Understanding Dengue Fever and Its Relevance to NTDs

Understanding Dengue Fever and Its Relevance to NTDs

Dengue fever is a mosquito-borne viral illness that has rapidly spread across tropical and subtropical regions in recent decades. Often misunderstood and underreported, dengue fever in Sudan has emerged as a significant Neglected Tropical Disease (NTD) due to its rising incidence, low public awareness, and lack of adequate control measures.

Neglected Tropical Diseases affect over 1.7 billion people worldwide. They are “neglected” not because they are rare—but because they typically impact the poorest, most marginalized populations. Dengue fits this definition perfectly in Sudan, where limited healthcare access, poor sanitation, and urban crowding allow the disease to thrive.


Epidemiology of Dengue Fever in Sudan

Although dengue has been endemic in Sudan for decades, its incidence has sharply increased in the last ten years. Outbreaks have been reported in Port Sudan, Kassala, Red Sea, and West Darfur—regions where flood-prone environments and poor infrastructure contribute to mosquito breeding.

According to WHO surveillance, Sudan experienced multiple localized dengue outbreaks between 2019–2024, with hundreds of confirmed cases and even more suspected but unverified due to diagnostic limitations. ERF Foundation has observed these trends firsthand, noting an uptick in cases following seasonal floods.


Dengue Transmission and Environmental Triggers

The Aedes aegypti mosquito—infamous for its daytime biting habits—is the primary vector of dengue. These mosquitoes thrive in stagnant water, discarded containers, and urban slums. Sudan’s rapid urban expansion without proper waste management, alongside climate change–driven rainfall, has created the perfect storm for mosquito proliferation.

Flooding, especially in regions like Kassala and Gezira, leaves pools of stagnant water in its wake. Combined with high humidity and temperatures above 25°C, these conditions make dengue transmission nearly inevitable during certain months.


Symptoms and Clinical Presentation

The incubation period for dengue is typically 4 to 10 days after a mosquito bite. Patients often present with:

  • High fever (up to 40°C)

  • Severe headache and retro-orbital pain

  • Muscle and joint pain (“breakbone fever”)

  • Rash and skin flushing

  • Mild bleeding (nose or gums)

In some cases, dengue develops into severe dengue or dengue hemorrhagic fever, leading to:

  • Persistent vomiting

  • Abdominal pain

  • Fluid leakage

  • Internal bleeding

  • Shock and organ failure

Without timely care, this can be fatal.


Diagnostic Challenges in Sudan

In Sudan, diagnosing dengue remains a major hurdle:

  • Limited availability of rapid diagnostic tests (RDTs)

  • Confusion with malaria or typhoid fever

  • Inadequate lab infrastructure outside Khartoum

These constraints mean many dengue cases go unreported or misclassified, which hinders national response planning.


Dengue Fever as a Public Health Threat in Sudan

Dengue does not discriminate by age or gender. However, in Sudan, it disproportionately affects:

  • Children under 10 (due to lower immunity)

  • Pregnant women (risk of complications)

  • Low-income families in overcrowded housing

In rural areas, access to hospitals is limited, and transportation costs delay critical care. Urban hospitals, meanwhile, are often overwhelmed during peak outbreak months.


NTDs in Sudan: The Bigger Picture

Sudan battles multiple NTDs: schistosomiasis, leishmaniasis, and now, increasingly, dengue. What sets dengue apart is its explosive potential during monsoons and its lack of a universally accessible vaccine.

Many NTDs overlap in symptomatology—fever, fatigue, and gastrointestinal issues—which makes distinguishing them difficult. This underscores the need for integrated diagnostic and surveillance systems, as advocated by WHO and championed locally by the ERF Foundation.


Vector Control Strategies in Sudan

Several vector control strategies have been implemented in Sudan, including:

  • Insecticide fogging in outbreak zones

  • Larval source reduction through draining water containers

  • Distribution of mosquito nets (although less effective for Aedes which bite during the day)

Challenges remain due to logistical gaps, limited funding, and community resistance in some areas due to lack of awareness.


