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(Sardjito Hospital & Depok I Health Center). DENGUE VALIDATION STUDY Country site :INDONESIA. Banguntapan. BANTUL. Kasihan. BANTUL. BANTUL. (Sewon HC). Sewon. BANTUL. Population and Dengue Incidence by Proposed Study Location. ACTIVITY. Participant s. Study elements.
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(Sardjito Hospital & Depok I Health Center) DENGUE VALIDATION STUDYCountry site :INDONESIA Banguntapan BANTUL Kasihan BANTUL BANTUL (Sewon HC) Sewon BANTUL
Study elements • Retrospective chart review • Questionnaires • Focus Group Discussions
Materialsused POSTER ALGORITHM CLINICAL GUIDE
Results Chart Review: former classification vs revised classification
Strengths of revised classification Simple and easy to use Safer for patients Useful for triage of patients Promotes early diagnosis and management Weaknesses of revised classification Too qualitative → no quantitative thresholds Can lead to overdiagnosis → excess hospital admission Not yet in line with existing systems (e.g. ICD, clinical audit, payment schemes) FGD (1)
FGD (2) • Strengths of revised algorithm • More aggressive in management of dengue with warning signs → shorter hospital stay • Patient education messages very useful • Weaknesses of revised algorithm • Too conservative for shock management • Too risky for patient outcome • Too risky for hospital in legal aspect
General recommendations • Reconsider adoption of quantitative parameters • Reconsider guidance for shock management • Facilitate implementation • Stronger involvement of professional associations • Strengthened training design (e.g. interactive CD-ROM) • Synchronization with ICD, billing system and clinical audits