scholarly journals Direct costs of managing in-ward dengue patients in Sri Lanka: A prospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258388
Author(s):  
Chathurani Sigera ◽  
Chaturaka Rodrigo ◽  
Nipun L. de Silva ◽  
Praveen Weeratunga ◽  
Deepika Fernando ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Dengue Fever ◽  
Dengue Infection ◽  
Cost Savings ◽  
Direct Costs ◽  
Healthcare Management ◽  
Budget Planning ◽  
Hospitalised Patients ◽  
Cost Efficient ◽  
A Prospective Study

Introduction The cost in managing hospitalised dengue patients varies across countries depending on access to healthcare, management guidelines, and state sponsored subsidies. For health budget planning, locally relevant, accurate costing data from prospective studies, is essential. Objective To characterise the direct costs of managing hospitalised patients with suspected dengue infection in Sri Lanka. Methods Colombo Dengue Study is a prospective single centre cohort study in Sri Lanka recruiting suspected hospitalised dengue fever patients in the first three days of fever and following them up until discharge. The diagnosis of dengue is retrospectively confirmed and the cohort therefore has a group of non-dengue fever patients with a phenotypically similar illness, managed as dengue while in hospital. The direct costs of hospital admission (base and investigation costs, excluding medication) were calculated for all recruited patients and compared between dengue and non-dengue categories as well as across subgroups (demographic, clinical or temporal) within each of these categories. We also explored if excluding dengue upfront, would lead to an overall cost saving in several hypothetical scenarios. Results From October 2017 to February 2020, 431 adult dengue patients and 256 non-dengue fever patients were recruited. The hospitalisation costs were USD 18.02 (SD: 4.42) and USD 17.55 (SD: 4.09) per patient per day for dengue and non-dengue patients respectively (p>0.05). Laboratory investigations (haematological, biochemical and imaging) accounted for more than 50% of the total cost. The costs were largely homogenous in all subgroups within or across dengue and non-dengue categories. Excluding dengue upfront by subsidised viral genomic testing may yield overall cost savings for non-dengue patients. Conclusion As non-dengue patients incur a similar cost per day as the dengue patients, confirming dengue diagnosis using subsidised tests for patients presenting in the first three days of fever may be cost-efficient.

scholarly journals A study of various hepatic manifestations in dengue fever and their correlation with severity of dengue fever

2020 ◽  
Vol 7 (3) ◽  
pp. 527
Author(s):  
Shravya Dhanwada ◽  
Samba Siva Reddy R.
Keyword(s):  
Dengue Fever ◽  
Complete Blood Count ◽  
Dengue Infection ◽  
Liver Function Tests ◽  
Warning Signs ◽  
Severe Dengue ◽  
Serum Total Bilirubin ◽  
Hepatic Involvement ◽  
Elevated Liver Enzymes ◽  
A Prospective Study

Background: Hepatic involvement in Dengue is known with protean of manifestations ranging from hepatomegaly, elevated liver enzymes to fulminant hepatic failure. Aim of the study was to study the hepatic manifestations in children with dengue illness.Methods: This is a prospective Study with 60 Patients hospitalized with Dengue infection (Seropositive for Dengue). Dengue Seropositive patients are selected and examined for Hepatomegaly and Jaundice and subjected to complete blood count and Liver function tests were analysed.Results: Of 60 serologically confirmed cases hospitalized with dengue, were classified into (i)(DF), (ii) DHF I (iii) DHF II (iv) DHF III and (v) DHF IV.  In our study, upon 60 seropositive cases were reported at our hospital during the study period of which 18 were DF, 12 were DHF I, 15 were DHFII, 8 were DHF III and 7 were DHF IV respectively. The Hematocrit levels were raised 20% from the baseline in four classes of Dengue and not raised in DF. Most commonly occurred in age group of 5-7 years. Hepatomegaly was the commonest clinical sign seen. Thrombocytopenia was seen in 88% of all cases. Serum total bilirubin was raised in 10% of subjects with severe dengue infection in DHF III and DHF IV. Serum SGOT and SGPT was raised in 63.3% and 56.7% of patients with dengue of all classes including DF respectively. Thrombocytopenia occurred in 75% of patients with dengue fever, 98% with warning signs and 100% in severe dengue.Conclusions: In developing country like India, incidence of dengue outbreaks is increasing. Hepatic involvement of varying degrees have been reported. As hepatic dysfunction in dengue is transient and reversible, early identification of the same would help to reduce life threatening complications. The role of hepato protective drugs in reducing morbidity and mortality should be analysed by further studies. 

scholarly journals Role of Pro-inflammatory IL-8 and Anti-inflammatory IL-10 Cytokines in Dengue Severity

2021 ◽  
Vol 53 (02) ◽  
pp. 69-75
Author(s):  
Mukesh Sharma ◽  
Keyword(s):  
Dengue Fever ◽  
Severe Disease ◽  
Dengue Infection ◽  
Fatal Outcome ◽  
Inflammatory Cells ◽  
Severe Dengue ◽  
Healthy Controls ◽  
Cytokine Levels ◽  
Ns1 Antigen ◽  
A Prospective Study

