A comparison of outcomes of management of Dengue Haemorrhagic Fever using minimal intervention and the standard management protocol in paediatric units of a Sri Lankan tertiary care facility; A retrospective comparative cross-sectional study

Abstract

Dengue is a mosquito-borne viral infection found in tropical and sub-tropical climates worldwide. Dengue Fever is a significant health concern in Sri Lanka. Dengue Hemorrhagic Fever is managed following a standard protocol laid down by the Ministry of Health Sri Lanka. During the recent epidemic of dengue a deviation from standard protocol was observed with minimal intervention (i.e. without intravenous fluids and urinary catheterisation).This study aimed to compare minimal intervention vs. standard protocol with regard to the development of complications and outcomes of children with Dengue Haemorrhagic Fever.A comparative cross-sectional study was conducted retrospectively using secondary data.The clinical records of paediatric patients with Dengue Haemorrhagic Fever (n=151) admitted to Teaching Hospital, Karapitiya, Galle, Sri Lanka during 2019. The study subjects were categorised into two groups as standard protocol and minimal intervention based on the type of management received.Of 151 patients , 98 (65%) were managed following standard protocol and 53 (35%) following minimal intervention. No significant differences were observed in the two groups in age (p=0.57), sex (p=0.72), day of fever on admission (p=0.65), and haematological parameters on admission (p>0.05). There was no difference in the recovery and duration of hospital stay in the two groups. However, infections (p=0.04) and fluid overload (p=0.004) were significantly more common in the standard protocol group compared to the minimal intervention group.Minimal intervention reduces complications of the management of DHF and reduces the burden to the health care system and patients.