Authors:

Abstract

Introduction: Fever is a common symptom in children and is a cause of great anxiety for parents and caregivers. The improvement in patient comfort appears to be a key therapeutic objective in busy general practices. However, nonsteroidal anti-inflammatory drugs (NSAIDs) in any form and steroids are best avoided especially in patients with fever without a focus. Sri Lanka has been witnessing an increase in dengue fever incidence over the years. Disease manifestations of dengue fever are complex and management is comparatively simple. However, lack of knowledge and erroneous practice at primary care level in managing these children could lead to increase morbidity and mortality.

Objective: To assess the current practice of a group of GPs management of children with fever without a focus and dengue fever, to determine whether this practice is in accordance with available guidelines and to assess the value of educational programmes on strengthening knowledge and practice.

Method This was an experimental, pre-test and post-test design study carried out at the Colombo South Teaching Hospital (CSTH). General Practitioners (GPs) from health divisions in close proximity to CSTH were invited for the study. The enrolled GPs were given a pre-piloted questionnaire. A seminar was conducted on management of fever without a focus and dengue fever for all who took part in the study and information, education, communication (IEC) material were given to all participants. Participant GPs were assessed by a post-test questionnaire. All the data were entered into an electronic format (spreadsheet) and analysed using SPSS version16.

Results: A total of 93 GPs participated in the study. Response rate for the pre-test and post-test questionnaires were 93% and 78% respectively. Before intervention overall median score was 75.68 (IQR-16.22) and after intervention overall median score was 85.14 (IQR-13.51), p value <0.001. Median scores of each knowledge component for managing dengue fever showed an improvement with intervention.

Conclusions: This study has clearly shown improvement of knowledge and perception on febrile phase management of dengue fever.

Sri Lanka Journal of Child Health, 2017; 46(4): 353-356

Keywords: Fever without a focus, fever management, febrile illnesses, antipyretics, dengue fever, General practitioners