When 22-year-old Ifeoma Adindu, a final-year Biology Education student at a university in the South-East, developed a high fever, body aches and a rash in late June, her family assumed it was malaria or, at worst, typhoid, which are the regular twin suspects usually associated with a fever.
\u201cI swallowed several antimalarial drugs. Carried out several tests, and the results indicated I had malaria. One even showed I had an infection in my bloodstream. I took some drips, but there was no improvement,\u201d she recounted.
After several weeks, Adindu decided to visit a specialist clinic in Awka, Anambra State, and after a few more tests, the real culprit was found to be dengue fever.
\u201cWhen they told me I had dengue fever and had to be hospitalised, I agreed immediately because it could be fatal. I didn\u2019t really understand how I contracted the ailment. I felt so terrible and had lost so much weight. The headaches were splitting. I couldn\u2019t sleep. I thought I was going to die. The doctors kept saying all I needed was fluid, as there really was no certain known treatment per se,\u201d she added.
For many Nigerians, dengue fever remains an unfamiliar name despite its devastating reach across the tropics. Experts warn that climate change, poor waste management and inadequate surveillance are fuelling a quiet surge.
Dengue fever explained
Dengue is a viral infection transmitted primarily by the Aedes aegypti mosquito, the same mosquito responsible for yellow fever and the Zika virus.<\/p>\n\n\n\n
According to the World Health Organisation, in a 2023 publication, an estimated 390 million infections occur annually worldwide, with around 96 million showing clinical symptoms.
While long thought to be confined to Asia and Latin America, dengue is now expanding across sub-Saharan Africa, including Nigeria.
Symptoms often mimic malaria: high fever, severe headache, joint and muscle pain, nausea, vomiting, swollen glands and rash.
In its severe form, dengue haemorrhagic fever may occur, and patients may suffer bleeding, plasma leakage, organ impairment and even death.
Re-emerging public health threat
For decades, dengue fever received little attention in Nigeria. A survey conducted by this reporter revealed that many Nigerians, especially in rural households, were not familiar with the disease.
When our correspondents went round markets on Lagos Island and Ajah, most traders said they were familiar with malaria and typhoid and had never heard the name \u2018dengue fever\u2019, wondering if it was a new illness or a strand of COVID-19<\/p>\n\n\n\n
\u201cI hope this one no be another COVID-19; make government no come lock us down o,\u201d wondered Mrs Moyosore Isah, a Point-of-Sale operative at the Ajah market.
A 2019 study published in the Pan African Medical Journal by Idowu et al. revealed evidence of dengue virus seroprevalence among febrile patients in Ibadan, Oyo State.
Another 2020 survey by Onoja et al., in Transactions of the Royal Society of Tropical Medicine and Hygiene, detected dengue antibodies in blood donors in Jos, Plateau State.
An infectious disease expert at the Niger Delta University Teaching Hospital, Professor Dimie Ogoina, explained in an interview that dengue was underreported because the health system primarily diagnoses malaria in febrile patients.
\u201cWithout proper laboratory confirmation, many cases slip under the radar,\u201d he noted.
In 2022, the Nigeria Centre for Disease Control acknowledged dengue as a re-emerging public health threat. Yet data remain patchy due to limited diagnostic capacity and overlapping symptoms with malaria.<\/p>\n\n\n\n
Experts link the rising dengue burden in Nigeria to environmental and climatic shifts, as warmer temperatures, erratic rainfall and poor waste-disposal practices create ideal breeding grounds for the Aedes mosquitoes.
\u201cPlastic containers, tyres and blocked drains provide stagnant water where these mosquitoes thrive,\u201d a Lagos-based public health physician, noted Dr Olubunmi Adeyemi, adding, \u201cUrbanisation without proper sanitation is a key driver.\u201d
Climate models predict that dengue transmission in Africa could rise dramatically by 2050.
A study published in Nature Microbiology in 2021 further warned that West Africa may witness some of the fastest growth in dengue cases globally due to shifting weather patterns.
Behind the data
For patients like Adindu, the lack of awareness adds to the ordeal.
\u201cWe never thought of dengue. Everyone talks about malaria. Even the nurses first assumed it was malaria,\u201d she said, recalling her three-week recovery ordeal<\/p>\n\n\n\n
In Port Harcourt, 38-year-old trader Kingsley described how his wife almost died after severe bleeding episodes.
\u201cDoctors kept testing for malaria. By the time they confirmed dengue, she was in critical condition,\u201d he said.