The Role of the ERF Foundation in Tackling Dengue

The Empowerment and Relief Foundation (ERF) has taken a proactive stance in Sudan's dengue crisis by:

  • Running awareness campaigns in Kassala, Red Sea, and Khartoum

  • Partnering with local clinics to improve diagnostic access

  • Training volunteers in early symptom recognition and community mobilization

ERF also collaborates with WHO and other global partners to support a One Health approach, tackling dengue through education, environment, and early care.


Preventive Measures and Community Education

The cornerstone of dengue prevention is community engagement. ERF’s on-ground programs focus on:

  • Teaching residents to clear stagnant water

  • Encouraging waste management to remove mosquito habitats

  • Distributing repellents and mosquito coils

  • Hosting school outreach sessions on dengue symptoms

Simple measures, like wearing long-sleeved clothing, using insect repellents, and installing window screens, can dramatically reduce mosquito bites.


Treatment and Healthcare Response

Treatment of dengue is supportive, as no specific antiviral exists. For mild cases:

  • Paracetamol is used to manage fever

  • Hydration is critical

  • Avoidance of NSAIDs like ibuprofen and aspirin (which can worsen bleeding)

For severe cases, hospitalization is essential. However, the lack of ICU beds, trained staff, and blood banks in rural Sudan makes outcomes more precarious.


Vaccine Development and Global Research

Two vaccines—Dengvaxia and Qdenga—have shown promise, but their deployment is limited. Dengvaxia is only approved for individuals previously infected, making it unsuitable for general immunization.

Sudan would benefit from international support in:

  • Introducing safe vaccines

  • Conducting clinical trials in African populations

  • Building cold chain infrastructure to support vaccine storage


Data Collection and Surveillance Systems

ERF is advocating for stronger disease surveillance by:

  • Promoting mobile reporting apps for field health workers

  • Encouraging standardized data collection

  • Collaborating with the Ministry of Health for disease mapping

These steps help predict outbreaks and preemptively deploy resources to at-risk zones.


Case Study: Dengue Outbreak in Kassala

In late 2022, Kassala faced a significant dengue outbreak:

  • Over 200 suspected cases within 6 weeks

  • 3 confirmed fatalities

  • Schools closed temporarily

ERF partnered with local authorities to:

  • Conduct fogging drives

  • Disseminate public health leaflets

  • Facilitate mobile medical units to reach isolated communities

This case underscored the importance of fast action and local engagement.


Policy and International Support

WHO and partners have categorized dengue as a priority NTD. Sudan receives limited funding from global NTD alliances—but more targeted international support is needed.

Policies should focus on:

  • Integrated vector management

  • Cross-border cooperation (as outbreaks spill into neighboring regions)

  • Funding grassroots NGOs like ERF working directly with communities


Future Outlook: Building Resilience in Sudan

Sudan's fight against dengue is far from over, but with the right mix of:

  • Government policy

  • Global partnerships

  • Community empowerment

...there is hope. ERF Foundation continues to lead grassroots efforts while pushing for systemic reforms to reduce the burden of dengue and all NTDs in Sudan.


🧠 FAQs about Dengue Fever in Sudan

Q1: What causes dengue fever?
Dengue is caused by a virus transmitted by the Aedes aegypti mosquito, often found in tropical environments.

Q2: How can I protect my family from dengue?
Eliminate stagnant water, use insect repellents, wear long clothing, and support local vector control campaigns.

Q3: Is dengue curable?
There is no cure, but supportive treatment like hydration and fever management is effective if started early.

Q4: Is there a vaccine for dengue in Sudan?
No. While vaccines exist globally, they are not yet widely available or approved for general use in Sudan.

Q5: Why is dengue considered an NTD?
Because it predominantly affects low-income populations and lacks sufficient global investment in prevention and treatment.

Q6: What is ERF Foundation doing about dengue?
ERF runs community education, diagnostic support, and prevention programs in several dengue-prone Sudanese regions.


Conclusion

The threat of dengue fever in Sudan is real, growing, and deeply tied to broader public health and socioeconomic challenges. By working with communities, improving healthcare access, and raising awareness, the ERF Foundation is playing a critical role in mitigating this NTD. But to truly turn the tide, sustained investment, education, and global collaboration are essential.

Comments

Popular posts from this blog

“From Survivor to Activist: How Dengue Fever Changed My Life Forever”

Dengue fever is a real catastrophe in Sudan during war