Third, we do not know as stated earlier whether the low implementation coverage of larval control or space spraying measures in households and schools or in water containers is a true reflection of what is happening or whether this relates to weak monitoring, recording, and reporting.
Finally, the data used in the study were all secondary and collected through the routine systems, so we have no means of checking accuracy or validity. Despite these limitations, there are three important programmatic implications from this study. First, the health facility-based reporting of dengue cases and deaths needs to be revisited to ensure there is functionality at full capacity, the data are collected and transmitted in a timely way, and through regular supervision, the data are quality assured. Whether monitoring can extend to community-level disease and asymptomatic infection needs further discussion, but more accurate measurements and estimates of disease burden will be essential for planning vaccination campaigns.
Vaccination, in combination with vector control, is seen as a promising tool in the fight against dengue. Second, there is need to strengthen a the monitoring and b recording of vector control measures, particularly for households, schools, and water containers. Vector control represents a substantial portion of government dengue-related costs, and it is important to note that control of Aedes aegypti is likely to impact not only on dengue but also on chikungunya and Zika viruses.
The chikungunya virus has been detected in Myanmar [ 29 , 30 ], but due to overlap in the clinical presentation with dengue and cross-reactivity of the serological tests, the burden of disease in the country has not been determined.
Zika virus was first detected in a foreign national in Myanmar in [ 31 ], but to date, there are no published reports of the burden of Zika virus in the country. Third, basic science research is crucial to understand more about the virus serotypes, genotypes, and strains , the immune responses, the immune correlates of protection and risk, and the development of dengue vaccines.
More attention also needs to be given to novel biological, genetic, and behavioral approaches that target mosquitoes such as the use of Wolbachia bacteria strains that infect Aedes aegypti mosquitoes [ 34 ] and genetically modified mosquitoes carrying lethal genes [ 35 ]. In conclusion, this study has described the large burden of hospital-recorded dengue in Myanmar between and , which was concentrated predominately in children and which included two outbreaks in and Implementation and coverage of dengue vector control measures, including larval control, space spraying, and health education, all increased between and , although there are concerns about low coverage of these interventions in households and schools.
Dengue virus serotype 1 predominated in the outbreak, while all four serotypes circulated in the outbreak. More attention is needed to improve the monitoring, recording, and reporting of cases, deaths, and vector control activities, and to avoid misclassification bias in reporting hospitalized dengue cases, the notification systems must just report the discharge diagnosis. Finally, more investment needed for programmatic research.
World Health Organization.
If the sound level from both the auxiliary and main magnetic heads was loud, the cutting head on the disc recording lathe was driven at its normal speed. These records have serious availability implications when used in environments such as on-premise data-centers, cloud infrastructure services, and platforms like Heroku. Bull World Health Organ. Islam and the people who call themselves Muslims have made an enormous impact on our world. Dengue 3. Not everyone is going to agree. I'll use our "Six Degrees of Degradation" model of music production.
Dengue and severe dengue. Fact Sheet.
Updated July WHO, Geneva, Switzerland. Accessed 29 May Dengue 1. Disease and economic burdens of dengue. Lancet Infect Dis. Khetarpal N, Khanna I. Dengue fever: causes, complications and vaccine strategies. J Immunonol Res. Symptomatic dengue disease in five South-East Asian countries; epidemiological evidence from a dengue vaccine trial. Dengue 2.
Prevention and control of dengue—the light at the end of the tunnel. The global distribution and burden of dengue. Refining the global spatial limits of dengue virus transmission by evidence-based consensus. Economic and disease burden of dengue in South East Asia.
The dengue strategic plan for the Asia Pacific Region — Available: www. Outwitting dengue threat and epidemics resurgence in Asia-Pacific countries: strengthening integrated dengue surveillance, monitoring and response systems.
Infect Dis Poverty. Comprehensive guidelines for prevention and control of dengue and dengue hemorrhagic fever, revised and expanded edition. New Delhi. Myanmar dengue outbreak associated with displacement of serotypes 2, 3 and 4 by dengue 1. Emerg Infect Dis. Myanmar Health Sci Res J. Department of Health, Ministry of Health, Myanmar.
Ministry of Health. Health in Myanmar The Republic of the Union of Myanmar. Control of soil-transmitted helminthiasis in Myanmar: results of 7 years of deworming. Tropical Med Int Health. Reemergence of dengue virus serotype 2 strains in the outbreak in Nepal.
Indian J Med Res. Relevance of non-communicable comorbidities for the development of the severe forms of dengue: a systematic literature review. Pathologic highlights of dengue hemorrhagic fever in 13 autopsy cases from Myanmar.
Hum Pathol. The effect of temperature and humidity on dengue virus propagation in Aedes aegypti mosquitos. Estimating dengue vector abundance in the wet and dry season: implications for targeted vector control in urban and peri-urban Asia. Pathog Glob Health. Vectorial capacity of Aedes aegypti: effects of temperature and implications for global dengue epidemic potential.
PLoS One. Characterization of the dengue epidemic in Myanmar with dengue virus 1 as the dominant serotype. Infect Genet Evol. Clinical, virological and epidemiological characterization of dengue outbreak in Myanmar, Epidemiol Infect.
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Asymptomatic humans transmit dengue virus to mosquitoes. Dengue 3. Dengue: knowledge gaps, unmet needs, and research priorities. Co-distribution and co-infection of chikungunya and dengue viruses. BMC Infect Dis. First case of Zika virus infection detected in Myanmar; mosquito control measures must be at the forefront of the fight against vector-borne diseases. October Accessed 30 May ]. Eco-bio-social determinants of dengue vector breeding: a multi-country study in urban and periurban Asia.
Bull World Health Organ. Community-centred eco-bio-social approach to control dengue vectors: an intervention study from Myanmar. Successful establishment of wolbachia in Aedes populations to suppress dengue transmission.
Suppression of a field population of Aedes aegypti in Brazil by sustained release of transgenic male mosquitoes. Download references.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.