World Health Day: Treating Dengue Fever in the DR

Today is World Health Day.  This year the WorldHealth Organization is calling attention to the increasing threat of vector-borne diseases.  Through its campaign, “Small Bite, Big Threat,” the organization says that many vector-borne illnesses like Dengue Fever have re-emerged or spread to new parts of the world over the past 20 years.   Dengue Fever, a severe, flu-like illness caused by mosquito bites, is now found in more than 100 countries and puts more than 2.5 billion people at risk.

Our Dr. Charles A. Sanders International Residency Scholarship program gives resident physicians from the state of North Carolina the opportunity to learn and practice medicine at Project HOPE program sites in the developing world.  One of our 2013 Sanders Scholarship recipients, Dr. April Edwards, recently returned from the Dominican Republic, where she had spent one month practicing medicine at Project HOPE’s women’s and children’s health clinics in Santo Domingo and Monte Plata.  Dr. Edwards had this to say about treating Dengue in the Dominican Republic and how the Project HOPE-affiliated clinics are helping.

“As I worked with the doctors in Monte Plata, I realized that though many things are very similar across disciplines in different countries, some things are very region dependent.  The prime example of this is probably infections.  Where I come from, bugs I worry about on an almost daily basis include MRSA/ORSA (methicillin/oxacillin resistant Staphylococcus aureus) and C. Diff (Clostridium dificile). (Those two bugs largely exist as a result of widespread use of antibiotics.)  As I quickly learned from my supervisors, here in the DR, among the top concerns are Dengue and Cholera.  I became better versed in how to recognize them, particularly Dengue, a mosquito-borne illness that causes fevers, low blood counts and can be fatal if not recognized and treated appropriately.

After spending a good deal of time in Monte Plata, I had the opportunity to go to a general hospital in a relatively poor area called Barahona.  I accompanied Dr. Manzueta, one of the pediatricians with whom I had been working in Monte Plata.  I was able to go on rounds with Dr. Manzueta and the pediatric residents there.  The first place we went that morning was a whole wing full of pediatric patients with Dengue Fever in various stages.  As I had never previously seen anyone with Dengue, I began furiously scribbling down notes and watching closely as the other physicians examined the patients and taught at the bedside.  One afternoon, I also worked with Dr. Manzueta as we did what are referred to a “consults,” which are basically miniature clinic visits in the hospital.  The chief complaints generally were much the same as those at the Monte Plata clinic, only suddenly, they were much more pressed for time.

The hospital visits made me realize how special the Project HOPE clinics are.  In a country where so many of the dangers to the health of children are from very preventable public health threats, it seems that strong patient advocates and education are key.  This is something that all members of the Project HOPE team do exceedingly well.  They are patient and take the time to educate patients and their families.  I will come away from this experience feeling invigorated and having learned a lot about neglected tropical diseases like Dengue and many other health threats that will make me a better physician.”