Rational use of ultrasonography with triaging of patients to detect dengue plasma leakage in resource limited settings: a prospective cohort study

Objectives To compare the traditional haematocrit-based criteria (>20% rise above baseline) with ultrasonography for diagnosing plasma leakage in dengue fever and to identify clinical indicators triaging patients resource-limited settings when demand is high. Methods The Colombo Dengue Study a prospective observational cohort study recruiting first three days of fever, before leakage. Serial haematocrit assessments were performed recruited from October 2017 February 2020. Clinical signs/symptoms laboratory investigation results independently associated ultrasound detected identified derivation confirmed validation cohort. Results 129 426 had ultrasonography-confirmed while 146 >20%. Those positive on also likely fulfil (OR: 4.42, 95% CI: 2.85–6.86), but two groups did not overlap fully. In (n = 317), platelet count <97 000/µl, AST/ALT > 51 IU/l having abdominal pain independent predictors ultrasound-detected 109), combination low high aminotransferase level better predictive capacity terms sensitivity specificity. Conclusion should be monitored both serial whenever possible diagnosed by either one these criteria. If accessibility scans limited, count, serum transaminase levels presence are useful triage patients.