Health Seeking Behaviour and Treatment Intentions of Dengue and Fever: A Household Survey of Children and Adults in Venezuela

BackgroundDengue in Venezuela is a major public health problem with an increasing incidence of severe cases. Early diagnosis and timely treatment influences the outcome of dengue illness, as delay in care-seeking is significantly associated with complications leading to severe dengue. We aimed to understand patterns of health seeking behaviour (HSB) in individuals exposed to high dengue incidence in order to improve early attendance to health centres.MethodsBetween September 2013 and February 2014 a cross-sectional household survey was performed in Maracay, Venezuela. Intended HSB of adults and children’s parents/guardians was assessed with respect to fever or suspected dengue. Data was collected through structured questionnaires from 105 individuals.ResultsMost individuals felt at risk of dengue and believed it could be a deadly disease. In the case of suspected dengue, the majority (60%) would choose to first seek medical help versus first treating at home, in contrast to 11% in the case of fever. Amongst those who decided to visit a doctor, a suspected dengue infection would prompt them to search medical help earlier than if having only fever (pConclusionKnowledge of HSB related to dengue is scarce in the Americas, our study attempts to contribute to a better understanding of HSB in this region. Improving early dengue disease recognition and awareness may enhance prompt attendance to medical care in affected populations and thereby reduce mortality and severity of dengue. Especially for those with a previous dengue infection, efforts have to be made to promote prompt health centre attendance.

背景：登革热在委内瑞拉是重大公共卫生问题，重症病例发病率持续攀升。早期诊断与及时治疗直接影响登革热患者的预后，因就医延迟与引发重症登革热的并发症显著相关。本研究旨在明确登革热高发暴露人群的就医行为（Healthcare-seeking Behaviour, HSB）模式，以期提升受影响人群前往医疗中心的早期就诊率。
方法：2013年9月至2014年2月，研究团队在委内瑞拉马拉凯开展一项横断面家庭调查。针对成人及儿童的父母/监护人，通过结构化问卷评估其出现发热或疑似登革热症状时的预期就医行为。本次研究共收集到105份有效问卷数据。
结果：绝大多数受访者认为自身存在登革热感染风险，并认为该病可致命。当出现疑似登革热症状时，多数（60%）受访者会优先选择就医，而非先居家自行处理；而仅出现发热症状时，仅有11%的受访者会优先就医。在选择就医的受访者中，疑似登革热感染相比仅出现发热时，会促使他们更早寻求医疗帮助（p）。
结论：美洲地区关于登革热相关就医行为的研究认知仍较为匮乏，本研究旨在为加深该地区就医行为的理解提供参考。提升登革热早期识别能力与疾病认知水平，可促使受影响人群及时就医，进而降低登革热的死亡率与重症发生率。尤其对于既往有登革热感染史的人群，需加大宣传力度以推动其及时前往医疗中心就诊。