Universität zu Köln

Petzold, Stephanie, Rosenberger, Kerstin D., Wills, Bridget, Deen, Jacqueline, Weber, Martin W. and Jaenisch, Thomas (2022). Dengue algorithms integrated into the IMCI guidelines: An updated assessment in five Southeast-Asian countries. Plos Neglect. Trop. Dis., 16 (10). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1935-2735

Full text not available from this repository.

Abstract

Background Dengue is not included explicitly in the WHO Integrated Management of Childhood Illness (IMCI) algorithm. However, the assessment, classification and management of dengue has been incorporated into several IMCI country adaptations. We aimed to evaluate the dengue algorithms incorporated into IMCI guidelines and discuss the need for harmonization, including an extension of the age range for IMCI. Methods This study included three steps. First, we investigated dengue algorithms incorporated into five Southeast-Asian (Myanmar, Philippines, Vietnam, Indonesia, Cambodia) country IMCI guidelines through a desk-based analysis. Second, we conducted an expert survey to elicit opinions regarding the integration of dengue and extension of the age range in IMCI. Third, we compared our findings with data from a large multicentric prospective study on acute febrile illness. Results We found considerable heterogeneity between the country specific IMCI guidelines in the dengue algorithms as well as classification schemes. Most guidelines did not differentiate between diagnostic algorithms for the detection of dengue versus other febrile illness, and warning signs for progression to severe dengue. Our expert survey resulted in a consensus to further integrate dengue in IMCI and extend the age range for IMCI guidelines beyond 5 years of age. Most of the interviewees responded that their country had a stand-alone clinical guideline for dengue, which was not integrated into the IMCI approach and considered laboratory testing for dengue necessary on day three of consecutive fever. Using data from a large multicentric study of children 5-15 years of age, we could confirm that the likelihood of dengue increased with consecutive fever days. However, a significant proportion of children (36%) would be missed if laboratory testing was only offered on the third consecutive day of fever. Conclusions This study supports the extension of the IMCI age range beyond 5 years of age as well as the inclusion of dengue relevant content in the algorithm. Because of the challenge of distinguishing dengue from other febrile illnesses, simple laboratory testing (e.g., full blood count) should be offered at an early stage during the course of the illness. Testing only children with consecutive fever over 3 days may lead to an underdiagnosis of dengue among those with acute febrile illness in children 5-15 years of age. In addition, specific laboratory testing for dengue should be made available to peripheral health facilities.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Petzold, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenberger, Kerstin D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wills, Bridget UNSPECIFIED UNSPECIFIED UNSPECIFIED Deen, Jacqueline UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Martin W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jaenisch, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-686444
DOI:	10.1371/journal.pntd.0010832
Journal or Publication Title:	Plos Neglect. Trop. Dis.
Volume:	16
Number:	10
Date:	2022
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1935-2735
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEMORRHAGIC-FEVER; SHOCK SYNDROME; RISK-FACTORS; CHILDREN; CLASSIFICATION; INFECTIONS; MANAGEMENT; DIAGNOSIS; SEVERITY; THAILAND Multiple languages Infectious Diseases; Parasitology; Tropical Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68644