Dengue: Punjab doctors in the dark about new diagnosis criteria

Patients feared to be misdiagnosed and mistreated.

LAHORE:

A majority of doctors remain unaware about a revised diagnostic criterion for dengue fever, leading to misdiagnosis, The Express Tribune has learnt.

The diagnostic criteria was revised by the Dengue Expert Advisory Group (DEAG), which is responsible for advising the Punjab chief minister on setting protocols for diagnosing and treating dengue patients.

According to documents available with The Express Tribune, DEAG Chairman Professor Faisal Masud wrote to the health secretary about the change in the diagnostic criteria on August 18; however, doctors in medical wards have still not been informed about it.

According to the revised criteria, a probable case with any of the three confirmatory evidence of the viral infection, based on detection of IgM or detection of viral antigen (NS1 antigen in blood) or detection of virus by PCR, should be declared a confirmed dengue case.

“This means that if IgM, PCR or NS1 test of any suspected dengue patient is positive, he should be declared a confirmed dengue patient. This, however, isn’t being practiced in Punjab and only those patients are being declared confirmed dengue patients whose NS-1 test comes positive,” a doctor familiar with the matter told The Express Tribune.

He added that this method was not the right way to determine dengue patients as NS-1 test becomes negatives after four days even if a patient has contracted dengue.

In most of the cases, he added, dengue patient reach hospitals after four days as they initially go to general physicians who are not aware of the NS-1 test.

“While this practice shows less cases of dengue virus in Punjab, it is a violation of standard protocol set by the DEAG. This means hundreds of dengue patients might have been masked as their NS-1 came negative despite the fact they were dengue patients,” the doctor said.

He further said that the revised criteria for diagnosis of dengue patients should have been circulated in all public and private hospitals for controlling dengue “but this is not being done to show the government’s ‘good performance’”.

Social mobilisation is also an important factor in combating dengue but blunders at the clinical side should be avoided,” another senior doctor said.

According to the Punjab health department spokesperson, only 15 people have tested positive for dengue in Punjab this year, while no casualty has so far been reported. Furthermore, 1,059 suspected patients tested negative for dengue.

Anti-Dengue Day

Separately, Punjab Chief Secretary Nasir Mahmood Khosa has directed heads of all government departments to ensure implementation of the working plan formulated for the Anti-Dengue Day, which falls on September 2.

He issued the directions while presiding over a meeting to review results of a special cleanliness campaign aimed at eradicating diseases. Heads of the departments informed him about the working plan formulated by their respective departments for making the Anti-Dengue Day a success.

Health Secretary Arif Nadeem said that fogger machines, spray pumps and chemicals are available with the health department and said that high dependency units had been made functional in all state-run hospitals.

He added that the current situation as compared to previous year was satisfactory.

The meeting was informed that the Information and Culture Department Punjab would  arrange walks, seminars and music shows on September 2, while artists of TV drama ‘Ainak Wala Jin’ will also present a drama regarding dengue.

Published in The Express Tribune, August 29^th, 2012.