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.

Santo Domingo.- The Executive Director of the National Institute for the Protection of Consumer Rights (Pro Consumidor), Eddy Alcántara, announced on Thursday that the initial laboratory studies conducted by the institution on a dozen rice brands sold in the country revealed no presence of harmful metals detrimental to people’s health.

Speaking at a press conference held at the Pro Consumidor headquarters, Alcántara assured that these studies provide assurance that the rice consumed in the Dominican Republic poses no health risks to consumers.

The official elaborated that these laboratory examinations were prompted by complaints appearing in various media outlets alleging contamination of rice with heavy metals like mercury, copper, arsenic, and lead. “However, such concerns have been dispelled by the findings of these studies, which we are disclosing today,” he emphasized in a press release.

Alcántara clarified that the tests encompassed several domestic and imported rice brands sourced from supermarkets, grocery stores, warehouses, and other establishments. “This initial study of the marketed brands in the country ensures peace of mind and food sovereignty,” he added.

As the market surveillance authority, Alcántara affirmed that upon receiving reports from certain media outlets, they promptly collected samples for laboratory analysis. “As soon as we obtained these initial results, we are sharing them with the public,” he affirmed.

He asserted Pro Consumidor’s commitment to conducting further tests on other rice brands available in the national market until a comprehensive review is completed. Alcántara reiterated that if the presence of heavy metals is detected in any other rice brands, the responsible parties will face sanctions, and the product will be removed from the market, in accordance with consumer protection law 358-05.

He underscored that the regulations stipulate that “products and services must be supplied or provided in such a manner that, when consumed or used under normal or foreseeable conditions, they do not pose any danger, harmfulness, or unforeseen risks to the health and safety of the consumer or user.”

Santo Domingo – The Dominican Republic managed a donation of 3,600 cm2 of Liolized Human Skin Tissue, donated by the Government of Mexico, to be used in caring for patients admitted to Dr. Thelma Rosario’s burn unit.

These are minors affected by severe burns during an explosion at the Salcedo carnival a week ago. This action will improve the health of patients who remain in critical condition and are admitted to the intensive care unit at the Arturo Grullón Regional Children’s Hospital in Santiago. The management was carried out through the Ministry of Public Health in coordination with the Ministry of Foreign Affairs (MIREX), the National Health Service (SNS), the National Institute for Transplant Coordination (INCORT), and the Embassy of the Dominican Republic in Mexico.

The coordination was made with the Ministry of Health, the Federal Commission for the Protection against Sanitary Risks, and the Authorization Commission of Mexico. The liquefied tissues were transported by the airline Aeromexico and guarded by the minister counselor, Orlando Rodriguez. They were received by the Regional Director of North Central Health, Dr. Manuel Lora, and the referred health center authorities.

This type of freeze-dried tissue is used as a temporary cover for wounds caused by burns, diabetic ulcers, varicose veins, decubitus, leprosy, and others.

Current situation
Until yesterday afternoon, the four minors admitted to the Robert Reid Cabral Hospital were taken to the conventional operating room area to be treated. Although this hospital has no burn area, care is being maximized.

Of the seven minors who were admitted to the burn unit of the Arturo Grullón hospital, one was discharged, two died, and four are in critical health conditions. The information was given by Dr. Yocasta Lara, Director of Hospitals of the National Health Service. A state of mourning and grief affected the community of Salcedo, as 19 people were injured with burns.

According to the Ministry of Public Health authorities, last year, the Dominican Republic ended with 24,735 cases and 23 deaths due to the disease transmitted by the bite of the infected Aedes aegypty mosquito.

The expert recalled that there is a very high viral load in the country, which implies many infected mosquitoes. For dengue cases to occur, a vector must specify that the mosquitoes did not disappear; they are still there. However, the population decreased, but as there is such a high viral load and so many viruses in human reservoirs that are still circulating, only a tiny population is needed for the disease to be transmitted.

Interviewed by Héctor Herrera Cabral in the program D’AGENDA, which is broadcast every Sunday on Telesistema Channel 11 and TV Quisqueya for the United States, the expert explained that it is estimated that in dengue-endemic countries, 85% of the population does not have clinical manifestations of the disease.

He added that that implies that if the Dominican Republic was seeing many symptomatic people at the end of last year, it means that only 15% of the entire population was being seen to be infected, and that is why the controversy of whether the Ministry of Public Health is telling the truth regarding the infections, but it can never tell it because you only know that a patient has dengue when they present the symptoms of the disease.

“It is very similar; we are going to have fewer probabilities, fewer cases, but we are going to have many cases of dengue, very similar to last year,” responded virologist Robert Paulino when questioned about the behavior of dengue for 2024.

He argued that “firstly because last year’s trend was to generate a permanence of a continuous viral load, and secondly, that the climatic factors are not going to disappear.”

“Because now we are experiencing the effects of the El Niño phenomenon, which is what happened in South America, Brazil currently has many cases that, although it is true that they have begun to distribute a vaccine, it does not represent anything that will change the trend, that is, that you will have a co-circulation of the virus in the population,” said the doctor.

He maintained that this is why the Pan American Health Organization’s alert is because this year, the indicators are identical or worse than those of 2023 from the climatic point of view because, although it may seem a cliché, every year it is reported that temperatures are higher than those of the previous year. Still, this is indeed happening.

“2024 is not visualized to be different from 2023, from the point of view of factors, and that potentiates the issue of dengue and, in addition, as type 3 was introduced last year, type 4, which we have not had that dengue for seven or eight years, at least in the genetic record of identifications, in the present year, because it is circulating in South America, which is now in summer, could enter the country because of human displacements,” he said.

Regarding the possibility of the Dominican Republic having a vaccine against dengue, Dr. Robert Paulino considers it very remote that it will be ready to be applied this year, and it would be necessary to wait until 2025 for it to become a reality.

