Communicable Disease Centre, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 2011 Dec;40(12):533-8.
Dengue fever remains a significant public health concern in Singapore. Appropriate, timely diagnosis and risk stratification for severe disease are crucial in the optimal management of this illness. In the outpatient setting, the primary care physician plays a key role in dengue diagnosis, management, and triage. We present a descriptive analysis of the variations in dengue knowledge, attitudes, and practices among primary care physicians (PCPs) in Singapore.
A survey of 25 multiple-choice questions was mailed to 2000 PCPs in Singapore. Responses were analysed by physician age group (21-40, 41-60, and >61) and practice setting (government subsidised polyclinic or private practice).
Of the 3 questions assessing dengue knowledge, 89.9% chose 2 or 3 of the preferred responses. Half of the respondents utilised dengue diagnostic tests at least 50% of the time, and 75% used serology when doing so. Older respondents and those from private practices used diagnostic tests more often than their counterparts, and both groups favoured non-serology tests. About 85% of surveyed PCPs monitored confirmed or suspected cases daily, and one-third referred patients to a hospital always or often.
While no major gaps in knowledge about dengue were identified in PCPs in Singapore, there were significant variations in clinical practice by physician age group and practice setting. The results of this survey provide a useful opportunity to identify strengths and areas in need of improved awareness in primary care management of dengue.
登革热仍然是新加坡一个重大的公共卫生关注点。在这种疾病的最佳管理中，及时进行适当的诊断和严重疾病的风险分层至关重要。在门诊环境中，初级保健医生在登革热的诊断、管理和分诊中起着关键作用。我们对新加坡初级保健医生（PCP）在登革热知识、态度和实践方面的差异进行了描述性分析。
向新加坡的 2000 名 PCP 邮寄了一份包含 25 个多项选择题的调查。根据医生年龄组（21-40 岁、41-60 岁和>61 岁）和执业环境（政府补贴的综合诊所或私人诊所）对回答进行分析。
在评估登革热知识的 3 个问题中，89.9%的人选择了 2 个或 3 个首选答案。一半的受访者至少 50%的时间使用登革热诊断测试，75%的人在这样做时使用血清学。年长的受访者和来自私人诊所的受访者比他们的同行更频繁地使用诊断测试，并且这两个群体都更喜欢非血清学测试。约 85%的被调查 PCP 每天监测确诊或疑似病例，三分之一的人总是或经常将患者转介到医院。
尽管新加坡的 PCP 在登革热知识方面没有发现重大差距，但在医生年龄组和执业环境方面，临床实践存在显著差异。这项调查的结果为确定初级保健管理登革热方面的优势和需要提高认识的领域提供了一个有用的机会。
