Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved]
Background: Complications in dengue usually occur between day four and day six after fever onset. Hence, early diagnosis and haematological monitoring are vital. Among all hospital reported dengue deaths in Myanmar in 2017-18, we assessed the i) patient profile, ii) proportion of patients who arrive...
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| Format: | Article |
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F1000 Research Ltd
2020-06-01
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| Online Access: | https://f1000research.com/articles/9-579/v1 |
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| author | Nwe Ni Linn Khine Wut Yee Kyaw Hemant Deepak Shewade Aye Mon Mon Kyaw Myat Min Tun San Kyawt Khine Nay Yi Yi Linn Aung Thi Zaw Lin |
| author_facet | Nwe Ni Linn Khine Wut Yee Kyaw Hemant Deepak Shewade Aye Mon Mon Kyaw Myat Min Tun San Kyawt Khine Nay Yi Yi Linn Aung Thi Zaw Lin |
| author_sort | Nwe Ni Linn |
| collection | DOAJ |
| description | Background: Complications in dengue usually occur between day four and day six after fever onset. Hence, early diagnosis and haematological monitoring are vital. Among all hospital reported dengue deaths in Myanmar in 2017-18, we assessed the i) patient profile, ii) proportion of patients who arrived with a dengue diagnosis at admission and iii) delays in diagnosis after fever onset. Methods: This was a descriptive study involving secondary data. For all the notified deaths, death investigation forms were not available in prescribed format and therefore, data were extracted from hospital case records. Results: Of 304 deaths, 184 (60.5%) were female and 233 (76.6%) were less than 10 years old. Township level hospitals or below reported 36 deaths (11.8%) and the remaining deaths were from higher level facilities. Dengue was diagnosed before admission in 26 (8.5%) people and 169 (55.6%) were in shock at admission. Of 208 with date of fever onset recorded, the median diagnosis delay was four (interquartile range-IQR: 3, 5) days. Patient level delay (median three days) was a major contributor to the diagnosis delay. Conclusions: Most of the patients who died did not have a diagnosis of dengue before admission. This calls for an urgent review of health system preparedness in peripheral health facilities to suspect, diagnose, monitor, refer and treat dengue in children and patient level factors for better understanding of the reasons of delay. Timely filling of death investigation forms in a prescribed format and quarterly death reviews based on these is recommended. |
| first_indexed | 2024-12-21T10:48:59Z |
| format | Article |
| id | doaj.art-05984b69b9f04a45a924b93ed9016a3a |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-12-21T10:48:59Z |
| publishDate | 2020-06-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-05984b69b9f04a45a924b93ed9016a3a2022-12-21T19:06:43ZengF1000 Research LtdF1000Research2046-14022020-06-01910.12688/f1000research.23699.126148Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved]Nwe Ni Linn0Khine Wut Yee Kyaw1Hemant Deepak Shewade2Aye Mon Mon Kyaw3Myat Min Tun4San Kyawt Khine5Nay Yi Yi Linn6Aung Thi7Zaw Lin8Vector Borne Disease Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarDepartment of Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, MyanmarCenter for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, FranceVector Borne Disease Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarVector Borne Disease Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarVector Borne Disease Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarVector Borne Disease Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarVector Borne Disease Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarVector Borne Disease Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarBackground: Complications in dengue usually occur between day four and day six after fever onset. Hence, early diagnosis and haematological monitoring are vital. Among all hospital reported dengue deaths in Myanmar in 2017-18, we assessed the i) patient profile, ii) proportion of patients who arrived with a dengue diagnosis at admission and iii) delays in diagnosis after fever onset. Methods: This was a descriptive study involving secondary data. For all the notified deaths, death investigation forms were not available in prescribed format and therefore, data were extracted from hospital case records. Results: Of 304 deaths, 184 (60.5%) were female and 233 (76.6%) were less than 10 years old. Township level hospitals or below reported 36 deaths (11.8%) and the remaining deaths were from higher level facilities. Dengue was diagnosed before admission in 26 (8.5%) people and 169 (55.6%) were in shock at admission. Of 208 with date of fever onset recorded, the median diagnosis delay was four (interquartile range-IQR: 3, 5) days. Patient level delay (median three days) was a major contributor to the diagnosis delay. Conclusions: Most of the patients who died did not have a diagnosis of dengue before admission. This calls for an urgent review of health system preparedness in peripheral health facilities to suspect, diagnose, monitor, refer and treat dengue in children and patient level factors for better understanding of the reasons of delay. Timely filling of death investigation forms in a prescribed format and quarterly death reviews based on these is recommended.https://f1000research.com/articles/9-579/v1 |
| spellingShingle | Nwe Ni Linn Khine Wut Yee Kyaw Hemant Deepak Shewade Aye Mon Mon Kyaw Myat Min Tun San Kyawt Khine Nay Yi Yi Linn Aung Thi Zaw Lin Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved] F1000Research |
| title | Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved] |
| title_full | Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved] |
| title_fullStr | Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved] |
| title_full_unstemmed | Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved] |
| title_short | Notified dengue deaths in Myanmar (2017-18): profile and diagnosis delays [version 1; peer review: 2 approved] |
| title_sort | notified dengue deaths in myanmar 2017 18 profile and diagnosis delays version 1 peer review 2 approved |
| url | https://f1000research.com/articles/9-579/v1 |
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