Author: Trang Nguyen

Vietnam remains one of the region’s dengue hotspots. From January to October 2025, the country recorded 110,503 cases and 23 deaths, placing Vietnam among the countries with the highest incidence in Southeast Asia.

Dengue presents highly variable symptoms. With no specific treatment available and rising infection rates among adults and older people, patient monitoring is becoming increasingly challenging. Although only 5–10% of cases progress to severe illness, doctors still struggle to accurately identify high-risk patients, making hospital admission and close monitoring essential.

Speaking at the conference, Dr Ho Quang Chanh, Head of the Dengue Research Group at OUCRU, noted that one of the biggest challenges is the inability to directly measure plasma leakage, the key mechanism that leads to shock. Invasive monitoring can cause bleeding in dengue patients, highlighting the urgent need for safe, non-invasive alternatives.

In response, OUCRU and the Hospital for Tropical Diseases in Ho Chi Minh City have investigated non-invasive wearable monitoring devices and an AI-powered clinical decision support tool.

Early findings show that stroke volume can predict severe progression hours before blood pressure drops. The bioimpedance with two sensors placed on the wrist and ankle can deliver accuracy comparable to ultrasound. When researchers analysed PPG signals, a light-based method that measures changes in blood volume, a transformer model combining PPG and clinical data predicted severe disease two hours ahead with around 80% accuracy.

At the same time, the team is working with engineers at Imperial College London to create a multi-wavelength wearable device to measure blood pressure and other haemodynamic parameters. A compact wrist-worn version is expected to be ready for clinical testing next year.

As part of the clinical decision-support effort, the group has built an AI model using over 20 years of dengue data from Vietnam. Unlike earlier models based mainly on paediatric data, this deep-learning model reaches an accuracy of around 80% and performs consistently on independent datasets.

Dr Chanh added: “Qualitative studies show that healthcare workers need tools that are practical, easy to use and aligned with hospital workflows, not just a prediction model. Only when a tool fits real-world practice can dengue management truly improve. This means it must integrate prediction, treatment guidelines, adjusted weight calculations and other useful features.”

The project has been under development at OUCRU since 2022 and recently received new funding from LifeArc. In the coming period, OUCRU will continue refining the device, improving its performance and optimising it for integration into clinical practice in Vietnam.

This article is informed by reporting from the following source:
https://moh.gov.vn/tin-tong-hop/-/asset_publisher/k206Q9qkZOqn/content/sot-xuat-huyet-dengue-la-nguy-co-voi-moi-lua-tuoi-chu-khong-rieng-tre-em?inheritRedirect=false

With more than 14 million dengue cases reported worldwide in 2024 alone, the mosquito-borne viral infection remains a major global health concern. Dengue often causes flu-like symptoms such as high fever, severe headache, pain behind the eyes, muscle and joint pain, nausea, and rash. Although the overall death rate is low, patients with severe dengue are at a much higher risk of dying.

Even with growing research interest, dengue clinical trials have used many different outcomes and measurement methods. This lack of consistency makes it hard to compare and combine data across studies – something that’s essential for improving guidelines and therefore patient care and outcomes. To address this issue, the researchers developed a Core Outcome Set (COS) and subsequently a Core Outcome Measurement Set (COMS) that can be used in dengue clinical trials worldwide.

A COS is an agreed-upon, standardised selection of outcomes that should be measured and reported in all clinical trials for a specific condition. A COMS recommends how these outcomes should be measured.

The COMS was developed in two phases:

Phase 1 – Development of the DEN-CORE COS

• Outcome identification: Researchers reviewed existing studies to find all outcomes reported in dengue infection research.
• Outcome voting and rating: Through an online Delphi process, participants rated which outcomes were most important for hospitalised patients. These participants were various stakeholders, including healthcare workers, and people with lived experience of dengue.

Phase 2 – Development of the DEN-CORE COMS

• Instrument identification: Measurement tools identified in the literature were mapped to the key outcomes from Phase 1, with additional suggestions from experts.
• Instrument review and voting: A separate group of experts reviewed these tools, discussed them in a consensus workshop, and voted on which should be recommended.

The DEN-CORE COMS defines which outcomes should be measured in all dengue trials but gives researchers flexibility in how they apply them. Which outcomes are used as main (primary) or secondary goals will depend on the type of treatment being tested, the phase of the trial, and its overall objectives.

