It is heartbreaking to live abroad, work in a reputable public health lab in North America, and read daily about dengue deaths in Bangladeshi newspapers. The situation is unacceptable.

We all know that Dhaka, along with other parts of Bangladesh, has been experiencing an alarming rise in dengue cases in recent years and that the current year is worse than previous years, with daily deaths this year. However, the authorities’ response remains insufficient. Dengue and mosquito-borne diseases in Bangladesh, like floods or cyclones, are a problem that is not going anywhere. Long-term action is needed and it is urgently needed. Unfortunately, this has not happened so far.

A long-term mosquito control program (MCP), similar to climate adaptation plans, could provide structured and consistent efforts to combat mosquito populations and dengue outbreaks over years. At the very least, we should do our best to prevent deaths from mosquito-borne diseases using science-based formulas. This would involve education, continuous surveillance and a coordinated mosquito control strategy.

Education and Community Engagement: Raising awareness at all levels of society about how to reduce mosquito breeding sites is essential. This could include grassroots campaigns, involving religious leaders, social workers, professionals and adding mosquito control education to school curricula.

Continuous monitoring: Regular monitoring of mosquito population and pathogens would allow proactive intervention. Surveillance data could help detect trends in mosquito species and breeding sites, guiding authorities in timely spraying and control efforts.

Control of mosquito larvae: Mosquito control at all stages is important; however, control of larval mosquitoes must be a priority. To effectively control mosquito populations, especially in urban areas like Dhaka, an integrated approach that focuses on mosquito larval control can have a huge impact. This method targets mosquito larvae in stagnant water sources before they mature into biting adults, which is the most effective stage to interrupt their life cycle and prevent mosquito-borne diseases.

Biological agents derived from naturally occurring bacteria such as Bacillus thuringiensis israelensis, Saccharopolyspora spinosa and Lysinibacillus sphaericus. These agents are environmentally friendly and effective in killing larvae without harming other organisms. They are available in liquid or solid form. It can be applied directly to water by knapsack, truck or airplane sprayers. Solid forms are available as dunks, tablets, pellets, granules, or briquettes that are placed in water where mosquitoes lay their eggs. This can be done using students, social workers and religious leaders.

Due to the rapid and unplanned growth of Dhaka city, large areas are inaccessible to trucks. One possible solution is to use crop dusters. These aircraft are affordable relative to the scale of the mosquito problem and can cover large areas quickly and efficiently. Dust collection aircraft for spraying and more frequent, large-scale treatments could be part of the immediate answer.

For Dhaka city, authorities could consider investing in crop dusters to apply larvicides, especially in hard-to-reach urban areas, and implement weekly applications and regularly monitor water samples to ensure that there is no presence larvae, adjusting efforts until open water sources are free of mosquitoes. .

Such measures, along with regular monitoring and targeted applications, can significantly reduce mosquito populations, helping to prevent mosquito-borne diseases.

Government Action and Coordination: Government MCP, supported by scientific input and coordination between city authorities, health departments and communities, is a must and needed NOW.

In the short term and for quick action: This should include immediate action such as spraying to kill adult mosquitoes using a crop duster and removing standing water sources in both public and private spaces.

Without consistent and coordinated action, the problem is likely to worsen as the breeding environment for mosquitoes improves with climate change. A plan focused on coordination, consistency and continuity (3C) would be the key to success and should be implemented immediately to stop unwanted death.

It is my sincere hope that the dengue control authorities will take immediate steps to prevent these unwanted deaths immediately.

Dr Muhammad Morshed is Clinical Microbiologist and Program Head at Zoonotic Diseases and Emerging Pathogens, BC Center for Disease Control, Vancouver and Clinical Professor, Department of Pathology and Laboratory Medicine, University of British Columbia.

The opinions expressed in this article are those of the author.

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