GUIDELINE DEVELOPMENT AND OBJECTIVE
The development group or this guideline consisted o a amily medicinespecialist, an emergency medicine specialist, a general physician, inectiousdisease physicians, intensivists, haematologists, public health physicians,a virologist and a nursing sister rom the Ministry o Health and Ministryo Higher Education, Malaysia.During the process o development o thisguideline, there was active involvement o a review committee.The previous edition o the CPG (2003) was used as the basis or thedevelopment o this present guideline.This guidelines provides :a. A detailed description o the clinical course o dengue illness whichreects the dynamism and systemic nature o dengue that have crucialbearing on the patient’s management.b. A detailed description o the basic pathophysiological changeso severe dengue (i.e. plasma leakage and hypovolaemia/shock)and provide guidance on the recognition o these changes and theappropriate action o management.c. A brie discussion on WHO Classifcation (1997) and its limitations.d. Some useul guides on the dierential diagnoses that can be conusedwith dengue or vice versa; they were described according to the stageo disease.e. A more ocused guide on the disease monitoring in accordance withthe dynamic changes as the disease progresses.. Emphasis on the importance o monitoring the plasma leakage [clinicalsigns o plasma leakage and haemotocrit (HCT)] and the haemodynamicstatus o the patient.g. Clearer algorithm on uid management in severe dengue.h. Emphasis on the importance o recognising or suspecting signifcantoccult bleed with some useul guides.i. A more systematic approach on the recognition o signs o recovery.Literature search was carried out at the ollowing electronic databases:International Health Technology Assessment Website, PUBMED, CochraneDatabase o Systemic Reviews (CDSR), Journal ull text via OVID searchengine, Comprehensive; Database o Abstracts o Reviews o Eectiveness,Cochrane Controlled Trials Registered, CINAHL via EBSCO search engine.In addition, the reerence lists o all relevant articles retrieved were searchedto identiy urther studies.