Dengue, cholera and respiratory diseases in 2023

Santo Domingo—A dengue epidemic that caused tensions in the health system for several months, cholera outbreaks, and a high incidence of respiratory infections, including a new variant of COVID-19, which arrived earlier than expected, colored the epidemiological behavior of the country this year, 2023.

Also, scandals linked to the death of 34 newborns at the San Lorenzo de Los Mina Maternity Hospital, the abduction and subsequent recovery of a newborn baby girl, and the discovery of newborn corpses scattered in a cemetery in Santo Domingo East captured the public’s attention. They caused the country’s maternity centers to be under scrutiny.

At least six epidemiological alerts were issued this year, including one in May and another in November linked to the risk of diseases arising from flooding as a consequence of atmospheric phenomena; two for an increased incidence of respiratory viruses, including one at the end of December for the presence of the new JN-1 variant of COVID-19; others for advanced cases of measles and chikungunya in the region, although the country did not register any of both cases.

Non-communicable diseases

Non-communicable diseases, such as cardiovascular diseases, diabetes, obesity, traffic events, and mental health conditions, continued to increase in the country amidst voices of concern from specialists.

As part of the actions aimed at strengthening prevention and health promotion and encouraging healthy living and thus impacting these indicators, the Minister of Health intensified his strategy of the “Ruta de la Salud: cambia tu estilo de vida” (Health Route: change your lifestyle), which takes medical and educational care to the different provinces of the country.

This year, 2023, 31 of these activities were completed, and 1,400,000,50 people benefited throughout the country, according to information provided by the Minister of Health, Dr. Daniel Rivera, who heads the activities.

The youngest

The Contact Center “Cuidad tu Salud Mental” of the Ministry of Public Health shows the impact of mental health problems in the country and its attention requirements.

Its latest report indicates that of the 6,377 calls received, 67% are from people between 21 and 40 years old who express sadness, anxiety, anguish, insomnia, and anger, among other ailments, including minors, who constitute 10% of those who demand these services.

Of the calls received at the center, which opened last March 16, to date, 60% correspond to sadness, 50% to anxiety, 49% to anguish, 39% to insomnia, 19% to anger, 17% to lack of appetite, 17% constant worry, 16% suicidal ideation and 14% imitation and feelings of guilt.

Medical conflicts

The conflicts between the Dominican Medical Association (CMD), the authorities of the National Social Security System, and the Health Risk Administrators (ARS) remained latent for a good part of the year.

This led the medical profession to exhaust a calendar of marches, work stoppages, and paralyzations of services to several ARSs, demanding changes in the social security system, including increased health coverage for the population and the rates and fees received for services rendered.

The National Social Security Council (CNSS) recently issued a new resolution increasing coverage and fees.

Last December 8, the CMD changed its board of directors, with Dr. Waldo Ariel Suero assuming the presidency of the guild for the sixth time, replacing Dr. Senén Caba.

Cholera and Covid

The year began with an outbreak of cholera, which spread mainly to different sectors of Greater Santo Domingo. In contrast, in the last quarter, another outbreak was registered in Barahona communities. This year, the country introduced its vaccination with the acquisition of 85 thousand vaccines, which have been applied in high-risk populations through a protocol developed for this purpose.

The COVID-19 virus, although still circulating in the country, maintained a low incidence, except for a slight peak in the number of cases registered this year. At the end of December, the circulation of the new highly contagious JN.1 variant was detected in the country, which prompted the Ministry of Public Health to issue a new epidemiological alert for respiratory viruses.

After over two years of issuing daily information bulletins, the health authorities issued the report once a week last March.

Dengue epidemic

The most significant stress to the hospital system was generated by the dengue epidemic, which continued for several months, especially in Greater Santo Domingo, where the high demand for medical attention exceeded the capacity of the leading pediatric hospitals, forcing the National Health Service (SNS) to set up a network of beds in different health centers.

As of mid-December, corresponding to the 50th epidemiological week, the total number of accumulated suspected cases detected by the system is 24,735, with 23 confirmed deaths, for a case fatality rate of 0.1 percent.

Under surveillance

Reports from the Epidemiology Directorate of the Ministry of Public Health indicate that during the first 11 months of 2023, 116 cases of cholera, 19,467 cases of dengue, 215 cases of malaria, 564 cases of leptospirosis; 23 cases of diphtheria; 29 cases of tetanus in non-neonatal ages; 10 cases of pertussis and six cases of meningococcal disease were reported to the system.

In addition to 150 maternal deaths and 2,700 infant deaths. The National Health Service reports an 11% reduction in neonatal mortality this year compared to 2022, following the implementation of the Neonatal Mortality Reduction Acceleration Plan.

New coverage approved

At the end of the year, the National Social Security Council (CNSS) announced the approval of new coverage, including that of outpatient medicines, which increased from 8,000 to 12,000 pesos per year for members of the Family Health Insurance (SFS) of the Contributive Regime.

Resolution No. 581-03 took this decision, including coverage for 70 new procedures, biopsies, and new approaches to reduce surgical complications and hospital stays.

In addition to an increase in the monthly per capita of the Family Health Insurance (SFS) of the Contributory Regime (RC) of RD$128.08 charged to the People’s Health Care Account, from RD$1,555.14 to RD$1,683.22 and a 50% reduction in the co-payment of the SFS of the Contributory Regime for hospitalization services, cesarean sections, surgeries, renal transplants and other high-cost illnesses.

There was a 40% increase in medical fees for procedures, a 50% increase in inpatient consultations, and a 7% increase in diagnostic tests and examination costs. There was also a 15% increase in the use of rooms, equipment, and rooms in clinics and hospitals.