NATIONAL DENGUE

PREVENTION AND
CONTROL PROGRAM

Ma. Michelle P. Acosta, RN, MN

Senior Health Program Officer
 DENGUE PREVENTION AND
CONTROL PROGRAM
VISION: Dengue Risk-Free Philippines
MISSION: To improve the quality of health of Filipinos by adopting
an integrated dengue control approach in the prevention
and control of dengue infection.

GOAL: Reduce morbidity and mortality from dengue infection by

preventing the transmission of the virus from the
mosquito vector human.

PROGRAM OBJECTIVES:
1. To reduce incidence from 32 cases/100,000 population to 20
cases/100,000 population
2. To reduce case fatality rate by < 1%.
3. To detect and contain all epidemics.
 DENGUE PREVENTION AND
CONTROL PROGRAM
PROGRAM COMPONENTS

• Dengue Integrated Vector Management

• Dengue Surveillance
• Dengue Case Management
• Social Mobilization & Communication
• Dengue Outbreak Response
• Research
Dengue Situation in Region 7
What is Dengue?
• a viral infection spread by
infected female Aedes
mosquitoes with any one of the
four serotypes of virus.
Vectors of Dengue

• Aedes aegypti

• Aedes albopictus
Course of Dengue Illness
 Dengue case classification by
severity
with 1.Severe plasma leakage
Without warning signs 2.Severe haemorrhage
3.Severe organ
impairment

Criteria for dengue ± warning signs Criteria for severe dengue

Probable dengue
Live in/travel to dengue
endemic area. Fever and 2 of
the following criteria:
• Nausea, vomiting
• Rash
• Aches and pains
• Tourniquet test positive
• Leucopenia
• Any warning sign
Laboratory confirmed
dengue
(important when no sign of
plasma leakage)
Warning signs*
• Abdominal pain or
tenderness
• Persistent vomiting
• Clinical fluid accumulation
• Mucosal bleed
• Lethargy; restlessness
• Liver enlargement >2cm
• Laboratory: Increase in
HCT concurrent with rapid
decrease in platelet count
* Requiring strict observation
and medical intervention
1. Severe plasma leakage
leading to:
• Shock (DSS)
• Fluid accumulation with
respiratory distress
2. Severe bleeding
as evaluated by clinician
3. Severe organ involvement
• Liver: AST or ALT>=1000
• CNS: Impaired
consciousness
• Heart and other organs
2019 ASEAN Dengue Day Theme:
 Enhanced 4 S: AO No. 2018-0021:
Guidelines for the Nationwide Implementation of the
Nehanced 4S Strategy against Dengue, Chikungunya
and Zika
1. Search and Destroy of Mosquito
Breeding Sites
2. Secure Self-Protection
3. Seek Early Consultation
4. Support fogging/spraying only in hot
spot areas where increase in cases is
registered for two consecutive weeks
to prevent an impending outbreak
 Enhanced 4S
1. Search and destroy of mosquito breeding sites
1.1.Vector control measures shall be implemented through the
coordinated and integrated efforts of the local government units LGUs
and stakeholders.
1.2. LGUs and other stakeholders shall conduct massive campaign to
eliminate key containers and non-essential containers and to manage
essential containers and all stagnant water.
1.3. The “4 o’clock shall be practiced daily at 4 o’clock in the afternoon”.
1.4. LGUs shall pass and implement appropriate legislation to
institutionalize this 1st “S” in the locality.
 Strategies on Prevention & Control

