Evaluation of implementation of Diagnostic Criteria of Dengue Fever (WS 216－2018)

  Objective  To evaluate the implementation of Diagnostic Criteria of Dengue Fever (WS 216-2018) and provide reference for the revision and better application of the criteria.

  Methods  Using stratified random sampling, general hospitals, community health service centers, centers for disease control and prevention (CDCs) and customs in Guangdong, Zhejiang and Chongqing were selected to conduct questionnaire survey and field investigation. EpiData 3.1 was used to establish a database, and SPSS 22.0 was used for statistical analysis. Inter group differences were compared with χ² test, analysis of variance and Kruskal-Wallis H test.

  Results  A total of 61 medical institutions were surveyed, and 637 questionnaires were collected, in which 443 were from Guangdong (69.54%), 102 from Chongqing (16.01%) and 92 from Zhejiang (14.44%). The institutions were mainly general hospitals (86.66%) and the medical and health institutions at district or county level accounted for 56.51%. The total mastery rate of the criteria was 67.66%. The mastery rate in Guangdong (69.31%) was higher than that in Chongqing (66.36%) and Zhejiang (61.14%), and the mastery rate in general hospitals (67.02%) was lower than that in community health service centers (69.05%) and CDCs (74.43%). The awareness rate of the criteria through training was highest, reaching 76.61%. In clinicians surveyed, 25.84% used the criteria all the time, 28.50% often used it, 33.63% used it occasionally and 12.03% never used it. There were 73.45% and 64.25% of clinicians who could answer the questions about the tests to be conducted for suspected cases within five days and within seven days after onset. Only 42.48% of clinicians knew the dengue diagnostic tests to be provided in their hospitals. 96.55% of general hospitals could provide NS1 screening for dengue virus antigen. In the community health service centers surveyed, 87.50% in Guangdong could carry out NS1 screening, 2 in Zhejiang could provide NS1 screening, and all in Chongqing could not provide NS1 screening. Three CDCs surveyed in Chongqing and Zhejiang were all able to conduct nucleic acid testing for dengue virus. Among the 12 CDCs surveyed in Guangdong, 58.33% (7/12) were allowed to conduct nucleic acid testing, and the CDCs in non-Pearl River Delta area could not provide nucleic acid testing. In the process of implementation of the criteria, a good consistency was found in relevant regulation documents.

  Conclusion  The mastery rate and use rate of the criteria were low in clinicians, it is necessary to further strengthen the training for the use promotion of the criteria.