Sri Jayewardenepura General Hospital, Kotte, Sri Lanka.
BMC Infect Dis. 2021 Sep 20;21(1):981. doi: 10.1186/s12879-021-06685-5.
The World Health Organization (WHO) has ranked dengue as one of the top ten threats to Global health in 2019. Sri Lanka faced a massive dengue epidemic in 2017, the largest outbreak in the country during the last three decades, consisting of 186,101 reported cases, and over 320 deaths. The epidemic was controlled by intense measures taken by the health sector. However, the reported dengue cases and dengue deaths in 2019 were significantly higher than that of 2018. Deaths were mostly due to delay in hospitalization of severe dengue patients. The mortality of dengue hemorrhagic fever is 2-5% if detected early and treated promptly, but is high as 20% if left untreated.
A descriptive cross-sectional study was done among patients with dengue fever presenting to the Sri Jayawardenepura General Hospital during October 2019. Data was collected using a questionnaire comprising 20 questions based on knowledge, attitudes and practices on dengue, which were categorized into questions on awareness of mortality and severity of dengue burden, prevention of dengue vector mosquito breeding and acquiring the infection, patient's role in dengue management, and warning signs requiring prompt hospitalization.
The mean KAP score on all questions was 55%, while a majority of 65.2% patients scored moderate KAP scores (50-75%) on all questions, and only 7.6% had high KAP scores (> 75%). The highest categorical mean score of 62% was on awareness of dengue prevention, followed by 54% on awareness of dengue burden, and only 51% on dengue management. Only 5.3% patients scored high scores on awareness of dengue management, followed by 28.5%, and 40.9% patients scoring high scores on awareness of dengue burden, and awareness of prevention of dengue respectively. The mean KAP scores on all questions increased with increasing age category.
The population relatively has a better awareness of dengue prevention, as compared to awareness of dengue mortality and dengue management. The identified weak point is patient awareness of the patients' role in dengue management, and identifying warning signs requiring prompt hospitalization. This results in delay in treatment, which is a major cause for increased mortality. There was a correlation between those who had good knowledge on dengue burden and those who were aware of patients' role in dengue management. An action plan should be implemented to improve public awareness through education programs on the role of the public and patients in dengue management to drive a better outcome.
世界卫生组织（WHO）将登革热列为 2019 年全球十大健康威胁之一。斯里兰卡在 2017 年遭遇了大规模的登革热疫情，这是该国三十年来最大的一次疫情，报告病例 186101 例，死亡超过 320 人。疫情通过卫生部门采取的密集措施得到控制。然而，2019 年报告的登革热病例和登革热死亡人数明显高于 2018 年。死亡主要是由于严重登革热患者住院时间延迟。如果早期发现并及时治疗，登革出血热的死亡率为 2-5%，但如果未治疗，死亡率高达 20%。
2019 年 10 月，在斯里贾亚瓦德纳普拉总医院就诊的登革热患者中进行了一项描述性的横断面研究。使用了一份包含 20 个问题的问卷收集数据，这些问题基于对登革热的知识、态度和实践，分为关于死亡率和登革热负担严重程度的认识、登革热媒介蚊子滋生和感染的预防、患者在登革热管理中的作用，以及需要及时住院的警告信号。
所有问题的平均 KAP 评分均为 55%，而大多数 65.2%的患者对所有问题的 KAP 评分均为中等（50-75%），只有 7.6%的患者 KAP 评分较高（>75%）。最高的分类平均分数为 62%，是关于登革热预防的意识，其次是 54%的关于登革热负担的意识，只有 51%的关于登革热管理的意识。只有 5.3%的患者在登革热管理意识方面得分较高，其次是 28.5%和 40.9%的患者在登革热负担和登革热预防意识方面得分较高。所有问题的平均 KAP 评分均随年龄组的增加而增加。
与登革热死亡率和登革热管理意识相比，人们对登革热预防的认识相对较好。确定的薄弱环节是患者对患者在登革热管理中的作用的认识，以及对需要及时住院的警告信号的认识。这导致治疗延误，这是死亡率增加的主要原因。那些对登革热负担有较好认识的人与那些对患者在登革热管理中的作用有认识的人之间存在相关性。应实施一项行动计划，通过教育计划提高公众对公众和患者在登革热管理中的作用的认识，以取得更好的结果。
