Materiały źródłowe

• #1 Predicting outcome from dengue | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0147-9

  Dengue is emerging as one of the most abundant vector-borne disease globally. […] These severe manifestations, including a unique plasma leakage syndrome, a coagulopathy sometimes accompanied by bleeding, and organ impairment, occur relatively late in the disease course, presenting a window of opportunity to identify the group of patients likely to progress to these complications. […] However, as yet, differentiating this group from the thousands of milder cases seen each day during outbreaks remains challenging, and simple and inexpensive strategies are urgently needed in order to improve case management and to facilitate appropriate use of limited resources. […] This review will cover the current understanding of the risk factors associated with poor outcome in dengue. […] The ability to identify patients at high risk of progression, who are likely to benefit from close observation and early intervention with supportive therapy, has become the focus of intense research efforts in recent years.

• #2 Risk and predictive factors for severe dengue infection: A systematic review and meta-analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267186

  Dengue is a major public health issue worldwide and severe dengue (SD) is life threatening. It is critical to triage patients with dengue infection in the early stage. However, there is limited knowledge on early indicators of SD. The objective of this study is to identify risk factors for the prognosis of SD and try to find out some potential predictive factors for SD from dengue fever (DF) in the early of infection. […] Practical factors and biomarkers for the identification of SD were established, which will be helpful for a prompt diagnosis and early effective treatment for those at greatest risk. These outcomes also enhance our knowledge of the clinical manifestations and pathogenesis of SD. […] To help clinicians evaluate the likelihood of severe disease, risk factors for SD have been reported, such as secondary infection, gastrointestinal pain, vomiting, diarrhea, intravascular leakage and bleeding.

• #3 Dengue: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215840-overview

  Dengue fever typically is a self-limiting disease with a mortality rate of less than 1%. […] When treated, dengue hemorrhagic fever has a mortality rate of 2-5%. […] When left untreated, dengue hemorrhagic fever has a mortality rate as high as 50%. […] The fatality rate associated with severe dengue varies by country, from 12-44%. […] In a 1997 Cuban epidemic, the fatality rate in patients who met criteria for severe dengue was approximately 6%. […] The mortality rate associated with dengue fever is less than 1%. […] Data from the 1997 Cuban epidemic suggest that, for every clinically apparent case of dengue fever, 13.9 cases of dengue infection went unrecognized because of absent or minimal symptoms. […] A 2005 review from Singapore of 14,209 patients found that useful predictors of death included the following: atypical presentations, significant comorbid illness, abnormal serum markers (including albumin and coagulation studies), secondary bacterial infections.

• #4 Risk and predictive factors for severe dengue infection: A systematic review and meta-analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267186

  It has been reported that the DSS mortality is 50 times higher than that of DF, and SD has been a leading cause of serious illness and death among children in some Asian and Latin American countries. […] Hence, the early prediction and recognition of severe cases are critical for dengue disease management. […] A total of 34 factors were found to be significantly different between DF and SD, age, diabetes history, secondary infection, seroDENV-2/3, bleeding, vomiting, ascites, pleural effusion, lethargy and petechiae, were positive associated with SD; HCT, ALT, AST, CK, BUN, LDH, IL-10, IL-8, sVCAM-1, and IP-10 were increasing but total protein, albumin and PLT were decreasing in level during SD. […] A list of 34 potential severity markers was investigated in this study; and nine factors, secondary infection, retro orbital pain, hepatomegaly, bleeding, pleural effusion, ascites, increased HCT, and AST, decreased PLT revealed positive relation with SD in early stage (7 days after onset). Hence, this study provides information regarding markers that can be used to identify SD in the early stage, facilitating prompt disease management.

• #5 Predicting outcome from dengue | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0147-9

  The new classification also encompasses a set of `warning signs intended to help clinicians identify patients likely to develop complications during the critical phase of the illness. […] This review will focus on the current knowledge of factors associated with disease progression, either considered in terms of DHF/DSS or dengue with warning signs/severe dengue. […] Epidemiological studies have identified a number of risk factors for more severe dengue disease, including secondary infection, the two extremes of age, pregnancy, under-nutrition and over-nutrition, and the presence of comorbidities such as diabetes and hypertension in adults. […] Several groups have attempted to identify the clinical symptoms and signs occurring during the acute illness that are associated with outcome.

