Unprepared for dengue – 40% of dengue screening results false’

LAHORE: The rapid screening method being used in a majority of public sector hospitals to detect dengue virus is not recommended by the World Health Organisation (WHO), as 40 percent of the screening results are false, senior doctors told Pakistan Today on Friday.
They said that the mostly available diagnostic tool of screening through kits for the detection of dengue virus was not a quantitative method, as a significant number of test results were “false positive” or “false negative”. Moreover, the WHO-recommended Eliza testing was available only in the Mayo Hospital, Jinnah Hospital and the Institute of Public Health (IPH).
A PhD in microbiology and specialist in viral diseases, Dr Tayyaba Ijaz of the Mayo Hospital said that the strips available in the market were not recommended, as the initial screening method was not up to the mark. “It only tells the quality of virus present in the blood. It gives false results as various other viruses of the same group can interfere in the testing process,” she added.
Commenting on the current situation, she said that the number of dengue patients would not decrease unless the city temperature decreased by another 10 degrees Celsius. “The mosquito becomes a little active after sunrise and sunset and the spray is also effective if done during these hours.
Interestingly, a dengue bite does not itch so all preventive measures be taken to avoid it. Toilet seats be covered and water pales be kept upside down,” Tayyaba added. She said that there was little price difference between the two methods. Mayo Hospital MS Dr Zahid Pervaiz said that Eliza testing was a quantitative method of testing, as it gives an exact IGG and IGM count.
He said that the initial screening could give false results, but Eliza was the confirmatory test for all dengue patients. Patients coming to public hospitals without the facility were referred to other health establishments for the Eliza test. Talking to Pakistan Today, Sir Ganga Ram Hospital MS Dr Aijaz said that all dengue patients were being referred to the IPH for confirmation, as the hospital lacked the facility.
Mega platelets kit not available
The mega platelets kits used in the blood transfusion of dengue patients are not available in any public hospital across the provincial metropolis, Pakistan Today has learnt. A house officer (HO) in the medical unit of Sir Ganga Ram Hospital said the normal platelet count ranges between 150,000 and 450,000, while the dengue virus causes breakdown of platelets in blood, reducing the number below 10,000.
He said the patient starts bleeding in such a situation and blood transfusion is employed to increase the platelet count. With the available equipment, platelets are separated from the blood after getting it from the donor and then transfused into the patient, he said. “Getting one bottle of blood from an individual is considered one platelet.
Since one donor can donate only one or two bottles of blood, the received number of platelets is very few. The mega platelets kits enable doctors to extract platelets directly from the donor, and a healthy individual can donate even 15 platelets in one go compared to one or two under the current circumstances,” the HO concluded. The lack of mega platelet kit has caused inconvenience to patients and their attendants who had to arrange multiple blood donors.
Talking to Pakistan Today, Mughees Ahmad, a patient’s attendant from Garhi Shahu in Mayo Hospital said, he had arranged 10 donors for blood transfusion for his aunt admitted in the hospital. “Despite having arranged 10 bottles, only 20 percent of the cure has completed. My aunt’s platelet count was 7,000 when we came here and even after transfusing 10 bottles, the blood count has still not normalised, although she is recovering. The latest [mega platelets] kits could have saved us the trouble of searching for so many donors,” Ahmad added.
A senior professor, seeking anonymity said the mega platelets kits were only available in Sheikh Zayed Hospital, Anmol Hospital and Shaukat Khanum Hospital. Moreover, he said the one machine was available at the office of the director of blood transfusion, but was not working. He said the latest mega platelets kit costs between Rs 4 to Rs 5 million and “can be easily bought for the teaching hospitals in the city, at least considering the magnitude of the deadly disease”.