Introduction: During dengue infection, cytokine levels may increase as various cytokines are released from infected inflammatory cells. This study was conducted to measure the levels of cytokines IL-8 and IL-10 in dengue patients and correlate them with dengue severity. Material & Methods: A prospective study was conducted on febrile patients suspected of dengue fever, seeking medical care in our institute. 107 cases confirmed to have dengue fever (by NS1/ IgM ELISA) and 100 healthy individuals with age and sex matched, were included in the study. The clinical features of all patients were recorded, and cytokine levels of IL-8 and IL-10 were estimated by ELISA in the dengue patients and healthy controls. Results: Out of 400 febrile patients suspected of having dengue fever, 107 (26.75%) cases were confirmed cases, of which 56 (52.3%), 20 (18.7%), and 31 (29%) were positive for only NS1 antigen, only IgM antibody, and both NS1 and IgM, respectively. Depending on the severity of the disease, 9 (8.5%) cases were classified as severe dengue cases while 98 (91.5%) as non-severe dengue fever. Mean levels (pg/ml) for IL-8 were 281.6 ± 76.6, 150.41 ± 55.9 and 75.4 ± 49.2 in severe dengue, dengue fever, and healthy controls respectively while for IL-10, the values were 219.4 ± 150.5, 38.9 ± 67.2, and 6.6 ± 0.65 among severe dengue cases, dengue cases, and healthy controls, respectively. Conclusion: Mean level of cytokines IL-8 and IL-10 were significantly raised in severe dengue patients as compared to non-severe dengue patients and healthy controls, suggesting their role in causing severe disease and as a potential predictor for disease severity and fatal outcome.

scholarly journals 1405. Clinical and laboratory features of fatal dengue fever in children: a case-control study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S710-S711
Author(s):  
Dolores E Freire ◽  
Jeniffer D Olaya ◽  
Michael Hawkes
Keyword(s):  
Dengue Fever ◽  
Case Control Study ◽  
Dengue Infection ◽  
Healthcare Providers ◽  
Case Control ◽  
Warning Signs ◽  
Total Leukocyte Count ◽  
Retrospective Case ◽  
Time To Death ◽  
Control Study

Abstract Background Dengue fever (DF) is a mosquito-borne illness that causes significant morbidity and mortality in tropical climates. This study compared the clinical features of fatal DF cases to severe non-fatal, and non-severe controls in Ecuador. Methods Retrospective case-control study of children (1 month to 15 years) hospitalized with serologically-confirmed DF in Guayaquil, Ecuador from 2013 to 2017. Cases of severe, fatal (SF) DF were compared to two control groups: (1) severe DF survivors (SS); and (2) patients with dengue with warning signs (DWS), matched 3:1 to cases for age, sex, and admission date. Observational trial profile Results 1051 patients were admitted with suspected DF and 552 were IgM-positive. Patients were classified as SF (n=11), SS (n=30), or DWS (n=511) (Figure1). Among SF cases, median age was 9.6 years (IQR 5.5-11), 7 (64%) were male, and median time to death was 1.5 days (IQR 0.8-4.0). (Table 1) SF cases had a median of 3 (Range 0-5) encounters with healthcare providers prior to presentation, compared to 2 (Range 0-5, p=0.02) for SS and 2 (Range 0-3, p=0.02) for DWS. Physical findings more common in SF cases than controls included: higher weight, tachycardia, tachypnea, delayed capillary refill, and hepatomegaly (p< 0.05 for all comparisons). Neurological manifestations were more prevalent in the SF group: 9/11 (82%) patients compared to 15/30 (50%, p=0.09) in SS and 7/33 (21%, p< 0.01) in DWS. Total leukocyte count (7.8x103/µL versus 4.5x103/µL, p=0.03) and absolute neutrophil count (5.1x103/µL versus 2.1x103/µL, p=0.03) were higher in SF cases than DWS controls. Fewer SF patients received intravenous dextrose than SS controls (27% versus 70%, p=0.03) (Table 2). Admission characteristics of children with dengue fever Management and outcome Conclusion Delayed recognition by healthcare workers, higher weight, vital sign abnormalities, hepatomegaly, neurological symptoms, leukocytosis, neutrophilia, and lack of dextrose in intravenous solutions were associated with mortality in children with DF. These findings have implications for optimizing the diagnosis and management of severe pediatric dengue infection. Disclosures All Authors: No reported disclosures

scholarly journals Multi-Tissue Transcriptomic-Informed In Silico Investigation of Drugs for the Treatment of Dengue Fever Disease

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1540
Author(s):  
Beatriz Sierra ◽  
Ana Cristina Magalhães ◽  
Daniel Soares ◽  
Bruno Cavadas ◽  
Ana B. Perez ◽  
...  
Keyword(s):  
Receptor Antagonist ◽  
Dengue Fever ◽  
In Silico ◽  
Serotonin Receptor ◽  
Neglected Tropical Diseases ◽  
Dengue Infection ◽  
Severe Dengue ◽  
Functional Evaluation ◽  
Atpase Inhibitor ◽  
Serotonin Receptor Antagonist

