Assessing changes in knowledge, attitude and practices on dengue diagnosis and management among primary care physicians after the largest dengue epidemic in Singapore

BMC Infectious Diseases

Research Article

Jing Jin¹  Tun Linn Thein¹  Junxiong Pang²  Yee Sin Leo³  Zoe Jane-Lara Hildon⁴ 

[1] Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 144 Moulmein Road, 308089, Singapore, Singapore;Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 144 Moulmein Road, 308089, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore;Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 144 Moulmein Road, 308089, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore;Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore;Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore;Johns Hopkins Center for Communication Programs, Johns Hopkins University, Baltimore, USA;Department of Global Health and Development, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK;

关键词: Dengue epidemic;    Primary care;    Dengue management;    Dengue diagnosis;    Knowledge;    Attitude;    Practices;   

DOI  :  10.1186/s12879-017-2525-3

 received in 2017-03-02, accepted in 2017-06-05,  发布年份 2017

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s). 2017