Dengue Hemorrhagic Fever (DHF) remains a serious health issue in Indonesia. By mid-2023, the Ministry of Health reported 35,694 dengue cases and 270 deaths.
Appropriate and comprehensive prevention is crucial to reduce the incidence of DHF.
Mosquito Control Program
The program to eliminate mosquito breeding sites is a concrete step in controlling the Aedes aegypti mosquito vector to prevent the spread of dengue fever.
The mosquito control program needs improvement, especially during the rainy season, as more rain creates more breeding sites, leading to increased mosquito activity.
Since June 2015, the Ministry of Health has launched the “1 Home 1 Jumantik” program to prevent deaths and illnesses from dengue fever (DHF).
The Jumantik program engages community members to voluntarily check for mosquito larvae and conduct routine mosquito control program.
Mosquito control program implementation is carried out through fumigation with insecticides in two cycles. The first cycle aims to eradicate adult mosquitoes carrying the dengue virus, while the second cycle is conducted one week later to destroy new mosquitoes emerging from larvae not exterminated in the first cycle.
How to Prevent Dengue Fever with 3M Plus
The 3M Plus strategy consists of three main components that must be consistently implemented:
1. Draining
Clean water storage containers such as bathtubs, buckets, drinking water containers, and refrigerator water reservoirs at least once a week. The container walls should be scrubbed to remove any mosquito eggs attached.
2. Covering
Tightly cover all water storage containers such as drums, water jars, and water towers to prevent mosquitoes from laying eggs.
3. Recycling
Get rid of old things that can collect rainwater.
Additional Plus actions include:
- Use larvicide in water storage areas that are difficult to drain
- Maintain fish that eat larvae
- Install wire mesh on vents and windows
- Arrange lighting and home ventilation
- Avoid placing used clothing in closed containers
- Use mosquito repellent
- Plant mosquito repellent plants
- Inspect places used to store water
- Repair drainage and gutter systems that are not functioning well
- Conduct communal clean-up initiatives to clean the environment
Dengue Vaccination Needed to Prevent Dengue Fever
Vaccination is an important preventive step in controlling Dengue Hemorrhagic Fever (DHF). In Indonesia, there are two types of DHF vaccines that have been approved by the BPOM: Qdenga (TAK-003) and Dengvaxia (CYD-TDV).
Tirta Medical Centre (TMC), with more than 30 branches across Indonesia, provides high-quality dengue vaccination services. TMC is known as a Medical Check Up Clinic with the most trusted and best laboratory in Indonesia.
Here are the details of the DHF vaccine prices at TMC:
- Qdenga Vaccine Price: IDR 649,000
- Qdenga Vaccine Package (2 doses): IDR 1,250,000
- Dengvaxia Vaccine 0.5 ml: IDR 1,400,000
The Qdenga vaccine shows an efficacy of 80.2% in preventing dengue infection and 95.4% in preventing hospitalization cases. Meanwhile, the Dengvaxia vaccine has an efficacy of about 80% in individuals with a previous history of dengue infection.
Symptoms of Dengue Hemorrhagic Fever
Symptoms of DHF usually appear within 4–10 days of the bite of an Aedes aegypti mosquito. DHF patients will go through three main phases:
1. Fever Phase
- Rapidly rising fevers peaking at 40°C
- Severe headache, especially in the forehead area
- Retro-orbital (behind the eye) pain
- Intense muscle and joint pain
- Nausea and vomiting
- Skin rash appears 2–5 days after the initial fever
2. Critical Phase
- Occurs 24–48 hours after the fever phase ends, with symptoms:
- Severe abdominal pain
- Persistent vomiting (at least 3 times in 24 hours)
- Bleeding from the nose and gums
- Presence of blood in vomit or feces
- Extreme fatigue
- Restlessness and irritability
3. Recovery Phase
- Lasts 48–72 hours after the critical phase, marked by:
- General condition improvement
- Increased appetite
- Stabilization of vital signs
Risk Factors for Dengue Hemorrhagic Fever
Several factors increase the risk of contracting DHF:
1. Geographical and Environmental Factors
- Living in tropical and subtropical areas, especially Southeast Asia
- High rainfall creating water stagnation
- Urbanization and population density
2. Individual Factors
- Previous DHF infection increases the risk of serious complications
- Weak immune system
- Habit of hanging clothes indoors
3. Temporal Factors
- Increased cases during the rainy season
- Higher risk during temperatures and humidity are optimal for mosquito breeding
References:
- E-Journal UMKU. Accessed in 2024. Health Promotion 3M Plus Efforts to Prevent Dengue Fever and Enhance Clean Healthy Living Behavior: https://jurnal2.umku.ac.id/index.php/JAI/article/viewFile/1500/909
- E-Journal Sam Ratulangi University. Accessed in 2024. Implementation of the 3M Plus Program to Counteract Dengue Fever Incidents in the Working Area of Puskesmas Maesaan, South Minahasa District: https://ejournal.unsrat.ac.id/v3/index.php/kesmas/article/view/30994/29746
- Medical Journal of Lampung University. Accessed in 2024. Mosquito Breeding Site Eradication (PSN) and 3M-Plus as Vector Control Efforts in Preventing Dengue Hemorrhagic Disease: https://juke.kedokteran.unila.ac.id/index.php/agro/article/download/1996/pdf
- Ayo Sehat, Ministry of Health. Accessed in 2024. Mosquito Breeding Site Eradication with 3M Plus: https://ayosehat.kemkes.go.id/pemberantasan-sarang-nyamuk-dengan-3m-plus
- BPOM. Accessed in 2024. Approval of Dengue Vaccine (Qdenga) Distribution License for Ages 6–45 Years: https://www.pom.go.id/siaran-pers/persetujuan-izin-edar-vaksin-dengue-qdenga-untuk-usia-6-45-tahun
- CDC. Accessed in 2024. Vaccine Safety & Efficacy Data | Dengue: https://www.cdc.gov/dengue/hcp/vaccine/safety-efficacy.html