Who issue the guideline and tool to control the dengue diagnosis inPakistan. It recommends a ‘simple diagnostic tool’ in the form of Tourniquet test which requires just a simple blood pressure to differentiate between seriously ill and uncomplicated cases of dengue fever. This test has sensitivity of above 80 per cent and specificity of 68 per cent.
There is no need to know a variety of clinical investigations for every patient cause by dengue fever as witnessed at public and private health facilities during the current wave of dengue virus, the new guidelines suggest.
NowPakistanhas been enlisted among other countries of the region for which the WHO has issued country-specified guidelines for health practitioners from both public and private sector to diagnose and treat the dengue patients.
The other countries already following the guidelines owing to dengue virus alerts areSri Lanka,Bangladesh,Maldives,India, Malaysia etc.
Headed by Allama Iqbal Medical College Principal Prof Dr Javed Akram, the core group members who furnished clinical management guidelines include WHO focal person for dengue, Pakistan, Rana Graber Kakar, WHO representative, Islamabad, Dr Zareef Khan, WHO epidemiologist, Pakistan, Dr Moosa Rahim, WHO Operator, Punjab, Dr Babar Alam, WHO representative, Punjab, Majid Latif, Institute of Public Health Dean Dr Yaqoob Qazi, Pakistan Medical Research Council Principal Officer Dr Arif Muneer, AIMC senior pathologist Prof Nosheen Waseem Yusuf and pharmacists.
Prof Javed Akram has termed it a big achievement saying that new guidelines will help minimise burden of patients visiting
the government and private hospitals with dengue virus.
Talking to Dawn, he says in the Tourniquet test a physician will apply the blood pressure cuff on the upper arm of dengue suspected patient and inflate the bulb to 90 millimeter of mercury. The purpose is to apply pressure to see blood spots on forearm of the patient. After a period of five minutes the physician will calculate the number of petechiae in squire inch on the forearm. If in this one inch the number of spots is more than 10 then the patient certainly will require hospitalisation and
further work up.
According to Dr Babar Alam, once circulated widely among the medical community the guidelines will go a long way in standardising the care of dengue patients thereby relieving them of miseries.
At the same time, he says, the overcrowded hospitals can work much more efficiently by differentiating the seriously-ill patients from those without any complications. “WHO has decided to publish more than 10,000 copies of new guidelines and will also hold training meetings throughout the country for doctors and pediatricians dealing with patients suffering from dengue.”
This is the first set of guidelines for this disease forPakistanissued by WHO and once the physicians are trained to use the same the much prevalent confusions in diagnosis and treatment shall subside.
He says the next plan is to identify some three to four master trainers from all the provinces of the country who will impart training to doctors at their respective areas following the WHO new guidelines.