Services Institute of Medical Sciences

Dengue Expert Advisory Group

Introduction

Dengue epidemic started in 2011 and then Dengue Expert Advisory Group (DEAG) was formed. It prepared charts, forms, algorithms and management protocols for patients, and in the subsequent years, we were able to control the dengue epidemic by taking drastic steps in the management and training of the doctors. The global burden of dengue and its geographic distribution have increased over the past several decades. The introduction of dengue in new areas has placed it in the list of top ten global threats released by WHO.

Dengue virus (DENV) is responsible for causing dengue fever (DF), which is an acute febrile illness that is often self-limiting. A small percentage of those who contract the infection however, develop the severe forms of the infection which could result in severe intravascular leakage, multiple organ failure and death. In general, most DF patients will enter the recovery phase without progressing through the critical phase, while others during the defervescence phase will progress to the more life-threatening severe dengue hemorrhagic fever and shock syndrome. Therefore, early diagnosis and prompt treatment are vital for successful management of severe DENV infections. With timely intervention, severe dengue mortality rates can be reduced from greater than 20% to less than 1%. Drawing on the experience in managing dengue cases according to DEAG guidelines, this workshop will provide the participants’ perspectives on key clinical lessons to improve dengue-related outcomes.

The challenges faced by healthcare providers in diagnosis of severe dengue i.e. DHF and DSS have never been empirically recognized. There is a need to have a proper training program to properly explain the DEAG developed Forms, Charts and Algorithms to minimize the constraints in diagnosing of severe dengue timely and treating adequately.  During this opportunity, our 2 days long meeting with the national and international experts, we will seek expert views regarding the current issues faced in the diagnosis of severe dengue, future prospects and opportunities in the development of diagnostics and treatment for severe dengue, and treating dengue in special situations like pregnancy and with other comorbidities. The overarching goal is to highlight the critical need for the development of integrated training modules, hands-on trainings and components needed to improve the quality of training for severe dengue and to help strengthen future research initiatives. Group will also identify issues encountered in clinical management in recent dengue epidemic, areas of improvement and way forward for the coming years.

DENGUE GCP GUIDELINES – 2012

These are the first Good Clinical Practice Guidelines published by Dengue Expert Advisory Group (DEAG) for the management of dengue Infection in adults, hence forth going to be referred to as GCP dengue-guidelines-2012. It must be emphasized that these guidelines are only meant to provide broad recommendations for good clinical practice, based on the best evidence available at the time of development of these recommendations – an overall management strategy in a garden variety of dengue patient. As each patient is unique hence adherences to these guidelines will, by no means, guarantee the best outcome in every case. Attending healthcare provider is best suited to make appropriate decisions for his patients, taking ground realities into consideration, regarding implementation / modifications of these “generic” protocols. After all, he is primarily responsible, for the management of his/her “unique patient” based on the clinical picture and the locally available management options.

The authors have issued these GCP guidelines in 2012. It would be reviewed in 2014 or sooner if new evidence becomes available.
DEAG Secretariat
Services Institute of Medical Sciences,
Jail Road, Lahore

Primary Authors:
 

  • Prof. Faisal Masud
  • Dr. Tayyaba Khawar Butt
  • Prof. Mohammad Ali

Development and Review Committee:

In addition to the primary authors the development and review committee for these guidelines consisted of:

  • Prof. Javed Raza Gardezi
  • Prof. Mehmood Ayyaz
  • Prof. Aziz ur Rehman
  • Dr. Sajid Nisar
  • Dr. Saqib Shafi
  • Dr. Tahir Bashir

Special Committees

During the process of development of these guidelines, there was active involvement of the special committees tasked to formulate recommendations for dengue associated with co-morbidities. Following authors contributed text of the manuscript:

  • Prof. Rakhshanda Rehman
    Dengue Fever in Pregnancy
  • Dr. Faisal Sultan and Dr. Syed Hammad Nazeer
    Dengue Fever in Immunocompromised Host

This Section explains different aspects and activities of DEAG (Dengue Expert Advisory Group). Use the links below to View / Download the relevant content of DEAG.

Dengue GCP Guidelines (pdf)

Dengue An Overview (ppt)

Dengue Monitoring (ppt)

Fluid Management in Dengue Hamorrhage (ppt)

Various Case Histories (ppt)

Dengue Reporting Form (pdf)

Dengue Admission Criteria and Standard Operating Procedures (SOP)

Revised Criteria for Diagnosis of Dengue Fever During Epidemic of Dengue fever

Revised Criteria for Diagnosis of Dengue Fever Applicable In Non Epidemic Setting

Radiology Form for DHF

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