Evaluation for Clinical Practical Guideline in Leptospirosis

Abstract

The objective of study is to evaluate the revised leptospirosis clinical practical guideline (CPG) to be used country-wide. The selected areas by purposive sampling method are among 11 provinces which have had reports of high leptospirosis occurrences. The record of fever of unknown origin or leptospirosis were used in data collection from Out Patient Department card (OPD card) in the hospital before and after CPG application between August 2004-December 2005, as well as the questionnaires for physician. The result of the study showed that after physician's use of CPG, there were 79.0 % of them reading, 79.0 % recognized of correct content, and 76.5 % of benefit gain. After physician's use of CPG, the question about the history of personal ailment, precedent fever, walking in the wet area and plough the field, and symptom record of leptospirosis were more significantly applied than before(P<0.01). To confirm leptospirosis, the laboratory examination, after using CPG, were frequently done at significant level (P<0.01), especially chemical chemistry such as Hct, WBC, N, Albu, Cr, T-biliru and serology according to CPG. The diagnosis of leptospirosis was significantly correct than before (P<0.01). This was due to the higher laboratory confirmed. For leptospirosis treatment, there were more drugs prescribed according to CPG, namely, PenicilinG, Doxycycline, and Cefotaxime/ Ceftriaxone. The results indicated that for the patient treatment of fever of unknown origin or leptospirosis, the physician realized the useful purpose of CPG. Also, it should be considered to be used nation-wide.