Utility of Tourniquet Test for Early Differentiation of Suspected Dengue Cases in the Dengue Camp during Outbreak, 2011
Abstract
Background: The increased workload of dengue patients in epidemic period necessitates prompt clinical diagnosis with all possible diagnostic tools to improve morbidity and mortality of patients.
Objectives: To determine possible role of simple clinical test for early diagnosis of suspected dengue infection during epidemic period while the blood cell counts of reporting adult persons are still relatively normal
Material & Methods: Cross-sectional survey was conducted in emergency dengue camp of Shalamar Hospital, Lahore from 1-10-2011 to 30-11-2011.Hematological investigation and Tourniquet test were carried out on reporting cases of suspected Dengue fever. Probable Dengue Fever and Dengue Hemorrhagic Fever were defined on WHO criteria. Comparison between positive and negative groups of Tourniquet test was also done, in terms of clinical features and hematological findings.
Results: Out of 129 suspected dengue infection cases, 111 cases fulfilled the selection criteria, with age range of 12 years to 68 years and comprised of 65.2% males. 92 cases were categorized as Probable Dengue fever patients. Tourniquet test was found positive in 26 out of 92 Probable Dengue fever and 3 out of 19 remaining Suspected patients. Diagnostic accuracy was 37.84% with positive predictive value of 89.65%. Platelets count (<100,000/L) was present in 44.56% patients. However, significantly less count was recorded in Tourniquet test positive group as compared to negative group (p =0.01).
White blood cells count (?5000 /L) and raised Hematocrit (>46% for male & >40% for female) were found in 64.1% and 39.1% patients respectively (p>0.05).
Conclusion: Positive Tourniquet Test is helpful in the early diagnosis of Dengue Fever and Dengue Hemorrhagic Fever in outdoor epidemic settings, without waiting for dengue serology for confirmed diagnoses.
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