Adherencia a la Guía de Práctica Clínica de la OPS 2016 sobre Dengue en un hospital del norte de Perú, 2022-2023.

Adherence to the 2016 PAHO Clinical Practice Guideline on Dengue in a Hospital in Northern Peru, 2022-2023.

Abstract

Objective: Effective dengue management enhances the chances of survival. The level of adherence to the suggestions in northern Peru is uncertain. The primary aim of the study was to assess adherence to the 2016 PAHO guideline on dengue in a hospital located in northern Peru during the period from 2022 to 2023. Methodology: The study performed a cross-sectional design and exploratory analysis, reviewing 140 medical records. Fifty-four percent were from 2023; 66.43% were from women; 38,57% came from a first level healthcare center; 77.14 % had diagnosis of dengue with warning signs and 20.71% had severe dengue; 18.44% died. Results: We found at least one error in the classification of severity and/or treatment in non-hospital healthcare facilities (95 %), triage (90.23%), and uviclin/observation (58.93%). Errors in classification and inadequate hydration in the first level healthcare centers, triage, and uviclin/observation were: 40.68%/60.0%, 31.0.6%/76.6%, and 15.32%/44.14 %, respectively. Persistent errors were inadequate hydration in triage (76.69%) and urinary flow in the center (81.67 %). In a bivariate analysis, mortality was associated with age 18 years or older (p = 0.047), having a case from 2023 (p = 0.008), and having severe dengue (p<0.001). In the multivariate analysis, only severe dengue (PR: 28.13, 95% CI :9.32-84.86 p<0.001), and age 18 years or older (PR:2.97, 95%CI:1.19-7.43 p: 0.020), were associated with mortality. Conclusions: We found a high frequency of misclassification and management errors in these three scenarios, but they were not associated with higher mortality.