Knowledge, Attitudes, and Practices of Physicians Regarding Dengue Fever in Chongqing, China: A Cross-Sectional Survey

Mosquitoes are more than just a summer nuisance; in many parts of the world, they are the primary carriers of a viral illness called dengue fever. This disease causes high fevers, severe body aches, and in some cases, life-threatening complications. Because there is no specific medicine to cure the virus and no widely available vaccine, the most effective way to stop an outbreak relies entirely on people. Health workers must be able to spot the disease early, doctors must treat patients correctly, and public health officials must track the mosquitoes to prevent them from spreading. If the people on the front lines do not know exactly what to look for or how to act, the virus can slip through the cracks and infect entire communities.

In the sprawling, mountainous municipality of Chongqing, China, the risk of dengue is rising. The climate is becoming more favorable for the mosquitoes that carry the virus, and cases have appeared in new areas over the last few years. To understand if the local medical system is ready for this threat, researchers from the Chongqing Center for Disease Control and Prevention conducted a massive check-up of the city's doctors and public health workers. They wanted to see if these professionals truly understood the disease, if they believed it was a serious problem, and if they were actually doing the right things to stop it. They surveyed nearly 7,200 medical professionals, asking them detailed questions about how they diagnose patients, how they report cases, and how they protect themselves and their communities from mosquito bites.

The results revealed a surprising gap between what these doctors felt and what they knew. Almost everyone surveyed agreed that dengue is a serious threat that can be prevented and controlled. They also reported that they were actively taking steps to protect patients and monitor for the disease. Their attitudes were overwhelmingly positive, and their reported actions were strong. However, when the researchers tested their actual knowledge, the scores dropped significantly. Only about two-thirds of the clinical doctors and slightly fewer public health workers could answer the basic questions about the disease correctly. Many struggled with specific details, such as the exact incubation period of the virus, the specific laboratory tests needed for diagnosis, or the precise criteria for reporting a case. It was as if the workers were eager to fight a fire and knew they had the hoses, but many did not know exactly how to turn on the water or where the fire was most likely to start.

The study found that this lack of knowledge mattered. The researchers discovered that doctors who had a solid grasp of the facts were much more likely to perform their duties correctly. But there was another powerful factor at play: attitude. Even among those who did not know all the technical details, those who felt strongly about the importance of the work still managed to do the right things most of the time. Their positive mindset seemed to drive them to follow the rules and seek help when they were unsure. This suggests that while a good attitude can keep the system running, it cannot fully replace the need for deep understanding. Without the right knowledge, a well-meaning doctor might miss a subtle sign of the disease or delay a critical report, which could allow the virus to spread further.

Where a doctor worked also made a big difference in how well they performed. Medical professionals in the central urban areas of Chongqing scored significantly higher than those in the northeastern and southeastern parts of the municipality. This suggests that resources, training opportunities, and experience with the disease are not spread evenly across the city. Doctors in the city center likely see more cases and receive more frequent updates, while their colleagues in other regions may be less prepared for an outbreak. The researchers also noted that experience played a role, but not always in the way one might expect. In the public health sector, younger workers with less seniority often performed better than their older, more experienced counterparts. This may be because the younger staff are more directly involved in the daily, hands-on work of tracking mosquitoes and investigating outbreaks, while senior staff often focus on management and supervision.

The study concludes that Chongqing's medical workforce is ready to act, but they need better tools to act effectively. The positive attitude of the doctors is a strong foundation, but it must be built upon a stronger base of knowledge. The researchers recommend that future training programs should not just be one-size-fits-all. Instead, they should be tailored to the specific needs of different roles and different regions. Doctors in the city might need advanced training on complex cases, while those in rural areas might need more basic instruction on how to recognize the disease and report it. By filling these knowledge gaps and ensuring that every doctor, regardless of where they work, has the same level of understanding, the city can better protect its people from the growing threat of dengue fever.