Effects of the Developing and Using a Model to Predict Dengue Risk Villages Based on Subdistrict Administrative Organization in Southern Thailand.

The purpose of this study was to evaluate the effects of developing and using a model to predict dengue risk in villages and of a larval indices surveillance system for 2372 households in 10 Thai villages. A community participatory action research method was used in five steps: (1) community preparation covering all stakeholders, (2) assessment of the understanding of a dengue solution and a larval indices surveillance system, (3) development of a prediction and intervention model for dengue risk villages, (4) implementation of the model that responds to all stakeholders, and (5) evaluation of the effects of using the model. The questionnaires to assess and evaluate were validated and reliability tested. The chi-square test and Fisher's exact test were used to analyze the quantitative data collected by means of questionnaires. Thematic analysis was applied to the qualitative data collected through interviews. The results found that the model consisted of six main activities, including (1) setting team leader responsibility, (2) situation assessment, (3) prediction of the dengue risk in villages, (4) the six steps of the larval indices surveillance system, (5) the understanding of the dengue solution and the understanding of the larval indices surveillance system training program, and (6) local wisdom innovation. The effects of using the model showed a statistically significant increase in correct understanding among 932 family leaders, 109 village health volunteers, and 59 student leaders regarding dengue prevention and control (p < 0.05). The larval indices and dengue morbidity were diminished and related to the nine themes present in the community leaders' reflections and to the satisfaction of the community members. Hence, local administrative organizations should use community-based approaches as the subdistrict dengue solution innovation to reduce the dengue problem.

Developing and using a dengue patient care guideline for patients admitted from households to primary care units and the district hospital: A community participatory approach in Southern Thailand.

BACKGROUND: Dengue has been an important health issue in southern Thailand. However, this area has only a surveillance-prevention system, without step-by-step guidelines on dengue treatment for patients admitted from households to primary care units (PCUs) and district hospitals. Therefore, this study were to develop and use a dengue patient care guideline (DPCG), and to evaluate knowledge, attitude, practice (KAP) of dengue patient care. METHODS: 26 health care providers (13 nurses, and 13 public health officials) from eight PCUs and the district hospital developed the DPCG. The study design was based on the community participatory action research that integrated the Iowa model involving the following steps: preparation, guideline development, use and monitoring, evaluation and conclusion, and referring technology. We assessed the improvement between before and after using the DPCG regarding the participants' KAP on patient care and preparedness of equipment. McNamara's test was used to compare the changing results before and after using the DPCG. Qualitative data collection was performed in two meeting discussions with six open-end items. Using a thematic analysis technique, we extracted conclusions and suggested solutions. RESULTS: The guideline included four steps for patients' care provision at households, PCUs, outpatient departments, emergency rooms, and inpatient departments. After using the DPCG in 39 dengue patients of which 30 patients were admitted to the inpatient department1 and two patients were referred to the tertiary care hospital without mortality. The overall participants' knowledge and attitude, two of six aspects of patients' care, and three of eight types of equipment management were significantly improved (p < 0.05). Eleven themes were evaluated which were associated with the quantitative data. CONCLUSION: The DPCG instructed dengue patient's care for health care providers from households to the PCUs and district hospital. All participants improved KAP, and equipment management. Step-by-step of DPCG use and participation of all stakeholders are needed.