Why is there so much infant mortality?
The Integrated Control Center of the Directorate of Health has reported the maximum death of 17 people in the country in a single day with measles and measles symptoms. With this, 300 deaths in measles this year. Questions have been raised whether measles deaths could have been reduced or not, whether the health department had taken the right steps to prevent deaths.
On Monday, the Integrated Control Center of the Department of Health reported two deaths with confirmed measles and 15 deaths with symptoms of measles in the last 24 hours (Sunday 8 am to Monday 8 am). 2 out of 15 died the previous day.
বিজ্ঞাপন
The Department of Health says that 259 people have died of measles symptoms so far; And 52 people died of measles. Total death is 311 people.
At the Nightag meeting on April 12, experts agreed that any patient with measles symptoms during a measles outbreak should be considered a measles death. 311 people died of measles.
বিজ্ঞাপন
Measles was first detected in a Rohingya refugee camp in Cox’s Bazar district in January this year. Not much is known about it. But measles continues to spread. In the middle of March, reports of measles spreading first in Rajshahi and later in some other districts came in the media. On April 24, the World Health Organization reported the outbreak of measles in Bangladesh in a news report on the outbreak. According to the news, measles has spread in 58 districts (91 percent districts) out of 64 districts of the country. The agency also said that 79 percent of those affected were under 5 years of age.
The government started a special vaccination program in 30 upazilas of 18 districts on April 5. Vaccination started in Dhaka North, Dhaka South, Mymensingh and Barisal City Corporation on April 12. After that, vaccination is being given across the country from April 20. This vaccination will continue till the 20th of this month for children aged 6 months to 5 years.
8-month-old Hasan died at Rangpur Medical College Hospital on May 3. Hasan’s house is Saptibari in Lalmonirhat Sadar. As there was no advanced treatment for measles in Lalmonirhat, the child was brought to Rangpur. The previous day i.e. May 2, an 8-year-old child named Tangtui Mro died of measles symptoms in Kurukpata union of Alikadam upazila of Bandarban district. Tangtui Mro was under treatment at Lama Upazila Health Center nearby. He was discharged from the hospital two days before his death. In this way, deaths due to measles or symptoms of measles continue to occur every day.
The government is talking about steps to increase ICU services in view of the rising number of child deaths. Health Minister Sardar Md. Sakhawat Hossain has given a ventilator to the hospital from the pharmaceutical company, there are also reports in the media. But the government is not releasing the information related to measles deaths. These include—age distribution of the dead children, how many days after measles they came to the hospital, which children were admitted with any complications, whether all the dead children had pneumonia, what other diseases accompanied the pneumonia, how many children were delayed in coming to the hospital, whether there were any errors in hospital management, what drugs were being used for treatment. Public health experts believe that the answers to these questions would play a role in preventing infant mortality.
When contacted in this regard yesterday, Director of Health Directorate (Hospital) Abu Hossain Md. Moinul Ahsan told Prothom Alo that the Department’s Disease Control Branch (CDC) is supposed to do these things. He suggested contacting the disease control branch.
Director of CDC Professor Halimur Rashid told Prothom Alo, CDC is not doing any such work.
Prothom Alo asked several expert doctors and health administration officials why death cannot be stopped.
Director of Bangladesh Children’s Hospital and Institute Prof. Mahbubul Haque told Prothom Alo that there is no antiviral medicine in the treatment of measles. Pneumonia is complicated by measles. Measles has many other complications. Children are brought to the hospital after many complications. They cannot be saved even with life support.
According to the information of the Children’s Hospital, 510 children from 42 districts of the country have received treatment in this hospital from January till yesterday. Among them, 22 people died.
In response to the question as to why infant mortality cannot be stopped, Additional Director General (Planning and Development) of the Department of Health, Prof. Foara Tasnim told Prothom Alo that children are being brought to the hospital late, in critical condition. Measles pneumonia damages the lungs. It is not possible to recover some children even with necessary support in the hospital.
Now, when children have fever, cold, cough or rashes on the body, many parents think that they have measles or are afraid of measles. According to the Integrated Control Center, 41 thousand 793 patients have come to the hospital for measles treatment this year. Among them, 28 thousand 842 people were admitted to the hospital. But 5 thousand 467 people have been diagnosed with measles.
But in reality, many more have been infected with measles. First, because of the kit problem, the health department is unable to test samples from all people with symptoms. On the other hand, some doctors are treating measles in their private chambers, which is not included in the official data.
Some experts believe that lung damage is caused by measles pneumonia. In these cases, oxygen acts as medicine. According to the Department of Health, there are 1,372 ICU beds in government hospitals across the country. Not all beds are suitable for use by children. Ventilator or ICU is required. But more children would have benefited if oxygen had been provided at a lower cost.
Child hygienist and former head of pediatric department of Dhaka Medical College Professor Abid Hossain Molla said that oxygen supply in hospitals was improved during the Covid-19 pandemic. High flow nasal cannulae were administered to provide high oxygenation to the patients. If it had been done, some of the children’s deaths might have been prevented.
Public health and pediatricians say not all patients need to come or be brought to the hospital. Many people are coming to the hospital with their children in fear, admitting them. In many cases, actual measles patients may not be admitted. Government statistics also say the same.
In this case, if six symptoms appear, the child should be brought to the hospital – 1. If the patient has shortness of breath or rapid breathing, give chest compressions; 2. If unable to take liquid food or breast milk; 3. Repeated vomiting; 4. Convulsions, dull, drowsy or unresponsive; 5. Mouth sores, eye problems, if you can’t open your eyes and 6. If suffering from severe dehydration or malnutrition.
Prof. Mahmudur Rahman, a prominent pathologist and former director of the government’s Pathology, Disease Control and Research Institute, told Prothom Alo that if patients are isolated in accordance with the advice of experts, quick detection of disease, improvement of patient management, and patient isolation will reduce the number of patients in the hospital. Fewer patients will receive more attention. It will reduce death.
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