Physicians, Primary Caregivers and Topical Repellent: All Under-Utilised Resources in Stopping Dengue Virus Transmission in Affected Households

Abstract

BackgroundPrimary health care facilities frequently manage dengue cases on an ambulatory basis for the duration of the patient’s illness. There is a great opportunity for specific messaging, aimed to reduce dengue virus (DENV) transmission in and around the home, to be directly targeted toward this high-risk ambulatory patient group, as part of an integrated approach to dengue management. The extent however, to which physicians understand, and can themselves effectively communicate strategies to stop focal DENV transmission around an ambulatory dengue case is unknown; the matter of patient comprehension and recollection then ensues. In addition, the effectiveness of N,N-diethyl-3-methylbenzamide (DEET)-based insect repellent in protecting dengue patients from Aedes aegypti mosquitoes’ bites has not been investigated.MethodologyA knowledge, attitude and practice (KAP) survey, focusing on the mechanisms of DENV transmission and prevention, was performed using semi-structured questionnaires. This survey was targeted towards the patients and family members providing supportive care, and physicians routinely involved in dengue patient management in Southern Vietnam. An additional clinical observational study was conducted to measure the efficacy of a widely-used 13% DEET-based insect repellent to repel Ae. aegypti mosquitoes from the forearms of dengue cases and matched healthy controls.Principal FindingsAmong both the physician (n = 50) and patient (n = 49) groups there were several respondents lacking a coherent understanding of DENV transmission, leading to some inappropriate attitudes and inadequate acute preventive practices in the household. The application of insect repellent to protect patients and their relatives from mosquito bites was frequently recommended by majority of physicians (78%) participating in the survey. Nevertheless, our tested topical application of 13% DEET conferred only ~1hr median protection time from Ae. aegypti landing. This is notably shorter than that advertised on the manufacturer’s label. No differences in landing time between febrile dengue cases or matched healthy controls (n = 19 experiments) were observed.Conclusion/SignificanceOur study identifies missed opportunities for primary care physicians to improve public health through communication of strategies that could prevent focal dengue transmission in and around a case household. We advocate better access to more efficient communication methods for physicians and auxilliary health workers, supporting to educate those at high risk of DENV transmission. Our empirical testing of a widely-available 13% DEET-based repellent was limited in its protective efficacy against Ae. aegypti mosquito bites, and therefore DENV transmission, suggesting more frequent application is necessary to be beneficial.

<p>Knowledge, attitude and practice towards dengue fever prevention and associated factors among public health sector health-care professionals: in Dire Dawa, eastern Ethiopia</p>

“…Primary physicians and nurses serve as the first-line health care providers to diagnose, notify and treat dengue cases. The KAP of HCPs regarding dengue diseases also provide early recognition and improve the outcome of dengue 21,37. According to this study, the larger proportion of HCPs 148 (49.3%) demonstrated a moderate level of knowledge towards dengue fever prevention.…”

Assessing changes in knowledge, attitude and practices on dengue diagnosis and management among primary care physicians after the largest dengue epidemic in Singapore

“…The right knowledge, attitude and practices on dengue management among PCPs are critical for dengue control and public education [16, 17]. Since 2011, there have been advances in providing better dengue management for suspected dengue patients in Singapore.…”

Pengaruh Seragamisasi Celana/Rok Panjang dalam Mencegah Kejadian Demam Berdarah Dengue pada Siswa Sekolah Dasar

“…6 Hal ini memberikan kesimpulan bahwa nyamuk Aedes aegypti sebagai vektor DBD dapat berkembang biak dan menggigit di dalam ruangan maupun di luar ruangan karena ditemukan jentik nyamuk Aedes aegypti di dalam dan luar ruangan. 7 Ada beberapa faktor yang dapat mencegah gigitan nyamuk Aedes aegypti yang berakibat anak/siswa terkena penyakit demam berdarah dengue yaitu pengaruh pemakaian celana/rok panjang, pengaruh penggunaan repellent, 8,9 pengaruh pemasangan kelambu pada tempat tidur, pengaruh pemasangan kasa nyamuk pada lubang ventilasi serta jendela, 10 pengaruh obat anti nyamuk bakar maupun listrik. 11,12…”