DENGUE CONTROL & PREVENTION EFFORT

The DRF has dedicated its efforts to first identify the most cost effective and efficient methods to control the dengue virus in Latin America, and second to procure financial support to ensure their fruition. Through extensive research, site visits, and financial/ analytical review, the directors of the DRF have determined that specified educational and health information technology efforts are perhaps the most effective means of controlling dengue in Latin America.

Nicaragua currently has two underfunded pilot programs that complete a number of the necessary prerequisites that establish the programs as excellent educational interventions for the control of dengue. The essential aspects of these programs are community empowerment and the development of community awareness of not only the principles of disease transmission but also methodologies pertaining to prevention. Educational interventions allow prominent community members to direct the campaign thus ensuring greater uptake within the community. Furthermore, brigades of community activists travel door to door within specified areas conducting site visits of locations that have shown higher indices of dengue. Site visits are directed with the primary intention of eradicating breeding grounds for the vector that transmits dengue, the mosquito. Next, instruction regarding the transmission and preventive measures against dengue are conducted in local schools. Inculcating these aspects into the educational curriculum are essential in formulating a stable base of citizens that have been raised in a culture of enhanced awareness pertaining to disease transmission and prevention strategies.

The DRF is determined and dedicated to supporting these educational initiatives in Nicaragua. All funds donated by the DRF to Nicaragua are strictly distributed with financial report cards such that finances can be tracked and explicitly tied to statistical outcomes. A yearly update with epidemiological statistics will be provided to donors demonstrating the use of their funds and the improvement regarding the reduction of the burden of disease throughout the country of Nicaragua where these pilot programs are initiated.

Finally, it is the hope and determination of the DRF to expand funding streams for these types of educational interventions with the express goal that more pilot programs can be established in a variety of regions. Moreover, the intention of the DRF is to formulate and establish a well funded program that has longevity and statistical significance in the reduction of the burden of disease in Nicaragua.

HEALTH PROFESSIONAL EDUCATION

Physician education is one of the main goals of the Dengue Relief Foundation. The world is growing and shrinking all at the same time. One could be hiking the Mombacho Volcano in Nicaragua one morning, and breathing the smog ridden air of Los Angeles International Airport in the afternoon. While studying the Dengue virus and the economic impact it has had on the country of Nicaragua, we realized that viruses travel around the world just as quickly as we do. A traveler from Latin America could easily have brought the virus to America - but would physicians be able to diagnose and treat this traveler properly? The same scenario is true for Leishmaniasis, malaria, and other infectious diseases as well.

It is important for physicians to have a world view not only of different cultures and peoples, but also to realize that diseases once considered to be threats in other countries, can be present in California and other regions with many immigrants. It is especially important for primary care physicians to be educated in the different presentations of infectious diseases. With intimate knowledge of the presentation, etiology, and the natural course of such diseases, immediate recognition, diagnosis treatment and eventually prevention can be achieved.

Recently, the DRF directors have been formulating a primary care infectious disease educational initiative. Projects of this nature specifically allow primary care physicians, medical students and public health professionals in the United States to obtain "hands on" infectious disease educational opportunities. The DRF has developed an extensive educational fellowship where health care professionals may travel to Nicaragua for a two to three week intensive preparatory course that specifically studies endemic infectious diseases such as Chagas, Leishmaniasis, Dengue and many others. As globalization progresses at an ever increasing rate the level of international travel has also been augmented at comparable levels. Parallel to the increase in globalization and travel there has also been an increase in what was once considered rare diseases previously not seen in the United States. Chagas, a parasitic disease endemic to more tropical regions is derived from the parasite organism Trypanosoma cruzi. The disease has increased in prevalence significantly over the last decade in the United States, a phenomenon that many attribute to enhanced travel between the citizens of nations that harbor an endemic disease status for Chagas.

The goal of such health professional educational programs is to allow students and health care providers, who are the front lines with respect to health care delivery, access to tools and the necessary education to make effective diagnosis of these rare diseases that are quickly becoming more prevalent in the U.S.