LAHORE, Sept 18: The World Health Organization (WHO) has approved new clinical management guidelines for dengue diagnosis and treatment for Pakistan.

‘National Guidelines for Dengue Fever/DHF/DSS’ are the country-specified course of action developed for the first time for Pakistan to address a particular disease on the recommendations of 19-member core group of national and international multiple disciplinary experts including medical practitioners, paediatricians, WHO representatives, public health officials and pharmacists.

Interestingly, the new guidelines recommend a ‘simple diagnostic tool’ in the form of Tourniquet test which requires just a simple blood pressure to differentiate between seriously ill and uncomplicated cases of dengue fever.

The group experts claim that this test has sensitivity of above 80 per cent and specificity of 68 per cent.

There is no need to undergo a variety of clinical investigations for every suspected dengue fever patient as witnessed at public and private health facilities during the current wave of dengue virus, the new guidelines suggest.

Although, came too late, the experts believe that the new guidelines are dire need of the time as the health experts have witnessed a rising trend of dengue cases in the country and huge crowd of disease-hit people at public and private health centres owing to mishandling of the patients by the physicians.

The federal government has endorsed a set of new guidelines for health practitioners to combat the menace of dengue more effectively which have been duly approved by the WHO last week.

Now Pakistan has been enlisted among other countries of the region for which the WHO has issued country-specified guidelines for health practitioners from both public and private sector to diagnose and treat the dengue patients.

The other countries already following the guidelines owing to dengue virus alerts are Sri Lanka, Bangladesh, Maldives, India, Malaysia etc.

Headed by Allama Iqbal Medical College Principal Prof Dr Javed Akram, the core group members who furnished clinical management guidelines include WHO focal person for dengue, Pakistan, Rana Graber Kakar, WHO representative, Islamabad, Dr Zareef Khan, WHO epidemiologist, Pakistan, Dr Moosa Rahim, WHO Operator, Punjab, Dr Babar Alam, WHO representative, Punjab, Majid Latif, Institute of Public Health Dean Dr Yaqoob Qazi, Pakistan Medical Research Council Principal Officer Dr Arif Muneer, AIMC senior pathologist Prof Nosheen Waseem Yusuf and pharmacists.

Prof Javed Akram has termed it a big achievement saying that new guidelines will help minimise burden of patients visiting the government and private hospitals with dengue virus.

Talking to Dawn, he says in the Tourniquet test a physician will apply the blood pressure cuff on the upper arm of dengue suspected patient and inflate the bulb to 90 millimeter of mercury. The purpose is to apply pressure to see blood spots on forearm of the patient. After a period of five minutes the physician will calculate the number of petechiae in squire inch on the forearm. If in this one inch the number of spots is more than 10 then the patient certainly will require hospitalisation and further work up.

According to Dr Babar Alam, once circulated widely among the medical community the guidelines will go a long way in standardising the care of dengue patients thereby relieving them of miseries.

At the same time, he says, the overcrowded hospitals can work much more efficiently by differentiating the seriously-ill patients from those without any complications. “WHO has decided to publish more than 10,000 copies of new guidelines and will also hold training meetings throughout the country for doctors and pediatricians dealing with patients suffering from dengue.”

This is the first set of guidelines for this disease for Pakistan issued by WHO and once the physicians are trained to use the same the much prevalent confusions in diagnosis and treatment shall subside.

He says the next plan is to identify some three to four master trainers from all the provinces of the country who will impart training to doctors at their respective areas following the WHO new guidelines.