Topic | Description | Items |
Basic information | Demographic and basic information about the patient and the treatment received | Type of treatment, where patient is enrolled (IPD vs OPD) Date of fever onset, duration of fever Current temperature Tourniquet test results Patient’s address (district and village-level) Date of visit, date of birth, age and sex Weight and height |
General health condition | Current condition of the patient (self-report) and underlying diseases of the patient | How well the patient could handle daily activities Pre-existing conditions |
Signs and symptoms during this illness | A set of signs and symptoms that may be related to fever and dengue (dengue fever and dengue haemorrhagic fever) at both visits 1 and 2 | Rash, fatigue, headache, retro-orbital pain, neck/ear pain, sore throat, breathing difficulty, cough, expectoration, gastrointestinal signs (nausea/vomiting, diarrhoea, abdominal pain and so on), haemorrhagic signs (nose/gum bleeding, ecchymosis, petechiae and so on), signs of shock (cyanosis, capillary refill), arthralgia, myalgia, loss of appetite, jaundice and so on |
Medical history | Previous dengue-related or other flavivirus infection as well as vaccination history (self-report) | Previous dengue infection and related hospitalisation Previous infection to other commonly circulating arboviral infection in the area (ie, Yellow fever vaccination history) |
Laboratory findings | Records from the routine laboratory tests widely used in clinical fever/dengue patient management, as part of the hospital care procedure | Platelet count, haematocrit, haemoglobin, leucocytes, neutrophils, protein level, AST, ALT, urine test results and so on |
Clinical diagnosis | Clinician’s diagnosis with or without referring to the RDT | Diagnosis given by the physician based on clinical presentation after physical examination of the patient |
Dengue testing results | Results from the dengue tests, mainly RDTs for dengue as well as other commonly circulating arbovirus in the area | Dates of blood draw Test results of the RDT IgM/IgG capture ELISA results PCR results (if available) |
Treatment | Medicine(s) prescribed and the starting and end dates | Antibiotics, paracetamol, ibuprofen, aspirin and others that may be site-specifically prescribed |
Outcome | Outcome of this particular visit | Hospitalised, returned home or referral |
Hospitalisation | Information collected only among hospitalised patients in the surveillance to record other severe signs and progression of illness | Admission and discharge diagnoses Presence of haemorrhagic signs or shock syndrome |
Hospital charges | Expenses and hospital charges incurred by patient on the visit 1 | Amount of the out of pocket payment by the patient or the family/or guardian Breakdown of the hospital charges (laboratory, medication, admission-related charges) |
Final outcome | Outcome of the patient’s illness at the second visit | Final diagnosis given for the patient, outcome of illness Completion of study participation (early termination and the reason and so on) |
ALT, Alanine AminoTransferase; AST, Aspartate aminotransferase; IPD, Inpatient department; OPD, Outpatient department; RDT, Rapid Diagnostic Test.