Strengthening arbovirus management through a co-designed, community-driven approach: A multi-level evaluation from local to global perspectives
Arbovirus Improving Patient Outcomes Plan (IPOP)
The Improving Patient Outcomes Partnerships (IPOP) programme is a multi-year research and implementation initiative designed to address key gaps in how arboviruses are managed in clinical and public health settings. These gaps directly affect both patient outcomes and the ability of health systems to respond effectively during outbreaks.
Our work will initially focus on four priority questions:
Diagnosis and outcomes
How does confirming the exact cause of illness influence clinical decisions and patient recovery?
Digital health solutions
Can telehealth and digital tools improve follow-up and continuity of care, particularly in at-risk groups?
Management gaps
What do patients and healthcare providers identify as the most urgent needs in current practice?
Risk factors for severe disease
How dcan we better predict which patients are most at risk of poor outcomes?
A phased, adaptive approach
The IPOP will be implemented in phases, with regular review to refine priorities as evidence emerges.
A conceptual framework for the iterative development and review of the arbovirus IPOP illustrating how projects will be launched with a staggered approach based on evidence generated throughout the life course of the programme.
The first phase (named Phase 0 and running until late 2026) is a comprehensive “mapping” to understand the arbovirus management landscape. This will involve:
- Understanding the contexts in which arboviruses are treated
- Characterising affected patient populations
- Identifying promising technologies and innovations
- Exploring patient-provider-community-health system dynamics
The proposed aims and scope of the arbovirus IPOP research programme include mapping individual, interpersonal, institutional, community and societal factors in the arbovirus management landscape, through systematic reviews, environmental scan, clinical and research capacity assessment, and patient and provider interviews.
By the end of this phase, findings will shape the next stage of the programme. We will also seek additional funding to expand into larger, more definitive research studies, ensuring the programme continues to adapt to emerging evidence and outbreak realities.
Activities in Phase 0
The activities in Phase 0 will provide the foundation for future large-scale clinical studies and targeted interventions. A summary of each project included in Phase 0 of the arbovirus IPOP is provided below. Outputs will be used to identify the most effective strategies for improving patient care in diverse settings, bridging the gap between public health systems and clinical management.
A systematic review of digital and telehealth technologies for diagnosis and management of arboviruses
Primary research question: What is the available evidence on digital and telehealth technologies that are being used or developed specifically for the diagnosis and management of arboviruses?
Status: Data extraction ongoing
More information: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251043618
A systematic review of point-of-care diagnostics for arboviruses
Primary research question: Does a specific aetiological diagnosis influence the clinical management of patients with arboviruses?
Status: Data extraction ongoing
More information: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251043605
An analysis of national surveillance data from Brazil to describe the clinical-epidemiological profile and outcomes of patients with dengue
A multi-level multi-country social science study of perceptions towards dengue management
Primary Objective: To assess and compare perceptions, attitudes, and confidence levels among patients and providers in relation to dengue virus management.
Secondary Objectives:
- To identify barriers and facilitators to effective dengue prevention
- To identify barriers and facilitators to effective dengue management.
- To catalogue and assess existing dengue-related resources, tools, and policies.
Tertiary Objective
- To provide actionable recommendations to enhance training, education, and communication.
Methodology: One-to-one interviews with a) patients, people with lived experience of dengue and/or people from communities affected by dengue, b) doctors, c) nurses and d) community health workers
Status: Study preparation ongoing.
Open to new collaborations: Yes. We are open to discussing new collaborations on this project, with potential limited funding available for collaborators in LMICs.
A multi-country perspective observational cohort study to understand clinical outcomes of patients with confirmed arboviral illnesses
Primary Objectives:
- Diagnostic Confirmation
- What proportion of suspected arbovirus cases are confirmed per healthcare level (e.g. primary, secondary, tertiary care) and geographic region?
- What diagnostic methods are used across healthcare levels and geographic regions?
- What proportion of confirmed cases involve co-infection?
- Clinical Characteristics
- What are the clinical features of each arbovirus during the acute phase?
- How frequent are these features in the general population and across age groups?
- How many days following onset of symptoms do patients typically present?
- What is the average length of stay in hospital?
- What outcomes do patients experience during the acute phase of illness?
- Severe Disease Manifestations
- What are the severe disease manifestations that occur within 10 days of initial presentation?
- What is their frequency?
- What are the risk factors and warning signs for progression to severe disease?
- What is the frequency of interventions used to manage severe disease manifestations?
Methodology: An international, multicentre, prospective observational cohort study conducted across primary, secondary, and tertiary healthcare facilities
Status: Study preparation ongoing.
Open to new collaborations: Yes. We are open to discussing new collaborations on this project, with potential limited funding available for collaborators in LMICs.
A multi-country survey to understand current patient management practices at different levels of health system
Primary Objective: To better understand the characteristics of the affected patient populations, clinical management practices, and contextual factors that will be helpful to inform the development of scientifically robust, operationally feasible arbovirus research across multiple countries affected by dengue.
Methodology: Online survey with clinicians involved in the clinical management of arboviruses.
Status: Data collection ongoing. You can participate in this survey using the following link: https://app.onlinesurveys.jisc.ac.uk/s/oxford/dengue-site-assessment
A co-designed telehealth solution designed for at home dengue care: a participatory design model
Use of ultrasound for the detection of complications in patients with severe dengue
Contact
If you wish to collaborate with us on any of the above projects or if you have any questions, please contact us.