PESHAWAR: The Khyber Pakhtunkhwa health department has been treating suspected dengue fever cases symptomatically after their tests show positivity on the local kits instead of sending samples to the National Institute of Health Islamabad, the only authorised public sector institution to confirm or exclude presence of dengue virus, experts say.

“The province has now become endemic to dengue fever like malaria because of prevalence of larva and presence of vector (mosquitoes) but the hospitals don’t follow standard protocols in diagnosis and treatment of patients,” they said.

The health department focal person for vector-borne diseases, Dr Khalid Khan, said that they had received 838 patients, who were treated for dengue fever when they were tested positive on rapid methods at the local hospitals. Later, their samples were sent to NIH, he added.

“There is no reported dengue fever case in the province,” Dr Khalid said. He added that government had approved Rs329 million for a three-year programme to control dengue through a multi-pronged approach including diagnosis, treatment and awareness.

Official says govt has approved Rs329 million for a three-year programme to control dengue

There are isolation rooms in hospitals in high-risk district and teaching hospitals which exclusively admit suspected dengue patients.

Dr Khalid said that a total of 22 suspected patients of dengue, including four at Khyber Teaching Hospital and 18 in Malakand, were currently hospitalised. The provincial diagnosis on the kit helped the physicals to provide first-aid to the patients till their ‘authentic reports’ came from NIH, he said.

Sources, however, said the preparedness level of the health department was not up to the mark. All those arriving with symptoms were treated as dengue patients when their tests conducted on local method emerged positive. “The kit on which the test is performed at the hospitals, can be substitute to NIH, which is the only certified institutions to conduct high-tech diagnostic work, like detection of polio, Congo etc,” they said.

Sources said that the treatment given to the patients was not according to the globally recognised methods but doctors were required to give prompt relief to the patients with high-grade fever associated with intense pain.

The government, according to sources, has not sought assistance from the World Health Organisation to send specimens from patients to NIH and totally banked on the result of hospital tests which is against the protocol. The WHO has been providing technical assistance to the health department since the disease first reported in the province few years ago.

In the past, the world health agency collected samples from the suspected patients at the hospitals and sent it to Islamabad. “Now, samples are not sent to NIH,” they said.

A doctor involved in dengue care at one of the hospitals said the health department had not approached the WHO due to which the doctors were unable to confirm patients.

Experts also fear that the disease can snowball into a major public health issue in the face of non-existence of a surveillance system to track down source of the disease, number of patients and the areas which have recorded most cases as such information are needed to prepare an effective strategy for control and prevention of the disease.

“We cannot prevent vector-borne ailments, including dengue when we don’t know the desired statistics,” they said. They added that the method was not internationally-recognised but it was effective for the purpose of fast-tracked treatment, therefore doctors relied on the kit.

Like dengue, the patients of suspected Congo get the same treatment. The patients representing Congo symptoms are treated as patients because there is no mechanism to collect samples and send the same to the NIH.

Dr Imran, who is looking after Congo patients at HMC, said that at least 10 persons had died of suspected Congo fever. He said that they sent patients to private hospitals where they were charged about Rs10, 000.

“We are receiving patients from Afghanistan and Khyber Pakhtunkhwa. The disease is prevalent and we are ready to deal with it,” he added.

Sahibzada Mohammad Saeed, chairman of Board of Governors of HMC, has meanwhile instructed the administration to start collecting samples from the patients to be sent to NIH. He said that patients couldn’t afford the test and the hospital would do it from now on.

“The patients will get proper treatment after NIH reports,” he said.

Published in Dawn, October 7th, 2015

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