BARANGAY-BASED APPROACH FOR DENGUE FEVER PREVENTION AND

CONTROL IN MARAGA-A, KIBLAWAN, DAVAO DEL SUR

A Research Report

Molopolo National High School

Kiblawan, Davao del Sur

In Partial Fulfillment of the Requirement for the Subject English 10

Researchers:

Group 9:

Kristine Sauro

Aubrey Chariz Tan

Natalie Vienn Alcazarin

Saicy Villagracia

John Michel Tan

Submitted to: Ma’am Michelle L. Maunes

June, 2023
 INTRODUCTION

Dengue is an infectious disease caused by any of the four dengue virus serotypes.
DENVs 1—4. It is a mosquito-borne disease and is primarily transmitted to humans by the
female aedes mosquito. Dengue is the most rapidly spreading mosquito- borne viral disease in
the world, which is mainly transmitted by the Aedes aegypti mosquitoes (Powell, 2018). The
disease is mainly concentrated in Tropical and Subtropical regions, putting nearly a third of the
human population, worldwide, at risk of infection. Infection with DENV results in varying
degrees of pathological conditions, ranging from mild asymptomatic Dengue Fever (DF) to
severe dengue hemorrhagic fever (DHF) and Dengue shock syndrome (DSS) which may turn
fatal. Dengue Hemorrhagic fever has symptoms of high temperature, bleeding, low platelet
counts and plasma leakage due to low concentration of proteins and albumins in blood. Dengue
shock syndrome can occur after 2-7 days of Dengue Hemorrhagic fever along with symptoms of
low blood pressure and pulse (Hasan,2018).

Pakistan has experienced an increase of the transmission of Dengue with a total of 25,
932 confirmed cases and 62 deaths being recorded as of the 27th of September 2022. Although
dengue is endemic to Pakistan the seasonal peak is the worst noted in the previous four years.
This raised figure of cases is similarly being attributed to the ongoing humanitarian crisis with
the unprecedented flooding which occurred in June of 2022 (Banerjee, et al, 2023).

In 2019, the highest number of cases in Asia was reported in the Philippines with 420,000
cases. Consequently, the Philippine declared a National Dengue epidemic in the country in
August 2019(DOH, 2019). As of December 10, 2022, a total of 216, 927 dengue cases and 706
deaths have been reported for the year in the Philippines. This was 187% higher compared with
the same period of the previous year (WHO 2023). The most high cases in the Philippines was in
CALABARZON and also in Parañaque City (Deen,2019).

In 2023, Dengue Fever is one of the most rampant issue in Maraga-a, Kiblawan , Davao
del Sur that the residents want to solve. The midwife in Barangay Maraga-a namely Dina Cona
has visited every household because several cases of Dengue fever has been reported due to the
sudden change of the weather. In Barangay Maraga-a , waste [3] are maintained and garbages in
every household were disposed properly. However, dirty clogged canals are the primary concern
of the residents in Maraga-a which could be a possible cause of dengue fever in the area.

Statement of the Problem

This study aims to help the residents in barangay Maraga-a to prevent and reduce the
cases of Dengue fever in the area. Since there are various cases of Dengue fever in barangay
Maraga-a because of the clogged canals and dirty areas, the goal of this study is to implement
general cleaning in the community to get rid of Dengue fever in the area.

These are the following questions for the respondents that they will need to answer:

1. What should you do if you suspect that you have a dengue?

2. .What are some possible solutions do you think in this kind of disease?

3. When do we need to go to the hospital if you have a symptoms of Dengue?

4. How can you help in your barangay to prevent dengue fever?

This research report will aim to benefit the following:

Residents. This research report may serve as a guide and reference for the residents and
be able to know the other cause of dengue fever, to make an action.

Barangay Officials. This research report will be beneficial to the barangay officials to
help solve dengue cases in the area so that the barangay officials would take action to this
rampant issue in Barangay Maraga-a.

Readers. This research report will be useful to the readers so that they could prevent the
possible dengue fever in their area.

Future Researchers. This research report will be useful reference for the researchers
who would plan to make any related study about dengue fever.

