Dengue fever Infections and Infestations Dengue fever
Conditions
Interventions
All patients presenting to the clinic with a history of fever for 3 days duration or more were identified by the triage counter nurses. It was standard practice that such patients would have a full bl
Sponsors
University of Malaya
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Patients who are suspected to have dengue fever from the history and examination findings by a primary healthcare clinician 2. History of fever for three days or more 3. Thrombocytopenia: Platelets equal to or less than 150 x 109/l. The platelet level of 150 x 109/L was chosen as the highest cut off point for thrombocytopenia because it is the lowest level of the normal range for platelets according to the University of Malaya Medical Centre’s clinical laboratories. During the early febrile illness, the platelets and total white blood cell count were found to be lower among patients with dengue compared with patients with other febrile illness. 4. Age equal to or more than 12 years old. This was arbitrarily set to ensure that the patient concerned can understand instructions and fill in the fluid chart reliably and independently
Exclusion criteria
Exclusion criteria: 1. Any type of current or active malignancy 2. Human Immunodeficiency virus (HIV) or other serious underlying medical conditions conferring immunodeficiency. Immunodefiency states such as HIV or serious medical conditions were excluded from the study as febrile illnesses in these patients are usually due to complicated and multifactorial aetiologies. 3. Patients who are not given a follow-up appointment to review the clinical progression and to repeat the full blood count test. This is to ensure that the patients enrolled in this study are similar to the target population, which are patients who are suspected to have dengue fever by a primary health care provider and are being followed up for outpatient monitoring 4. Patients who are assessed on the first outpatient clinic visit and found to require hospital admission
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The outcomes were assessed at the end of the two month period of data collection. The two pilot study groups were compared in terms of: 1. The hospitalization rates 2. The need for intravenous fluid treatment During the follow up and data collection period for each participant, information regarding whether they required admission was collected, either from their medical records, or verbally from the patient during the telephone calls the research team made during defaulter tracing. Information regarding whether intravenous fluids were required for these suspected dengue patients were obtained using the fluid chart for the intervention group, and verbal interview for the control group during the participant's follow up. The feasibility of the intervention in the form of the fluid chart was assessed by its usage in the intervention group, and feedback from the intervention group participants during follow up. The feasibility of the intervention was also assessed by measuring the drop out rate of the study. The duration of data collection was for the whole duration the patient was under follow up in clinic over the 2 month period 1st June 2010 to 30th July 2010. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. The severity of haemoconcentration. Four surrogate endpoints were utilized to determine this, and they were as follows: 1.1. The mean peak haematocrit 1.2. The difference in haematocrit level between the values of clinic consultation 2 – clinic consultation 1. 1.3. Those above the local cut off value of haematocrit indicative of plasma leakage. 1.4. Haematocrit fluctuation of 20% or more 2. With regards to assessing the severity of the platelet drop, two secondary endpoints were used: 2.1. The mean nadir platelet count 2.2. The difference in the platelet level between the values of clinic consultation 2 – clinic consultation1. Data regarding the platelet and haematocrit levels were collected from the laboratory results available electronically, from the dengue home based card held by each patient, and from the medical records for each study participant. The duration of data collection was for the whole duration the patient was under follow up in clinic over the 2 month period 1st June 2010 to 30th July 2010. | — |
Countries
Malaysia
Outcome results
None listed