Editorial 1 : Why are dengue cases on the rise worldwide?
Context
Dengue cases have surged in India, with Karnataka, Kerala, and Tamil Nadu seeing significant increases. According to data published by the National Centre for Vector Borne Diseases Control, as of April 30, India recorded 19,447 cases and 16 deaths, with Kerala and Tamil Nadu leading in numbers.
What is the global situation of dengue?
- According to the World Health Organization (WHO), as of April 30, over 7.6 million cases of dengue were reported in 2024.
- This included 3.4 million confirmed cases, over 16,000 severe cases and over 3,000 deaths.
- The WHO noted that at least five countries, including India, were grappling with the onset of monsoon season, which created suitable conditions for the breeding and survival of Aedes mosquito.
- Urbanisation and population movements have also played a pivotal role in the increasing burden in the region.
- Dengue is endemic in more than 100 countries in the WHO regions of Africa, the Americas, the Eastern Mediterranean, South-East Asia and Western Pacific.
- The Americas, South-East Asia and Western Pacific regions were the most seriously affected, with Asia accounting for around 70% of the global disease burden.
- However, it also noted that dengue is spreading to new areas in Europe, the Eastern Mediterranean and South America.
How does dengue spread and how is it treated?
- Dengue virus is transmitted to humans through the bite of infected mosquitoes, with the primary vector that transmits the disease being Aedes aegypti.
- While cases are mostly asymptomatic or mild, some may develop severe dengue that could include shock, severe bleeding or organ impairment.
- According to the National Guidelines for Clinical Management of Dengue Fever, dengue presents as an acute febrile illness lasting two to seven days, characterised by symptoms such as headache, retro-orbital pain, myalgia, arthralgia, rash, and hemorrhagic manifestations.
- In those without any warning signs or complications, dengue is managed through symptomatic and supportive treatment.
What are the emerging patterns in dengue?
- Researchers and public health experts have been closely monitoring the emerging patterns in dengue.
- According to the WHO, factors contributing to the increasing risk of dengue epidemics include the changing distribution of the Aedes aegypti vector, urbanisation, and human activities that create conducive environments for vector-host interaction, and climate change-induced shifts in weather patterns.
- The first epidemic of clinical dengue-like illness was recorded in erstwhile Madras in 1780. Dengue virus was isolated in India during 1945 for the first time.
Conclusion
There are more cases in a short time if control measures are not taken on time. As for Tamil Nadu, we expect cases to rise in the coming months. Surveillance and immediate response are critical. Along with this, community empowerment and education is needed.
Editorial 2 : Breaking the taboo around men’s reproductive health
Context
It is time to recognise and address the subject of male reproductive health issues in India.
Reproductive Health
- World Population Day (July 11) has passed. As we grapple with the multifaceted challenges of global population dynamics, it is crucial to turn the spotlight on a subject often overshadowed in discussions on reproductive health: male infertility.
- Male infertility remains a stigmatised issue, shrouded in silence and with misconceptions.
- This neglect exacerbates the emotional and psychological toll on those who are affected and impedes progress towards effective solutions.
- In 2004, the World Health Organization (WHO) estimated that globally, between 60 million to 80 million couples struggle with infertility.
- Extrapolating from WHO’s data, it is suggested that approximately 13 million to 19 million Indian couples may face infertility issues.
- This incidence is only set to increase, shaped by factors such as environmental pollution and adverse lifestyle shifts.
- Male infertility accounts for 50% of all infertility cases in the country. Thus, it is important to shed light on male infertility, understand its causes, and identify solutions to aid the millions of affected couples.
Understanding the subject
- Male infertility is not a standard experience. Its causes, and therefore its forms, vary. Infertility in men can manifest as an absence of sperm, low sperm count, low sperm motility, or both.
- The form of infertility can depend on various factors that include stress, hormonal imbalance, genetic, anatomical and epigenetic factors, or even exposure to certain infections.
- External factors such as environmental pollution and an indiscriminate use of pesticides on crops, plastics, and plasticisers can also affect fertility and influence the epigenetic makeup.
- Lifestyle factors such as diets, sleep patterns, work schedules, and consumption of alcohol and tobacco also play a major role.
- Adding to these factors is a growing preference for late marriages among youth, creating challenges due to declining sperm quality with age.
- While the challenges listed above may appear daunting, male reproductive health can be safeguarded through various lifestyle interventions.
- First and foremost, it is imperative to be aware of reproductive and sexual health and the factors that influence it, particularly during the formative period from secondary school to junior college.
- Here, parents, particularly fathers, play a critical role and must educate their sons on the issue.
- At an individual level, young men should proactively adopt good lifestyle practices, ensuring healthy eating, regular sleep patterns, and eliminating the consumption of alcohol, tobacco, and other intoxicants.
- While mobile phones and laptops have become occupational hazards in most fields, their excessive usage, in proximity to the body, should be avoided.
- Stress is a major deterrent to reproductive health, and regular exercise, yoga, and meditation can go a long way in reducing its adverse effects on well-being.
- Couples together must also adopt such healthy lifestyle practices to safeguard their reproductive health and enhance their well-being.
Treatment options
- While lifestyle interventions play a critical preventative role, it is also important to discuss treatments available for those grappling with infertility.
- Treatment options are varied, and their efficacy depends on the cause and the form of infertility.
- It is important to seek help from a medical professional to identify and treat the issue.
- The medical professional will guide the person to undergo a routine semen analysis, conducted after a two to seven day period of sexual abstinence (WHO recommended).
- If the issue is physical or anatomical such as blocked sperm flow, undescended testicles, or an abnormal urethral opening, these can be fixed with surgery.
- If the issue is an absence of sperm, then treatments such as intra cytoplasmic sperm injection (ICSI) should be undertaken.
- Alternatively, couples facing this issue can also opt for donor sperm insemination or adoption.
- In cases where the sperm count is very low, there is a chance for the couple to conceive naturally if sperm motility is very good.
- However, if both sperm count and motility are low, intrauterine insemination (IUI), in vitro fertilisation (IVF), or ICSI are advocated.
- In cases of male infertility due to gene mutation/s, genetic counselling is of utmost importance before seeking the support of assisted reproductive technologies such as IVF and ICSI.
Conclusion
Awareness building, sex education, and timely medical interventions are key to supporting couples on their journey to parenthood. By breaking the taboo surrounding male infertility and fostering a more informed and supportive environment, we can help many couples realise their dream of having children