Transcriptomics, proteomics and pathogen-host interactomics data are being explored for the in silico–informed selection of drugs, prior to their functional evaluation. The effectiveness of this kind of strategy has been put to the test in the current COVID-19 pandemic, and it has been paying off, leading to a few drugs being rapidly repurposed as treatment against SARS-CoV-2 infection. Several neglected tropical diseases, for which treatment remains unavailable, would benefit from informed in silico investigations of drugs, as performed in this work for Dengue fever disease. We analyzed transcriptomic data in the key tissues of liver, spleen and blood profiles and verified that despite transcriptomic differences due to tissue specialization, the common mechanisms of action, “Adrenergic receptor antagonist”, “ATPase inhibitor”, “NF-kB pathway inhibitor” and “Serotonin receptor antagonist”, were identified as druggable (e.g., oxprenolol, digoxin, auranofin and palonosetron, respectively) to oppose the effects of severe Dengue infection in these tissues. These are good candidates for future functional evaluation and clinical trials.

scholarly journals Infectious Disease Relational Data Analysis Using String Grammar Non-Euclidean Relational Fuzzy C-Means

2021 ◽  
Vol 18 (15) ◽  
pp. 8153
Author(s):  
Apiwat Budwong ◽  
Sansanee Auephanwiriyakul ◽  
Nipon Theera-Umpon
Keyword(s):  
High Risk ◽  
Dengue Fever ◽  
Policy Development ◽  
Dengue Infection ◽  
Prevention Policy ◽  
Fuzzy C Means ◽  
North East ◽  
B Virus ◽  
North And South ◽  
Better Than

Statistical analysis in infectious diseases is becoming more important, especially in prevention policy development. To achieve that, the epidemiology, a study of the relationship between the occurrence and who/when/where, is needed. In this paper, we develop the string grammar non-Euclidean relational fuzzy C-means (sgNERF-CM) algorithm to determine a relationship inside the data from the age, career, and month viewpoint for all provinces in Thailand for the dengue fever, influenza, and Hepatitis B virus (HBV) infection. The Dunn’s index is used to select the best models because of its ability to identify the compact and well-separated clusters. We compare the results of the sgNERF-CM algorithm with the string grammar relational hard C-means (sgRHCM) algorithm. In addition, their numerical counterparts, i.e., relational hard C-means (RHCM) and non-Euclidean relational fuzzy C-means (NERF-CM) algorithms are also applied in the comparison. We found that the sgNERF-CM algorithm is far better than the numerical counterparts and better than the sgRHCM algorithm in most cases. From the results, we found that the month-based dataset does not help in relationship-finding since the diseases tend to happen all year round. People from different age ranges in different regions in Thailand have different numbers of dengue fever infections. The occupations that have a higher chance to have dengue fever are student and teacher groups from the central, north-east, north, and south regions. Additionally, students in all regions, except the central region, have a high risk of dengue infection. For the influenza dataset, we found that a group of people with the age of more than 1 year to 64 years old has higher number of influenza infections in every province. Most occupations in all regions have a higher risk of infecting the influenza. For the HBV dataset, people in all regions with an age between 10 to 65 years old have a high risk in infecting the disease. In addition, only farmer and general contractor groups in all regions have high chance of infecting HBV as well.

scholarly journals The financial impact of improved hand hygiene on healthcare-associated infections in the UK

2020 ◽  
pp. 117-122
Author(s):  
Katie-Rose Cawthorne Cawthorne ◽  
Jason Dean ◽  
Richard PD Cooke
Keyword(s):  
Hand Hygiene ◽  
Financial Analysis ◽  
Cost Savings ◽  
Direct Costs ◽  
Healthcare Associated Infections ◽  
Financial Assessment ◽  
Paediatric Hospital ◽  
The Uk ◽  
Healthcare Associated ◽  
The Impact

Background: Though high hand hygiene (HH) levels significantly reduce the risk of healthcare-associated infections (HCAIs), the current cost of HCAIs and the impact of optimal HH practices on HCAIs are poorly defined. The last NHS England financial assessment was in 2009. Methods: The number of HCAIs per bed per year for NHS England were calculated and average costs were attributed using data from three sources; National Audit Office report, a commercially available calculator, and a financial analysis by a specialist paediatric hospital in England. Improved HH compliance for NHS England was based on a sustained rise in compliance rates from 50 to 80% combined with an HCAI reduction of at least 20%. The cost savings based on such improvements were then calculated. Results: In 2020, it is estimated that the number of HCAIs per bed per year ranges from 3.0 to 9.3, with a midpoint of 5.1. The direct costs of HCAI to NHS England were found to lie between £1.6 and £5 billion. Based on a 20% reduction in HCAI rates, this could lead to cost savings of between £322 million and £1 billion per year. Conclusion: Current direct costs of HCAIs consume approximately 1.3% to 4.1% of NHS England’s annual budget. Improving HH compliance among healthcare workers can lead to significant cost savings. There appears to be a strong financial argument for investment into innovative HH compliance technologies that have been historically perceived as too expensive.

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