Santo Domingo.- Foreign Minister Roberto Álvarez assured that anthrax, which has raised health concerns in Haiti, remains under control in the Dominican Republic. He confirmed that no cases of the bacteria have been reported entering the country as of now.

Before attending a session with Attorney General Miriam Germán, Álvarez stated that the Ministries of Health and Defense are overseeing all entry points to prevent the bacteria from crossing into Dominican territory.

On a different note, the Foreign Minister expressed optimism about the new Haitian government led by Garry Conille. He praised Conille’s extensive experience and the skilled team he has assembled to manage the Haitian State.

Regarding the Kenyan-led peacekeeping mission, Álvarez noted that Kenyan troops are now patrolling alongside Haitian police, and results from these efforts are expected soon.

Houston-Sydney-Massachusetts – Extreme heat can increase the danger of heat-related illnesses and, more subtly, threaten health by amplifying the side effects of many common medications.

Heat can also damage medications such as insulin, which requires refrigeration. Inhalers can explode. Epinephrine injectors, such as EpiPens, can malfunction. Medications that are shipped through the mail can deteriorate.

A look at common problems and solutions related to heat and medicine:

What medications could cause problems with heat?

Blood pressure pills that reduce fluid in the blood can cause dehydration. Beta-blockers for heart conditions can reduce blood flow to the skin and make you less aware of dangerous heat.

Some antidepressants can make it harder to stay calm. Aspirin and other over-the-counter pain relievers reduce fluid and sodium levels, making it difficult to manage high temperatures.

In addition, the combination of heat and medication side effects can lead to dizziness and falls. Alcohol increases the danger, said pharmacist Bradley Phillips of the University of Florida College of Pharmacy.

Learn more about your medications’ side effects and storage requirements at the National Library of Medicine’s MedlinePlus website.

Phillips said you can also check with your doctor or pharmacist. Ask how much water you should drink if you take medications that increase dehydration.

He recommends staying hydrated and “not relying on your body’s ability to tell you that you’re thirsty.”

Some medications (antibiotics, antifungals, and acne) can increase sun sensitivity, leading to rashes and burns. If you’re taking them, stay under an umbrella or wear sun-protective clothes and sunscreen, said Dr. Mike Ren, a family physician at Baylor College of Medicine in Houston.

“You may be on antibiotics, not think too much of it, go to the beach and then come back with a huge sunburn,” Ren said.

How should travel medications be stored?

Generally, medications should be kept in a cool, dry place unless they need refrigeration, which can be tricky when traveling.

Before a summer road trip, check labels for storage requirements for your medications. Carry medications in a cooler when traveling by car, even if they do not require refrigeration. The trunk or glove compartment of the car may become too hot to store them, even at room temperature.

Traveling by plane? It is always best to carry medications in carry-on luggage if checked luggage is delayed or lost, and it may be too cold in the cargo hold.

What about mailed prescriptions?

Mail-order pharmacies are responsible for keeping medications at safe temperatures during storage and transport. The best practice is to ship sensitive medications in special containers with ice packs and temperature monitors.

But that doesn’t always happen. Or delivery can come at a bad time, said Ren, who recently helped his vacationing mother by bringing her shipment of supplements to her Houston home as the region faced sweltering heat.

“If you know you’re going to be at work all day or if you’re on vacation and you’re having medications delivered to your home, you definitely don’t want them outside in the scorching 38-degree sun,” Ren said. If you think the heat has damaged your mail-order medication, call the pharmacy to report the problem.

Is more research needed?

Yes. Researchers in the U.S. and Australia say some of the usual warnings about heat and medications don’t have much scientific evidence to back them up. Ollie Jay of the University of Sydney found support for only four of the 11 categories of medications that the World Health Organization lists as of concern in relation to intense heat.

He suggests changing behaviors, not medications, such as not exposing oneself to heat. “You have to be a little more cautious,” he said.

Dr. Renee Salas, an emergency physician at Massachusetts General Hospital, said that as climate change accelerates, there is a need to know which medications are the most risky in the heat.

“We don’t have that answer yet, and it’s one we need to figure out quickly. Some medications (antibiotics, antifungal and acne medications) can increase sensitivity to the sun, leading to rashes and burns.ente,” Salas said.

Dengue is becoming a severe problem in Latin America and the Caribbean, warned the Pan American Health Organization (PAHO).

However, thanks to the biological modification of the mosquitoes that transmit this disease, the World Mosquito Program is managing to reduce cases by leaps and bounds in some regions of the world.

After years of hard work, the World Mosquito Program reduced dengue cases by 95% in the Antioquia region of Colombia.

How? By breeding and later releasing mosquitoes born with the Wolbachia bacterium, which “prevents transmission” of this tropical endemic disease, which causes headaches, vomiting, and, in some cases, even death.

