Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil.

Autor: Sicuro Correa L; Department of Pediatrics, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.; School of Medicine, Estácio de Sá University, Rio de Janeiro, RJ, Brazil., Hökerberg YH; Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.; School of Medicine, Estácio de Sá University, Rio de Janeiro, RJ, Brazil., Oliveira RV; Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil., Barros DM; Department of Pediatrics, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil., Alexandria HA; Department of Obstetrics and Gynecology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil., Daumas RP; Germano Sinval Faria Teaching Primary Care Center, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brasil., Andrade CA; Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil., Passos SR; Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil., Brasil P; Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2016 Oct 07; Vol. 11 (10), pp. e0163946. Date of Electronic Publication: 2016 Oct 07 (Print Publication: 2016).
DOI: 10.1371/journal.pone.0163946
Abstrakt: Objective: The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system.
Methods: 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 (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0.05).
Results: The 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.
Discussion: Although 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.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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