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International Research Consortium on Dengue Risk Assessment, Management and Surveillance (IDAMS)

Funding:

European Union, 7th Framework Programme

Time frame:

September 2011 - August 2016

Scientists (Section Clinical Tropical Medicine):

T. Jänisch, T. Junghanss, J. Kaur, R. Gaczkowski, K. Rosenberger

Cooperating partners:

in Germany, UK, Vietnam, Switzerland, Malaysia, Indonesia, Cambodia, Cuba, El Salvador, Brasil, Ghana and the Netherlands

Web:

www.idams.eu

 

In the IDAMS project a consortium of international experts work together to develop new and innovative tools to be applied to the control of dengue in a global context and aims at

1. improving diagnosis and clinical management of dengue through two linked work packages designed a) to identify readily available clinical and laboratory parameters and/or viral and immunological markers, that differentiate between dengue and other common febrile illness within 3 days of fever onset, and b) to identify any of the available markers that are predictive of the likelihood of evolving to a more severe disease course.

2. assessing the risk of dengue spread through linked work packages focused on a) mapping and modelling techniques to define the current extent of dengue disease globally and to evaluate possible scenarios of spread or risk to previously uninfected regions in the future, and b) developing effective and affordable early warning and outbreak response systems.

 

 

Towards sustainable DENgue COntrol (DENCO)

Funding:European Union 6th Framework Programme (INCO-DEV)
Time frame:2005–2008
Scientists (Section Clinical Tropical Medicine):

T. Jaenisch, J. Barniol, T. Junghanss, R. Gaczkowski,
K. Rosenberger (Unit Epidemiology and Biostatistics)

Cooperating partners:

in Germany, United Kingdom, Belgium, Switzerland, Thailand, Philippines, Vietnam, Malaysia, Venezuela, Cuba and Nicaragua

 

The DENCO project deals with essential matters in five “work packages”, from virology and immunology to aspects regarding the implementation of vector control measures. The Section Clinical Tropical Medicine coordinates the clinical-epidemiological work package with the aim to revise the existing dengue classification distinguishing between Dengue Fever (DF), Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) and, if possible, validate warning signs for severe disease.

 

 

International Research Consortium on Dengue Risk Assessment, Management and Surveillance (IDAMS)

Funding:

European Union 7th Framework Programme

Time frame:

September 2011 – August 2016

Scientists
(Section Clinical Tropical Medicine):

T. Jaenisch, T. Junghanss, J. Kaur, R. Gaczkowski,
K. Rosenberger

Collaborating partners:

· Department of Zoology, University of Oxford, Oxford, UK

· Oxford University Clinical Research Unit, Hospital for Tropical
Diseases, Ho Chi Minh City, Vietnam

· Liverpool School of Tropical Medicine (LSTM), UK

· Institute for Research in Biomedicine, Bellinzona, Switzerland

· TDR/WHO, Special Program for Research and Training of the
World Health Organization, Switzerland

· Department of Pediatrics, University of Malaya Medical Center,
Kuala Lumpur, Malaysia

· Department of Pediatrics, University Gadja Mada, Yogyakarta,
Indonesia

· Friends Without a Border – Angkor Hospital for Children,
Siem Reap, Cambodia

· Pedro Kouri Institute of Tropical Medicine, Havana, Cuba

· Ministry of Health and Social Welfare – Hospital National de Ninos Benjamin Bloom, San Salvador, El Salvador

· Ceara State University, Fortaleza, Brazil

· Environmental Research Group Oxford Limited, Oxford, UK

· INDEPTH Network, Accra, Ghana

· Red Cross / Red Crescent Climate Centre, Den Haag, The Netherlands

Web:

www.idams.eu

 

