ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Effect of a Dengue Clinical Case Management Course on Physician Practices in Puerto Rico.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Assessing the diagnostic performance of clinical, serological and molecular approaches to improve dengue case detection in the Peruvian Amazon.PLoS neglected tropical diseases · 2026Article
- Doctors' knowledge, attitudes, and practices in managing dengue fever amid war: A study in three governmental hospitals in Port Sudan, Red Sea State, Sudan (2024).SAGE open medicine · 2026Article
- Knowledge and Perceptions about Diagnosis, Clinical Management, and Prevention of Dengue Fever among Physicians during the 2023 Outbreak: A Cross-Sectional Study in Peru.The American journal of tropical medicine and hygiene · 2024Article
- Urgent Response Needed: Addressing the Dengue Crisis in the Andean and Southern Cone Latin American Regions.The American journal of tropical medicine and hygiene · 2024Article
- Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country.PLoS neglected tropical diseases · 2021Article
- Lessons Learned from Dengue Surveillance and Research, Puerto Rico, 1899-2013.Emerging infectious diseases · 2019Article
- Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014.The American journal of tropical medicine and hygiene · 2017Article
- A New Look at an Old Disease: Recent Insights into the Global Epidemiology of Dengue.Current epidemiology reports · 2017Review
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Authors and funding
9 authors.
Funding
Abstract
backgroundPrior to 2010, the clinical management of dengue in Puerto Rico was inconsistent with World Health Organization guidelines. A 4-hour classroom-style course on dengue clinical management was developed in 2009 and mandated for Puerto Rico medical licensure in 2010. Fifty physicians were trained as "master trainers" and gave this course to 7638 physicians. This study evaluated the effect of the course on the clinical management of hospitalized dengue patients.
methodsPre- and post-course test responses were compared. Changes in physician practices were assessed by reviewing medical records of 430 adult and 1075 pediatric dengue patients at the 12 hospitals in Puerto Rico that reported the most cases during 2008-2009 (pre-intervention) and 2011 (post-intervention). Mixed-effects logistic regression was used to compare key indicators of dengue management.
resultsPhysician test scores increased from 48% to 72% correct. Chart reviews showed that the percentage of adult patients who did not receive corticosteroids increased from 30% to 68% (odds ratio [OR], 5.9; 95% confidence interval [CI], 3.7-9.5) and from 91% to 96% in pediatric patients (OR, 2.7; 95% CI, 1.5-4.9). Usage of isotonic intravenous saline during the critical period increased from 57% to 90% in adult patients (OR, 6.2; 95% CI, 1.9-20.4) and from 25% to 44% in pediatric patients (OR, 3.4; 95% CI, 2.2-5.3).
conclusionsManagement of dengue inpatients significantly improved following implementation of a classroom-style course taught by master trainers. An online version of the course was launched in 2014 to expand its reach and sustainability.
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