Dengue panic disrupts hospital operations
Test kits run out due to increase in demand
MUBTASIM FUAD, Dhaka
Panic created by dengue has disrupted the operations of several hospitals, affecting the treatment of actual patients. The Independent visited several hospitals and found that the panic has created a twofold problem: first, a shortage of dengue testing kits is being felt because of a surge in the demand for blood tests; second, the massive increase in the demand for blood tests has clogged the test report delivery channels.
Visits to government and private hospitals as well as diagnostic centres over the past three days revealed panic-stricken people thronging these facilities to be tested for dengue, adding to the pressure on the already stretched medical units. Many anxious guardians and patients were seen waiting near pathological labs, many of them shouting at the staffers because of a delay in giving the test reports.
Private diagnostic centres in the capital, too, were overburdened with the task of performing blood tests, especially the NS1 (nonstructural protein 1) test because of a large number of suspected dengue patients.
Government hospital doctors said the number of tests had doubled in the past five to seven days. The rush began after doctors advised blood tests for anyone with fever and especially after the tests were made free.
While persons suffering from fever have to wait in a queue for a couple of hours just to get the tests done, the actual patients are getting the reports late. So, despite showing the symptoms of the disease, they could not be admitted to hospitals without the reports.
Director of Shaheed Suhrawardy Medical College Hospital, Uttam Kumar Barua, said when the outbreak had just begun, they had to perform around 300 to 400 dengue tests a day.
But over the past one week or so, especially once the tests were made free, we are forced to conduct over a 1,000 tests a day, he added.
Dhaka Medical College Hospital and some other public hospitals are also struggling to cope with the pressure of performing blood
tests and delivering the reports on time. The authorities of several hospitals, clinics and dialogistic centres said they were doing the NS1 test only when they found it absolutely necessary because their stock of kits was fast running out.
They also said that fear was one of the main reasons driving people with any kind of fever to get their blood tests done. This rush, in turn, is leading to an excessive use of kits and the resultant shortage.
Now that dengue has spread to all 64 districts of the country, the difficulties related to performing blood tests and delivering the reports have only become more acute.
Hospital sources said nearly two-thirds of the people with fever were seeking NS1 tests, although many of them were not stricken by dengue. This is causing a huge shortage of kits in the hospitals.
Health experts and doctors say the government must import kits in large numbers so that suspected dengue patients do not have to suffer late detection.
The kits take only about 15 minutes to give the result after a doctor or a lab technician takes blood samples from a suspected patients fingertip.
The kit is needed to perform the NS1 antigen test, which was introduced in 2006. It allows rapid detection even on the first day of fever.
Asked about the shortage, Prof. Sanya Tahmina, director of communicable disease control at the DGHS, said the government had imported 40,000 NSI kits this year and distributed them among different government hospitals in and around the capital.
Weve already completed the procedure to import another 50,000 kits on an emergency basis. We will get them within seven days, she added.
Pronoy Debnath, medical officer of the Shaheed Suhrawardy Medical College Hospital, said one had to get the complete blood count test (CBC) done if diagnosed with dengue in the first three testsNS1 antigen test, IgG and IgM. But even people who do not have fever are coming to get the CBC test done. This is indeed the result of panic. Many are distraught after catching seasonal fever. They imagine any mosquito they see to be an Aedes mosquito, he added.
Experts say people need not panic simply because they have fever.
Dr AFM Helaluddin, a specialist in medicine, said: After an Aedes mosquito bites a person, the symptoms of dengue can appear anywhere from four days to 10 days. They can typically last for two to 7 days.
Dengue symptoms include headache, muscle, bone and joint pain, nausea, vomiting, pain behind the eyes, swollen glands and rash. Most people recover within a week or so. In some cases, symptoms worsen and can become life-threatening. Blood vessels often become damaged and leaky. And the number of clot-forming cells (platelets) in your bloodstream drops. This can cause dengue hemorrhagic fever or dengue shock syndrome, he explained.
He also said there was no need to rush to a hospital just because one had fever. But within the first three to four days of the fever, the CBC and NS1 antigen tests should be performed. If the tests detect dengue, the patient can be treated at home for the first five to six days.
Drink plenty of water and fluids, eat nutritious food, and take rest. However, if there are symptoms like nausea and vomiting, eating disorders, restlessness and abnormal behaviour, severe abdominal pain, among others, the patient must be taken to a hospital, he said.
The patient should be taken to the hospital if complications, such as decreased blood pressure, cooling of hands and feet, cold sweat, restlessness and incontinence, decreased urine volume, shortness of breath and abnormal bleeding, among others, arise. Another symptom is the number of platelets falling below one lakh.
IK
