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印度德里实习医生关于结核病及直接观察短程治疗的知识、态度和做法

Knowledge, attitude and practices regarding tuberculosis and dots among interns in delhi, India.

作者信息

Rajpal Sanjay, Mittal Anshu, Dhingra V K, Malhotra Rahul, Gupta Rajni, Malhotra Chetna, Taneja D K

机构信息

Department of Epidemiology, New Delhi Tuberculosis Centre, Jawaharlal Nehru Marg, New Delhi - 110002, India.

出版信息

J Coll Physicians Surg Pak. 2007 Aug;17(8):457-61.

Abstract

OBJECTIVE

To assess the knowledge, attitude and practices regarding tuberculosis (TB) and DOTS among young medical graduates (interns).

DESIGN

Cross-sectional study.

PLACE AND DURATION OF STUDY

Lady Hardinge Medical College and Maulana Azad Medical College, New Delhi, India, during November and December 2002, simultaneously.

SUBJECTS AND METHODS

A pre-tested semi-structured questionnaire consisting of 30 items was administered to the young medical graduates/interns posted in different departments. The questions covered mode of transmission, symptoms of pulmonary TB, investigations, short course chemotherapy including DOTS as well as conventional anti-tubercular treatment, special situations, health education and chemoprophylaxis.

RESULTS

A total of 287 interns were surveyed. Majority of the study subjects (92.7%) ranked DOTS strategy as more successful for treating tuberculosis in comparison to self-administered therapy. However, a mere 4.2% study subjects were aware of all modes of transmission. One hundred and eighty-nine (65.9%) correctly chose sputum examination for acid fast bacilli as the single most confirmatory test for diagnosing pulmonary TB. The rest either gave incorrect responses (including ELISA-17.0%, PCR-9.8%, X-ray chest-4.2%, ESR-1.7%) or did not respond (1.4%). Only 2.1% marked pyrazinamide and rifampicin as the agents to be avoided in patients with liver disease. One hundred and forty-one different treatment regimens were mentioned in the responses received and of those only 11(7.8%) were scientifically acceptable.

CONCLUSION

TB is a major health problem in South-East Asian countries. There is a need for appropriate changes to be made in the undergraduate medical teaching/training curriculum in the concerned countries with regard to TB.

摘要

目的

评估年轻医学毕业生(实习生)对结核病(TB)及直接观察短程化疗(DOTS)的知识、态度和实践情况。

设计

横断面研究。

研究地点及时间

2002年11月和12月,同时在印度新德里的哈丁夫人医学院和莫拉纳·阿扎德医学院进行。

研究对象与方法

向不同科室的年轻医学毕业生/实习生发放一份经过预测试的包含30个条目的半结构化问卷。问题涵盖传播方式、肺结核症状、检查、包括DOTS在内的短程化疗以及传统抗结核治疗、特殊情况、健康教育和化学预防。

结果

共对287名实习生进行了调查。大多数研究对象(92.7%)认为与自我给药治疗相比,DOTS策略治疗结核病更成功。然而,仅有4.2%的研究对象知晓所有传播方式。189名(65.9%)正确选择痰涂片抗酸杆菌检查作为诊断肺结核的唯一最具确诊性的检查。其余的要么给出错误回答(包括酶联免疫吸附测定法-17.0%、聚合酶链反应-9.8%、胸部X线检查-4.2%、红细胞沉降率-1.7%),要么未作答(1.4%)。只有2.1%指出肝病患者应避免使用吡嗪酰胺和利福平。在收到的回答中提到了141种不同的治疗方案,其中只有11种(7.8%)在科学上是可接受的。

结论

结核病是东南亚国家的一个主要健康问题。相关国家的本科医学教学/培训课程有必要针对结核病做出适当调整。

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