NEED FOR THE STUDY

“Dengue virus infection is increasingly recognized as one of the world's emerging infectious
diseases. About 50–100 million cases of dengue fever and 500,000 cases of Dengue Hemorrhagic
Fever, resulting in around 24,000 deaths, are reported annually. Over half of the world's population
resides in areas potentially at risk for dengue transmission, making dengue one of the most
important human viral disease transmitted by arthropod vectors in terms of morbidity and
mortality. WHO declares dengue and dengue hemorrhagic fever to be endemic in the Asian sub-
continent Presently, dengue is endemic in 112 countries of the world. In a developing country’s
preventable diseases such as dengue have the potential to cause the greatest mortality. Despite the
magnitude of problem, no documented evidence exists on the awareness and practices of the adult
population regarding dengue fever9.
In the last 25 years of the 20th century, a dramatic global geographic expansion of
epidemic Dengue /dengue haemorroghic fever occurred, facilitated by unplanned
urbanization in tropical developing countries, modern transportation, lack of effective
mosquito control and globalization. As we go into the 21st century, epidemic DF/DHF is one
of the most important infectious diseases affecting tropical urban areas. Epidemic DF/DHF
has an economic impact on the community of the same order of magnitude as malaria and
other important infectious diseases10.

In India dengue deaths rates are statically greater than other affected areas. As many cases go
unreported, highest statistics in 2010 reported that in Delhi confirmed dengue cases were 5837 and the
reported deaths were 8.And in Uttar Pradesh confirmed dengue cases were 496 and the reported deaths
were 8. In 2011 dengue cases were reported in Karnataka 206 and deaths are 3.

Dengue have been showing regular occurrence in all over India. Most of the urban areas are
having turned vulnerable for DF. In 2011 the total number of cases was 12317 which was reduced in 2012
that were 5534 and 11476 in 2013 up to November which is showing increasing trends. The peak
transmission occurred in the month of October and August to November is high transmission season. Due
to batter case management the case fatality rate is going to be down which was 1.49% and 1.25% in 2011
and 2012 respectively and 0.69% in 2013.12
The incidence of dengue has grown dramatically around the world in recent decades.
Some 2.5 billion people – two fifths of the world's population – are now at risk from dengue.
WHO currently estimates there may be 50 million dengue infections worldwide every year. In
2007 alone, there were more than 890 000 reported cases of dengue in the Americas, of which
26 000 cases were DHF. The disease is now endemic in more than 100 countries in Africa,
the Americas, the Eastern Mediterranean, South-east Asia and the Western Pacific. South-east
Asia and the Western Pacific are the most seriously affected. Before 1970 only nine countries
had experienced DHF epidemics, a number that had increased more than four-fold by 1995.
Not only is the number of cases increasing as the disease is spreading to new areas, but
explosive outbreaks are occurring. In 2007, Venezuela reported over 80 000 cases, including
more than 6 000 cases of DHF.
Some other statistics:

 During epidemics of dengue, infection rates among those who have not been
previously exposed to the virus are often 40% to 50%, but can reach 80% to 90%.
 An estimated 500 000 people with DHF require hospitalization each year, a very
large proportion of whom are children. About 2.5% of those affected die.
 Without proper treatment, DHF fatality rates can exceed 20% 11.

100 countries through out the America, South East Asia, the Western Paciffic Islands, Africa and
the Eastern Mediferranean. The disease is responsible for the loss of 653,000 DALYS (Disablity Adjusted
life years) across the globe & 21000 deaths annually. World wide nearly 2.5 – 3 billion people (40% of
global population) continue to live at constant risk of contracting infection. WHO currently estimates that
there may be 50 million cases of dengue – infection world wide every year. The South – East Asia region
contributes 52% & 1.3 billion cases annually.
As per a study in Karnataka where among the 417 fever cases 15 blood samples of chikungunya
and 45 samples of dengue were sent to viral diagnostic laboratory at Shimoga for testing. Of the blood
samples sent, seven chikungunya cases, including three from Jalavalli in Honnavar taluk and four from
Banavasi in Sirsi taluk have been confirmed. In case of dengue fever, foru from Hegdekatta in Sirsi taluk,
one each from Kasarkod and Jalavalli, five from Nagarbastikeri and two cases from Nandolli have been
reported. Last year, the district had witnessed 162 chikungunya cases and 49 dengue fever cases, the
release stated14
Dengue virus infection is increasingly recognized as one of the world’s emerging infectious
diseases. About 50-100 million cases of dengue fever and 5,00,000 cases of Dengue Hemorrhagic fever,
resulting in arou8nd 24,000 deaths, are reported annually. Over half of the world’[s population resides in
areas potentially at risk for dengue transmission, making dengue one of the most important human viral
disease transmitted by arthropod vectors in terms of morbidity and mortality. WHO declares dengue and
dengue hemorrhagic fever to be endemic in the Asian sub continent presently, dengue is endemic in 112
countries of the world. In a developing country’s preventable diseases such as dengue have the potential
to cause the greatest mortality. Despite the magnitude of problem, no documented evidence exists on the
awareness and practices of the adult population regarding dengue fever. 10
The incidence of dengue has grown dramatically around the world in recent decades. Some 2.5
billion people-two fifths of the world’s population-are now at risk from dengue. WHO currently estimates
there may be 50 million dengue infections worldwide every year. In 2012 alone, there were more than
8,90,000 reported cases of dengue in Americas, of which 26,000 cases were DHF. The disese is now
endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, South-east Asia
and the Western Pacific. South-east Asia and Western Pacific are the most seriously affected. Before
1970 only nine countries had experienced DHF epidemics, a number that had increased more than four-
fold by 1995. Not only is the number of cases increasing as the disease is spreading to new areas, but
explosive outbreaks are occurring. In 2012, Venezuela reported over 80,000 cases, including more than
6000 cases of DHF.
Some other statistics:
⮚ During epidemics of dengue, infection rates among those who have not been previously exposed
to the virus are often 40% to 50%, but can reach 80% to 90%.
⮚ An estimated 5,00,000 people with DHF require hospitalization each year, a very large proportion
of whom are children. About 2.5% of these affected die.
⮚ Without proper treatment, DHF fatality rates can exceed 20%. 11

