Al-Maniri Abdullah A, Al-Rawas Omar A, Al-Ajmi Fatmah, De Costa Ayesha, Eriksson Bo, Diwan Vinod K
Department of Public Health Sciences, Division of International Health (IHCAR), Karolinska Institutet, Sweden.
BMC Public Health. 2008 May 26;8:177. doi: 10.1186/1471-2458-8-177.
Early detection of smear positive TB cases by smear microscopy requires high level of suspicion of TB among primary care physicians. The objective of this study is to measure TB suspicion and knowledge among private and public sector general practitioners using clinical vignette-based survey and structured questionnaire.
Two questionnaires were distributed to both private and public GPs in Muscat Governorate. One questionnaire assessed demographic information of the respondent and had 10 short clinical vignettes of TB and non-TB cases. The second questionnaire had questions on knowledge of TB, its diagnosis, treatment, follow up and contact screening based on Ministry of Health policy. TB suspicion score and TB Knowledge score were computed and analyzed.
A total of 257 GPs participated in the study of which 154 were private GPs. There was a significant difference between private and public GPs in terms of age, sex, duration of practice and nationality. Among all GPs, 37.7% considered TB as one of the three most likely diagnoses in all 5 TB clinical vignettes. Private GPs had statistically significantly lower TB suspicion and TB knowledge scores than public GPs.
In Oman, GPs appear to have low suspicion and poor knowledge of TB, particularly private GPs. To strengthen TB control program, there is a need to train GPs on TB identification and adopt a Private Public Mix (PPM) strategy for TB control.
通过涂片显微镜检查早期发现涂片阳性结核病病例需要基层医疗医生对结核病有高度怀疑。本研究的目的是通过基于临床病例的调查和结构化问卷来衡量私营和公共部门全科医生对结核病的怀疑程度和知识水平。
向马斯喀特省的私营和公共部门全科医生发放了两份问卷。一份问卷评估了受访者的人口统计学信息，并包含10个结核病和非结核病病例的简短临床病例。第二份问卷包含基于卫生部政策的关于结核病知识、诊断、治疗、随访和接触者筛查的问题。计算并分析了结核病怀疑得分和结核病知识得分。
共有257名全科医生参与了研究，其中154名是私营全科医生。私营和公共部门全科医生在年龄、性别、执业年限和国籍方面存在显著差异。在所有全科医生中，37.7%在所有5个结核病临床病例中将结核病视为最有可能的三种诊断之一。私营全科医生的结核病怀疑得分和结核病知识得分在统计学上显著低于公共全科医生。
在阿曼，全科医生对结核病的怀疑程度似乎较低，知识水平较差，尤其是私营全科医生。为加强结核病控制项目，有必要对全科医生进行结核病识别培训，并采用公私混合（PPM）结核病控制策略。
