Características y errores más frecuentes en el diagnóstico y tratamiento del dengue en un hospital del norte peruano, 2022

León Jiménez, Franco Ernesto; Inga-Chero, Joel Emmanuel; Mendoza-Farro, Nathaly Blanca Flor; Montoya Reátegui, Adriana; Dioses Díaz, Karim; Cavalcanti Ramírez, Sofia; Moyano, Luz

doi:10.15381/anales.v84i2.25494

An Fac med

2023

DOI: 10.15381/anales.v84i2.25494

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Características y errores más frecuentes en el diagnóstico y tratamiento del dengue en un hospital del norte peruano, 2022

Franco Ernesto León Jiménez,

Joel Emmanuel Inga-Chero,

Nathaly Blanca Flor Mendoza-Farro

et al.

Abstract: Sr. Editor, En el Perú, estamos viviendo una de las peores epidemias de dengue. Hasta junio del 2023, hubo 126 726 casos, 51% confirmados y 132 fallecidos. Piura, en el norte peruano, concentra la más alta frecuencia de fallecidos con 31,7% (1). A pesar de que la letalidad es menor al 1%, un tamizaje inadecuado de la severidad y un tratamiento conservador pueden incrementarla (2).

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2024

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Time analysis of dengue deaths that occurred in two regions of Peru during the climatic-atmospheric phenomena El Niño Costero and Cyclone Yaku

Ramos,

Oyola-García,

Aguirre

et al. 2024

Preprint

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OBJECTIVE: To perform a dengue-related death time analysis that occurred in Piura and Ica (Peru) during the atmospheric phenomena of El Nino Costero and Cyclone Yaku in 2023. MATERIAL AND METHODS: A case-series study was performed. We included the deaths between January 1 and June 3, 2023. We reviewed the research data base of the deaths as well as the clinical epidemiology records, death certificates and laboratory test results. A time analysis was performed from the date of onset of symptoms, date of first visit at a health establishment, date that dengue diagnosis was first registered and date of death. RESULTS: We included 40 deaths by dengue in the study. 70% were females, the median age of death was 51 years of age, and 70% came from Piura. 51.2% presented some comorbidity and 14% had self-medicated with metamizole, other NSAIDS or corticoids before the initial medical consultation. 37.5% presented an unconventional clinical pattern at admission and dengue was not suspected in 40% during the initial assessment. The median time until the initial assessment, the diagnosis time, and the time from diagnosis until death were 3 days, 0 days, and 1 day, respectively. Adults presented a time until the initial assessment significantly greater than the other age groups (p=0.048), the diagnosis time was significantly less than those seen at the Health Department establishments and regional government establishments (MINSA/GORE) than in private establishments (p=0.014) and greater in pediatrics (p=0.018). The time from diagnosis until death was significantly less in those that self-medicated before the initial assessment (p=0.041). CONCLUSION: The adults presented a significantly greater time until the initial assessment; the diagnosis time was less than those seen in MINSA/GORE establishments and greater in pediatrics, furthermore, the time from diagnosis until death was significantly less in those who self-medicated before the initial assessment. An important fraction of deaths presented comorbidities and an unconventional clinical pattern at admission, with dengue frequently not suspected during the initial assessment.

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Time analysis of dengue deaths that occurred in two regions of Peru during the climatic-atmospheric phenomena El Niño Costero and Cyclone Yaku

Ramos,

Oyola-García,

Aguirre

et al. 2024

Preprint

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Adherence to the 2016 PAHO Clinical Practice Guideline on Dengue in a Hospital in Northern Peru, 2022-2023

León Jiménez,

Mendoza-Farro,

Montoya Reategui

et al. 2024

Preprint

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Background: Effective dengue management enhances the chances of survival. The level of adherence to the suggestions in northern Peru is uncertain. The primary aim of the study was to assess adherence to the 2016 PAHO guideline on dengue in a hospital located in northern Peru during the period from 2022 to 2023. Methodology/principal findings: The study performed a cross-sectional design and exploratory analysis, reviewing 141 medical records. Fifty-four percent were from 2023; 65.9% were from women; 46.1% came from another healthcare center; 76.6% had diagnosis of dengue with warning signs; 20.7% had severe dengue; and 18.44% died. We found at least one error in the classification of severity and/or treatment in non-hospital healthcare facilities (91.5%), triage (88.5%), and uviclin/observation (52.6%). Errors in classification and inadequate hydration in the non-hospital healthcare centers, triage, and uviclin/observation were: 35.8%/53.7%, 30.6%/76.6%, and 10.1%/45.6%, respectively. Persistent errors were inadequate hydration in triage (76.86%) and urinary flow in the center (73.13%). In a bivariate analysis, mortality was associated with older age (p = 0.035), having a case from 2023 (p = 0.0073), having a case from the study hospital (p = 0.083), and having severe dengue (p<0.001). In the multivariate analysis, only severe dengue (OR 318.4, 95% IC [33.8-2996], p<0.001) was associated with mortality. Conclusions/significance: We found a high frequency of misclassification and management errors in these three scenarios, but they were not associated with higher mortality.

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Características y errores más frecuentes en el diagnóstico y tratamiento del dengue en un hospital del norte peruano, 2022

Cited by 2 publications

References 2 publications

Time analysis of dengue deaths that occurred in two regions of Peru during the climatic-atmospheric phenomena El Niño Costero and Cyclone Yaku

Time analysis of dengue deaths that occurred in two regions of Peru during the climatic-atmospheric phenomena El Niño Costero and Cyclone Yaku

Adherence to the 2016 PAHO Clinical Practice Guideline on Dengue in a Hospital in Northern Peru, 2022-2023

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