Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre

Background: Dengue fever places a substantial burden on healthcare systems in endemic areas. Traditional inpatient management places strain on hospital capacity during seasonal surges. This study evaluates an expanded nurse-led Dengue Outpatient Management (DOM) program at a tertiary centre in Singa...

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Main Authors: Jinghao Nicholas Ngiam, Matthew Chung Yi Koh, Brenda Mae Alferez Salada, Dale Fisher, Sophia Archuleta, Jolene Ee Ling Oon
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Travel Medicine and Infectious Disease
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Online Access:http://www.sciencedirect.com/science/article/pii/S1477893925000882
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author Jinghao Nicholas Ngiam
Matthew Chung Yi Koh
Brenda Mae Alferez Salada
Dale Fisher
Sophia Archuleta
Jolene Ee Ling Oon
author_facet Jinghao Nicholas Ngiam
Matthew Chung Yi Koh
Brenda Mae Alferez Salada
Dale Fisher
Sophia Archuleta
Jolene Ee Ling Oon
author_sort Jinghao Nicholas Ngiam
collection DOAJ
description Background: Dengue fever places a substantial burden on healthcare systems in endemic areas. Traditional inpatient management places strain on hospital capacity during seasonal surges. This study evaluates an expanded nurse-led Dengue Outpatient Management (DOM) program at a tertiary centre in Singapore. Methods: A prospective observational study was conducted from January 2023 to August 2024. DOM inclusion criteria were broadened to include older adults and patients with comorbidities, if clinically stable. Patients received physician evaluation, a nurse-led symptom-based assessment and vital signs monitoring. Results: There were 167 patients managed in DOM in the study period. The model saved an average of 3.3 bed-days per patient, amounting to approximately 231 bed-days saved in 2023. Conclusion: This expanded nurse-led outpatient dengue management model demonstrates safety, feasibility, and resource efficiency. With structured patient selection and monitoring protocols, DOM significantly reduces hospital bed occupancy while offering a scalable solution for dengue-endemic regions.
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spelling doaj-art-1ad800cebf8241b5b115e38c1f73ea932025-08-20T03:22:48ZengElsevierTravel Medicine and Infectious Disease1873-04422025-09-016710288210.1016/j.tmaid.2025.102882Redefining outpatient dengue management 18 years on: lessons from a national tertiary centreJinghao Nicholas Ngiam0Matthew Chung Yi Koh1Brenda Mae Alferez Salada2Dale Fisher3Sophia Archuleta4Jolene Ee Ling Oon5Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore; Corresponding author. 1E Kent Ridge Rd, NUHS Tower Block, Level 10, 119228, Singapore.Division of Infectious Diseases, Department of Medicine, National University Health System, SingaporeDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, SingaporeBackground: Dengue fever places a substantial burden on healthcare systems in endemic areas. Traditional inpatient management places strain on hospital capacity during seasonal surges. This study evaluates an expanded nurse-led Dengue Outpatient Management (DOM) program at a tertiary centre in Singapore. Methods: A prospective observational study was conducted from January 2023 to August 2024. DOM inclusion criteria were broadened to include older adults and patients with comorbidities, if clinically stable. Patients received physician evaluation, a nurse-led symptom-based assessment and vital signs monitoring. Results: There were 167 patients managed in DOM in the study period. The model saved an average of 3.3 bed-days per patient, amounting to approximately 231 bed-days saved in 2023. Conclusion: This expanded nurse-led outpatient dengue management model demonstrates safety, feasibility, and resource efficiency. With structured patient selection and monitoring protocols, DOM significantly reduces hospital bed occupancy while offering a scalable solution for dengue-endemic regions.http://www.sciencedirect.com/science/article/pii/S1477893925000882DengueOutpatientSingaporeIntravenous fluidsHospital admission
spellingShingle Jinghao Nicholas Ngiam
Matthew Chung Yi Koh
Brenda Mae Alferez Salada
Dale Fisher
Sophia Archuleta
Jolene Ee Ling Oon
Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre
Travel Medicine and Infectious Disease
Dengue
Outpatient
Singapore
Intravenous fluids
Hospital admission
title Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre
title_full Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre
title_fullStr Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre
title_full_unstemmed Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre
title_short Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre
title_sort redefining outpatient dengue management 18 years on lessons from a national tertiary centre
topic Dengue
Outpatient
Singapore
Intravenous fluids
Hospital admission
url http://www.sciencedirect.com/science/article/pii/S1477893925000882
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