Doctors told to improve dengue treatment

JAKARTA (JP): Respected medical experts have said that doctors who hastily recommend blood transfusions for dengue patients are "inexperienced".

In a media briefing held by the Indonesian Hematology and Blood Transfusion Association yesterday, the experts also called the widespread practice "misguided".

They said that only patients suffering from internal bleeding needed a blood transfusion.

"We provide a hotline service for doctors who want to learn about dengue treatment. They can call 390 5839," Zubairi Djoerban, head of the association, said.

H.M.S. Markum from the University of Indonesia's School of Medicine urged doctors to learn about the rapid advances made in the treatment of dengue fever.

He said that doctors, particularly junior ones, were often coerced into recommending a blood transfusion by patients' relatives.

"To satisfy relatives, inexperienced doctors often recommend that the patient be given blood at an inappropriate stage in the course of the illness," he said.

In Jakarta, the recent outbreak of dengue fever has claimed 54 lives and lead to a shortage of blood in hospitals around the city.

Dozens of relatives have been forced to spend more than a day waiting at the understaffed Indonesian Red Cross (PMI) office in Central Jakarta to donate blood, or receive blood from other donors. Supplies are reportedly very low.

The government, alarmed by the rising death toll, has called on the public to donate blood to help the thousands of people being treated for dengue across the country.

A. Harryanto Reksodiputro, also from the university's school of medicine, said that blood transfusions were needed only if the patient was suffering from internal bleeding.

"If there are no red spots on the patients skin then there is nothing to worry about, even if the number of thrombocytes per microliter of blood is less than 50,000," he said.

A healthy person normally has between 200,000 and 400,000 thrombocytes per microliter of blood.

Dengue fever is transmitted by the Aedes aegypty mosquito. The virus increases the permeability of blood cell walls and reduces the number of thrombocytes in the blood.

As a result, water contained in the blood permeates into other tissue more easily, hampering the circulation of blood.

Harryanto said that plasma containing lactic acid was needed at this stage, not a blood transfusion.

In a related development, the Ministry of Health distributed 200,000 bottles of plasma to hospitals throughout the city yesterday.

Head of the ministry's office in the city, E. Sutarto, said the donation was intended to supply hospitals with enough plasma to ensure they could treat all patients admitted.

"There is no reason for hospitals to refuse patients treatment. Even if there are no rooms left they can still administer this simple treatment," he said.

The number of reported cases was 5,860 yesterday.

Also yesterday, Governor Sutiyoso donated 500 bottles of plasma to the city-owned Koja Hospital, Tugu Hospital and Sukamulya Hospital, all in North Jakarta. (ind/ivy)