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Dengue DiseaseDengueCBDRNCT07409857

International Registry of Dengue Infection in Congenital Bleeding Disorders (DengueCBDR)

An observational study of Dengue Disease and Dengue Haemorrhagic Fever, run by Mahidol University at 1 site in Thailand.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Dengue fever, a viral infection transmitted by Aedes mosquitoes, is a major health issue in tropical and subtropical regions. Around 20-30% of symptomatic patients developed Dengue Hemorrhagic Fever (DHF), which leads to impaired hemostasis, subsequently increasing the risk of bleeding. Read more about this study

Who is it for?
Any age
How many people
100 participants
Where
1 siteThailand
Study dates
1 Dec 2025to 31 Dec 2030
How long will I take part?
14 Days
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: Patients with congenital bleeding disorders of any age who have dengue infection

Who may be able to join

  • Patients, aged ≥ 1 day old, diagnosed with CBDs (e.g., hemophilia, von Willebrand disease, and other coagulation factor deficiency) who are diagnosed with dengue infection, based on WHO criteria as follow;
  • Clinical dengue infection:
  • Symptoms of high sustained fever for 3-7 days with 2 of the following: headache, retroorbital pain, myalgia, arthralgia/bone pain, hemorrhagic manifestation, positive tourniquet test, leukopenia (WBC ≤5000/uL)
  • Probable dengue infection:
  • Positive dengue IgM
  • Definite dengue infection:
Show all 21Show fewer
  • Seroconversion of dengue IgM between acute and convalescent serum OR Rising of dengue IgG (HAI) at least 4 folds between acute and convalescent serum OR Positive NS1 Ag or other dengue-specific antigen tests
  • Dengue hemorrhagic fever:
  • Dengue infection with signs of bleeding (including positive tourniquet test) with platelet count < 100,000/uL and with signs of leakage (one of the following):
  • Increase Hct at least 15-20% from baseline
  • Serum albumin < 35 g/L
  • Presence of pleural effusion or ascites
  • Dengue shock syndrome:
  • Narrow pulse pressure (< 20 mmHg)
  • Hypotension
  • Signs of poor tissue perfusion
  • Severity of DHF:
  • Grade I: Positive tourniquet test
  • Grade II: Spontaneous bleeding
  • Grade III: Circulatory failure (narrow pulse pressure ≤20 mmHg, hypotension, or signs of poor tissue perfusion)
  • Grade IV: Profound shock with undetectable blood pressure

Who cannot join

  • Patients with CBDs with dengue infection who are not willing to participate in the study

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Nongnuch Sirachainan, MD contact

+66865603103

nongnuch.sir@mahidol.ac.th

Sawitree Chawwapee contact

+6622011749

imdrunkcat@hotmail.com

Thailand1 site, 1 recruiting
  • Ramathibodi Hospital

    Bangkok

    Nongnuch Sirachainan, MD, +66865603103, nongnuch.sir@mahidol.ac.th

    Recruiting

Other trials in Thailand

About this study

Dengue fever, a viral infection transmitted by Aedes mosquitoes, is a major health issue in tropical and subtropical regions. Around 20-30% of symptomatic patients developed Dengue Hemorrhagic Fever (DHF), which leads to impaired hemostasis, subsequently increasing the risk of bleeding.

The hemostatic abnormalities associated with dengue infection included vascular permeability, platelet dysfunction, and coagulation defects. Therefore, Individuals with underlying bleeding disorders are at increased risk of bleeding. Dengue infection in patients with hemophilia was reported, including six of 843 patients in the cohort with underlying hemophilia: five with hemophilia A and one with hemophilia B. Replacement therapy was more commonly used in patients with bleeding disorders and dengue than in patients with other febrile illnesses. All of them had bleeding during dengue infection. The mortality rate was high at 16%.

Read more

Despite the importance of this issue, there is a lack of registries or data-collection systems to determine the bleeding complications, the requirement for replacement therapy, and the outcome of dengue infection in congenital bleeding disorders (CBDs). Therefore, this research aims to establish a registry of dengue infections among individuals with CBDs.

The study is a multicenter, retrospective study from 1 January 2015 to 31 December 2025 and a prospective cohort study involving hospitals that treat individuals with CBDs and dengue. The registry format will be provided using REDCap system.

Read the detailed description

Background:

The global incidence of dengue has markedly increased over the past two decades, posing a substantial public health challenge. From 2000 to 2019, the World Health Organization (WHO) documented a tenfold surge in reported cases worldwide, increasing from 500,000 to 5.2 million, with reported instances spreading across 129 countries.

