The Efficacy of Education with the WHO Dengue Algorithm on Correct Diagnosing and Triaging of Dengue-Suspected Patients; Study in Public Health Centre

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Background: Correct diagnosing and triaging dengue fever remains clinical, but is difficult because of unspecific flu-like symptoms. Best tool at the moment is the easy–to-use 2009 WHO guidelines. Objective: To investigate the efficacy of educational intervention with the (adapted and translated) algorithm from the 2009 WHO dengue guideline to healthcare providers in the Indonesian primary health care setting of Central Java. Methods: Quasi-randomized intervention study implemented in two Public Health Centres (PHCs), one being intervention and the other control. Intervention consisted of educational actions on healthcare providers with a presentation, hand-outs and posters. All patients with fever seen in policlinic or emergency department were included. Data were collected with a participatory observation using the WHO algorithm as a guidance. Results: Pre-intervention, a total of 88 patients (n=38 intervention group; n=50 in the control group), and post-intervention, a total of 231 patients (n=105 in the intervention group; n=126 in the control group) were included. Pre-intervention, correct diagnosing and triaging was not significantly different (63.2% vs 64.0% ; p=0.935), while post-intervention, the intervention group scored higher (75.2% vs 62.7% ; p=0.041). However, in both pre- and post-interventional phase, more than 50% of the cases in 19/22 domains were not investigated by the intervention group. Conclusion: Statistical analyses showed a significantly better outcome in correct diagnosis in the intervention group. However, results are considered inconclusive due to incompleteness of relevant information, which most probably leads to many false positive correct diagnoses and triaging.

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