Overall, this research report will aid:

The residents, Barangay Officials, the readers and Future Researchers so that they would
take an action with this issue.
 REVIEW OF RELATED LITERATURE

According to, (Goethals, et al, 2023) Dengue is a major health threat and the number of
symptomatic infections caused by the four dengue serotypes is estimated to be 96 million with
annually around 10,000 deaths.However, no antiviral drugs are available for the treatment or
prophylaxis of dengue. We recently described the interaction between non-structural proteins
NS3 and NS4B as a promising target for the development of pan-serotype dengue virus (DENV)
inhibitors. Here we present JNJ-1802—a highly potent DENV inhibitor that blocks the NS3–
NS4B interaction within the viral replication complex. JNJ-1802 exerts picomolar to low
nanomolar in vitro antiviral activity, a high barrier to resistance and potent in vivo efcacy in mice
against infection with any of the four DENV serotypes. Finally, we demonstrate that the small-
molecule inhibitor JNJ-1802 is highly efective against viral infection with DENV-1 or DENV-2
in non-human primates.

In Thailand, the first report of dengue infection in the country was around 1949, and the
first outbreak was 1958. The recent reports indicated that the significant Dengue-endemic occurs
typically every 3-5 years. In the last decades, The Bureau of Epidemiology reported that
approximately 40,000-150,000 dengue cases per year. Kongsin et al. estimated the total annual
economic burden of dengue in Thailand was 125-191 million US dollars, which approximately
72% was the cost of dengue illness and 28% was dengue control programs. In general, the
patterns and epidemiological characteristics of Dengue mostly depend on climate factors.
Umidity, temperature, and rainfall are the key factors .Owever, the patterns of dengue incidence
also essential to understand the pattern of dengue incidence because it may assist the authorities
to prepare and prevent the outbreak (Polwiang, 2018).
 Moreover, (Dwivedi, 2022) also stated that Dengue is one of the most widespread
epidemics in India in recent times. The case has increased from 30,000 in 2010 to 100,000 in
2016. It has turn out to be a big worry to public healthcare system. As general cases recover with
little medication but considering the serious probable haemorrhagic complications, it is essential
for country like India to have a system in place that can efficiently meet this challenge.Dengue
most often shows symptoms like abrupt onset of fever for 5 to 8 days following a bite from one
of numerous groups of Aedes mosquito, including A. aegyptii, A. albopictus, and A. scutellaris.
It is observed that after2 to 4 days of headache, fever, and muscle aches, the illness relieves for
12 to 48 hours and then again come back with a skin rash, chills, swollen and reddened eyes, and
the unbearable joint pains which is also called as “break bone fever,” an synonym that is still in
use. Dengue fever is normally benign and get controlled by little or very less medications but in
certain cases, it advances to the Hemorrhagic form due to which blood loss from multiple organs
and mucosal surfaces occurs also for this type of cases the mortality rate of about 5 percent has
been reported. Till now no vaccine and medicines are available for the treatment of dengue.

According to, (Hasan, et al, 2018) Dengue virus gains entry into the host organism
through the skin following an infected mosquito bite. Humoral, cellular, and innate host immune
responses are implicated in the progression of the illness and the more severe clinical signs occur
following the rapid clearance of the virus from the host organism. Hence, the most severe
clinical presentation during the infection course does not correlate with a high viral load.
Alterations in endothelial microvascular permeability and thromboregulatory mechanisms lead to
an increased loss of protein and plasma. Proposed theories suggest that endothelial cell activation
caused by monocytes, T-cells, the complement system, and various inflammatory molecules
mediate plasma leakage. Thrombocytopenia may be related to alterations in
megakaryocytopoiesis, manifested by infection of human hematopoietic cells and compromised
progenitor cell growth. This may cause platelet dysfunction, damage, or depletion, leading to
significant hemorrhages.

Due to the treatment of the disease being predominantly supportive, the prevention of the
spread through enhanced and improved vector control and elimination is recommended. The use
of eradication programs, impregnated mosquito nets, larvicidal and chromosomal manipulation
therapies are the most effective methods to aid and abet the control of this deadly virus. The
coming months and response of the spread of the virus to the intimated control programs
implemented in Nepal will act as a yardstick for the future development and course of the
outbreak of Dengue within the mountainous region. The same control measures and vector
elimination is vital for the control of the spread of the virus within Southern Asia and specifically
India, furthermore it is advised that increased national funding as well as planning at both a state
and central

Governmental level within India will be most poignant and effective in actively trying to
reduce the burden and spread of the virus within the continent. A collaborative effort between all
the burdened countries, with the ongoing sharing of resources and information will be
instrumental in controlling the outbreak (Robinson, et al,2023).