Dengue fever, a viral infection transmitted by Aedes mosquitoes, is a major health issue in tropical and subtropical regions. Dengue virus (DENV) causes systemic infection in 25% of infected individuals. The symptoms include fever, rash, and, in severe cases, hemorrhagic manifestations. Around 20-30% of symptomatic patients developed Dengue Hemorrhagic Fever (DHF), which leads to increased vascular permeability, thrombocytopenia, and coagulopathy, which are known to increase the risk of bleeding. The most serious presentation is Dengue Shock Syndrome (DSS), which can cause substantial morbidity and mortality, particularly in vulnerable populations. One such vulnerable group is individuals with congenital bleeding disorders (CBDS), such as hemophilia, von Willebrand disease (vWD), platelet disorders, and other coagulation factor deficiencies.

Individuals with CBD have an inherent predisposition to bleeding complications, which could be exacerbated by the platelet dysfunction and vascular leakage associated with dengue infection. In addition, the interaction between the pathophysiology of dengue and bleeding disorders creates significant challenges in the diagnosis, management, and treatment of these individuals. Despite the importance of this issue, there is a lack of comprehensive registries or data-collection systems that track the incidence and outcomes of dengue infection among individuals with congenital bleeding disorders.

Dengue infection in patients with hemophilia was reported. A total of six patients in a cohort of 843 patients had underlying hemophilia; five with hemophilia A and one with hemophilia B. Replacement therapy was higher in patients with bleeding disorders with dengue, compared to other febrile illnesses. All of them had bleeding during dengue infection. The mortality rate was 16%. In addition, severe hemophilia patients presented with bleeding during the febrile stage while the platelet count was normal, then required factor replacement therapy. However, there is limited data on bleeding severity, replacement or prophylaxis protocols, and outcomes for this population.

This research aims to establish a registry of dengue infections among individuals with CBDs to understand bleeding complications, management, and outcomes of these patients. The registry will gather data on the clinical course, complications, management strategies, and outcomes of dengue infection in this population.

Primary Objective:

  1. To develop a registry of dengue infections in individuals with CBDs.
  2. To evaluate the bleeding complications, replacement therapy and outcomes of dengue infections in individuals with CBDs.

Secondary Objectives (if any):

To compare bleeding severity and outcome among types of bleeding disorders

Study design/methodology:

An international multicenter, retrospective, from 1 January 2015 to 31 December 2025, and prospective cohort study, involving hospitals that treat individuals with CBDs with dengue infection. The registry format will be provided using a REDCap system

Study Population:

Inclusion Criteria

Patients, aged ≥ 1 day old, diagnosed with CBDs (e.g., hemophilia, Von Willebrand disease, and other coagulation factor deficiency) who are diagnosed dengue infection, based on WHO criteria

Exclusion Criteria

Patients with CBDs with dengue infection who are not willing to participate the study

Registration information (include in the document link)

PART A: General information

Age at diagnosis.......year.........month

Sex

Underlying inherited bleeding disorder: Hemophilia, Coagulation factor deficiency, Platelet disorders, von Willebrand disease Prophylaxis: Factor dose and frequency

PART B: Dengue infection

Diagnosis: Clinical, probable, definite, uncertain (criteria is defined) Onset of presentation Fever Bleeding symptoms Replacement therapy during dengue infection Febrile stage Toxic (leakage, shock) stage Recovery

Outcome Survive Improved without sequelae Improved with sequelae Death from Bleeding Organ failure Infection Other ……………………………………….

Complication None Infection-associated hemophagocytic syndrome Encephalitis/Meningitis Renal failure Liver failure Rhabdomyolysis Other infection

Statistical analysis Descriptive statistics will be used to characterize the study population, and statistical tests (e.g., the chi-square test, t-tests, logistic regression) will be employed to analyze and comparison severity of bleeding and outcomes among types of bleeding disorders

Keywords
Dengue, Congenital bleeding disorders, Replacement
Medical subject headings
Dengue

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07409857
Study groupRoleWhat they receive
Dengue infection in patients with congenital bleeding disordersNot described

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Severity of Bleeding

    Percentage of major and clinically relevant non-major bleeding (CRNMB)

    Major bleeding: Fatal bleeding, clinically overt bleeding associated with a decrease in Hgb of at least 20 g/L (2 g/ dL) in a 24-hour period, critical site bleeding such as retroperitoneal, pulmonary, pericardial, intracranial, or otherwise involves the central nervous system, bleeding that requires an intervention via an invasive procedure such as surgery in an operating suite, interventional radiology, or endoscopy

    Clinically relevant non-major bleeding (CRNMB): Bleeding that results in a medical or procedural intervention not meeting major bleeding criteria, examples include: hormonal therapy, tranexamic acid (TXA), iron, nasal packing, nasal cautery, laparoscopic arthroscopic retrograde cholangiopancreatography (LARC) placement, bleeding that results in hospitalization or increased level of care, overt bleeding for which a blood product is administered, and does not meet criteria for major bleeding

    Measured: Day of fever (Day 1) to Day 14 or Day of discharge from the hospital (if less than day 14)

  2. Amount of replacement therapy

    Percentage of patients receiving blood product, Percent of factor activity requirement during dengue infection

    Measured: Day of fever (Day 1) to Day 14 or Day of discharge from the hospital (if less than day 14)