Despite these promising results, PAHO warns that Latin America and the Caribbean will experience their “worst dengue season” this year, with some 9.3 million cases and at least 4,500 deaths between January and June due to climate change, lack of water services, and overpopulation.

Nelson Grisales, responsible for this project in Medellín, explains that the first step to solving the problem is to raise awareness among governments:

When they begin to understand and accept biological control methods, particularly this one, which is a natural method without manipulation, governments will start to require them. That willingness to understand takes time for something revolutionary, but we are on the right track.

Another factor preventing the implementation of this prevention system is the lack of resources to adopt it in tropical and subtropical developing countries.

“We all know that the resources available for public health and diseases such as dengue, which are not necessarily very lethal, are neglected diseases,” said Morales, who assured that these nations do not have much budget to be able to control them.

For this reason, the specialist stressed the importance of “international cooperation and donors” to support government work and allocate or reallocate some resources.

THE RISK OF DISINFORMATION
Finally, the expert points to misinformation hindering program integration in some regions. For example, in September last year, a handful of people protested in front of his laboratory, arguing that Bill Gates, one of the project’s funders, releases chips through mosquitoes to control minds.

“information, at the moment, is a problem at the public health level: the anti-vaccine, anti-medicine, anti-medicine campaigns, in general terms, are huge and affect all countries,” he said. In his opinion, this generates a “mistaken understanding” of many factors, which can lead to disinformation campaigns with a mistaken narrative, however intuitive or normal they may be.

All these obstacles may delay the project’s implementation in some countries, but experts are convinced that the World Mosquito Program will soon become a public health measure. He assures that its mission will not end until dengue fever is eradicated.

Santo Domingo – Nearly 80% of the patients who arrive at an emergency room are emergency cases. This highlights the need to educate the population about the difference between emergency rooms and urgencies so that they know where to go in the event of a medical eventuality, said Dr. Josué Hernández, medical director of Médico Express.

Urgency can be any health condition that requires quick medical assistance but does not put a patient’s life at risk. Examples include migraines, back pain, ear pain, fever, mild trauma, and viral or allergic processes.

An emergency is when a person has a life-threatening situation requires immediate attention. These almost always require hospitalization or intensive care, for example, chest pain, loss of consciousness, convulsions, profuse bleeding, and polytrauma, among others, added Hernandez.

People who attend Médico Express will be able to have most of their health conditions and situations treated from the point of view of urgency, consultation, diagnosis, and even outpatient surgeries.

The emergency medicine specialist emphasized, “We do not perform hospitalizations; our rooms are emergency rooms. It is important that the citizens know these differences and scope.” Educating and orienting the patient benefits the system.

Santo Domingo – Infectious diseases continue to affect the population in the Dominican Republic, with dengue, malaria, and leptospirosis among the most prevalent.

However, leptospirosis continues to claim lives, with two new deaths, for a total of 26 so far this year, standing out as a threat to the population, especially in this period of rains and floods.

The Epidemiology Department of the Ministry of Public Health report indicates that Epidemiological Week SE 26 registered two new deaths due to leptospirosis, a disease transmitted by animal urine, mainly mice, whose symptoms are similar to those of other infections. This SE 26 covers the period from June 23 to 29.

Nine cases of leptospirosis were reported in just one week, for a total of 305 so far this year. Of these, 35% are suspected, 13% probable, 8.52% ruled out, and only 8% (24/305) are confirmed cases, states the Public Health Bulletin.

“Of all reported cases, the male sex has been the most affected with 73% (229/305). The accumulated incidence of is 5.7 cases per 100,000 inhabitants, with the province of Monte Cristi having the highest incidence with 73.2 cases per 100,000 inhabitants,” he adds about the behavior of this disease.

Dengue
The incidence of dengue, a disease transmitted by the bite of the Aedes aegypti mosquito, has a record of 8,312 suspected cases, of which 670 were reported in the last four epidemiological weeks and 146 during week 26. According to Public Health, confirmed cases to date total 935, and nine deaths have occurred.
In SE 26, seven cases were confirmed, and no deaths.

“Of the confirmed cases as of SE 26,minors are the most affected, with 80%. The male sex accounts for 51%, while the municipalities with the highest number of cases are Santiago, San Francisco de Macoris, Puerto Plata, San Juan, San Jose de Ocoa, and Espaillat province”, specifically about dengue.

Malaria
So far this year, 26,875 suspected cases of malaria have been reported, of which 572 were positive by laboratory tests, and another five were confined during this period.
The number of cases of this disease, also transmitted by mosquito bites, has increased by 278% in the country compared to the previous year, when there were 151.
The accumulated incidence is 10.72 per 100,000 inhabitants. Azua and San Juan provinces have reported 95% of the cases.

