Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.

Dengue is a major cause of morbidity in Puerto Rico and is well-known to its physicians. Early case identification and timely initiation of treatment for patients with severe dengue can reduce medical complications and mortality. To determine clinical management and reporting practices, and assess k...

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Autores principales:	Kay M Tomashek, Brad J Biggerstaff, Mary M Ramos, Carmen L Pérez-Guerra, Enid J Garcia Rivera, Wellington Sun
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/c2be5dad6aa849b7976b74e8c73c1455
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spelling	oai:doaj.org-article:c2be5dad6aa849b7976b74e8c73c14552021-11-25T06:31:56ZPhysician survey to determine how dengue is diagnosed, treated and reported in puerto rico.1935-27271935-273510.1371/journal.pntd.0003192https://doaj.org/article/c2be5dad6aa849b7976b74e8c73c14552014-10-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0003192https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735Dengue is a major cause of morbidity in Puerto Rico and is well-known to its physicians. Early case identification and timely initiation of treatment for patients with severe dengue can reduce medical complications and mortality. To determine clinical management and reporting practices, and assess knowledge of dengue and its management, a survey was sent to 2,512 physicians with a medical license in Puerto Rico. Of the 2,313 physicians who received the survey, 817 (35%) completed the questionnaire. Of the respondents, 708 were currently practicing medicine; 138 were board certified (Group 1), 282 were board eligible (Group 2), and 288 had not finished residency (Group 3). Although respondents clinically diagnosed, on average, 12 cases of dengue in the preceding three months, 31% did not report any suspected cases to public health officials while about half (56%) reported all cases. Overall, 29% of respondents correctly identified early signs of shock and 48% identified severe abdominal pain and persistent vomiting as warning signs for severe dengue with the proportion of correct respondents highest in Group 1. Reportedly about sixty percent (57%) appropriately never give corticosteroids or prophylactic platelet transfusions to dengue patients. One third (30%) of respondents correctly identified administration of intravenous colloid solution as the best treatment option for dengue patients with refractory shock and elevated hematocrit after an initial trial of intravenous crystalloids, and nearly one half (46%) correctly identified administration of a blood transfusion as the best option for dengue patients with refractory shock and decreased hematocrit after a trial of intravenous crystalloids. Even though dengue has been endemic in Puerto Rico for nearly 4 decades, knowledge of dengue management is still limited, compliance with WHO treatment guidelines is suboptimal, and underreporting is significant. These findings were used to design a post graduate training course to improve the clinical management of dengue.Kay M TomashekBrad J BiggerstaffMary M RamosCarmen L Pérez-GuerraEnid J Garcia RiveraWellington SunPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 8, Iss 10, p e3192 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Kay M Tomashek Brad J Biggerstaff Mary M Ramos Carmen L Pérez-Guerra Enid J Garcia Rivera Wellington Sun Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.
description	Dengue is a major cause of morbidity in Puerto Rico and is well-known to its physicians. Early case identification and timely initiation of treatment for patients with severe dengue can reduce medical complications and mortality. To determine clinical management and reporting practices, and assess knowledge of dengue and its management, a survey was sent to 2,512 physicians with a medical license in Puerto Rico. Of the 2,313 physicians who received the survey, 817 (35%) completed the questionnaire. Of the respondents, 708 were currently practicing medicine; 138 were board certified (Group 1), 282 were board eligible (Group 2), and 288 had not finished residency (Group 3). Although respondents clinically diagnosed, on average, 12 cases of dengue in the preceding three months, 31% did not report any suspected cases to public health officials while about half (56%) reported all cases. Overall, 29% of respondents correctly identified early signs of shock and 48% identified severe abdominal pain and persistent vomiting as warning signs for severe dengue with the proportion of correct respondents highest in Group 1. Reportedly about sixty percent (57%) appropriately never give corticosteroids or prophylactic platelet transfusions to dengue patients. One third (30%) of respondents correctly identified administration of intravenous colloid solution as the best treatment option for dengue patients with refractory shock and elevated hematocrit after an initial trial of intravenous crystalloids, and nearly one half (46%) correctly identified administration of a blood transfusion as the best option for dengue patients with refractory shock and decreased hematocrit after a trial of intravenous crystalloids. Even though dengue has been endemic in Puerto Rico for nearly 4 decades, knowledge of dengue management is still limited, compliance with WHO treatment guidelines is suboptimal, and underreporting is significant. These findings were used to design a post graduate training course to improve the clinical management of dengue.
format	article
author	Kay M Tomashek Brad J Biggerstaff Mary M Ramos Carmen L Pérez-Guerra Enid J Garcia Rivera Wellington Sun
author_facet	Kay M Tomashek Brad J Biggerstaff Mary M Ramos Carmen L Pérez-Guerra Enid J Garcia Rivera Wellington Sun
author_sort	Kay M Tomashek
title	Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.
title_short	Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.
title_full	Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.
title_fullStr	Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.
title_full_unstemmed	Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.
title_sort	physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/c2be5dad6aa849b7976b74e8c73c1455
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Physician survey to determine how dengue is diagnosed, treated and reported in puerto rico.

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