How a digital tool aims to prevent Vietnam's Dengue epidemic

Fishers on the Mekong River, Vietnam.

A mosquito epidemic affects provinces near the Mekong River each year. Image: Adobe Stock/Newroadboy

A mosquito epidemic affects provinces near the Mekong River each year. Image: Adobe Stock/Newroadboy

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It has become Vietnam's annual epidemic. More than 2 million people are estimated to become infected by dengue fever each year, with only about 95,000 going on to be treated for the mosquito-borne illness.

Symptoms include high fever, rash and muscle and joint pain. In severe cases there is serious bleeding and shock, which can be life-threatening. Those who are infected a second time develop a significantly higher risk for other diseases.

It is a confronting issue close to the heart of The University of Queensland's Dr Dung Phung, a Senior Lecturer in the School of Public Health and Theme Leader of Climate Change and Health at the Queensland Alliance for Environmental Health Sciences.

Moved by Vietnam's decades-long struggle with the virus and climate change, he has developed an early warning detection system for dengue outbreaks.

E-Dengue, as it's known, uses a prediction model to help local communities and health centres mitigate outbreaks of the mosquito-borne disease in the Mekong Delta Region.

With the assistance of global charitable foundation Wellcome Trust, Dr Phung has received an $8,445,649 grant to lead the project's development across 13 provinces and 134 districts that are highly vulnerable to climate change between 2023 and 2027.

"Vietnam is substantially affected by dengue, which is one of the leading causes of hospitalisation during the dengue transmission season," Dr Phung said.

"The economic burden of dengue in Vietnam is estimated to be $43-138 million Australian dollars per annum.

"Dengue epidemics are observed year-round in many parts of the country, particularly in the Mekong Delta Region located in the Southern part of Vietnam."
Dr Dung Phung
Mosquitos on water

Climate change has seen an increase in mosquito numbers in South Central Asia. Image: Adobe Stock/Esther Kok/EyeEm

Climate change has seen an increase in mosquito numbers in South Central Asia. Image: Adobe Stock/Esther Kok/EyeEm

The E-Dengue project will be rolled out across 3 phases.

Phase 1 will include building a climate-informed predictive model to accurately anticipate dengue incidence and outbreaks two months in advance at the district level.

Phase 2 will develop E-Dengue as an open-source software system that has a user-friendly web-based and mobile-app interface based on the prediction model determined in phase 1.

During phase 3, E-Dengue’s effectiveness and cost-efficiency will be evaluated through a community-based cluster-randomised controlled trial study, making it the first climate-driven emergency warning system (EWS) to be thoroughly evaluated with a gold-standard method.

The aim of the EWS is to help health practitioners proactively mobilise local communities to implement dengue control measures that significantly reduce disease incidence and outbreaks.

Dr Phung said once completed, the EWS would be considered to be implemented in local medical centres at the Mekong Delta Region and extended to other areas in the future.

“Researchers will assess E-Dengue user acceptance to ensure that it meets the needs of local medical centres and is easily integrated into the current communicable disease surveillance system," he said.

“We anticipate the EWS will be successful, based on previous studies which show that sustained community involvement can substantially improve dengue disease control."

A mosquito resting on grass

A mosquito resting on grass. Image: Adobe Stock/Achkin

A mosquito resting on grass. Image: Adobe Stock/Achkin

To date, dengue prevention efforts in Vietnam include community education campaigns, breeding site reduction programs and outdoors low-volume insecticide spraying to kill adult mosquitoes in areas with reported dengue cases.

“The limitation of these preventive measures is that they reactively take place after cases have happened, so vector control, dengue diagnosis and reporting all suffer delays," Dr Phung said.

“A lack of reliable and scalable blood tests to diagnose dengue infection has also prevented broad roll-out of the Dengvaxia vaccine in Vietnam.

"Where it is available, the vaccine provides high levels of protection against disease in people with previous exposure to dengue viruses, but it may also increase the risk of severe dengue if given to individuals who test negative to the virus."

Dr Phung said he expected E-Dengue to overcome these issues and it will be scalable to other regions in Vietnam and worldwide, once its effectiveness has been demonstrated.

The World Health Organisation estimates up to 400 million dengue infections occur globally each year with most being asymptomatic or producing mild flu-like symptoms. However, in Asian and Latin American countries, severe dengue is now the leading cause of hospitalisation and death in children and adults.

Dr Dung has thanked Wellcome for their technical support and generous funding to make this project possible.

Dr Dung Phung

Dr Dung Phung has background in both medicine and public health. He has experienced diversity roles from clinical practice, health management, and research and teaching academic before joining to the UQ School of Public Health as a senior lecturer in environmental health.

Contact:
+61 7 334 64684
d.phung@uq.edu.au