According to (Malavige, et al, 2018) Dengue viral infections are one of the most
important mosquito borne diseases in the world. They may be asymptomatic or may give rise to
undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock
syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur
worldwide. Ninety percent of DHF subjects are children less than 15 years of age. At present,
dengue is endemic in 112 countries in the world. No vaccine is available for preventing this
disease. Early recognition and prompt initiation of appropriate treatment are vital if disease
related morbidity and mortality are to be limited. This review outlines aspects of the
epidemiology of dengue infections, the dengue virus and its mosquito vector, clinical features
and pathogenesis of dengue infections, and the management and control of these infections.

However, (Panda, et al, 2022) stated that treatment of dengue depends on the patient’s
illness phase. Those presenting early without any warning signs can be treated on an outpatient
basis with acetaminophen and adequate oral fluids. Such patients should receive an explanation
regarding the danger signs and be asked to report to the hospital immediately if they notice any.
Patients with warning signs, severe dengue, or other situations like infancy, elderly, pregnancy,
diabetes, and those living alone need to be admitted. Those with warning signs can be initiated
on IV crystalloids, and the fluid rate is titrated based on the patient’s response. Colloids can be
started for patients in shock and are also preferred if the patient has already received previous
boluses of crystalloid and has not responded. Blood transfusion is warranted in case of severe
bleeding or suspected bleeding when the patient remains unstable, and hematocrit falls despite
adequate fluid resuscitation. Platelet transfusion is considered when platelet count drops to
<20,000 cells/microliter, and there is a high risk of bleeding. Avoid giving aspirin and
nonsteroidal anti-inflammatory drugs, and other anticoagulants. No antiviral medications are
recommended.

During the febrile phase, a sudden high-grade fever of approximately 40 C occurs that
usually lasts two to seven days. Saddleback or biphasic fever is seen in approximately 6% of
cases, particularly in patients with DHF and severe dengue. It is described as a fever that remits
at least for one day, and the next fever spike starts, which lasts at least for one more day.[10]
Associated symptoms include facial flushing, skin erythema, myalgias, arthralgias, headache,
sore throat, conjunctival injection, anorexia, nausea, and vomiting. For skin erythema, a general
blanchable macular rash occurs in the first one to two days of fever and the last day of fever. Or,
within 24 hours, a secondary maculopapular rash can develop (Schaefer, et al, 2022).

Furthermore, Dengue fever is one of the most important arbovirus diseases in the world.
The distribution of cases has also increased significantly with the number of affected areas the
highest in history. Dengue fever mainly occurs in southern provinces in China and its epidemic
showed a trend of high incidence in 2019. This study estimated the economic burden of dengue
fever in China in 2019 from the perspectives of both family and organisation. We recruited 1,027
dengue fever patients from Zhejiang Province, Chongqing City and Yunnan Province. At the
same time, the costs related to dengue fever prevention and control from governments, CDCs,
communities and subdistrict offices of 30 counties located in Zhejiang Province and Chongqing
City were also collected. The results showed that in family perspective, the total economic
burden of dengue in 2019 is estimated to be 46,805,064.00 CNY. In terms of organization
expenditures, the regions with a higher incidence had higher costs (Xu, et al, 2022).
 According to, (Leung, et al, 2023) Dengue is considered as a major public health
challenge and a life-threatening disease affecting people worldwide. Over the past decades,
numerous forecast models have been developed to predict dengue incidence using various factors
based on different geographical locations. Dengue transmission appears to be highly sensitive to
climate variability and change, however quantitative models used to assess the relationship
between climate change and dengue often differ due to their distribution assumptions, the nature
of the relationship and the spatial and/or temporal dynamics of the response. We performed a
systematic review to examine current literature surrounding existing quantitative model based on
development methodology, predictor variable used and model performance. Our analysis
demonstrates several shortcomings in current modelling practice, and advocates for the use of
real time primary predictor data, the incorporation of non-climatic parameters as predictors and
more comprehensive reporting of model development techniques and validation. This review
collates methodological approaches adopted in the modelling practices in the field across current
literature. This will provide an evidence-based framework for upgrading future modelling
practice to develop more accurate predictive models with robust techniques. In turn, this also
provided an opportunity for the effective distribution of limited public health resources to
prepare for demand.

