The Dengue Treatment and Prevention Program, better known as the DTP program, is a collaborative effort of the World Health Organization (WHO), the United Nations Children’s Hospital in New Delhi, India, the Bill & Melinda Gates Foundation, and the National Institute for Occupational Safety and Health (NIOSH). The program works by evaluating the current knowledge on the cause, prevention, and treatment of dengue in children. For this purpose, there is a need to conduct multiple country evaluations on the disease, to make a global assessment on its occurrence and epidemiology. For this, DTP seeks to make use of the latest methodology and epidemiological information available. The global dengue treatment market was valued at US$ 296 Million in 2019 and is projected to reach US$ 727 Million by 2027 expanding at a CAGR of 13.3 % during the forecast period, 2021-2027.
Like most acute infections, the management of dengue fever in children depends largely on prompt diagnosis and initiation of effective treatment. The key to achieving this is prompt identification of fever and persistent headache symptoms. If these symptoms are not present or if the presence of the symptoms is detected very late, the doctor may opt to give a prescription for oral or intravenous anti-fever medications and painkillers, or prescribe a combination of these medicines. In some cases, a physician might also consider prescribing a single agent to control the overall fever and provide relief to the child with more frequent doses of anti-fever medication.
It has been found that the major cause of death in children is due to infections resulting from unhygienic conditions. In order to avoid such circumstances, vaccines have been developed to prevent dengue infection, particularly in children below six years of age. However, these vaccines are only available in poor countries, where transportation and storage facilities for the vaccines are not available. Also, the DTP vaccine is not yet licensed in the USA due to insufficient evidence that it can provide significant benefit to those who have not been infected with the infection.
For treating uncomplicated acute dengue, the options include conventional therapy and complementary therapy. Ayurvedic medicines can be used in advanced cases to reduce the fever and shorten the duration of the illness. Medicines like Punarnavadi Mandur, Tapyadi Loh, Kaishor Zindhi, Lohasav, Vatikari Rasbandh, Suvarna Bhasma and Makar Sutshekhar Rasa are used to treat the basic symptoms of the disease. Medicines that act on the ‘Ras’ and ‘Manch’ dhatus (tissues) of the body are useful in this condition. These medicines include Indrayav (Holarrhina antidysentrica), Indrashashash (Holarrhina rubra), Kutaj (Picrorrhiza kurroa), Saariva (Hemidesmus indicus), Patha (Cissampelos pareira) and Musta (Cyperus rotundus).
Standard therapeutic procedures like fluid restriction, fluid infusion, oral irrigation and IV fluids are usually administered after a certain period of time to control symptoms and improve the health of the patients. However, in some cases, the disease has progressed too far and fluid treatment might not be sufficient to cure the infection. In such situations, antiviral treatment is required to prevent the virus from spreading and thus resulting in a full remission. To this end, all patients are treated with antiviral medications.
One of the most common complications of severe dengue is pulmonary shock or deep vein thrombosis (SST), a condition which may occur due to obstruction in the lung arteries supplying blood to the lungs. This condition occurs when there is insufficient flow of fresh oxygen and the lungs are unable to compensate by producing more blood. This can result in swelling and extreme pain and is thus treated with medications like intravenous analgesia and heparin. The most common cause of SST is blocked arteries. Such patients are placed on chest compressions and other interventions to reduce the severity of shock.
There is another very serious complication associated with severe dengue, which is called fatal malaria. Malaria is caused by parasites known as Plasmodium falciparum. When such parasites invade the blood stream, they attack red cells, disrupting their function. The result is death from asphyxia – loss of oxygen to the brain and vital organs. It is caused when the parasites breach the red blood cell walls and infiltrate the nucleus of the cells, causing mutations that cause the death of the infected organism.
Since the causative agents are potentially fatal, the only option for preventing fatalities is through a combination of medication and surgery. Surgery reduces the number of mosquitoes that can breed inside the human body and interrupt the breeding cycle by closing the mosquito passages. Medications reduce the fever and vomiting, while colloidal hydration facilitates the production of fluids needed by the body to counter the effect of malaria. Dengue patients who survive the initial onslaught of the disease often succumb to death due to the same disease two or three weeks later. Because of these facts, the medical world has developed a number of medications and techniques that prolong life and prevent death among dengue patients.