  3. Mortality

    Percentage of mortality

    Measured: Day of fever (Day 1) to Day 14 or Day of discharge from the hospital (if less than day 14)

Secondary outcomes (2)
  1. Severity of bleeding among congenital bleeding disorders

    Compared percentage of severity of bleeding between hemophilia and other bleeding disorders

    Measured: Day of fever (Day 1) to Day 14 or Day of discharge from the hospital (if less than day 14)

  2. Mortality among congenital bleeding disorders

    Compared percentage of mortality outcome between hemophilia and other bleeding disorders

    Measured: Day of fever (Day 1) to Day 14 or Day of discharge from the hospital (if less than day 14)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Feb 2026
  2. Study start1 Dec 2025
  3. Primary completion31 Dec 2030 (estimated)
  4. Study completion31 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Other
Enrolment
100 participants (estimated)
Target duration
14 Days
IDs, dates and publications
ClinicalTrials.gov ID
NCT07409857
Sponsor's protocol ID
7249
Other IDs
MURA2025/385
Acronym
DengueCBDR
Status last verified
Jan 2026
First submitted
20 Jan 2026
Last updated
17 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • 1. World Health Organization. Disease Outbreak News Dengue Global Situation. Last modified December 21,2023 https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498#:~:text=After%20a%20slight%20decline%20of%20cases%20between%20the,scale%2C%20and%20simultaneous%20occurrence%20of%20multiple%20outbreaks%2C%20sprea

  • Krishnamurti C, Kalayanarooj S, Cutting MA, Peat RA, Rothwell SW, Reid TJ, Green S, Nisalak A, Endy TP, Vaughn DW, Nimmannitya S, Innis BL. Mechanisms of hemorrhage in dengue without circulatory collapse. Am J Trop Med Hyg. 2001 Dec;65(6):840-7. doi: 10.4269/ajtmh.2001.65.840.

    PubMed 11791984
  • Wijayaratne D, Ranasinghe P, Mohotti SP, Dilrukshi SA, Katulanda P. Dengue fever in a patient with severe haemophilia: a case report. BMC Res Notes. 2015 Mar 12;8:78. doi: 10.1186/s13104-015-1043-x.

    PubMed 25889043
  • Chuansumrit A, Tangnararatchakit K, Sirachainan N, Khositseth A, Kuptanon T, Wanitkun S, Withurawanit W, Songdej D. Dengue virus infection in haemophilic patients: aggravation of bleeding risk. Haemophilia. 2011 May;17(3):553-6. doi: 10.1111/j.1365-2516.2010.02413.x. Epub 2010 Nov 11. No abstract available.

    PubMed 21070495
  • Sosothikul D, Thisyakorn U, Thisyakorn C. HEMOSTATIC STUDIES IN DENGUE PATIENTS. Southeast Asian J Trop Med Public Health. 2015;46 Suppl 1:43-5.

    PubMed 26506731
  • Sosothikul D, Seksarn P, Pongsewalak S, Thisyakorn U, Lusher J. Activation of endothelial cells, coagulation and fibrinolysis in children with Dengue virus infection. Thromb Haemost. 2007 Apr;97(4):627-34.

    PubMed 17393026
  • Chuansumrit A, Chaiyaratana W. Hemostatic derangement in dengue hemorrhagic fever. Thromb Res. 2014 Jan;133(1):10-6. doi: 10.1016/j.thromres.2013.09.028. Epub 2013 Sep 26.

    PubMed 24120237
  • Chuansumrit A, Tangnararatchakit K, Sirachainan N, Pakakasamal S, Hongeng S, Chaiyaratana W, Kitpoka P, Yoksan S. Dengue infection in hematologic-oncologic pediatric patients: aggravation of anemia and bleeding risk. Southeast Asian J Trop Med Public Health. 2012 Mar;43(2):311-22.

    PubMed 23082583
  • Gubler DJ. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev. 1998 Jul;11(3):480-96. doi: 10.1128/CMR.11.3.480.

    PubMed 9665979
  • Simmons CP, Farrar JJ, Nguyen vV, Wills B. Dengue. N Engl J Med. 2012 Apr 12;366(15):1423-32. doi: 10.1056/NEJMra1110265. No abstract available.

    PubMed 22494122
  • Kalayanarooj S. Clinical Manifestations and Management of Dengue/DHF/DSS. Trop Med Health. 2011 Dec;39(4 Suppl):83-7. doi: 10.2149/tmh.2011-S10. Epub 2011 Dec 22.

    PubMed 22500140

Questions about this trial

What is this clinical trial studying?

An observational study of Dengue Disease and Dengue Haemorrhagic Fever, run by Mahidol University at 1 site in Thailand.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 21 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 17 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Thailand. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Nongnuch Sirachainan, MD (+66865603103, nongnuch.sir@mahidol.ac.th), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Severity of Bleeding (time frame: Day of fever (Day 1) to Day 14 or Day of discharge from the hospital (if less than day 14)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07409857, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2026.

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