Clinical Research Directory

Inclusion Criteria: * Age ≥5 years * Decision to hospitalise * Clinical diagnosis of dengue * Participants must also have at least one of the following: 1. Severe abdominal pain or tenderness 2. Vomiting more than 3 times in the past 24 hours 3. Pleural effusion or ascites on clinical or radiological examination 4. Absolute haematocrit \>50% 5. 15% increase in haematocrit compared with a baseline sample (defined as the first sample taken during the current illness) 6. Absolute platelet count \<50 × 10⁹/L 7. Absolute platelet count \<100 × 10⁹/L AND a drop \>50 × 10⁹/L in the past 32 hours 8. ALT or AST \>400 IU/L 9. Pulse pressure \<20mmHg or hypotension for age AND at least one of: peripheral capillary refill time \>2 seconds; urine output 0.5ml/kg/hr; cold/clammy peripheries; agitation or altered mental state 10. Bleeding leading to hypotension for age or requiring blood transfusion or medical intervention (e.g. surgery, endoscopy, or vasoactive drugs) 11. Symptomatic bleeding into a critical site (intracranial, intraspinal, intraocular with visual impairment, retroperitoneal, intra-articular, pericardial, or intramuscular with compartment syndrome) 12. Requirement for organ support, including vasopressors or inotropes, assisted ventilation, dialysis or haemofiltration, or coma (unresponsive to pain without sedation) or requirement for intravenous antiseizure medications Exclusion Criteria: * Patients on ≥ day 10 of illness or who are clinically improving in the opinion of the managing doctor (the 'recovery phase') will be excluded from recruitment. Other exclusion criteria are specific to individual treatment comparisons, and do not preclude randomisation to other arms of the study. * A participant may not enter a specific treatment comparison if that treatment is considered to be indicated or contraindicated by the responsible clinician.