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Dengue Guidelines

The 'Killer'...
Take a good look at 'Aedes Aegypti', vector of Dengue.
Beware...
If they breed, you will bleed.
Take Measures...
Prevention is the best policy.
Kill the Killer...
Kill it, before it kills you.
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These are official guidelines of DEAG (Dengue Expert Advisory Group), and are formulated locally, keeping in mind the needs of Pakistani population.

Guidelines can be read and downloaded in PDF format, compiled separately in different chapters according to following list.

PREFACE ( preface & table of contents )

1.GUIDELINES DEVELOPMENT AND OBJECTIVE

2.GUIDELINES DEVELOPMENT COMMITTEE

3.REVIEW COMMITTEE

4.OBJECTIVES

5.EXTERNAL REVIEWERS

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1. EPIDEMIOLOGY ( Epidemiology )

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2. VIROLOGY ( Virology )

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3. CLINICAL MANIFESTATIONS AND PATHOPHYSIOLOGY ( Clinical manifestation & pathophysiology )

3.1 Spectrum of Dengue Infection

3.2 Clinical Course of Dengue Infection

I .Febrile Phase

II. Critical Phase

III. Convalescent Phase

3.3 Pathophysiology of Plasma Leak

3.4 Tourniquet Test

3.5 WHO Dengue Classification

3.5.1 Limitations of WHO Classification

3.5.2 Suggested WHO Classification 2009

3.6 Other Important Manifestations

3.7 Diagnostic Challenges

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4. DISEASE NOTIFICATION ( Disease Notification )

4.1 Epidemiological Classification for Disease Reporting

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5. LABORATORY INVESTIGATIONS ( Lab Investigations )

5.1 Disease Monitoring Laboratory Tests

5.2 Diagnostic Tests

5.2.1 Dengue Serology Tests

5.2.2 Virus Isolation

5.2.3 Polymerase Chain Reaction (PCR)

5.2.4 Non-structural Protein-1 (NS1 Antigen)

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6. INVESTIGATION OF POSTMORTEM CASE ( Postmortem Investigations )

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7. MANAGEMENT OF DENGUE INFECTION ( Management )

7.1 Introduction

7.2 Triaging the patient at Emergency and Outpatient Department

7.3 Criteria for Hospital Referral / Admission

7.3.1 Referral from Primary Care Providers to Hospital

7.3.2 Referral from Basic Health Units / Hospitals without Specialist to the Hospitals with Requisite Expertise

7.4 Disease Monitoring

7.4.1 Principles of Disease Monitoring

7.4.2 Outpatient Disease Monitoring

7.4.3 Inpatient Disease Monitoring

7.5 Fluid Management

7.5.1 Dengue with Warning Signs

7.5.2 Patients in Critical Phase without Shock

7.5.3 Dengue Shock Syndrome (DSS)

7.5.4 Principles for Fluid Resuscitation

7.5.5 Calculation of Fluid Quota for Adults

ALGORITHM A -FLUID MANAGEMENT IN COMPENSATED SHOCK

ALGORITHM B -FLUID MANAGEMENT IN DE-COMPENSATED SHOCK

7.6 Management of Bleeding/Hemostasis

7.6.1 Hemostatic Abnormalities in Dengue Infection

7.6.2 How to Recognize Significant Occult Bleeding?

7.6.3 Management of Bleeding in Dengue

7.6.4 Management of Upper Gastrointestinal Bleeding (UGIT)

7.6.5 The Role of Prophylactic Transfusions in Dengue

7.6.6 The Role of Adjunctive Therapy in Dengue

7.7 High Dependency Management

7.7.1 Indications for Respiratory Support (Non-invasive and Invasive Ventilation)

7.7.2 Indications for Hemodynamic Support

7.7.3 Safety & Risk – A Guideline for Invasive Procedures

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8. DISCHARGE CRITERIA ( Discharge Criteria )

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9. PREVENTION OF DENGUE TRANSMISSION IN HOSPITALS ( Prevention of dengue transmission in hospitals )

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10. VACCINATION ( Vaccination )

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11. DENGUE FEVER IN PAEDIATRIC POPULATION ( Dengue in Pediatric Population )

11.1.1 Calculation of Ideal Body Weight

11.1.2 Choice of Fluid

11.1.3 Rate of Administration of IV Fluids in Critical Phase without Shock

11.1.4 Rate of Administration of IV Fluids – During Shock

11.2 Special Considerations for Infants

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12. DENGUE FEVER IN PREGNANCY ( Dengue in Pregnancy )

 

13. DENGUE FEVER IN IMMUNE-COMPROMISED PATIENTS ( Dengue fever in immune-compromised )

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14. ANTI HYPERTENSIVE TREATMENT IN DENGUE FEVER ( Anti hypertensive treatment in dengue )

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15. DENGUE FEVER IN PATIENTS ON ANTITHROMBOTIC THERAPY ( Dengue & antithrombotic )

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16. SURGERY IN DENGUE FEVER ( Surgery in Dengue )

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17. REFERENCES ( References )

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18. LIST OF APPENDICES:

 

Proformas ( All_Proformas )

APPENDIX 1a – Investigations Summary

APPENDIX 1b – Radiology Request Form

APPENDIX 2 – Dengue Monitoring Charts APPENDIX 10 – List of Abbreviations

APPENDIX 3a – OPD “Form O”

APPENDIX 3b – Inpatients “Form I” APPENDIX 11 – Acknowledgements

APPENDIX 4 a – Reporting “Form R” (Suspected/Probable case)

APPENDIX 4 b – Reporting Form (Confirmed Case)

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APPENDIX 4 c – SOP for Reporting Dengue Patients ( SOPs of reporting dengue )

APPENDIX 5 – Diagnostic criteria – Non Epidemic Setting ( Critieria for diagnosis of dengue )

APPENDIX 6 – Dengue Regulations (Govt. of the Punjab) ( Punjab prevention & control of dengue regulations 2011 )

APPENDIX 7 –WHO – Classification of DF & DHF (1997) ( WHO definitions )

APPENDIX 8 – Methods of Sample Collection ( Sample collection method )

APPENDIX 9 – Home Care Advice Leaflet ( Advice leaflet for patient )

APPENDIX 10 – List of Abbreviations ( Appendices_Abbrev )

APPENDIX 11, 12, 13 ( acknowledge_disclosure_funding )

APPENDIX 11 – Acknowledgement

APPENDIX 12 – Disclosure Statement

APPENDIX 13 – Source of Funding

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APPENDIX 14 – Outcome & management indicators ( Outcome and Management Indicators )

APPENDIX 15 – Self-Evaluation & Review ( Self Test )

 

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