Citizens on Sunday urged the quarters concerned to improve the disease surveillance system to effectively deal with the dengue outbreak in twin cities of Rawalpindi and Islamabad. According to them, the absence of an effective and extensive surveillance system has resulted report of several hundred dengue cases and there was no mechanism to avoid from the situation.
They said that there was a need to have research based preventive measures and community involvement to create awareness in the society besides availability of facilities for dengue patients. They also asked the administrations of public sector federal capital's hospitals to ensure implementing health protocols by its doctors, nurses and para medical staff for management and treatment of dengue patients.
They complained that despite clear directions and monitoring of the federal government, the staff deployed at dengue wards of both major hospitals were not observing these protocols causing complications to patients at Pakistan Institute of Medical Sciences (PIMS) and Federal Government Polyclinic (FGPC).
Amin Khalid, a patient at PIMS dengue ward said that he didn't find observing of set protocols at hospital as the staff is totally unaware of all this.
He added due to such negligence there were high chances of carrying other communicable diseases by patients as there was no culture of anti-mosquito or anti-germs spray to protect patients from carrying new viruses. Amir Kaleem, a patient admitted at Polyclinic dengue ward said that despite displaying hospital protocols at ward, laboratory and other areas, the hospital staff including doctors were least interested to follow this.
He added due to this unprofessional attitude of doctors and nurses, sensitive patients may carry serious infectious diseases. He added there was no trend of changing bed sheets or use of gloves or masks by medical staff at ward. When contacted an official from the Ministry of National Health Services said that the government had taken concrete measures to control the dengue virus.
He added bets medical care was being provided to patients while there was effective disease surveillance system to further control it outbreak particularly in twin cities.
Spokesman PIMS Dr Wasim Khawaja said that as per protocols, the doctors and deputed staff will be responsible for regular lab investigation of dengue patients that included detection of dengue virus protein (NS1) from day first to day fifth and detection of antibody (IgM) from day fifth onward.
Similarly, there will be regular blood CP test to know rising hematocrit, thrombocytopenia and leukopenia besides liver function tests to check greater elevation of the AST as compared to the ALT.
He added tests like ECG and Cardiac Enzymes for observing Myocarditis are also necessary. He added the hospital staff at dengue wards will regular fill the monitoring sheet of every patient with having name, age, gender, date and status of all tests like BP, ALT, TLC, Hb, HctPP, pulse and PLT.
Dr Khawaja said that the hospital staff will be responsible to prepare a chart for every patient for having calculation of total fluids during critical phase with mentioning of age, deficit, and total fluid quota. He added as per clinical and laboratory criteria, all those patients can be managed at home with having absence of clinical and warning signs and able to tolerate orally well, good urinary output and no history of bleeding.
Assistant Executive Director Federal Government Polyclinic (FGPC) and Focal Person for Dengue Control, Dr Abdul Wali Khan said that the hospital has issued protocols to deal with dengue patients.
He said that under protocols, the hospital has fixed a criteria for patients' admission, referral, discharge and treatment methodology at hospital. He said that those patients will be admitted on priority with co-morbidity like diabetes, hypertension, ischemic heart disease, coagulopathies, morbid obesity, renal failure and chronic liver disease.
He said that the hospital will also immediate give admission to those patients with age more than 65 years, pregnant women and patients facing social factors that limit follow-up like living far from health facility, no transport and living alone.
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