Department of Gastroenterology and Hepatology, St George Hospital, Kogarah, New South Wales, Australia.
Intern Med J. 2012 May;42(5):497-504. doi: 10.1111/j.1445-5994.2011.02440.x.
Escalating morbidity and mortality associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent a major health burden in Australia, particularly among migrants from endemic areas who may present late.
We evaluated the knowledge and educational needs of general practitioners (GPs) in the St George Division, Sydney which serves a large migrant population. The aims of the study were to identify gaps in knowledge about viral hepatitis that may affect management and referral patterns. GPs completed a survey comprised of 15 questions. They were also invited to comment on barriers to managing viral hepatitis in migrant patients.
A 44% response rate was achieved from 280 eligible GPs. Forty-two per cent of GPs lacked confidence in interpreting HCV serology and 20% for HBV serology. Twenty-two per cent of GPs did not recognise HCC as a complication of HBV and 18% for HCV. Twenty per cent of GPs were unaware of treatment for HBV. Forty-seven per cent of GPs were uncertain whether pregnant women could receive HCV treatment. Twenty-three per cent and 21% of respondents believed that all HCV- or HBV-infected mothers, respectively, should not breast-feed. Eighty-nine per cent of GPs identified language difficulties as the main barrier to treatment among the migrant population.
There were gaps in the knowledge of GPs particularly concerning natural history, diagnosis, treatment availability and management of pregnant or lactating women with viral hepatitis. Specific educational initiatives targeting these deficits are required as well as increased availability of language resources for managing patients from a non-English-speaking background.
乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染导致的发病率和死亡率不断上升，给澳大利亚带来了沉重的健康负担，尤其是在来自流行地区的移民中，他们可能就诊较晚。
我们评估了悉尼圣乔治区的全科医生（GP）的知识和教育需求，该地区服务于大量移民。该研究的目的是确定可能影响管理和转诊模式的有关病毒性肝炎的知识差距。GP 填写了一份包含 15 个问题的调查问卷。他们还被邀请就管理移民患者的病毒性肝炎的障碍发表意见。
从 280 名符合条件的 GP 中获得了 44%的回复率。42%的 GP 缺乏解读 HCV 血清学的信心，20%的 GP 缺乏解读 HBV 血清学的信心。22%的 GP 没有认识到 HCC 是 HBV 的并发症，18%的 GP 没有认识到 HCC 是 HCV 的并发症。20%的 GP 不知道治疗 HBV 的方法。47%的 GP 不确定是否可以对孕妇进行 HCV 治疗。23%和 21%的受访者分别认为所有 HCV 或 HBV 感染的母亲都不应母乳喂养。89%的 GP 认为语言障碍是移民人群治疗的主要障碍。
GP 的知识存在差距，特别是在自然史、诊断、治疗的可及性以及对患有病毒性肝炎的孕妇或哺乳期妇女的管理方面。需要针对这些不足开展具体的教育活动，并增加管理非英语背景患者的语言资源。
