Abstract
This descriptive study was conducted in Huai Rai-Sajae Village of Mae Chan district,
Chiang Rai Province in the period from May 20, 2007 to July 20, 2007 to determine
the characteristic of the dengue hemorrhagic disease in order to understand the distribution
of the disease and independent factors for outbreaks, and to identify patients in the
community for treatment and prevention the epidemic. The data were analyzed by using
the SPSS version 12 software package for Windows to calculate the percentage, ratio,
means, cross-tabulations and chi-square.
The first case of dengue hemorrhagic fever emerged on May 21, 2007. The outbreak
became progressively worse, reaching a total number of 568 cases, among whom the diagnosis
of 63 cases was confirmed by serology and 525 cases remained probable cases
according to clinical criteria. The prevalence Rate of the disease in Mae Chan district was
492.33 cases per 100,000 population; the mortality rate was 0.17 percent. Most patients
(534 cases) lived in Huai Rai-Sajae Village; the remainder lived in other villages in Mae
chan district. The mean age was 24.88 years (SD= 16.82). Patients represented all age
groups, the youngest being 1 month old and the oldest 84 years old; the male to female
ratio was 1:1.24. The frequency of clinical signs and symptoms of the patients were fever,
99.31 percent; headache, 80.1 percent; myalgia, 63.27 percent; positive tourniquet test,
62.18 percent; and maculopapular rash, 43.5 percent. Impending shock and dengue shock
syndrome were seen in 12.41 percent of the cases.
The causes of the dengue epidemic in this village were inadequate control of mosquito
larvae in the community, poor sanitation and environment, lack of knowledge, and
a poor health-care system. In recent years, public health authorities have emphasized
disease prevention and mosquito control through community efforts to reduce larval breeding
sources. Although this approach will probably be effective in the long run, it is unlikely
to have a beneficial impact on disease transmission in the near future. We must,
therefore, develop improved, proactive, laboratory-based surveillance systems that can
provide early warning of an impending dengue epidemic. At the very least, surveillance
results can alert the public to take action and physicians to diagnose and properly treat of
cases.
