Dengue Control through Schoolchildren in Thailand.

ABSTRACT

Dengue haemorrhagic fever (DHF) was first recognized in Thailand in 1949. Although the morbidity from DHF seems to have stabilized over the past few years, the mortality and case fatality rates have been dramatically brought down. However, DHF remains a crucial public health problem, particularly for young children who are the most affected. After several trials on dengue control, a national dengue control programme was started through the schoolchildren approach in 1992. With a target of reducing DHF morbidity among schoolchildren from 447.8/100 000 to 240/100 000 by 1996, and to 160/100 000 by 2001, the project had achieved the goal of morbidity reduction to 219.2/100 000 pop. by 1996. The project was also evaluated from 96 school samples nationwide during September-November 1994. It was found that 93.7% of the schools sampled had been involved in the project. 62.5% of the provinces and 64.3% of the districts surveyed showed decreasing morbidity rates among both schoolchildren and all other age groups. The majority of both health and education staff had positive attitudes to the objectives and strategies of the project. However, the main constraints were low frequency and non-regularity of the teaching and learning process, lack of consistent supervision from health staff, poor communication and coordination between different organizational personnel and, lastly, insufficiency and irregular and delayed supplies for school support. These weaknesses have been vigorously overcome during the past 2-3 years in order to improve the project implementation.