• #6 Dengue: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215840-overview

  Factors that affect disease severity include the following: patient age, pregnancy, nutritional status, ethnicity, sequence of infection with different dengue serotypes, virus genotype, quality and extent of available medical care. […] In 20-30% of dengue hemorrhagic fever cases, the patient develops shock, known as the dengue shock syndrome. […] Worldwide, children younger than 15 years constitute 90% of dengue hemorrhagic fever patients; however, in the Americas, dengue hemorrhagic fever occurs in both adults and children.

• #7 Development of a bedside score to predict dengue severity | medRxiv

  https://www.medrxiv.org/content/10.1101/2020.11.25.20238972v1.full-text

  In 2017, New Caledonia experienced an outbreak of severe dengue causing high hospital burden (4,379 cases, 416 hospital admissions, 15 deaths). […] We built robust and efficient models to calculate a bedside score able to predict dengue severity in our setting. […] Identifying risk factors for severe dengue is of prime importance to improve patients medical care and better manage in-hospital patient flow. […] The purposes of this study were to investigate clinical and biological parameters associated with severe dengue and elaborate an operational model to score patients risk to develop severe dengue in the NC medical facilities setting. […] We report a 4.7 fold increased risk of severe dengue in patients who had a serologically documented history of previous dengue infection, in accordance with the Antibody-Dependent Enhancement (ADE) theory stating that secondary dengue infections are usually more severe.

• #8 Prognostic Factors in Adult Patients with Dengue: Developing Risk Scoring Models and Emphasizing Factors Associated with Death ≤7 Days after Illness Onset and ≤3 Days after Presentation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6262376/

  The present study aimed to further stratify fatal cases into two categories: (i) individuals who died 7 days after the onset of dengue and (ii) those who died 3 days after hospital presentation. […] The multivariate analysis revealed that gastrointestinal bleeding 72 h after presentation (adjusted odds ratio (aOR): 20.278; 95% confidence interval (CI): 5.08984.426), platelet count 50 109 cells/L at presentation (aOR: 5.422; 95% CI: 1.39821.025), and the presence of leukocytosis (aOR: 12.763; 95% CI: 3.78843.003) and hemoconcentration (aOR: 55.674; 95% CI: 13.110236.422) during hospitalization were independently correlated to overall mortality from dengue. […] The occurrence of gastrointestinal bleeding 72 h after presentation increased the odds of death in adult patients with dengue throughout the entire clinical course. This finding is in accordance with those from previous studies, which have emphasized the importance of the early recognition of gastrointestinal bleeding to prevent mortality and morbidity. […] In our study, thrombocytopenia (platelet count 50 109 cells/L) was an independent predictor of mortality 3 days of presentation and in the overall study population.

• #9 Development of clinical decision rules to predict recurrent shock in dengue | springermedizin.de

  https://www.springermedizin.de/development-of-clinical-decision-rules-to-predict-recurrent-shoc/9712546

  Mortality from dengue infection is mostly due to shock. Among dengue patients with shock, approximately 30% have recurrent shock that requires a treatment change. Here, we report development of a clinical rule for use during a patients first shock episode to predict a recurrent shock episode. […] The results showed that shorter admission day (fewer days prior to admission), purpura/ecchymosis, ascites/pleural effusion, low platelet count and narrow pulse pressure were independently associated with recurrent shock. Our logistic prediction model was capable of predicting recurrent shock when compared to the null method (P0.05) and was not outperformed by other prediction models. Our final scoring rule provided relatively good accuracy (AUC, 0.73; sensitivity and specificity, 68%). […] Our simple clinical rule is not to replace clinical judgment, but to help clinicians predict recurrent shock during a patients first dengue shock episode.

