Sri Lanka Successfully Conducts Capacity Building Program in Clinical Management of Dengue– For Bangladeshi Health Staff

Dengue is a public health problem in Sri Lanka with over 50 000 cases reported each year in the recent past. The country has been successful in bringing down the Case Fatality Rate (CFR) over the last two decades which was around from 5% in 1996 to 1% in 2009 and has declined gradually over time to 0.07% in 2023. It shows the resilience and high capacity of the curative sector in managing of dengue patients. However, the country experiences rising cases during the rainy seasons in June-July and October-December every year. During the last quarter of 2023, almost all districts of the country have reported dengue cases, with Colombo, Gampaha and Kalutara districts in the Western Province having the highest case detection rates during this year.

Sri Lanka’s achievement is due to multiple factors such as the availability of evidence-based clinical guidelines, continuous capacity building of clinical staff, and regular organization of dengue death review processes, which were streamlined from 2009 onwards. However, dengue continues to be a challenge for Sri Lanka.

National Institution of Infectious Diseases (NIID) which was established in 1926 is the pioneer infectious disease hospital in Sri Lanka. NIID rendered its valuable service during recent major events, notably during the Dengue 2017 epidemic and COVID-19 (2020-2021) pandemic. The hospital has modern treatment facilities (including a specialized dengue treatment unit), a highly skilled and dedicated staff, and a national level training facility for clinical management of dengue.

In 2022 and 2023 around 500 doctors and nurses were trained by NIID on clinical management of dengue. These programmes were conducted in collaboration with the National Dengue Control Unit (NDCU). The World Health Organization (WHO) has always given technical and financial support when requested for these training.  

NIID team conducted a training in Bangladesh covering specialties as general medicine and pediatrics in October 2023. Anticipating another potential dengue outbreak season in 2024, in order to refresh the staff knowledge, Ministry of Health and Family Welfare (MOHFW) in Bangladesh requested NIID Sri Lanka to provide a Training of Trainers program on dengue case management. To respond to this need, WHO Regional Office for South-East Asia and WHO country offices in Sri Lanka and Bangladesh worked together with Sri Lanka Medical association (SLMA) , NIIID and NDCU to formulate a-7-day training program. This program was covering specialties of general medicine, pediatrics, virology/immunology, pharmacology and critical care management.

 

The National Institute of Infectious Diseases in collaboration with the National Dengue Control Unit of the Ministry of Health, Sri Lanka, conducted the first international training on dengue case management from 22 to 28 July 2024. This training was designed for a group of selected doctors and nurses nominated by the Ministry of Health and Family Welfare, Bangladesh. In addition to the hands-on training, the participants also learnt on how health facilities need to be set up for treatment and monitoring of dengue patients and also gained an understanding on the leading roles of nurses in dengue case management and monitoring. The training comprised of presentations/lectures, discussions, hands-on training, clinical training, field visits and interactive sessions. Moreover, a symposium composed of knowledge sharing sessions was held with the Ministry of Health top officials, renowned clinicians, academicians, research staff and provincial and district level officials. 

This initiative is set to significantly enhance the dengue case management in Bangladesh and strengthen healthcare ties between two countries in years to come.

Nepal, Bhutan and Myanmar have expressed their interests in receiving the training on dengue case management in Sri Lanka through NIID. Therefore, national efforts will continue to introduce regular capacity building programs for countries that showed interests.