ඩෙංගු රෝගය සක්‍රිය වෙසි. මුළු රටම අවදානමේ: Worst-ever epidemic of dengue fever. The whole country is at risk.

Dengue is the fastest spreading mosquito-borne viral infection in the world. Spreading in epidemic proportions, dengue has become a major public health problem in Sri Lanka. From 1st January to 19th July in 2017, The Ministry of Health has reported 97,125 dengue fever cases, including 250 deaths. "The number of cases this year is three-and-a-half times more than the average number of cases for the same period between 2010 and 2016,” officials say.

The current dengue fever outbreak occurs in a context of massive heavy rains and flooding in May-June and is currently affecting 15 out of 25 districts in Sri Lanka where almost 600,000 people have been affected. The health authorities are particularly worried they can see a further increase in the number of dengue cases because of the stagnant water that the floods leave in their wake, which is the last thing needed by families and communities that have already lost so much. The geography of dengue fever is a typical local one, as the dengue mosquito can fly only 100 to 500 meters.

The organisation of HELP has for many years educated parents and children about the risk of dengue fever. HELP has organised many community campaigns to keep the local environment clean, removing all breeding sites for this particular mosquito (Aedes aegypti). HELP has also introduced other practical measures to be adopted at household level. All children attending the Sathkara school are expected to remove trash from their home and garden as part of their "homework duties". Doing so, they reduce the number of artificial water containers that hold water (plastic cans, used tyres, empty bottles, coconut shells, etc.). Recently, HELP members assisted in a shramadana (voluntary labour) to clean the land of a neighboring family, where one of the family members was hospitalised because of dengue fever. The patient is now much better.



Cleaning the land of one of our neighbors, close to Silarathana Mawatha, on the way to Horana. If road ditches do not flow and contain stagnant water for one week or longer, they can produce large numbers of mosquitoes. Photo: Siripala Gamage

Sharing a meal during our shramadana. Photo: Siripala Gamage

වතුර හින්දා මදුරුවෝ බෝ වෙනවා. මදුරුවෝ හින්දා ලෙඩ බෝ වෙනවා. Translation: Mosquitoes breed because of water. Diseases spread because of mosquitoes.



Communicable diseases: Even though non-communicable diseases (NCDs, e.g. cardiovascular disorders, diabetes, kidney disease, cancer and mental illness) are now the leading cause of death in Sri Lanka, communicable diseases (CDs, e.g. malaria fever, dengue fever, HIV/AIDS, tuberculosis, diarrheal diseases) remain a health burden. Even though the actual number of deaths caused by CDs is relatively small, the infectious nature of these diseases is cause of grave public concern, with a large number of patients seeking treatment at hospitals. Kalutara district Dengue is the major public health burden in Sri Lanka. Kalutara is one of the highly affected districts. Understanding the drivers of dengue is vital in controlling and preventing the disease spread. A recent study focused on quantifying the influence of weather variability on dengue incidence over 10 Medical Officer of Health (MOH) divisions of Kalutara district. Weekly weather variables and data on dengue notifications, measured at 10 MOH divisions in Kalutara from 2009 to 2013, were retrieved and analysed. There was a pronounced relationship with medium and high rainfall levels occurring 6–12 weeks before incidence, and a similar pattern following high temperatures. Rainfall affects vector abundance by replenishing breeding sites and stimulating egg hatching. Incidences of malaria in Sri Lanka has markedly declined from year 2000 onwards, with a steady reduction in the proportion of Plasmodium falciparum cases. In fact, the recorded annual case numbers have been below 1,000 since 2006 with the majority of cases due to Plasmodium vivax. During the years of 2011 and 2012 there were only 124 and 23 respectively of indigenous malaria cases. Since October 2012, the number of cases of malaria was reduced to zero and no locally transmitted cases have been recorded in Sri Lanka thereafter. On the 5th of September, 2016, the World Health Organisation (WHO) certified that Sri Lanka was successful in eliminating malaria. Sri Lanka is the second among the 11 countries in the WHO South-East Asia Region to eliminate malaria after Maldives. Sources: Liyanage, P., Tissera H., Sewe M., Quam, M., Amarasinghe, A., Palihawadana P., Wilder-Smith, A., Louis V. R., Tozan Y. and Rocklöv J. (2016): A Spatial Hierarchical Analysis of the Temporal Influences of the El Niño-Southern Oscillation and Weather on Dengue in Kalutara District, Sri Lanka. In: Int. J. Environ. Res. Public Health 2016, 13, 1087; doi:10.3390/ijerph13111087. Karunaweera, N. D., Galappaththy, G. N.L. and Wirth, D. F. (2014): On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs. In: Malaria Journal 2014, 13:59 Lucas, G.N. (2017): Malaria-free Sri Lanka. In: Sri Lanka Journal of Child Health, 2017; 46(1): 1-2.