Dengue Fever is a mosquito-borne illness commonly present throughout the tropics. Dengue virus belongs to flaviviridae family and circulates with 4 different serotypes circulating in environment. In India four different serotypes of the virus are seen throughout country. The disease has a wide spectrum from an asymptomatic stage to DHF and DSS. Annually 100 million cases of dengue and a half million cases of DHF occurs worldwide with a case fatality of 0.5% to 3.5%. The combined laboratory interventions with the clinical spectrum can reduce the mortality in disease. With this background study was carried out at a peripheral centre to optimise, correlate and predict the laboratory interventions in management of the patients. Probable cases of dengue fever were selected clinically in both indoor and outdoor patients. Retrospective study was carried out at a peripheral centre for duration of 06 months. Depending upon the immunopathogenesis of the disease different tests were combined. Composite haematological, rapid and serological methods were used in all the patients. All the parameters in the data sheet were scrutinised in detail. MacElisa is a highly specific test for the diagnosis of dengue so it was used for the selected cases. Total no of 1158 samples were collected from patients. Major cases reported during august to September. 16.75% were NS1 positive,6.3% IgG positive and 3.8% IgM positive. Mac ELISA detected IgM antibody in 2.15%. There was decrease in platelet count in more no of patients because of decrease in sensitivity or simultaneous progression of some other viral illness. Haematological parameters helped in monitoring progression of illness. Though most of the dengue cases are asymptomatic or which may recover after a fever spike. There have been several reports of panic situation in community because of asymptomatic cases. Combined investigation approach would definitely reduce the panic condition, psychological effects and would reduce the complications of the disease if any. . Early detection of NS1 the antigen would help in monitoring of cases and regular surveillance with haematological parameters. Rapid methods are easy to perform, interpret and less time consuming. Secondary antibody IgG was present in 12.34%. Secondary antibodies can facilitate the progression of the disease to DHF or DSS. Secondary antibody would help in understanding the progress of disease spectrum. Further to add to the study Mac ELISA was performed. At peripheral centres there are no facilities for the blood component preparation and storage. Dengue is serious with a low platelet count. Considering these things at a peripheral centre, combined approach of clinical and laboratory methods were used. These methods are appropriate for timely evacuation of the patients with reduction in mortality and morbidity. In the present study also one patient progressed to DHF. He was immediately transferred to tertiary care centre and successfully managed. Thus we recommend for the combined approach in periphery for better clinical outcome.

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