World Health
Organization. World Health Organization. (2011). Dengue Data.
Retrieved June 22 from
http://www.wpro.who.int/health_topics/dengue/data.htm
