An Evaluation of Integrated Dengue Prevention and Control Project in Disease Outbreak Areas, Chiang Rai Province
Keywords:
Program evaluation, Dengue, Fever without localizing signs, Chiang RaiAbstract
Objective : The objectives of this study were to evaluate the usefulness of the project in both qualitative and quantitative aspects.
Methods : We performed a multiple cross-sectional design by reviewing the medical records of patients (n=517) between 1st June 2018 and 31st December 2018 (Control period), and 1st June 2020 and 31st December 2020 (Intervention period). We interviewed program stakeholders (n=53) from three hospitals (Wiang Chiang Rung Hospital, Padad Hospital, and ChiangKhong Crown Prince Hospital). Univariable and multivariable analyses were conducted to assess the impact of the policy on changes in dengue diagnosis, treatment outcomes, hospitalization rate, and duration of hospitalization among dengue patients and patients with acute fever without localizing signs (AFWLS).
Results : We found that the presence of the test kits was significantly associated with a decrease in dengue diagnosis in AFWLS patients (adjusted OR=0.2, 95% CI 0.1-0.4). However, there was no significant relationship between the test kit and hospitalization rate or admission days. For the qualitative aspects, most hospital staff found the project useful. However, an interviewee who was an expert in the Division of Vector-Borne Diseases expressed concern that the project might induce inappropriate laboratory utilization.
Conclusion : The SD BIOLINE Dengue Duo test kit project was associated with dengue diagnosis. The project also helped increase the confidence of healthcare workers and reduced their workload due to unnecessary outbreak investigations. However, concerns about doctors' misdiagnosis due to over-reliance on the test and inappropriate laboratory utilization were significant.
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