Liver involvement associated with dengue fever is commonly seen and may progress to
fulminant hepatic failure. Meticulous use of N-acetylcysteine with rising transaminases is shown
to be beneficial in some studies. Antibiotics are not routinely recommended, but secondary
bacterial sepsis can occur due to Leucopenia and immune paresis, even leading to severe septic
shock, where appropriate antibiotics are indicated. Pregnancy and dengue, it is not uncommon
for pregnant mothers to get dengue during different stages of gestation. Pregnancy carries a high
risk of complications and clinical management needs multidisciplinary expert advice. The
physiological changes of pregnancy should be considered when interpreting investigations and
deciding on treatment. During labour, the blood loss should be estimated and should be replaced
with fresh blood (Kularatne, et al, 2022).
 According to, (Obi, et al, 2021) Dengue is the most prevalent arthropod-borne viral
disease worldwide and affects approximately 2.5 billion people living in over 100 countries.
Increasing geographic expansion of Aedes Aegypti mosquitoes (which transmit the virus) has
made dengue a global health concern. There are currently no approved antivirals available to
treat dengue, and the only approved vaccine used in some countries is limited to seropositive
patients. Treatment of dengue, therefore, remains largely supportive to date; hence, research
efforts are being intensified for the development of antivirals. The nonstructural proteins, 3 and 5
(NS3 and NS5), have been the major targets for dengue antiviral development due to their
indispensable enzymatic and biological functions in the viral replication process. NS5 is the
largest and most conserved nonstructural protein encoded by flaviviruses. Its multifunctionality
makes it an attractive target for antiviral development, but research efforts have, this far, not
resulted in the successful development of an antiviral targeting NS5. Increase in structural
insights into the dengue NS5 protein will accelerate drug discovery efforts focused on NS5 as an
antiviral target. In this review, we will give an overview of the current state of therapeutic
development, with a focus on NS5 as a therapeutic target against dengue.

Mortality from severe dengue is low, but the economic and resource burden on health
services remains substantial in endemic settings. Unfortunately, progress towards development
of effective therapeutics has been slow, despite notable advances in the understanding of disease
pathogenesis and considerable investment in antiviral drug discovery. For decades antibody-
dependent enhancement has been the prevalent model to explain dengue pathogenesis, but it was
only recently demonstrated in vivo and in clinical studies. At present, the current mainstay of
management for most symptomatic dengue patients remains careful observation and prompt but
judicious use of intravenous hydration therapy for those with substantial vascular leakage.
Various new promising technologies for diagnosis of dengue are currently in the pipeline. New
sample-in, answer-out nucleic acid amplification technologies for point-of-care use are being
developed to improve performance over current technologies, with the potential to test for
multiple pathogens using a single specimen. The search for biomarkers that reliably predict
development of severe dengue among symptomatic individuals is also a major focus of current
research efforts. The first dengue vaccine was licensed in 2015 but its performance depends on
serostatus. There is an urgent need to identify correlates of both vaccine protection and disease
enhancement. A crucial assessment of vector control tools should guide a research agenda for
determining the most effective interventions, and how to best combine state-of-the-art vector
control with vaccination (Smith, et al, 2019).

According to, (Agrupis, et al, 2019) Dengue is a disease caused by four separate but
related viruses transmitted by mosquitos. In this systematic review, we aimed to describe dengue
research in the Philippines, where the disease is of great concern, to better understand the types
of dengue research and the main findings and important gaps. We identified 135 studies that
described dengue research in the Philippines during the past 60 years. Our review showed that in
the early years, dengue studies were mainly simple descriptive studies and case reports. Recently
the types of investigations have become more complex and diverse, reflecting advancement in
local research capacity and infrastructure but more research activity would be beneficial in
several areas.

(Xu, et al, 2022) stated that the economic burden of dengue fever patients was calculated
from both family and the organisation perspectives. A survey was conducted among 1,027
dengue fever patients in Zhejiang, Chongqing, and Yunnan Provinces. Treatment expenses, lost
working days, and insurance reimbursement expenses information were collected to estimate the
total economic burden of dengue fever patients in 2019. The expenditures related to dengue fever
prevention and control from government, Center for Disease Control and Prevention (CDC),
communities and sub-district offices of 30 counties (or districts) in Zhejiang Province and
Chongqing City were also collected.

According to, (Figer, 2023) The barangay is the basic unit of the decentralized system of
government in the Philippines. A barangay captain is in charge of each barangay. The barangay
is in responsible of upholding law and order within its borders and offering its residents welfare,
sanitation, health, and educational services. Law and order must be maintained inside the
boundaries of each barangay, and this is the duty of the public safety personnel who serve them.
As mostly self-governing entities, barangays have a lot of autonomy when it comes to raising
public safety awareness. Additionally, as barangays are autonomous bodies with their own staff
and officials, there is no need for a centralized police force to carry out these duties because local
officials are already aware of issues developing within their spheres of influence. Implementing
programs akin to community policing inside specific communities could considerably enhance
public safety conditions within each barangay in the Philippines, as long as data indicates that
crime rates have decreased in some regions after doing so.