Knowledge, attitudes, and practices of Florida physicians regarding dengue before and after an educational intervention.

Susanne Doblecki-Lewis,Renee Jiddou-Yaldoo,Kay M Tomashek,Paola Lichtenberger,Aileen Chang,Leena Anil,Danielle Stanek

doi:10.1186/s12909-016-0647-8

Abstract

BackgroundFailure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease. In Florida, travel-related and autochthonous dengue occur and are likely under-recognized. The objective of this study was to evaluate physician knowledge of dengue and its management before and after an educational intervention in Florida.MethodsFrom 2012–13 we conducted 14 grand-rounds style lectures on dengue clinical management attended by 413 physicians, and analyzed data from the pre- and post-tests.ResultsOf those attending, 231 and 220 completed the pre-and post-tests, respectively. Overall, the mean pre-test score for knowledge-based questions was 74.3 and average post-test score was 94.2 %, indicating a mean increase of 19.9 % (P < 0.0001, 95 % CI 17.7–22.4). Reported confidence in dengue recognition and management also increased. Non-US trained physicians and those who had treated more than ten dengue cases performed significantly better in the pre-test. Post-test scores did not differ by subgroup.ConclusionsThe train-the-trainer approach with grand-rounds style presentations appear to be an effective intervention to improve knowledge of dengue among physicians.

Highlights

Failure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease
Florida is at risk for dengue outbreaks with locally acquired dengue cases because of its largely nonimmune population, an abundance of the mosquito vectors, Aedes aegypti and Aedes albopictus, and importation of dengue virus via viremic tourists and residents returning from neighboring dengue-endemic areas including Mexico, Central and South American, and the Caribbean
A total of 413 physicians attended 14 dengue grandrounds presentations offered in Florida between January 2012 and October 2013

Summary

Introduction

Failure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease. In Florida, travel-related and autochthonous dengue occur and are likely under-recognized. Prior to 1940, dengue outbreaks occurred regularly in Florida including approximately 15,000 cases from 1934–1935. Florida is at risk for dengue outbreaks with locally acquired dengue cases because of its largely nonimmune population, an abundance of the mosquito vectors, Aedes aegypti and Aedes albopictus, and importation of dengue virus via viremic tourists and residents returning from neighboring dengue-endemic areas including Mexico, Central and South American, and the Caribbean. The majority of dengue cases reported in Florida are travel-associated cases [3]. Florida is a leading reporter of travel-associated dengue cases among the U.S states and in 2015, Florida was second only to California [6]. Infection with one serotype gives lifelong immunity to that serotype 197/224 (83.2 %)

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