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Epidemics Prevention and Control Program

Background:

Dengue is the most rapidly spreading mosquito-borne viral disease in the world. In the last 50 years, incidence has increased many folds with increasing geographic expansion to new countries and, in the present decade, from urban to rural settings. An estimated 50 million dengue infections occur annually and approximately 2.5 billion people live in dengue endemic countries (WHO 2009). It is amongst the Viral Hemorrhagic Fever (VHF) group of diseases which is an emerging and re‐emerging threat the world over. It is one of the important public health emergencies of international concern as per International Health Regulations (IHR).  

The cases of Dengue and Dengue Hemorrhagic Fever are on the rise worldwide. Lately, the number of countries affected has been more than 100. The number of such countries during 1970 was just nine (9) as compared to 100 in 2011.

In Pakistan the first confirmed outbreak of DHF occurred in Karachi in 1994 with 145 cases and one fatality reported. In October 1995, a second outbreak of Dengue like febrile illness was reported from southern Balochistan, affecting the employees of a construction company working on a power generation plant. Fifty-seven out of 76 persons investigated, were found positive against Dengue virus. In September 2003 an outbreak was detected in Haripur district of KPK with a reported morbidity of 1,000 cases and 7 deaths. Thereafter, sporadic cases of DHF continued to be documented from different parts of the country. During 2005-2006, there was an unprecedented increase in DHF epidemic in the country, with a large number of cases being reported from Karachi. More than 3,640 patients were admitted to several referral hospitals in the country. There were 40 deaths, of which 37 were from the province of Sindh, making it the largest and most severe outbreak of DF in the country in terms of case mortality rate. 
 
Dengue viral cases started coming up in Punjab in recent years but were generally controlled with lesser number of causalities. However, the disease suddenly saw an upsurge in 2011 especially in Lahore and adjoining areas of Punjab. By 31-12-2011, a total of 21685 cases of Dengue were reported in the province, including 17610 in Lahore alone. A large number of these cases were cured while a total of 350 deaths in the province including 298 in Lahore were reported till 31-12-2011. After Lahore, maximum cases were reported from Faisalabad, followed by Rawalpindi, Pakpattan and Sheikhupura. A number of factors were assigned to this incidence including untimely rains conducive for growth and proliferation of Aedes larvae, prevalence of small water bodies especially in residential areas, less rigorous community preventive measures adopted early this year and lower level of public awareness regarding disease prevention. The disease assumed proportions of a full scale outbreak towards September and resulted in emergence of thousands of cases with several hundred deaths across Punjab but with a primary and predominant concentration in Lahore and its adjoining areas.
 
Program Description:
 
To combat unprecedented Dengue Epidemic in 2011, although Government started multipronged activities but there was lack of a comprehensive plan with clearly defined roles and responsibilities. To meet this deficiency, Department of Health developed a Plan under the title of “Prevention and Control Program of Epidemics in Punjab” spanning on one year. 
 
This programme initiated its activities from 07th January 2012 and was supposed to end on 06th January 2013 but now it will continue its operations as has been shifted from developmental to non-developmental funds. It is the result of effective and efficient implementation of Dengue prevention and control activities that in year 2012, only few hundred cases were reported while one death occurred because of Dengue Syndrome and in 2013 there has been around 3000 confirmed cases 17 deaths mainly due to more rainfalls and dengue epidemics in Karachi and Swat. 
 
The main components of the program are Disease and Vector Surveillance, Health Education, Communication, Social Mobilization and Advocacy, Institutional & Capacity Building, Research & Development for five high-risk cities in particular and generally for all the districts of Punjab.
 
Objectives:
  • Make  institutionalized and sustainable arrangements to combat Dengue and other Epidemics  
  • Protect the population of Punjab from Dengue fever and other infectious diseases.
  • Introduce comprehensive health including preventive, promotive, curative and rehabilitative components.
  • Enhance coverage and quality of health care at all levels including districts, tehsils/towns and union councils.
  • Maintain preparedness all the time to combat Dengue and other epidemics.
  • Ensure involvement of community, civil society community leaders in controlling Dengue and other epidemics in the Punjab.
Program Financing, Releases & Expenditure:
 

Year

Phasing as per PC-I

PSDP Allocations

Releases

Expenditure

1.

FY 2011-12

590.000

295.00

185.856

2.

FY 2012-13

345.000

345.000

345.000

3.

FY 2013-14

249.100 

234.986

Yet to consolidate

 

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Site Last Updated: 15th August 2017