Deadlier dengue increases burden of treatment cost

Highlights:

• Dengue patients can be treated at home at a cost of around Tk10,000, but this year, shock due to multiple variants of the virus, so, treating dengue patients at home is not possible in many cases.
• The cost of treating dengue at government hospitals often reaches Tk20,000-25,000 and in private hospitals the cost is much higher.
• The death toll from dengue in the country has reached 110, which is the second highest in the last 22 years.

When Mahmuda Akhtar Brishti's six-year-old son Junayed was diagnosed with dengue around a week ago, she initially continued providing him treatment at home, which cost around Tk12,000. 

But when his condition deteriorated, Junayed was admitted to Bangladesh Shishu Hospital and Institute (BSHI), where his treatment required around Tk7,000 in only two days.

All these expenses became a heavy burden for Mahmuda, a cleaner in a private company, and her husband Shafiqul, a security guard, as their combined monthly income – around Tk20,000 – was already spent and they did not know how long Junayed's treatment would continue.

Doctors said dengue patients can be treated at home with paracetamol along with a liquid diet and by daily monitoring their platelet level, which would cost around Tk10,000 in total. However, this year, dengue patients are rapidly going into shock due to multiple variants of the virus, so, treating dengue patients at home is not possible in many cases.

Many dengue patients, especially those with low-income, are suffering heavily due to the bigger treatment cost at hospitals.

The cost of treating dengue at government hospitals often reaches Tk20,000-25,000. In private hospitals the cost is much higher as the expenses including bed rent there are relatively high. If dengue patients need to be given platelets or kept in ICU, the cost increases even further.

Roni Chowdhury, father of a two-year-old-girl named Nilima Chowdhury, said he has spent around Tk25,000 for his daughter's treatment at Bangladesh Shishu Hospital in the last nine days.

He said expenses at the hospital included Tk300 for blood test, Tk700 for bed rent, and Tk500-700 for medicine per day. On one particular day, he had to buy medicines worth Tk2,500.

Professor Dr Ahmedul Kabir, a medicine specialist, told TBS that many of the patients suffering from dengue this year have contracted the virus for the second time, so the disease is very severe for them.

"Besides, dengue fever usually subsides after three days, but the patient's condition suddenly worsens on the fifth day. If the patient stops taking liquid food when the fever subsides, thinking that he has recovered, and his blood pressure is not controlled, he goes into shock," said Dr Ahmedul Kabir, secretary general of Bangladesh society of Medicine.

"This year, the patients' conditions are rapidly deteriorating as they are suffering from variants of dengue virus – DEN-1, DEN-3 and DEN-4. Dengue patients have to eat more liquid food, and monitor if his blood pressure is going down.  If the patient vomits frequently and suffers blood loss, he needs to be hospitalised," he added.

According to a study published in November 2021 by the Bangladesh Institute of Development Studies (BIDS), the average cost of treating a dengue patient in Bangladesh is around Tk34,000.

The study report titled "Epidemiological and Economic Burden of Dengue in Dhaka, Bangladesh" said the average cost of dengue treatment in a government hospital was Tk22,379 and in a private hospital Tk47,230.

Dr Abdur Razzaque Sarker, health economist at BIDS, told TBS that the cost of dengue treatment is catastrophic for low-income people as it amounts to about 139% of their total household income on an average.

The authorities should focus on raising awareness and preventive measures, like fogging and cleanliness, especially during the peak season of dengue infections August to November, to prevent the dengue spread, said Dr Abdur Razzaque Sarker.

The death toll from dengue in the country has reached 110, which is the second highest in the last 22 years.

A total of 3,207 dengue patients, including 2,182 in the capital, are now receiving treatment at hospitals across the country, according to the Directorate General of Health Services (DGHS).

According to the DGHS, 93 people died from dengue in the country in 2000, and 58 people in 2002. After that, the number of dengue deaths was below 15 for many years, before reaching 179 in 2019 which was the highest in the country's history.

3 hospitals prepared to treat dengue patients

Health Minister Zahid Maleque said in an event on Thursday that Dhaka North City Corporation Hospital, a new wing of Bangabandhu Sheikh Mujib Medical University Hospital and Lalkuthi Hospital have been readied for the treatment of dengue if the number of cases increase.

"However, it must be remembered that the health ministry can provide treatment for dengue patients but it cannot kill Aedes mosquitoes. It is the responsibility of the city corporations and municipalities to kill the mosquitoes," said the health minister.

"The number of dengue patients will decrease if mosquitoes decrease. Consequently, the pressure on the hospitals will decrease too," he added.