Abstract
ObjectiveThe aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system.MethodsCross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0.05).ResultsThe final sample comprised 474 participants (97%), mean age of 37 years (standard deviation = 10.3), mainly females (83.8%), physicians (40.1%) and from tertiary care (75.1%). The majority (91%) reported using warning signs for dengue in pediatrics clinical practice. The most widely used and highly valued signs were major hemorrhages (gastrointestinal, urinary), abdominal pain, and increase in hematocrit concurrent or not with rapid decrease in platelet count. Persistent vomiting as well as other signs of plasma leakage such as respiratory distress and lethargy/restlessness were not identified as having the same degree of importance, especially by nurse technicians and in primary or secondary care.DiscussionAlthough most health care staff reported using dengue warning signs, it would be useful to extend the training for identifying easily recognizable signs of plasma leakage that occur regardless of bleeding.
Highlights
Dengue is currently a difficult-to-control global health problem, mainly affecting developing countries
In 2010, there were an estimated 96 million apparent infections, of which 14% occurred in the Americas, with half of these in Brazil [2]
Based on studies in various countries [9,10], the World Health Organization (WHO) proposed a new classification [4] aimed at improving the identification of severe forms and optimizing the clinical management of dengue
Summary
Cross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (KruskalWallis) were assessed according to health care occupation and level of care (p
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