Maternal deaths
Three maternal deaths were reported during this epidemiological week, of which one was Dominican and two were Haitian, with a mean age of 30 years and a range of 29-31 years.
They resided in the provinces of Santo Domingo, Santiago, and Azua. From SE 1 to SE 26 of 2024, 85 maternal deaths were reported, of which 56% (48/85) were Dominican and 44% (37/85) were Haitian.

Infant deaths
Regarding infant deaths, during SE 26 of 2024, 46 deaths were reported. This represents a 32% decrease compared to the same period of the previous year. Neonatal infant deaths also reflect a 35% decrease compared to 2023. “Although this decrease is encouraging, it is important to continue working to reduce infant mortality and ensure the health and well-being of children,” Public Health expresses in its report.

Santo Domingo, DR – The families living in “La Cueva,” in the Maquiteria sector of Villa Duarte, Santo Domingo East municipality, where, according to neighbors, three children have died of suspected dengue fever, live amidst accumulated water and garbage in a septic tank which reflects the poor hygiene.

The apparent sewage drain has a deteriorated metal cover with several holes. According to residents, the surrounding cement cover has a hole through which water comes out when it is completely full and overflows in times of downpours. The constant dripping of water from the “cave” produces a humidity that covers several of the zinc-roofed houses below.

“There are too many mosquitoes here, too many, too many mosquitoes, just that hole over there is full of water and mosquitoes,” said Franklin Ogando, a resident of the area.
Elainy Pérez’s neighbors and relatives attribute the death of her son and two other children in the area with suspected dengue fever to this calamitous situation.

Mauricio Perez, the father of the nine-year-old girl who died on July 2nd, says that the infant presented fever, vomited once, and had bruises and convulsions until she lost her life while she was being taken to a medical center.
Perez indicated that up to the moment, the information provided by the medical center where she was treated indicated that it could have been dengue fever. However, they are still waiting for the National Institute of Forensic Sciences (Inacif) to deliver the autopsy results.

She said that her daughter spent much time playing in the houses near the sewer.
“When it rains, it is a total mess, a lagoon,” said Perez when talking about the hole.
The last case registered in this sector, with suspicions, is about a girl who was one year and seven months old and died last Wednesday at the Robert Read Cabral Hospital.

Ercilia Hernandez, the infant’s great-grandmother, said that she had a high fever and that she immediately went to take her to the Los Mina maternity hospital. Still, when the fever went down, she was sent home.
Hernandez said that in the early hours of the morning, “she felt hot” again and vomited. She explains that at that moment, she decided to take her to the polyclinic of Villa Duarte, where she was assisted and put on oxygen until she was referred to the Robert Read Cabral Hospital.

Although the neighbors speculate about the situation, Hernandez expressed that he prefers to know the results of the autopsy that will be delivered in 45 days.
As of midday this Saturday, the Inacif had not delivered the body of the deceased to the relatives, who were desperately waiting outside the institution.

INTERVENTION OF THE AUTHORITIES

Some families go further and show their concern about the issue. Because of this, they ask Public Health to come to their aid, inspect the place, sanitize it, and carry out fumigation campaigns.

Santo Domingo. – Martinique, Guadeloupe, and Puerto Rico are among the Caribbean territories with the highest life expectancy, between 80 and 83 years, while other countries in the region, such as the Dominican Republic, Bahamas, or Dominica, have ranges that do not exceed 75 years.

The information is contained in the ranking “Life Expectancy by Country,” developed by World Population Review with data from the United Nations (UN), corresponding to 2023.
The platform details that the last places are Jamaica, St. Kitts and Nevis (72 years), and Haiti, with a life expectancy of 65 years.

The Dominican population would grow until 2060

According to current projections, World Population Review notes that “the population of the Dominican Republic is expected to grow until approximately 2060 when it will reach its peak population of 12.89 million.”
“After reaching its peak population, the Dominican Republic will experience a demographic decline that will leave the population at 11.01 million people,” the organization states.

It adds, “The fertility rate in the Dominican Republic is currently 2.36 births per woman, which has declined year after year since the 1950s. This decline in the fertility rate, in combination with negative net migration, has considerably slowed the population growth rate.”

It further highlights that “from 2019 to 2020, the population growth rate was 1.01%, which added about 109,000 people to the population. This overall decline in the population growth rate will eventually bring it to zero and then the decline in the country’s population will begin.”

NSO data

Last week, the National Statistics Office (ONE) presented its latest report on the X National Population and Housing Census conducted in 2022, stating that the Dominican population growth rate has declined to 1.11% since the beginning of the last century.

Santo Domingo – As of May 31, the Dominican Republic had 7,574 cases of dengue fever, as it now faces the beginning of the season of greatest circulation of the virus, driven by the heat and the rains, which favor the spread of the vector.

This was emphasized yesterday by the local representation of the Pan American Health Organization (PAHO/WHO), highlighting the effort made by the country to keep dengue cases under control and the support offered by this organization to the different actions being developed, including the training of health personnel.