These stories echo a systemic gap: inadequate diagnostics, poor health worker training and public ignorance.<\/p>\n\n\n\n
Economic burden
Beyond health, dengue fever imposes steep financial costs. Treatment often requires hospitalisation, during which intravenous fluids and blood transfusions are required in severe cases.
According to a 2020 World Bank brief, households in dengue-prone regions spend an average of 20 to 30 per cent of their monthly income on treatment and related expenses.
\u201cIn Nigeria, where out-of-pocket expenditure dominates healthcare, families face catastrophic costs,\u201d explained US-based health economist, Dr Zainab Mohammed.
\u201cFor small businesses and informal workers, illness means loss of income and productivity.\u201d
Diagnosis and treatment
Currently, there is no specific antiviral treatment for dengue. Care is largely supportive and includes hydration, fever management and close monitoring. Severe cases require hospitalisation. Early detection is critical to reduce mortality, yet Nigeria\u2019s diagnostic infrastructure lags.
Rapid diagnostic tests exist, but few primary healthcare centres have access to them. \u201cDoctors in rural areas often misdiagnose febrile illnesses as malaria,\u201d Professor Ogoina said, stressing the need for stronger laboratory networks.
Vaccines and preventive strategies
A vaccine, Dengvaxia, exists, but its use seems controversial. The WHO recommends it only for individuals who have previously had dengue, due to the risk of severe illness upon subsequent infection in dengue-na\u00efve individuals. Nigeria has yet to adopt widespread vaccination prevention, hence, it hinges on vector control: eliminating mosquito breeding sites, using insecticide-treated nets, indoor residual spraying and personal protection (repellents, clothing). Community-based interventions remain vital.
In Lagos, civil society groups such as the Health Awareness Nigeria Initiative have launched clean-up drives targeting stagnant water in slums.<\/p>\n\n\n\n
Mosquitoes breed in little pockets of water. Simple measures like clearing drains and covering containers can save lives,\u201d said its founder, Ngozi Chukwu.
Government response and gaps
The fight against dengue fever has remained a significant public health challenge worldwide, compelling governments to adopt multi-layered responses that combine prevention, treatment and international collaboration.
The disease is endemic in more than 100 countries, particularly across Asia, Africa and Latin America, with Southeast Asia and the Americas reporting the highest burdens.
Governments in highly affected regions have prioritised vector control as a central policy. This includes widespread fumigation campaigns, elimination of stagnant water sources where mosquitoes breed and community awareness drives.
In countries such as Singapore, where dengue outbreaks recur yearly, strict environmental management laws mandate households and property owners to keep their surroundings free of mosquito breeding sites, with heavy penalties for violations.
Similarly, Brazil has deployed innovative tools, including the release of genetically modified mosquitoes designed to curb mosquito populations.<\/p>\n\n\n\n
Nigeria and other African nations, where dengue is often underdiagnosed due to weak surveillance systems, are under pressure to strengthen response policies.
WHO has urged African governments to integrate dengue surveillance into existing malaria and yellow-fever control frameworks, noting that improved diagnosis will provide clearer data for policy decisions.
In 2024, the African Union\u2019s health desk called for a continent-wide mosquito-control strategy to address multiple vector-borne diseases, including dengue.
Globally, WHO\u2019s Global Strategy for Dengue Prevention and Control 2012\u20132020 has been extended with updated targets: a 25 per cent reduction in mortality and a 50 per cent reduction in morbidity by 2030.
Achieving these goals requires sustained government funding, community involvement and international partnerships.
With climate change expanding the habitats of Aedes mosquitoes, experts warn that dengue\u2019s threat is no longer confined to tropical nations but is a looming global health emergency.
While the NCDC has begun integrating dengue into its surveillance framework, experts argue that more urgency is needed<\/p>\n\n\n\n
\u201cWe cannot wait for a full-blown epidemic before acting. Nigeria must prioritise diagnostic capacity, public education and integrated vector management,\u201d warned Adeyemi.
The Federal Ministry of Health has rolled out campaigns under its Integrated Vector Management programme, but funding gaps persist.
\u201cMalaria dominates the discourse and funding streams, leaving dengue and other arboviruses neglected,\u201d said Mohammed.
Scholars and medics are calling for integrated approaches that combine surveillance, research, community engagement and international collaboration.
As Professor Ogoina noted, \u201cDengue is a wake-up call. Nigeria must invest in preparedness or risk being overwhelmed.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
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