Paulino warns that tourism is an element of risk for introducing new pathogens.

Roberto Paulino, a renowned researcher of tropical diseases at the Universidad Iberoamericana, warned that tourism is a risk factor for introducing new pathogens.

“I know that at the governmental level it looks bad to say it, but we have to understand that tourism is an element of risk for the introduction of new pathogens, it is not wrong to understand it, what we have to do is to armor ourselves,” said Dr. Paulino Ramirez when he was interviewed in the program D’AGENDA.

He insisted that “what we have to do is to take care of our borders, and not only the air borders, but also the land borders, because there is a country with which we share the island that does not have control of its territory, and we even have to watch over that.”

“That is to say, here we still have elements in the elimination agenda such as the case of malaria, which depends strictly on the climatic factors as well, because it is transmitted just like dengue, with another type of mosquito, and although it is said that it is more rural, those who live in the South are Dominicans just like us, and therefore we must take care of all our population,” warned the doctor.

He clarified that “these are elements that, more than feeling them as an attack, should call our attention to the importance of looking at ourselves and determining how our epidemiological system works, how sensitive we are being at the moment of understanding the signals and, in addition, understanding that epidemiological surveillance includes, today, elements as simple as social networks.”

“People already write things and say things, in the media there is already such a high democratization of information that anywhere we have television channels and journalists that do not necessarily reach the traditional media, but those media are the ones that give us the alerts, and that is public health, not the institution as such, but public health as a concept, that is where we have to see ourselves in a more integrated way,” he said.

There is an urgent need for an awareness campaign on measles because it kills and is transmitted very quickly.

According to Dr. Robert Paulino Ramirez, a specialist in viral diseases, the only way Latin American countries can avoid the appearance of cases and possible outbreaks of measles is by increasing vaccination.

“In fact, the only alert of international importance that is still open is measles, and the only way we can prevent an outbreak or an onset of cases in Latin America is by increasing vaccination,” reiterated Dr. Ramirez Paulino.

He called attention that from 2020 to 2022, the Dominican Republic experienced a 15% reduction in vaccination coverage. However, he does not know the data for 2023 to see if that situation could be reversed.

“Measles needs at least 99% of children born or living in the Dominican Republic to be vaccinated, we have to carry out a very strong awareness campaign directed towards parents and guardians regarding the measles vaccine, because it is a disease that kills and is transmitted very quickly,” the physician warned when questioned about this disease on the D’AGENDA program.

He recalled the case of the Omicron variant of the Coronavirus that infected all the people in a house, “well, measles is like that, it is a disease that has a transmissibility rate of 16, that is, for every infected child, if there are 16 susceptible children, all of them will be infected.”

“So, if we want to prevent this phenomenon from occurring, we have to armor ourselves as a population, because the United States has already had several outbreaks, which means that it is right next to us,” urged Dr. Paulino.

He clarified that this is not only a responsibility of the state authorities through the Ministry of Public Health but also a duty of all people, mainly parents or guardians.

Santo Domingo – The director of the National Health Service (SNS), Mario Lama, delivered more than 29 million pesos in medical equipment for four hospitals of the Regional Metropolitan Health Service (SRSM) to strengthen the attention to the users who come to these centers.

The head of the SNS said that this equipment is part of Luis Abinader’s government plan to improve the quality of care for Dominicans. “We have to continue saving lives, which is the most important thing, to provide quality service in hospitals and that a patient should not be told there is no such thing when they arrive at a public health center.”

Dr. Mario Lama also highlighted that thanks to the constant interventions of remodeling, equipment, and appointment of new collaborators in the health centers, there has been an increase in services never seen before, “Since 2021,5 the amount of services that the Public Network has reported in January has never been reflected,” he emphasized.

Likewise, he called on the collaborators in all the benefited hospitals to make proper use of the equipment and translate it into services, the reinforcement of their centers.

Equipment delivered
The Darío Contreras Hospital received a vascular, orthopedic C-arm, and nine five-parameter vital monitors with a wall base for a total of RD$6,645,766.63.

The El Almirante Hospital received a medium-sized electric autoclave and a digital monopolar/bipolar electrosurgical scalpel with cart, valued at over one million pesos.

Likewise, the Ciudad Juan Bosch Hospital received a portable digital X-Ray with printer, two instrument trays (one for minor surgery and the other for IUD insertion), two examination couches with three positions, five wheelchairs for adults, a five-drawer file, two clinical office desks, four stackable metal chairs, two executive armchairs with P20 arm, two computers with UPS, a medical office display case and 15 computers complete with UPS, valued at 5.8 million pesos.

Meanwhile, Dr. Francisco Vicente Castro Sandoval Hospital (Hospital Nuevo de Boca Chica) received an echocardiograph, a three-channel adult pediatric electrocardiograph with cart, digital mammography, an intrauterine and cardio fetal activity monitor, three standard binocular microscopes, 25 five-section metal shelves, a placenta crusher, six instrument trays (three for minor surgery and three for IUD insertion) and three LED goose-neck examination lamps.

Also, seven three-position examination couches, three three-drawer files, a five-drawer metal file, four clinical office desks, a laboratory refrigerator (reagent), eight visitor’s chairs, four P20 executive chairs, ten C7 comfortable swivel chairs, a 42-inch LED television with wall base, three office display cases and 15 computers complete with UPS, with a total investment of RD$15,535,385.76.

The delivery of the equipment took place in the different hospitals. The directors of the SNS attended it, Alexander Ramírez of Infrastructure and Equipment and Yoany Arias of Clinical Laboratories and Medical Imaging, as well as Edisson Féliz Féliz, director of the SRS Metropolitano, the directors of the benefited health centers and collaborators.