It indicates that in response to the worrying increase in dengue cases in the region of the Americas in 2024, the Dominican Republic has reinforced its actions to combat this disease with the support of PAHO/WHO and highlights that so far this year, the countries of the region have reported more than 8.6 million cases of dengue, surpassing the 5.6 million in 2023.

Facing the challenge

In a press document, PAHO in the Dominican Republic indicates that the country is now facing the beginning of the season of increased dengue circulation, driven by heat and rains, which favor the spread of the vector.

To address this challenge, he recalled that the Ministry of Public Health launched last March 20 the Dominican Republic’s National Plan for the Prevention and Control of Dengue, based on PAHO’s Integrated Management Strategy (EGI) for the prevention and control of arboviral diseases.

He recalls that this plan seeks to strengthen the country’s capacity for early detection, clinical management of cases, intersectoral coordination and integrated vector management, with a cross-cutting axis of communication and community participation for behavioral change in dengue prevention.

Positive impact

It emphasizes that this integrated approach has shown to have a positive impact in controlling the spread of the disease and that political commitment at the highest level has been fundamental in preparing the country to face the threat of dengue and has been reflected in the intersectoral coordination between the Ministries of Health, Education, municipalities, academia, specialized medical societies and representatives of civil society.

He highlights that during 2024, PAHO/WHO, both the regional office and the national team, in coordination with the National Health Service (SNS) and universities, have supported the training of health professionals at different levels of care, including more than 1,200 doctors from provinces throughout the country and more than 570 medical and nursing students.

Collaboration

The PAHO/WHO representative in the Dominican Republic, Alba María Ropero Álvarez, highlighted the Organization’s collaboration in the deployment of communication and community participation campaigns to raise awareness among the population about the importance of their active and permanent participation in dengue prevention and early care seeking.

He said that PAHO has supported the design and reproduction of educational material for mass distribution to health personnel in emergency rooms, outpatient consultations and hospitalization, including algorithms for the clinical management of dengue cases.

In addition, it has supported vector control actions to reduce the populations of Aedes aegypti mosquitoes that transmit dengue, chikungunya and Zika, through the training of entomologists, epidemiologists and environmental health personnel and the organization of breeding ground elimination days.

He emphasizes that it is essential to maintain these interventions and the involvement of all governmental sectors and society to effectively control dengue.

Santo Domingo – The Minister of Housing and Buildings (Mived), Carlos Bonilla, endorsed the US$190 million loan agreement between the Dominican Republic and the International Bank for Reconstruction and Development (IBRD) because he said it will be invested in health infrastructure.

According to the official, resources oriented to health are a requirement for the sustainable development of society.

He was invited by the Permanent Commission of Finance of the Chamber of Deputies as part of the process of socialization of the loan, pending approval. Before the Commission of legislators presided by Deputy José (Bertico) Santana, the Vice Minister of Mived, Ernesto Mejía, pointed out that they have already made the surveys of the places that require hospital constructions and first level primary care centers that require renovation.

Santo Domingo – Private clinics and clinical laboratories are receiving a significant increase of patients in their consultation and emergency areas, as well as clinical laboratories of people with flu-like symptoms seeking tests to determine the presence of Covid-19, influenza or any other respiratory virus.

The number of people with fever, sore throat and muscle pain, headache and general malaise and in some cases diarrhea, vomiting and loss of smell and taste, has increased in recent weeks in the country, which is attributed by specialists to the rains and high temperatures that have been recorded.

The high demand of patients with indications to undergo respiratory panels, to determine the type of virus affecting them, or only Covid-19 and influenza tests has been increasing in the main clinical laboratories of the country, according to patients’ reports.

In addition, the search for information from people interested in knowing where the Ministry of Public Health is performing the free Covid test is increasing.

INFLUENZA A AND B
A similar situation is also being experienced in private clinics, with an increase of patients with respiratory processes, mostly with influenza A and B, both in their consultation services, emergencies and in some cases, hospitalization, confirmed Rafael Mena, president of the National Association of Private Clinics and Hospitals (ANDECLIP).

He said that so far it is a moderate increase, which has not overflowed the capacity of the centers, and that when the test is done most of the cases are influenza A and B.

The doctor explained that hospitalizations are occurring mostly in those patients who have comorbid conditions, among them those suffering from asthma.

Special attention to hygiene
Avoid conglomerates, use masks when going to health centers or where people are crowded, cover your mouth when coughing using handkerchiefs or your elbow, stay at home isolated, do not go to work, school, or places where there are more people, are among the recommendations made by doctors specialized in the management of viral processes to avoid spreading the disease.

They consider it essential not to self-medicate and to go to the doctor, because there is also circulation of dengue and other diseases and it is important to know what type of virus is affecting the patient and to sanitize hands frequently.