Is India mishandling its dengue data concerning deaths from the disease? The latest report by The Lancet claims there is a mismatch between the numbers from its study and the ones reported by India to the World Health Organization (WHO).
The mosquito-borne tropical disease – which the WHO considers the world’s fastest-growing mosquito-borne disease and is endemic throughout all 35 Indian states and union territories – has so far claimed six lives and affected 6,210 people this year, according to the information given by the government in the Lok Sabha on June 21, 2019.
Of the five worst-hit states, four are in South India. Karnataka has 1303 cases; Tamil Nadu has 988 cases; Telangana has 767 cases; and Kerala has 469 cases with four deaths, according to Ashwini Choubey, Minister of State for Health and Family Welfare, in reply to a Parliament question raised by B. K. Hariprasad, a Rajya Sabha Member of Parliament from Karnataka.
The Lancet’s research states India contributes 34 of 96 million apparent global dengue infections, in stark contrast to the 12,484 cases reported by India to the WHO. In another Lancet study, the actual number of dengue cases were 282 times higher than what was reported by the National Vector-borne Disease Control Programme.
Discrepancies in the reportage of death also linger onto different regions across the country. Seroprevalence – the level of pathogen, a cause of dengue virus, in a population – differed greatly between regions. South India reported 76·9 percent seroprevalence, followed by 62·3 percent in West India and 60·3 percent in North. The levels were higher in urban population at 70.9 percent as compared to 42·3 percent in the rural population. It is believed that due to a high rate of urbanisation the cases are expected to rise.
The overall seroprevalence of dengue infection in India is 48·7 percent, registering an increase of 28·3% percent among children aged 5–8 years; 41·0 percent among children aged 9–17 years; and to 56·2 percent (49·0–63·1) among individuals aged 18–45 years.
Experts believe the major challenge lies with India’s dengue surveillance system. “Although [the] National Vector Borne Disease Control Programme (NVBDCP), data confirms that dengue is established and endemic across India, an exclusive dengue surveillance system does not exist,” the paper states.
“Instead, dengue surveillance is embedded within the NVBDCP’s sentinel surveillance network, consisting of 500 sentinel hospitals and fifteen referral laboratories across India,” it said, adding that the NVBDCP captures less than 0.5 percent of the annually occurring dengue cases across India
To combat a deadly epidemic which is killing hundreds of Indians, the country needs to strengthen its surveillance system and understand the deep impact the virus is having on its population. As only when the country can truly estimate the damage will they allocate adequate resources to end the annual epidemic impacting the whole country