In 2008, for the South East Asia region as a whole, there is about 18% increase in the number of
reported cases and about 15% increase in the number of reported dengue deaths as compared to the
same period in the previous year. The case fatality rate in Thailand is below 0.2%, in Indonesia and
Myanmar it is around 1%.
Dengue fever is an arthropod borne viral fever. It is acquiring epidemic proportion in this part of
the world and it has become major public health problem with high mortality. Estimates suggest that 50
million cases of dengue infection and 500,000 cases of dengue hemorrhagic fever occur in Asian
countries .Earlier it was prevalent in those areas with humid atmosphere and plenty of rain, but with
changing monsoon pattern this disease becoming prevalent in Deccan landscape including Karnataka 13.
A record based study was conducted in costal district of Karnartaka to study the clinical
manifestation, trends and outcome of all confirmed dengue cases among 466 patient using pre- designed
questionnaire. The result shows that majority were males, 301(64.6%) and in the and in the age group of
12-44 years, 267 (57.5%). Maximum number of cases were seen in 2007, 219 (47%) and in the month of
September, 89 (19.1%). The most common presentation was fever 462 (99.1%), followed by myalgia 301
(64.6%), vomiting 222 (47.6%), headache 222 (47.6%) and abdominal pain 175 (37.6%). The most
common hemorrhagic manifestation was petechiae 84 (67.2%). 391 (83.9%) cases presented with dengue
fever, 41 (8.8%) dengue hemorrhagic fever, and 34 (7.3%) with dengue shock syndrome. Out of 66
(14.1%) patients who developed clinical complications, 22 (33.3%) had ARDS and 20 (30.3%) had
pleural effusion. Deaths reported were 11(2.4%). 15

Dengue infection is an important arboviral infection that has become a public health concern.
Dengue vaccination is the expected primary prevention for this infection. However, dengue
 vaccine is not presently available. In this article, the author discusses and comments on the
problem hope and present status in dengue vaccine development. 15

In the past 15 years, there has been a dramatic resurgence of

dengue and dengue hemorrhagic fever worldwide, with increased frequency of epidemics and
geographic expansion of both the mosquito vectors and the viruses. The reasons for this
resurgence are not well understood, but include uncontrolled and unplanned urbanization,
increased movement of people and viruses by airplane and lack of effective control of Aedes
aegypti, the principal mosquito vector of dengue viruses. The recommended method for Ae.
Aegypti control during the past 20 years has been ultra-low volume (ULV) application of
insecticides, a method which targets the adult mosquito. Lack of efficacy of the ULV
approach led to a reevaluation of recommended strategies for prevention and control of
epidemic dengue and ultimately, resulted in development and widespread use of community-
based, integrated approaches to Ae. aegypti control. This chapter reviews the use of
community participation for controlling Ae. aegypti via larval source reduction and critically
discusses programs in four countries from the standpoint of effectiveness and sustainability.
It is concluded that a combination of vertically structured centralized and community-based
approaches should provide short-term success as well as long-term sustainability.16

During the community health nursing experience and by studies shows increased incidences of
dengue in India. When the researcher’s observation regarding mosquito breeding at Vijayapur and the
lack of knowledge regarding dengue fever among people living in rural and urban area, so this made the
investigator to take study on Video assisted teaching programme regarding prevention of dengue fever.