Dengue clinical management : facilitator's training manual

Overview

This facilitator’s manual is designed to support the implementation of the Dengue Clinical Management training course. The guide contains specific instructions for the facilitator and provides:

• a detailed description of the clinical course of dengue illness, which reflects the dynamic and systemic nature of dengue that has crucial bearing on the patient’s management;
• a detailed description of the basic pathophysiological changes of severe dengue (i.e. plasma leakage and hypovolaemia/shock) and guidance on the recognition of these changes and appropriate action of management;
• a brief discussion on WHO classification (1997) and its limitations;
• guidance on the differential diagnoses that can be confused with dengue or vice versa; they were described according to the stage of disease;
• a more focused guide on the disease monitoring in accordance with the dynamic changes as the disease progresses;
• emphasis on the importance of monitoring the plasma leakage (haemodynamic status of the patient, clinical signs of plasma leakage and haematocrit);
• a clearer algorithm for fluid management in cases of severe dengue; and
• emphasis on the importance of recognizing or suspecting significant occult bleed. Keep the facilitator’s manual with you each day as you prepare and deliver the information. Use it as a reference when delivering classroom presentations, but avoid reading directly from it during sessions.