Survey on the management of dengue infection in Sri Lanka: opinions of physicians and pediatricians.

The management of dengue infection is variable and clinicians often adopt their own methods based on clinical experience. Hence, there is a lack of uniformity in the practice and management of dengue fever (DF) and dengue hemorrhagic fever (DHF) in Sri Lanka. The objectives were to describe the opinions of clinicians regarding certain management issues of, and their clinical experiences in DF/DHF. A self-administered questionnaire survey of 50 consultant physicians and pediatricians that were currently practicing in Government Hospitals was conducted. Their cumulative experience was based on managing approximately 15,119 patients for a period of three years in 15 districts of the island. The WHO guidelines were used by only 16(45%) physicians and 6(40%) pediatricians in the management of DF/DHF Most of the clinicians did not agree on the value of steroids and antibiotics. However, the majority was in favor of platelet and plasma transfusions, although most had no fixed policy on fluid management. In the experience, clinicians observed the recurrence of dengue, post-viral fatigue syndrome, and many other complications. A conclusion was made that a national policy and guidelines should be created to suit the local context, based on the evidence and experiences of clinicians managing dengue infection.