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BMC Infectious Diseases

, 17:428

Viral diseases

Abstract

BackgroundDengue results in high morbidity and mortality globally. The knowledge, attitude and practices KAP of dengue management, including diagnosis, among primary care physicians PCPs are important to reduce dengue transmission and burden. However, there is a lack of understanding on the impact of dengue epidemic on dengue management. Hence, the aim of this study is to examine the changes in KAP on dengue management among PCPs before and after the largest dengue epidemic in 2013 in Singapore.

MethodsSurveys were mailed to 2000 and 1514 PCPs registered under the Singapore Medical Council in March of year 2011 and 2014, respectively. Survey data were then collected between April and June of that year. Chi-square or Fisher’s exact test was used for comparing categorical variables. A multivariate logistic regression model was implemented to determine independent factors for frequent use of dengue diagnostic tests DDTs. All tests were conducted at 5% level of significance. Adjusted odds ratio and corresponding 95% confidence intervals were reported, where applicable. Qualitative data were descriptively coded for themes and analysis.

ResultsAmong PCPs surveyed in 2011 and 2014, 89.9% and 86% had good knowledge on dengue management respectively. The usage of DDTs had increased significantly in 2014 N = 164;56% as compared to 2011 N = 107;29.5% in both private and public clinics p < 0.001. Dengue Duo point-of-care test POCT kits was independently associated with frequent use of DDTs adjusted odds ratio = 2.15; 95% confidence interval = 1.25–3.69. There was a significant reduction in referral of dengue patients to hospital 31.4% in 2011; 13.3% in 2014; p < 0.001, and a significant increase in frequency of clinic follow-ups 18.4% in 2011; 28.5% in 2014; p = 0.003. One key theme highlighted was that dengue management can be improved with availability of POCT kit, better awareness of the disease and any revised clinical guidelines.

ConclusionThe knowledge on dengue management remained high, while the attitude and practices, particularly on the usage of DDTs improved significantly after a large epidemic. Furthermore, PCPs had more confident in managing dengue patients in primary care settings and in educating patients on the importance of vector control and dengue warning signs to reduce dengue transmission and burden.

KeywordsDengue epidemic Primary care Dengue management Dengue diagnosis Knowledge Attitude Practices AbbreviationsDDTsDengue diagnostic tests

DFDengue fever

DHFDengue haemorrhagic fever

DSSDengue shock syndrome

KAPKnowledge, attitude and practices

PCPsPrimary care physicians

POCTPoint-of-care-test

Electronic supplementary materialThe online version of this article doi:10.1186-s12879-017-2525-3 contains supplementary material, which is available to authorized users.





Author: Junxiong Pang - Zoe Jane-Lara Hildon - Tun Linn Thein - Jing Jin - Yee Sin Leo

Source: https://link.springer.com/



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