Dengue: Moving from Current Standard of Care to State-of-the-Art Treatment

Gan, Victor C.

doi:10.1007/s40506-014-0025-1

Cited by 25 publications

(19 citation statements)

References 133 publications

(119 reference statements)

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“…Hypoalbuminemia, one parameter of the Dengue Score, has been reported to be a cause of fluid accumulation, and this condition could be used as a surrogate marker for severe plasma leakage [ 22 , 23 ]. Thein et al [ 24 ] reported that a combination of three variables, i.e., hemoconcentration, rapid decrease in platelet count, and fluid accumulation, had high specificity for predicting severe dengue.…”

Section: Discussionmentioning

confidence: 99%

Dengue score as a diagnostic predictor for pleural effusion and/or ascites: external validation and clinical application

Suwarto

Hidayat²,

Widjaya³

2018

BMC Infect Dis

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BackgroundThe Dengue Score is a model for predicting pleural effusion and/or ascites and uses the hematocrit (Hct), albumin concentration, platelet count and aspartate aminotransferase (AST) ratio as independent variables. As this metric has not been validated, we conducted a study to validate the Dengue Score and assess its clinical application.MethodsA retrospective study was performed at a private hospital in Jakarta, Indonesia. Patients with dengue infection hospitalized from January 2011 through March 2016 were included. The Dengue Score was calculated using four parameters: Hct increase≥15.1%, serum albumin≤3.49 mg/dL, platelet count≤49,500/μL and AST ratio ≥ 2.51. Each parameter was scored as 1 if present and 0 if absent. To validate the Dengue Score, goodness-of-fit was used to assess calibration, and the area under the receiver operating characteristic curve (AROC) was used to assess discrimination. Associations between clinical parameters and Dengue Score groups were determined by bivariate analysis.ResultsA total of 207 patients were included in this study. The calibration of the Dengue Score was acceptable (Hosmer-Lemeshow test, p = 0.11), and the score’s discriminative ability was good (AROC = 0.88 (95% CI: 0.83–0.92)). At a cutoff of ≥2, the Dengue Score had a positive predictive value (PPV) of 79.03% and a negative predictive value (NPV) of 90.36% for the diagnostic prediction of pleural effusion and/or ascites. Compared with the Dengue Score ≤ 1 group, the Dengue Score = 2 group was significantly associated with hemoconcentration> 20% (p = 0.029), severe thrombocytopenia (p = 0.029), and increased length of hospital stay (p = 0.003). Compared with the Dengue Score = 2 group, the Dengue Score ≥ 3 group was significantly associated with hemoconcentration> 20% (p = 0.001), severe thrombocytopenia (p = 0.024), severe dengue (p = 0.039), and increased length of hospital stay (p = 0.011).ConclusionThe Dengue Score performed well and can be used in daily practice to help clinicians identify patients who have plasma leakage associated with severe dengue.

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Section: Discussionmentioning

confidence: 99%

Dengue score as a diagnostic predictor for pleural effusion and/or ascites: external validation and clinical application

Suwarto

Hidayat²,

Widjaya³

2018

BMC Infect Dis

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“…Based on these signs and symptoms, health providers need to correctly assess, diagnose, and treat dengue to decrease the length of stay and complications [16] because the death rate of dengue patients is 30% [14]. A study showed the necessity of appropriate health provider treatment and/or evidence-based management guidelines [19]. Then, the area needs to develop the appropriate DCPG.…”

Section: Introductionmentioning

confidence: 99%

Dengue Clinical Practice Guideline from Household to Hospital: A Case Study of Development and Evaluation in Southern Thailand

Suwanbamrung¹,

Le²,

Maneerattanasak³

et al. 2020

Preprint

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Background Dengue is an important health problem in southern Thailand. However, the area has a surveillance-only prevention system, and there are no continuing guidelines for dengue treatment from households to primary care units (PCUs) or district hospitals. The objectives were to develop and evaluate the dengue clinical practice guideline (DCPG) from household to hospital. Methods The study design used community participatory action research that integrated the IOWA model in 44 villages in the Lansaka district of southern Thailand. The DCPG was developed and tested with 26 health providers in five steps: 1) community preparation, 2) development of the guidelines, 3) use and monitoring, 4) evaluation and conclusion, and 5) referring technology. The questionnaires for evaluating opinion, knowledge, and practice contained 84 items. The content validity was verified by three experts (CVI= 0.80), and reliability was verified by 30 participants (Cronbach’s alpha = 0.90). The Wilcoxon signed rank test was used to compare the situation before and after the use of DCPG, and guidelines were developed with accompanying diagrams. Results Two results were found: 1) DCPG consisted of four steps: guidelines at households, primary care units, outpatient departments and emergency rooms, and inpatient departments in hospitals. A total of 39 dengue patients were divided into 20 cases admitted for IPD; observation at home, 18 cases; and one patient referred to province hospital; with no deaths during the study period. 2) The 26 health providers from the PCUs and hospital increased their knowledge, and attitude increase was not significantly different ( P>0.05 ). The 5 components of practice increased significantly ( P<0.05 ), but the practice of only taking intravascular fluid was not significantly different ( P>0.05 ). Conclusion DCPG was an appropriate dengue solution from household to hospital. However, all stakeholders need to participate, integrate, and coordinate for continued use, monitoring and evaluation.

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“…Currently, there is no effective treatment for DENV infections. The first DENV vaccine was recently licensed for use after several decades of efforts, unfortunately, it confers only partial protection to all DENV serotypes (Gan, 2014 ; Thisyakorn and Thisyakorn, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

DEAD-Box Helicase DDX25 Is a Negative Regulator of Type I Interferon Pathway and Facilitates RNA Virus Infection

Feng

Sun

et al. 2017

Front. Cell. Infect. Microbiol.

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Dengue is a mosquito-borne viral disease that rapidly spread in tropic and subtropic area in recent years. DEAD (Glu-Asp-Ala-Glu)-box RNA helicases have been reported to play important roles in viral infection, either as cytosolic sensors of viral nucleic acids or as essential host factors for the replication of different viruses. In this study, we reported that DDX25, a DEAD-box RNA helicase, plays a proviral role in DENV infection. The expression levels of DDX25 mRNA and protein were upregulated in DENV infected cells. During DENV infection, the intracellular viral loads were significantly lower in DDX25 silenced cells and higher in DDX25 overexpressed cells. Meanwhile, the expression level of type I interferon (IFN) was increased in DDX25 siRNA treated cells during viral infection. Consistent with the in vitro findings, the Ddx25-transgenic mice have an increased susceptibility to lethal vesicular stomatitis virus (VSV) virus challenge. The viremia was significantly higher while the anti-viral cytokine levels were lower in Ddx25-transgenic mice. Further, DDX25 modulated RIG-I signaling pathway and blocked IFNβ production, by interrupting IFN regulatory factor 3 (IRF3) and NFκB activation. Thus, DDX25 is a novel negative regulator of IFN pathway and facilitates RNA virus infection.

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Dengue: Moving from Current Standard of Care to State-of-the-Art Treatment

Cited by 25 publications

References 133 publications

Dengue score as a diagnostic predictor for pleural effusion and/or ascites: external validation and clinical application

Dengue score as a diagnostic predictor for pleural effusion and/or ascites: external validation and clinical application

Dengue Clinical Practice Guideline from Household to Hospital: A Case Study of Development and Evaluation in Southern Thailand

DEAD-Box Helicase DDX25 Is a Negative Regulator of Type I Interferon Pathway and Facilitates RNA Virus Infection

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