• #10 Predicting outcome from dengue | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0147-9

  The decision tree was subsequently validated in another Singaporean cohort, and has been suggested as a tool to guide triage of patients who require hospitalisation versus outpatient treatment. […] Although a rapid decrease in platelet count concurrent with an increase in haematocrit is presented as one of the warning signs for likely progression to shock in the 2009 WHO dengue classification, specific values have not been defined as yet. […] The rate of change in serial haematological markers, particularly the platelet count, may also carry important prognostic information, and efforts are in progress to develop models that incorporate longitudinal data from repeated sampling to see if this improves the accuracy of risk prediction. […] Hepatic involvement is common in dengue, and liver enzymes are frequently elevated in infections of all severity grades.

• #11 Predicting outcome from dengue | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0147-9

  Hypoproteinaemia is well recognised during the critical phase, and correlates with the severity of leakage; however, like haemoconcentration, hypoproteinaemia is difficult to identify without serial measurements or a known baseline value for an individual. […] Studies using ultrasound have demonstrated that pleural effusions, ascites and gall bladder wall oedema are common during the critical phase, and correlate with disease severity. […] Thus ultrasonography can be a useful monitoring tool, and where available, should be considered in the overall assessment during the febrile phase. […] In the face of the rapidly expanding global pandemic, many research groups are attempting to assess a variety of potential biomarkers for associations with dengue disease progression. […] Higher viraemias, considered to reflect a greater dengue-infected cell mass, have been linked to severe disease, with early peak viral loads appearing to correlate with subsequent disease severity.

• #12

  https://www.ijpediatrics.com/index.php/ijcp/article/view/2129

  Dengue fever presents with a diverse clinical spectrum. […] Hepatic dysfunction was present in all forms of dengue infection, with SGOT rising significantly more than SGPT. […] All biochemical liver parameters were significantly deranged in patients with severe dengue fever indicating prolonged illness and poor prognosis.

• #13 Predictors and Outcome of Severe Dengue Illness in Children. | IMSEAR

  https://pesquisa.bvsalud.org/portal/resource/pt/sea-214692

  Dengue fever has become a major public health concern during the last few years with an alarming increase in the incidence in 2017. […] This study was conducted to evaluate the clinical and demographic profile of children affected with dengue fever and determine the predictors of severity. […] Thrombocytopenia, elevated serum hepatic enzymes both SGOT and SGPT, abnormal renal function tests, low sodium, hypoalbuminemia, hypoglycaemia, abnormal radiological findings were found to be the predictors of severity. […] There are definite clinical and lab parameters which can predict the severity in Dengue fever. […] The mortality can be reduced to zero even in patients having expanded dengue syndrome and Dengue shock syndrome.

• #14 The Predictive Diagnostic Value of Serial Daily Bedside Ultrasonography for Severe Dengue in Indonesian Adults | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002277

  Identification of dengue patients at risk for progressing to severe disease is difficult. […] The aim of the study was to determine the predictive diagnostic value of serial ultrasonography for severe dengue. […] Presence of subclinical plasma leakage at enrollment had a positive predictive value of 35% and a negative predictive value of 90% for severe dengue. […] Serial ultrasonography, in contrast to existing markers such as hematocrit, may better identify patients at risk for development of severe dengue. […] This study shows that serial handheld ultrasonography at the bedside may be useful to identify patients at risk for severe dengue. […] Our findings suggest that careful monitoring of circulatory status is merited in those patients with ultrasonographic evidence of subclinical plasma leakage since there is a significant risk for progressing to shock. […] Compared to serial hematocrit values, serial ultrasonography had a better predictive value in identification of those patients at risk for severe dengue.

• #15 Prognostic Indicators for the Early Prediction of Severe Dengue Infection: A Retrospective Study in a University Hospital in Thailand

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9416179/

  This study aimed to develop simple diagnostic guidelines which would be useful for the early detection of severe dengue infections. […] Multivariate analysis was conducted to determine independent diagnostic predictors of severe dengue infection and to convert simple diagnostic guidelines into a scoring system for disease severity. […] The cut-off score for predicting dengue severity was higher than 14, with an area under the receiver operating curve (AUROC) of 0.902. […] Our study demonstrates that several diagnostic parameters can be effectively combined into a simple score sheet with predictive value for the severity evaluation of dengue infection. […] Epidemiological studies have identified indicators for severe dengue infections, which may be useful as prognostic markers for the course of the disease, particularly for pediatric patients.