Dengue is an emerging disease of major global significance and represents an enormous burden for health care systems in endemic countries. Differentiating dengue from other common febrile illnesses before complications develop is difficult - simple and inexpensive strategies are urgently needed to support early and accurate diagnosis, as well as to identify patients at high risk of developing complications, in order both to improve case management and to facilitate appropriate use of limited resources. Evaluation of early clinical features alongside readily available laboratory tests in a large cohort of patients encompassing the breadth of dengue disease encountered in endemic settings is necessary to develop a robust case definiton for dengue, and could also prove to be very useful for the development of prognostic algorithms. Similarly, characterisation of the profiles of important viral and serological biomarkers in such a cohort is likely to provide valuable information that could contribute additional input into diagnostic and prognostic algorithms. Improved strategies for early diagnosis and risk prediction would also enhance the conduct of clinical trials of early therapeutic interventions for dengue e.g. use of anti-viral or immuno-modulatory drugs. If the fight to gain control of the current global pandemic is to be successful, however, it is equally important to consider interventions and strategies at the population level. Early detection of outbreaks with improved surveillance systems and a prompt effective response to imminent outbreaks, could prove highly significant in reducing the numbers of dengue cases globally. In combination with identification of areas likely to be at risk of dengue outbreaks, as defined by risk mapping, such strategies could bring great health benefits by preventing outbreaks and reducing numbers of cases, with consequent reductions in overall morbidity and mortality from dengue.



For further information please visit our project homepage Opens external link in new windowwww.idams.eu

 

 

Towards sustainable DENgue COntrol (DENCO)

 

Funding: Europäische Union, 6. Rahmenprogramm (INCO-DEV)

Time frame: 2005 - 2008

Scientists (Section Clinical Tropical Medicine): T. Jaenisch, J. Barniol, T. Junghanss, R. Gaczkowski, K. Rosenberger (Sektion Biostatistik und Epidemiologie)

Cooperating partners:

● Dept. of Molecular Virology, University Hospital, Heidelberg, Germany

● Liverpool School of Tropical Medicine (LSTM), United Kingdom

● Prince Leopold Institute of Tropical Medicine (ITG), Antwerp, Belgium

● TDR/WHO, Special Program for Research and Training of the World Health Organization, Switzerland

● Queen Sirikit National Institute of Child Health, Bangkok, Thailand

● Department of Vector-Borne/Blood-Borne Infections, San Lazaro Hospital, Manila, Philippines

● Oxford University Clinical Research Unit, Hospital for Tropical Diseases and Paediatrics, Ho Chi Minh City, Vietnam

● Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

● Universidad de los Andes, Research Centre Trujillo, Venezuela

● Virology Department, PAHO/WHO Collaborating Center for Viral Diseases, Tropical Medicine Institute Pedro Kouri (IPK), Havana, Cuba

● Children's Hospital Manuel Jesus de Rivera, Managua, Nicaragua and Department of Virology, National Diagnostics and Reference Center, Ministry of Health, Managua, Nicaragua

 

 

 

The DENCO project deals with essential matters in five “work packages”, from virology and immunology to aspects regarding the implementation of vector control measures.

The Section Clinical Tropical Medicine coordinates the clinical-epidemiological work package with the aim to revise the existing dengue classification distinguishing between Dengue Fever (DF), Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) and, if possible, validate warning signs for severe disease.

In recent years, the existing WHO classification has increasingly been considered deficient. The WHO classification emphasises the haemorrhagic vs. the capillary leakage component as an indicator of severe disease, which leads to misclassification in patients exclusively showing symptoms of shock. What is more, the existing WHO classification reveals problems regarding both sensitivity (if cases with clinical shock are considered the gold standard for severe disease) and specificity, i.e. patients treated by a clinician with a standard protocol are currently assigned a severity attribute (e.g. DHF, Dengue Haemorrhagic Fever).

This results in the fact that better endpoints representing actual disease severity are urgently needed also for pathophysiological and clinical studies.

 

Project results of the clinical project component coordinated by the Section Clinical Tropical Medicine: A prospective observational study was carried out in 11 hospitals from 7 countries across Southeast Asia and Latin America. 2,259 children and adults with suspected dengue were recruited and followed daily with a detailed survey instrument (questionnaire).

All patients were categorised into one of three intervention groups depending on the level of medical and nursing care required. Using a pre-defined analysis plan, the clinical and laboratory parameters characterising these intervention groups were evaluated to ultimately provide a suggestion based on empirical evidence for a revised dengue classification.

 

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