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Comparison and critical appraisal of dengue clinical guidelines and their use in Asia and Latin America

Santamaria, R., Martinez, E., Kratochwill, S., Soria, C., Tan, L.H., Nuñez, A., Dimaano, E., Villegas, E., Bendezú, H., Kroeger, Axel, Castelobranco, I., Siqueira, J.B., Jaenisch, T., Horstick, O. and Lum, L.C.S. (2009) 'Comparison and critical appraisal of dengue clinical guidelines and their use in Asia and Latin America'. International health, Vol 1, Issue 2, pp. 133-140.

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Summary The World Health Organization (WHO) dengue classification scheme for dengue
fever (DF) and dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS) has been
adopted as the standard for diagnosis, clinical management and reporting. In recent years,
difficulties in applying the WHO case classification have been reported in several countries.
A multicenter study was carried out in Asia and Latin America to analyze the variation and
utility of dengue clinical guidelines (DCGs) taking as reference the WHO/PAHO guidelines
(1994) and the WHO/SEARO guidelines (1998). A document analysis of 13 dengue guidelines
was followed by a questionnaire and Focus Group discussions (FGDs) with 858 health care
providers in seven countries. Differences in DCGs of the 13 countries were identified including the concept of warning signs, case classification, use of treatment algorithms and grading into
levels of severity. The questionnaires and FGDs revealed (1) inaccessibility of DCGs, (2) lack of
training, (3) insufficient number of staff to correctly apply the DCGs at the frontline and (4)
the unavailability of diagnostic tests. The differences of the DCGs and the inconsistency in their
application suggest a need to re-evaluate and standardise DCGs. This applies especially to case
classification and case management.

Item Type: Article
Corporate Authors: DENCO Study Group
Subjects: WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WC Communicable Diseases > Virus Diseases > Infectious Mononucleosis. Arbovirus Infections > WC 528 Dengue
Digital Object Identifer (DOI):
Depositing User: Rachel Dominguez
Date Deposited: 26 Mar 2013 14:13
Last Modified: 24 Jan 2022 15:17


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