{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:19:12Z","timestamp":1789708752855,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the traditional haematocrit\u2010based criteria (&gt;20% rise above baseline) with ultrasonography for diagnosing plasma leakage in dengue fever and to identify clinical indicators for triaging patients in resource\u2010limited settings when the demand for ultrasonography is high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Colombo Dengue Study is a prospective observational cohort study recruiting dengue patients in the first three days of dengue fever, before plasma leakage. Serial haematocrit assessments and ultrasonography were performed in patients recruited from October 2017 to February 2020. Clinical signs\/symptoms and laboratory investigation results independently associated with ultrasound detected plasma leakage were identified with a derivation cohort and confirmed in a validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>129 of 426 patients had ultrasonography\u2010confirmed plasma leakage while 146 had a haematocrit rise &gt;20%. Those positive on ultrasonography were also likely to fulfil the haematocrit\u2010based criteria (OR: 4.42, 95% CI: 2.85\u20136.86), but the two groups did not overlap fully. In the derivation cohort (<jats:italic>n\u00a0<\/jats:italic>=\u00a0317), platelet count &lt;97\u00a0000\/\u00b5l, AST\/ALT\u00a0&gt;\u00a051\u00a0IU\/l and having abdominal pain in the first three days of fever were independent predictors of ultrasound\u2010detected plasma leakage. In the validation cohort (<jats:italic>n\u00a0<\/jats:italic>=\u00a0109), the combination of low platelet count and high aminotransferase level had better predictive capacity in terms of sensitivity and specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dengue patients should be monitored with both serial haematocrit and ultrasonography whenever possible and plasma leakage should be diagnosed by either one of these criteria. If accessibility to scans is limited, platelet count, serum transaminase levels and presence of abdominal pain are useful to triage patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13594","type":"journal-article","created":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T22:23:52Z","timestamp":1619216632000},"page":"993-1001","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Rational use of ultrasonography with triaging of patients to detect dengue plasma leakage in resource limited settings: a prospective cohort study"],"prefix":"10.1111","volume":"26","author":[{"given":"Ponsuge Chathurani","family":"Sigera","sequence":"first","affiliation":[{"name":"Department of Parasitology Faculty of Medicine University of Colombo Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Weeratunga","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Faculty of Medicine University of Colombo Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumadhya","family":"Deepika Fernando","sequence":"additional","affiliation":[{"name":"Department of Parasitology Faculty of Medicine University of Colombo Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipun","family":"Lakshitha De Silva","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Faculty of Medicine General Sir John Kotelawala Defense University Ratmalana Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaturaka","family":"Rodrigo","sequence":"additional","affiliation":[{"name":"Department of Pathology School of Medical Sciences University of New South Wales Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senaka","family":"Rajapakse","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Faculty of Medicine University of Colombo Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature12060"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30473-X"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)00026-8"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12333"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-017-0095-y"},{"key":"e_1_2_7_7_1","volume-title":"Dengue guidelines for diagnosis, treatment, prevention and control","author":"World Health Organization","year":"2009"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH09-03-0208"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0218939"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002277"},{"key":"e_1_2_7_11_1","first-page":"193","article-title":"Gallbladder wall thickening for early detection of plasma leakage in dengue infected adult patients","volume":"50","author":"Nainggolan L","year":"2018","journal-title":"Acta medica Indonesiana"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2014.05.001"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1656-2"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4304-9"},{"key":"e_1_2_7_15_1","volume-title":"Guidelines on management of dengue fever and dengue haemorrhagic fever in adults","author":"Ministry of Health Sri Lanka","year":"2012"},{"key":"e_1_2_7_16_1","volume-title":"Dengue haemorrhagic Fever: Diagnosis, Treatment and Control","author":"World Health Organization","year":"1997"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001397"},{"key":"e_1_2_7_18_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000258612.26743.10"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-015-2013-y"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1671-3"},{"key":"e_1_2_7_22_1","first-page":"519","article-title":"Acute acalculous cholecystitis in dengue fever, JPMA","volume":"59","author":"Bhatty S","year":"2009","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X11006637"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.12659\/PJR.902861"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.1870230605"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9062.242568"}],"container-title":["Tropical Medicine &amp; 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