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  • Perbedaan Guidline WHO 1997 2009 2011

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    Abdullah Attamimi
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    The document summarizes guidelines for dengue fever (DF) and dengue hemorrhagic fever (DHF) published by the World Health Organization (WHO) in 1997, 2009, and 2011. It compares the titles, focuses, grading systems, fluid management recommendations, and definitions of DHF for each set of guidelines. The 1997 WHO guidelines classified disease severity into DF, DHF grades I-IV. The 2009 guidelines classified disease based on presence or absence of warning signs and severity. The 2011 guidelines expanded disease classification and management recommendations. Development of dengue vaccines is also discussed, noting four types still undergoing clinical trials for improvement.

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    The document summarizes guidelines for dengue fever (DF) and dengue hemorrhagic fever (DHF) published by the World Health Organization (WHO) in 1997, 2009, and 2011. It compares the titles, focuses, grading systems, fluid management recommendations, and definitions of DHF for each set of guidelines. The 1997 WHO guidelines classified disease severity into DF, DHF grades I-IV. The 2009 guidelines classified disease based on presence or absence of warning signs and severity. The 2011 guidelines expanded disease classification and management recommendations. Development of dengue vaccines is also discussed, noting four types still undergoing clinical trials for improvement.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    80 views4 pages

    Perbedaan Guidline WHO 1997 2009 2011

    Uploaded by

    Abdullah Attamimi
    The document summarizes guidelines for dengue fever (DF) and dengue hemorrhagic fever (DHF) published by the World Health Organization (WHO) in 1997, 2009, and 2011. It compares the titles, focuses, grading systems, fluid management recommendations, and definitions of DHF for each set of guidelines. The 1997 WHO guidelines classified disease severity into DF, DHF grades I-IV. The 2009 guidelines classified disease based on presence or absence of warning signs and severity. The 2011 guidelines expanded disease classification and management recommendations. Development of dengue vaccines is also discussed, noting four types still undergoing clinical trials for improvement.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 4

    Perbedaan guidline WHO

    1997 2009 2011

    Judul

    1997
    Guidline for treatment of
    DF and DHF in small
    hospitals WHO Searo
    1999

    Focus

    Manifestasi klinis,
    diagnosis, case
    management

    Grade

    Dengue fever
    DHF grade I
    DHF grade II
    DHF grade III
    DHF grade IV

    Fluid management

    DHF grade 1-II


    6-7 ml/kg/jam
    5 ml / kg/ jam
    3 ml/kg/jam stop
    setelah 24-48 jam

    DSS
    10-20 ml/kgBB bolus,

    2009
    Dengue guidline for
    diagnosis, treatment,
    prevention and
    control WHO TDR
    2009
    Epidemiologi dan
    parahnya penyakit ,
    clinical management,
    vector management,
    lab diagnostic,
    pengawasan dan
    emergency respon,
    terobosan baru
    Dengue without
    warning sign
    Dengue with warning
    sign
    Severe dengue (severe
    plasma leakage,
    severe hemorrhage,
    severe organ
    involvement)
    With warning sign
    RL, NaCl 0,9
    5-7 ml/kg/jam (1-2
    jam)
    3-5 ml/kg/jam (2-4
    jam)
    2-3 ml/kg/jam orless
    according to the
    clinical response

    2011
    Comprehensive guidline
    for prevention and
    control of dengue and
    DHF WHO Searo 2011

    Severe denguecompensated shock

    DHF gradeIII
    10ml/kg in children

    Epidemiologi, keparahan
    penyakit, manifestasi
    klinik, diagnosis (+
    laboratorium),
    management,
    pengawasan, investigasi,
    monitoring, rencana
    rencana
    Dengue fever
    DHF grade I
    DHF grade II
    DHF grade III
    DHF grade IV
    *expanded dengue
    syndrome

    DHF grade I-II


    Maintenance (1 hari) +
    5% deficit
    (oral + IV)

    repeat if necessary

    Isotonic crystalloid 510 ml/kg/hour over


    one hour reassess

    300-500 mk in adult
    over one hour or by
    bolus

    Severe dengue
    hypotensive shock
    Critaloid / koloid 20
    ml/kg dalam 15 menit

    DHFgrade IV
    10ml/kg of bolus fluid
    (10-15 min)
    When the blood pressure
    is restored, further
    intravenous fluid may be
    given as in grade 3
    If shock is not reversible
    after the first, repeat.

