Hospital based clinical surveillance for dengue haemorrhagic fever in Bandung, Indonesia 1994-1995.

In Indonesia, by law dengue haemorrhagic fever (DHF) cases must be reported within 24 h to the district health authority. The objective of this study was to evaluate the adequacy, accuracy and reporting delay of this reporting system. In four major hospitals of the city of Bandung, medical records of hospitalised DHF cases admitted between April 1994 and March 1995 were reviewed. This list of DHF cases was compared with the list of reported cases to the Bandung Municipality Health Office. During the study period, 569 DHF cases and 81 dengue shock syndrome (DSS) cases were diagnosed. Only 199 (31%) of the 650 hospitalised cases with suspected DHF/DSS were reported to the Bandung Municipality Health Office. The percentage of fatal cases was significantly lower among all hospitalised cases 11/650 (1.7%) than among reported cases 5/199 (2.5%). In only 443 of the 583 hospitalised cases (76%) in which a dengue serological test was performed, was this test positive. Of the 199 reported DHF/DSS cases 151 (76%) had a positive haemagglutination inhibition test. This study shows that the surveillance system for DHF/DSS in Bandung should be strengthened. DHF/DSS cases should be reported on the basis of a diagnosis made during hospitalisation preferably after a serological confirmation is obtained.