• #16 Prognostic Factors in Adult Patients with Dengue: Developing Risk Scoring Models and Emphasizing Factors Associated with Death ≤7 Days after Illness Onset and ≤3 Days after Presentation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6262376/

  Dengue is a mosquito-borne viral disease that is a threat to global health. However, information relating to mortality 7 days after dengue onset and 3 days after presentation is limited. We retrospectively analyzed 1086 adults with dengue during a 12-year period. Three scoring models were established: model-1 (death 3 days after presentation), model-2 (death 7 days after illness onset), and model-3 (overall fatality). In total, 39 patients with fatal dengue were identified, of which 17 and 14 patients died 7 days after illness onset and 3 days after presentation, respectively. In model-1 (range: 04 points), gastrointestinal bleeding 72 h after presentation, thrombocytopenia (50 109 cells/L) at presentation, and acute kidney injury after hospitalization, using a cutoff level of 2 points, exhibited good discrimination (area under the receiver curve (AUC): 0.975) between survivors and non-survivors. In model-2, the significant predictors were gastrointestinal bleeding 72 h after presentation, and hemoconcentration and leukocytosis after hospitalization. Model-2 (range: 04 points) showed an AUC of 0.974, with a cutoff value of 2 points. The independent factors in model-2 were the predictors of overall mortality (model-3), which include thrombocytopenia (50 109 cells/L) at presentation. Using a cutoff value of 2 points, model-3 (range: 07 points) revealed an excellent discrimination between survivors and non-survivors (AUC: 0.963).

• #17 Prognostic Indicators for the Early Prediction of Severe Dengue Infection: A Retrospective Study in a University Hospital in Thailand

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9416179/

  The prediction by the scoring system was correct with a positive predictive value (PPV) of 68% and a negative predictive value (NPV) of 94.1%. […] In summary, the selected factors that determine predictions for disease progression were proven useful to be incorporated in an uncomplicated diagnostic model for the prognosis of severe dengue diseases. […] The scoring system we present here is generally applicable to most clinical laboratories and could reduce the likelihood that serious cases of dengue diseases escape medical attention unrecognized.

• #18 Development of a bedside score to predict dengue severity | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06146-z

  In 2017, New Caledonia experienced an outbreak of severe dengue causing high hospital burden (4379 cases, 416 hospital admissions, 15 deaths). […] We built robust and efficient models to calculate a bedside score able to predict dengue severity in our setting. […] The predictive models provide a score. Score threshold is derived from the ROC curve as the threshold optimal value for which sensitivity and specificity are the highest for the whole dataset. […] We developed a bedside score to predict dengue severity.

• #19 Development of a bedside score to predict dengue severity | medRxiv

  https://www.medrxiv.org/content/10.1101/2020.11.25.20238972v1.full-text

  We were able to build two robust and efficient logistic regression models to evaluate patients risk of developing severe dengue in men and women. […] The bedside scoring tool we propose is very simple and easy to use, results ranging from 0 (minimal risk of severe dengue) to 1 (maximal risk). […] We developed a bedside score to predict dengue severity.

• #20 Development of clinical decision rules to predict recurrent shock in dengue | springermedizin.de

  https://www.springermedizin.de/development-of-clinical-decision-rules-to-predict-recurrent-shoc/9712546

  Recurrent shock occurs in about 28% of dengue-infected patients with shock. We derived a simple clinical decision rule with a sensitivity and specificity of 68%, which could help clinicians treating dengue patients during the early stage of a first shock episode to predict the development of recurrent shock. The usefulness of this decision rule needs to be validated by several independent studies in the future.

• #21 Predicting dengue importation into Europe, using machine learning and model-agnostic methods | Scientific Reports

  https://www.nature.com/articles/s41598-020-66650-1

  The geographical spread of dengue is a global public health concern. […] The mitigation of the continuous spread of dengue in Europe lies in part in the ability to effectively predict importation risk. […] Our best performing model achieved high predictive accuracy, with an area under the receiver operating characteristic score of 0.94 and a maximized sensitivity score of 0.88. […] We demonstrated the high predictive performance of a machine learning model in predicting dengue importation and the utility of the model-agnostic methods to offer a comprehensive understanding of the reasons behind the predictions. […] Our best-performing model was the extreme gradient boosting model with an AUC score of 0.94. […] Given this predictive performance, our model holds great potential as a forecasting tool which can markedly improve dengue surveillance in Europe.

