Table 5 Knowledge-Based Questions (n = 76)

1. How is dengue spread?

Aedes mosquito

75 (99 %)

2. At what time of day are people most likely to be infected by dengue?

Any answer other than “Night”

57 (75 %)

3. Which of the dengue serotypes have been found in Ecuador?

DENV 1–4 are all present

- Note: 0.25 point given per correct answer, with a total of 1 point available

DENV 1

54 (71 %)

DENV 2

54 (71 %)

DENV 3

48 (63 %)

DENV 4

34 (45 %)

4. What advice do you give your patients to prevent dengue infection?

- Note: Question is worth a total of 2 points

- 0.25 point given per correct answer, with a maximum of 1 point. Column to the right indicates the n (%) of respondents receiving

- 1 point given for not selecting “Take Paracetamol”

1. Frequently change the water in flower vases

66 (87 %)

2. Remove containers that accumulate clean water

69 (91 %)

3. Eliminate tanks or puddles with stagnant water

55 (72 %)

4. Keep drinking water containers (cisterns, tanks) tightly closed

67 (88 %)

Did not select “Take Paracetamol”

54 (71 %)

5. Which group of patients should be hospitalized?

- Note: Each response is worth 1 point. Question is worth a total of 4 points

- If the answer is correctly selected, the respondent gains 1 point

- If the answer is correctly left blank, the respondent gains 1 point

- Responses that are correct are marked here as (T) and if incorrect are marked as (F)

1. Dengue without warning signs (F)

76 (100 %)

2. Dengue without warning signs but with comorbidities (T)

17 (22 %)

3. Dengue with warning signs (T)

59 (78 %)

4. Severe dengue (T)

58 (76 %)

Percent answering all 4 correctly

15 (20 %)

6. According to the WHO’s 2010 Clinical Management of Dengue guidebook, what signs and symptoms can be used to identify an infection of dengue without alarm signs?

Correct Responses

n (%) selecting response

- Note: Question is worth 1 point

- Each response is worth 1/19 point, which is given for either correctly selecting a true response or correctly leaving a false response blank

Headache

59 (78 %)

Muscle pain

60 (79 %)

Retro-orbital pain

62 (82 %)

Positive tourniquet test

45 (59 %)

Fever/subjective warmth

64 (84 %)

Petechial rash

33 (43 %)

Vomit

25 (33 %)

Incorrect

Ascites

1 (1 %)

Constipation

5 (7 %)

Diarrhea

10 (13 %)

Dyspnea

3 (4 %)

Dysuria

2 (3 %)

Chest pain

1 (1 %)

Edema

2 (3 %)

Icterus

1 (1 %)

Lymphadenitis

3 (4 %)

Nasal secretions

11 (14 %)

Persistent cough

3 (4 %)

Thrombocytopenia

15 (22 %)

7. Select any the treatments you could use in a patient suspected to have dengue

Oral Hydration

70 (92 %)

- Note: Question is worth 1 point

- 0.5 points given for hydration (either oral and/or IV) and 0.5 points given for paracetamol. Recipient is given 0 points if anti-bacterial or anti-viral medication is selected

IV Hydration

12 (16 %)

Paracetamol

71 (93 %)

Anti-bacterial

1 (1 %)

Anti-viral

1 (1 %)

Any of the following (listed individually in survey): Aspirin, NSAIDs/Steroids/Immunosuppressants (methotrexate, cyclosporine, etc.)/Opioids/Platelets/Plasma/Whole blood transfusion

0 (0 %)