Moa Jamir
Nagaland's inconsistent dengue figures need streamlining
On September 2, after consulting with numerous medical professionals from various healthcare facilities, The Morung Express published a report that raised doubts about the accuracy of the dengue data provided by the Nagaland chapter of the National Centre for Vector Borne Diseases Control (NCVBDC). According to the official records, Nagaland reported 227 confirmed dengue cases as of September 1.
In the weeks that followed, dengue cases and the associated concerns about data accuracy showed no signs of abating. However, the apprehension reached a higher level when one scrutinises two separate sets of 'official' data presented to the media just last week.
On October 27, during a press conference in Kohima, the Directorate of Health & Family Welfare disclosed that as of October 26, Nagaland had recorded 2899 dengue-positive cases, with one fatality reported in Mon district. Dimapur led the tally with 1398 cases, followed closely by Mon at 933.
However, just two days later, on October 29, officials from District Hospital Mon reported that they had admitted a total of 1523 dengue patients from August 14 to October 27. This figure contradicted the 933 cases provided by the Directorate just two days earlier.
This incongruity raises two possibilities – either a shocking 590 new cases were detected in the two-day interim, or one of the figures is profoundly unreliable. If one factor in the 25 cases referred to outside facilities in Mon, the discrepancy widens to a concerning 615 cases. Meanwhile, the official health department records indicate only one reported death due to dengue. However, anecdotal accounts suggest that the actual number could be much higher.
The Blood Bank at District Hospital Dimapur record handling of over blood units in recent past is a clear indicator of potential underreporting of cases. For instance, the Blood Bank typically manages a monthly workload of approximately 700-800 blood units. However, in July, this figure increased to 1080 requisitions, and it sharply surged to 2940 units in August according to an official. In September, there was a record draw of over 4000 units. This unprecedented surge in blood and blood component requests has been directly linked to the dengue outbreak in Dimapur and the surrounding areas.
The inconsistencies in the data, among other concerning issues, give rise to three critical and pressing concerns. First, it raises serious doubts about the ability of health and concerned authorities to collect accurate data, casting a shadow of doubt on their capability to effectively manage the outbreak.
Further scrutiny begs the question of whether the outbreak has been combated effectively and in a coordinated manner, despite the constitution of a dengue Response Team headed by Nagaland's Minister for Health and Family Welfare on September 20.
As a result of these first two concerns, public faith in the health system could be severely eroded. The collateral damage may negatively impact other health-related activities, such as immunisation.
Accordingly, it is imperative that the department and concerned authorities take immediate action to streamline the data and provide clarifications regarding the criteria for designating a case as dengue or otherwise, as well as detailed information about fatalities and co-morbidity related to the disease. The public deserves and has the right to know the ground reality, and only transparency and accountability can begin to restore trust in the system.
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