• #22 Predicting dengue importation into Europe, using machine learning and model-agnostic methods | Scientific Reports

  https://www.nature.com/articles/s41598-020-66650-1

  Our model included 17 predictor variables, which broadly captures the importation risk factors (as presented by the connectivity indices) and the influence of the air transport network (i.e. the centrality measures). […] Overall, our work offers the following contributions. First, to the best of our knowledge, this is a first attempt at applying machine learning algorithms to model the risk of dengue importation into Europe. […] When combined, these contributions can assist public health practitioners looking to develop a reliable, cost-effective, and scalable early warning surveillance system for dengue importation.

• #23 Scoring systems for prediction of malaria and dengue fever in non-endemic areas among travellers arriving from tropical and subtropical areas | Emergency Medicine Journal

  https://emj.bmj.com/content/41/4/242

  In total, 2113 adults (1894 years) and 202 children (117 years) were included, with 112 (4.8%) confirmed malaria by blood thick smear and 90 (3.9%) PCR/serology dengue-positive cases. […] Two scoring systems with points between 0 and 7 for prediction of malaria or dengue were created based on the above predictors. Scores 3 indicated 80% sensitivity and specificity for malaria and 90% specificity for dengue in children and adults (area under the curve (AUC) for dengue: 0.92 in adults (95%CI 0.90 to 0.95) and 0.95 in children (95%CI 0.88 to 1.0); AUC for malaria: 0.93 in adults (95%CI 0.91 to 0.96) and 0.88 in children (95%CI 0.78 to 0.99)). […] The presented scoring systems provide novel tools for structured assessment of patients with tropical fever in a non-endemic area and highlight clinical signs associated with a potential severe aetiology to direct the need for microbial investigation.

• #24 Scoring systems for prediction of malaria and dengue fever in non-endemic areas among travellers arriving from tropical and subtropical areas | Emergency Medicine Journal

  https://emj.bmj.com/content/41/4/242

  We have derived two new scoring systems by combinations of symptoms and rapidly available laboratory tests for the early detection of potential malaria and dengue cases. […] The scoring systems may help to make the correct diagnosis in returning travellers in the ED earlier. External validation is needed before the tools can be used in clinical practice. […] We developed two separate scoring models for the prediction of malaria and dengue for patients in all age groups and believe that this is particularly useful at the ED where many junior physicians with limited exposure to the management of imported fevers are on duty. […] The scoring systems can easily be applied at the ED, triage and primary care for both children and adults to guide the need and urgency for further investigations. This may reduce the risk of delayed diagnostic procedures and overuse of antibiotics, and has the potential to contribute to improved management of common tropical diseases with a high severity potential. […] In conclusion, we developed two scoring systems that are valuable tools for improvement of the management of post-travel illness in both adults and children in non-endemic settings. This could lead to earlier treatment and prevention of severe disease of malaria and dengue.

• #25 DDPM: A Dengue Disease Prediction and Diagnosis Model Using Sentiment Analysis and Machine Learning Algorithms

  https://www.mdpi.com/2075-4418/13/6/1093

  The aedes mosquito-borne dengue viruses cause dengue fever, an arboviral disease (DENVs). […] Dengue hemorrhagic fever can progress into dengue shock syndrome, which can be fatal. […] To provide accessible and timely supportive care and therapy, it is necessary to have indispensable practical instruments that accurately differentiate Dengue and its subcategories in the early stages of illness development. […] Dengue fever can be predicted in advance, saving one’s life by warning them to seek proper diagnosis and treatment. […] The worldwide public health system has a continuing need for the early detection of dengue fever, and machine learning algorithms may help medical professionals recognize and prevent infection at an earlier stage. […] The purpose of this paper is to pursue an early diagnostic model that helps doctors in the prompt prognosis and diagnosis of dengue disease by using machine learning algorithms.