b. Case Management
Refer to hospital, not all cases need to be hospitalized
3. Surveillance
- Types: Clinical
Laboratory-based surveillance – IgM ELISA
Epidemiological (NESS)
4. Health Education
- Social mobilization
Community organizing
- Interpersonal communication
Consultation/lectures
Focus group discussion
 Enhanced 4S
2. Secure Self-Protection
2.1. Use of light-colored clothing and long-sleeves top, long pants and
socks during daytime (in areas as school, workplace etc.)
2.2. Application of insect repellent (with DEET also known as N,N-
diethyl-3-methylbenzamide as active ingredient) on uncovered skin.
2.3. Use of door and windows or insecticide-treated screens/curtains
for doors and windows as physical barrier and chemical
intervention.
2.4. Use of spatial repellents which release vaporized chemical capable
of affecting mosquito behavior at a distance. Most vapor chemical
actives also knock down, kill or inhibit feeding of mosquitoes.
Long Lasting Insecticide Curtain Nets
 Enhanced 4S
3. Seek Early Consultation
3.1. Encouraging early treatment seeking behavior.
3.2. Reiteration of the AO No. 2016-0043: Guidelines for the
Nationwide Implementation of the Dengue Rapid Diagnostic Test
(RDT) for early detection of the disease.
3.3. Reiteration and implementation of the AO No.. 2012-0006: Revised
Dengue Clinical Case Management Guidelines 2011 and case
referral.
3.4. Conduct of systematic mortality review as needed.
3.5. Monitor changes in the distribution of dengue cases geographically
over time.
3.6. Making sure that dengue fast lanes are established in all hospitals
and are functional.
 Enhanced 4 S
4. Support fogging/spraying only in hot spot areas where
increase in cases is registered for two consecutive weeks
to prevent an impending outbreak
4.1. The objective of space spraying is the massive, rapid destruction
of the adult vector population.
Space spraying
- recommended to prevent an impending outbreak
- either thermal fogging or cold fogging
- conducted using the right insecticides, right dilution, right method
of application, right timing, right PPE and proper community
preparation.
- must be done for 4 cycles and at least 7 days interval per cycle
 Enhanced 4 S
4. Support fogging/spraying only in hot spot areas where
increase in cases is registered for two consecutive weeks
to prevent an impending outbreak
4.2. The objective of Targeted Residual Spraying is to reduce intra-
dormiciliary and peri-domestic mosquito infestation.

Targeted Residual Spraying

- application of chemical insecticides on walls and other surfaces
targeting Aedes mosquitoes resting sites inside enclosed spaces
(Targeted Indoor Residual Spraying or TIRS) and nearby
outdoor areas (Targeted Outdoor Residual Spraying or TORS).
- TIRS: shall be conducted for at least 2 – 3 times a year.
- TORS: shall be conducted for 2 – 3 times a year for
supplemental control
CURTAIN IMPREGNATION
INSECTICIDE RESIDUAL SPRAYING
SPACE SPRAYING: MISTING/FOGGING
DOH ASSISTANCE TO LGUS
• Provision of technical assistance to the local
government units in terms of capability building
such as orientations of the program, trainings on
Integrated Vector Management and Dengue
Clinical Management, Rural Sanitation
Inspectors Summit, advocacies, media forums
and meetings.
• Monitoring through surveillance and conduct of
entomological surveys.
• Provision of logistics such as IEC materials,
larvicidals, dengue rapid test kits, mosquito bed
nets, curtain nets and chemicals for adulticides,
misting/fogging, insecticide spraying and
impregnation.
LGU ACTION POINTS
• Enact local ordinances supporting the National Prevention and
Control Program (NDPCP)
• Conduct entomological surveys to priority barangays as
baseline data.
• Intensify education and information dissemination and clean-
up campaigns on dengue in communities and schools
emphasizing the importance of eliminating the breeding places
of mosquitoes
• Mobilize the community to actively participate in
environmental sanitation activities such as clean up drives.
• Establish Dengue Brigades in barangays and schools lead by
barangay officials and school personnel.
• Sustain disease surveillance on dengue.
• Notify Provincial Epidemiology and Surveillance Unit
(PESU) on dengue cases and deaths.
• Conduct NS1 testing and procure dengue rapid diagnostic
test kits for suspected case/s having fever for 2 – 5 days.
ACTION POINTS
To the School Authorities:
• 1. Emphasize school-based programmes targeting parents
and children in schools to eliminate vector breeding places
at home and in the school.
• 2. Create “Dengue School Brigades” and sup-port its
sustainability.

To the General Public:

• 1. Clean all possible mosquito breeding places (flower
vases, dish drains, old tires, roof gutters, used cans, etc.)
where water can pool or accumulate.
• 2. Use personal protective measures such as mosquito nets,
use of insect repellent lotion or install window screens.
• 3. Cover water receptacles (drums, jars, etc.).
• 4. Maintain the habit of cleaning up areas in-side and
outside homes.
FREE US FROM DENGUE!

THANK YOU!!!