    WHO 1997
    Grade
    DF
    DHF

    Sign and Symptoms


    DHF without plasma leakage
    Demam tanpa sebab yang jelas,
    manifestasi perdarahan (tes
    tourniquet+)
    DHF grade I + perdarahan
    spontan
    Kegagalan sirkulasi ditandai
    dengan nadi cepat dan lemah,
    tekanan darah turun
    (menyempit), akral dingin
    Profound shock with
    undetectable blood pressure

    II
    III

    IV

    Lab
    Trombosit <100.000 /
    L

    WHO 2009
    Dengue case classification by severity
    Any warning sign dengue with or without warning sign
    Dengue without warning sign
    Live in / travel to dengue

    Dengue with warning sign


    Abdominal pain or tenderness

    Severe dengue
    1. severe plasma

    endemic area
    Fever + 2 of the following
    criteria
    - Nausea, vomiting
    - Rash
    - Aches and pains
    - Tourniquet test +
    - leucopenia

    Persistent vomiting
    Clinical fluid accumulation
    Mucosal bleed
    Lethargy, restlessness
    Liver enlargement > 2cm
    Increase in HCT concurrent
    with rapid decrease in platelet
    count

    leakage :
    shock (DSS)
    fluidaccumulation with
    respiratory distress
    2. severe bleeding
    3. severe organ
    involvement :
    liver AST, ALT > 1000
    CNS : impaired
    consciousness
    Heart and other organs

    WHO 2011
    Infeksi virus dengue :
    1. Asimptomatik
    2. Simptomatik
    a. Undefferentiatd fever
    b. Dengue fever : with / without haemorrhage
    c. Dengue haemorrhagic fever : DSS or not
    Grade
    DF

    DHF

    II

    Sign and symptoms


    Fever; with 2 of the following
    Headache
    Retro orbitasl pain
    Myalgia
    Athralgia / bone pain
    Rash
    Haemorrhagic manifestations
    No evidence of plasma
    leakage
    Fever and haemorrhage
    manifestation (tourniquet +)
    and evidence of plasma
    leakage
    As in grade I + spontaneous
    bleeding

    DHF*DSS

    III

    As in grade I or II plus
    circulatory failure

    DHF*DSS

    IV

    As in grade III plus proufund

    Laboratory
    Leucopenia (<
    5000L)
    Trombositopeni <
    150.000 L
    Peningkatan Hct (510%)

    Trombositopeni <
    100.000 L
    Hct rise 20%
    Trombositopeni <
    100.000 L
    Hct rise 20%
    Trombositopeni <
    100.000 L
    Hct rise 20%
    Trombositopeni <

    shock with undetectable blood 100.000 L


    Hct rise 20%
    presure and pulse
    Vaksin untuk DHF
    Dalam 10 tahun perkembangan vaksin dengue terus berkembang, dalam jurnal eJKI
    dengan judul Perkembangan Mutakhir Vaksin Demam Berdarah Dengue oleh Hilman
    Zulkifli Amin, Saleha Sungkar dinyatakan bahwa terdapat 4jenis vaksin, yaitu LAV,
    vaksin chimera, vaksin DNA dengue, dan vaksin DENV. Semua jenis vaksin ini masih
    dalam uji klinis untuk penyempurnaan.
    (http://journal.ui.ac.id/index.php/eJKI/article/viewFile/3007/2466 )

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