• #26 DDPM: A Dengue Disease Prediction and Diagnosis Model Using Sentiment Analysis and Machine Learning Algorithms

  https://www.mdpi.com/2075-4418/13/6/1093

  The model will be able to make correct predictions regarding the progression of the disease as well as allow for early diagnosis of the disease. […] Based on the findings, it appears that the R.F. technique is the one to choose. Because of this, it has been determined that, out of all these various machine learning algorithms, the RF-based diagnostic model is the one that is best suited for accurately diagnosing dengue fever at an earlier stage.

• #27 Predicting deterioration in dengue using a low cost wearable for continuous clinical monitoring | npj Digital Medicine

  https://www.nature.com/articles/s41746-024-01304-4

  Close vital signs monitoring is crucial for the clinical management of patients with dengue. […] We performed a prospective observational study in patients admitted to hospital in Vietnam for the management of dengue, with the aim of investigating the relationship between continuous PPG monitoring, physiological derangement and illness severity. […] A multi-task approach integrating both basic clinical information with PPG waveform data was associated with better predictive performance: the optimised STF model predicted individual patient risk 2h ahead and with an AUROC of 0.83 and AUPRC of 0.67. […] Integration of PPG signals with clinical information through a multi-modal, multi-task deep learning approach predicted patient illness severity in real time for patients hospitalised with dengue.

• #28 Predicting outcome from dengue | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0147-9

  However, these parameters are relatively insensitive, and show little change until the critical phase of the infection. […] The compensatory reserve index (CRI) is a new computational algorithm that uses feature analysis of the arterial pulse waveform to track real-time changes in central blood volume. […] Studies to assess the utility of the CRI in predicting likely progression to shock, and to track fluid resuscitation status in patients with established shock, are ongoing in Southeast Asia. […] Predicting outcome in dengue remains challenging, and the search for more robust methods continues. […] A major global study currently in progress, aiming to recruit 10,000 to 12,000 suspected dengue cases during the early febrile phase, should provide useful information for risk prediction. […] However, given the rather broad range of signs and symptoms seen in dengue, inclusion of one or more specific biomarkers is likely to be needed in order to develop a robust algorithm.

• #29 Predicting outcome from dengue | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0147-9

  However, the kinetics of NS1 antigenaemia are known to be influenced by several factors, including the infecting serotype, with lower levels seen in DENV2 than in DENV1 infections after adjusting for viral load, and the host immunity, with faster clearance times seen in secondary than in primary infections. […] The defining feature of severe dengue is disruption of vascular barrier function, resulting in plasma leakage, intravascular volume depletion, and eventually cardiovascular collapse and death if appropriate fluid therapy is not instituted promptly. […] Current techniques to identify and monitor leakage rely on surrogate markers of intravascular volume depletion, including serial haematocrit measurements, and close observation of cardiovascular indices, particularly the pulse pressure and heart rate.

• #30

  https://link.springer.com/article/10.1007/s10729-021-09571-3

  Purpose: Our objective is to identify the predictive factors and predict hospital length of stay (LOS) in dengue patients, for efficient utilization of hospital resources. […] Moreover, the study showed that blood transfusion, emergency admission, assisted ventilation, low haemoglobin, high total leucocyte count (TLC), low or high haematocrit, and low lymphocytes have a significant correlation with prolonged LOS. […] This method can identify the patients at highest risks and help focus time and resources.

• #31 COMET Initiative | The Core Outcome Measures for Dengue (DEN-CORE)

  https://comet-initiative.org/Studies/Details/3029

  Currently, there is no specific treatment available for dengue or severe dengue. […] Different outcomes measurements are therefore needed for the different stages of disease, reflecting the different goals of interventions. […] By incorporating input from various stakeholders, including patient groups, health professionals and researchers, DEN-CORE will ensure that research is both relevant and patient-centered, facilitating better informed clinical and policy decisions on a global scale for this major public health concern. […] This project will also anchor the development of target product profiles for therapeutic agents for the treatment of dengue.

Zobacz więcej