Daniel Munblit, Co-Lead of the DEN-CORE Project, Reader in Paediatrics at King’s College London and ISARIC Member Representative for Sechenov University, said “With dengue spreading rapidly across continents, we urgently need new treatments. This global standard provides the clarity regulators and researchers require to evaluate therapies faster and make them more widely accessible.”

Sophie Yacoub, Co-Lead of the DEN-CORE Project, Associate professor, University of Oxford said that “Bringing together a global consensus on clinically relevant outcomes to be measured in all future dengue clinical trials, is a major step forward for the dengue therapeutics field.”

Laura Merson, Head of Data, ISARIC, said “Harmonising outcomes across dengue trials strengthens both the quality of each study and the scientific value of the data generated. Initiatives like this support the World Health Organization’s efforts to advance clinical trials globally, ensuring robust evidence for health interventions.”

The authors note that while participants came from 36 countries, most were from Latin America and Southeast Asia, with fewer from Africa and parts of the Western Pacific. This may affect how well the results apply to all regions.

Read the full paper on The Lancet Infectious Diseases.

Vietnam is among the countries most affected by extreme weather, which fuels the spread of infectious diseases. Prolonged heat and humidity create ideal conditions for mosquitoes to breed, driving dengue and other vector-borne illnesses. Flooding, meanwhile, increases exposure to waterborne and digestive diseases. Together, these climate-sensitive risks underline the urgent need for early warning and response systems to protect public health. 

A research team at OUCRU Vietnam, led by Associate Professor Jennifer Ilo Van Nuil and Dr Marc Choisy, has been conducting in-depth qualitative research to examine how advanced warning and response (AW&R) systems can be strengthened to address dengue and other climate-sensitive infectious diseases. The study identifies barriers and facilitators for integrating early warning tools, such as OUCRU’s Dengue Advanced Readiness Tools (DART), into existing surveillance systems. 

This research is part of the  Advance Warning and Response Exemplars (AWARE) project, a three-year global initiative (2023–2025) led by Brown University’s Pandemic Centre and funded by the Gates Foundation, Gates Ventures, and Wellcome. OUCRU Vietnam is one of four in-country research partners, alongside Brazil, Kenya, and South Africa. 

On 30 September, a dissemination workshop was organised to share the Vietnam site findings. Participants, around 30 representatives from the Department of Health, the Centres for Disease Control in Hanoi and Ho Chi Minh city, the National Institute of Hygiene and Epidemiology, Pasteur Institute Ho Chi Minh City, and leading hospitals, also discussed opportunities to improve outbreak prediction and rapid response.  

As infectious diseases grow increasingly complex in the face of climate change, participants agreed that Vietnam has both the opportunity and responsibility to lead by example in advancing early warning and response systems, offering lessons with global relevance. 

Prof Guy Thwaites, Director of OUCRU, underlined the importance of building on Vietnam’s strong disease surveillance system: “Many emerging infectious diseases in Vietnam are first detected here at the Hospital for Tropical Diseases in Ho Chi Minh City. Bringing together expertise and data from across the country, we can move from strong surveillance to even stronger outbreak prediction.”  

Assoc Prof Jennifer Van Nuil, Principal Investigator at OUCRU, emphasised Vietnam’s international recognition: “We have spent the past year exploring the strengths and challenges of Vietnam’s response systems. Through AWARE, Vietnam is being recognised globally as a model for outbreak preparedness, thanks to the collaborative work of OUCRU’s social science, mathematical modeling, and dengue research teams, alongside our partners at HTD. This research is not only about understanding barriers, but also about identifying what works and scaling it.” 

Global significance 

The AWARE project was inspired by the COVID-19 response Exemplars in Global Health programme, which underscored the importance of rapid detection and coordinated responses. By examining “positive outliers” in low- and middle-income countries, AWARE aims to identify best practices and core capacities that enable effective AW&R systems. 

In Vietnam, the project focuses on dengue prevention and control, a pressing challenge as climate change drives more frequent and severe outbreaks. OUCRU’s findings will contribute to evidence-based policymaking, support multi-sectoral collaboration, and strengthen the integration of predictive tools into the national infectious disease surveillance system.