Few doctors trained to treat dengue fever<\/p>\n
Dewi Santoso, The Jakarta Post, Jakarta<\/p>\n
The Ministry of Health says many more doctors need training on
\nthe detection and treatment of dengue fever, but due to a lack of
\nfunds, physicians with private practices and fresh graduates were
\nmissing out.<\/p>\n
Dr. Rita Kusriastuti, the ministry's head of arbovirology,
\nsaid that intensive training on dengue fever treatment had been
\nconducted since 2000 at state and city-run hospitals.<\/p>\n
But she lamented that those who worked in private hospitals,
\namong others, had not been trained. \"The ministry's limited
\nbudget for training is making the situation worse,\" she told The
\nJakarta Post on Saturday.<\/p>\n
The ministry refers to the World Health Organization's guide
\non training doctors published in 1999. The guide provides
\ninformation on the tests that must be conducted to detect dengue
\nfever symptoms.<\/p>\n
Rita said that first the patient's blood was tested every two
\nhours for three consecutive days. She said that if the patient
\ncouldn't afford the tests, doctors sometimes ran them every six
\nhours.<\/p>\n
\"If a patient's condition is improving, the blood can be
\ntested every 12 hours,\" she added.<\/p>\n
The normal hemoglobin count in blood is between 12 and 14
\nmilligrams percent. If, in three days, the hemoglobin count was
\ndropping, then the doctor would conduct a thrombocyte test.<\/p>\n
Rita said that usually a decreasing hemoglobin count was
\nfollowed by a decreasing thrombocyte count. However, it was
\npossible for the hemoglobin count to remain normal while the
\nthrombocyte count decreased.<\/p>\n
The minimum thrombocyte count in blood is 100,000 platelets
\nper cubic-millimeter.<\/p>\n
If both tests show that hemoglobin and thrombocyte counts are
\ndecreasing, the patient must undergo a blood transfusion as these
\nare symptoms of internal bleeding.<\/p>\n
If the patient has a high fever but hemoglobin and thrombocyte
\ncounts remain normal, the doctor will use a tourniquet test to
\ndetect bleeding under the skin.<\/p>\n
\"The test uses blood-pressure equipment. If the patient
\ndevelops a rash within five minutes of the commencement of the
\ntest, like mosquito bites on the lower arm, then they have tested
\npositive to dengue fever,\" Rita said.<\/p>\n
The last test is the hematocrit test, which takes between 24
\nand 48 hours.<\/p>\n
\"Once the doctor has confirmed that the patient is suffering
\nfrom dengue fever, they will proceed with three steps,\" she said.<\/p>\n
First, the patient must receive a Ringer Lactate (RL)
\ntransfusion to replace the amount of fluid lost. If the RL
\ntransfusion did not help, Rita said, this indicated that the
\npatient had suffered massive fluid loss and a colloid transfusion
\nwas necessary. If both transfusions failed, a blood transfusion
\nwas necessary.<\/p>\n
Rita said that if the hemoglobin count did not decrease but
\nthe thrombocyte count did, then a thrombocyte transfusion was
\nrequired.<\/p>\n
In the case of Maulidina Putri, 5 -- whose died last Thursday
\ndue to dengue fever -- a blood test had indicated that her
\nthrombocyte count (blood platelet) per milliliter was around
\n200,000, but there was no data on her hemoglobin count.<\/p>\n
Rita called on parents to monitor their children. If a child
\ndrank a lot but urinated infrequently, parents should report this
\nto the doctor immediately, as it was possible that the child was
\nalready experiencing fluid loss, she warned.<\/p>\n
The dengue fever outbreak has spread to 19 of the country's 32
\nprovinces, with the death toll approaching 200. In Jakarta alone,
\nthe death toll is 38.<\/p>\n
I-box<\/p>\n
MEDICAL STEPS FOR DENGUE FEVER PATIENTS<\/p>\n
Tests
\n1. Hemoglobin and thrombocyte tests at least every 12 hours.
\n2. Tourniquet test, to check for internal bleeding.
\n3. Hematocrit test.<\/p>\n
Treatment steps
\n1. Ringer Lactate (RL) transfusion to replace the loss of fluid.
\nDoctors must monitor patients every two hours. If the patient is
\ngetting better, the patient may be monitored every four to six
\nhours.
\n2. Colloid transfusion.
\n3. Blood transfusion, if the two transfusions above fail.<\/p>\n
Source: The Ministry of Health<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/few-doctors-trained-to-treat-dengue-fever-1447893297", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }