Table 3. Knowledge of early signs of shock and warning signs for severe dengue, how to make laboratory diagnosis and reported criteria for referral to hospital.* .
| Overall (n = 708)Group 1 (n = 138)Group 2 (n = 282)Group 3 (n = 288) | p-value | ||||
| No./Total No. Who Answered: Estimated Percentage (95% CI) | |||||
| Clinical diagnosis (% who always use): | |||||
| Use 1997 WHO case definition† | 624/678: 92(90,94) | 15/128: 88(80,93) | 255/273: 93(90,96) | 254/277: 92(88,94) | 0.20 |
| Use platelet count | 654/685: 96(94,97) | 122/130: 95(90,97) | 265/278: 95(92,97) | 267/277: 96(94,98) | 0.66 |
| Use white cell count | 600/680: 89(86,91) | 111/130: 86(80,91) | 245/275: 89(85,92) | 244/275: 89(84,92) | 0.76 |
| Use tourniquet test | 119/626: 19(16,22) | 19/126: 11(8,16) | 48/253: 19(5,24) | 52/247: 21(17,26) | 0.07 |
| Knowledge (% who correctly identified): | |||||
| Tachycardia & delayed capillary refill as early sign of shock | 215/708: 29(26,33) | 54/138: 38(30,46) | 101/282: 36(31,41) | 60/288: 21(17,26) | <0.001 |
| Severe abdominal pain and persistent vomiting as warning signs | 347/708: 48(44,51) | 86/138: 63(55,71) | 132/282: 47(41,52) | 129/288: 45(39,50) | 0.003 |
| All warning signs listed† | 181/665: 26(23,30) | 44/126: 35(27,44) | 75/266: 28(23,33) | 62/274: 23(18,28) | 0.04 |
| All laboratory tests used to diagnose acute cases of dengue | 40/578: 6(4,7) | 21/119: 15(10,22) | 16/232: 7(4,11) | 3/227: 1(0.5,4) | <0.001 |
| Hospital Referral Criteria (% who refer for): | |||||
| Criteria consistent with 1997 Guidelines | 216/677: 31(28,34) | 47/125: 33(25,41) | 101/275: 37(31,42) | 68/277: 25(20,30) | 0.002 |
| Minor bleeding without shock or hemoconcentration | 457/677: 68(64,71) | 74/125: 58(49,67) | 189/275: 69(63,74) | 194/277: 70(65,75) | 0.02 |
| Platelet count ≤100,000 without bleeding, hemoconcentration, or shock | 213/677: 32(28,35) | 32/125: 24(17,32) | 106/275: 38(33,44) | 75/277: 27(22,32) | <0.001 |
* Percentages incorporate survey design weights, and thus may not equal the crude proportions. Fewer than 12% of respondents failed to answer any individual question; the denominator includes only those who answered the question in order to give the most conservative estimate.
†
1997 WHO case definition defined dengue as an acute febrile illness of 2 to 7 days duration with 2 or more of the following: headache, retro-orbital pain, myalgia, arthralgia, rash, hemorrhagic manifestations, leucopenia. Warning signs include: severe abdominal pain, persistent vomiting, cold and clammy skin/extremities, narrowing pulse pressure, hypotension, change in mental status (e.g., irritability, lethargy).