National Institute of Cholera and Enteric Diseases, Epidemiology, Kolkata, West Bengal, India.
International Vaccine Institute, SNU Research Park, Division of Data Management, Seoul, Republic of Korea.
Epidemiol Infect. 2014 Feb;142(2):314-26. doi: 10.1017/S0950268813001076. Epub 2013 May 10.
Diarrhoeal management practices are unsatisfactory in India especially in the slum areas. Dearth of information regarding physicians' diarrhoea-related knowledge and practice in India necessitated this cross-sectional study of allopathic practitioners in the slums of Kolkata, to assess the distribution and interrelationship between physicians' characteristics, knowledge and practice regarding diarrhoea. A total of 264 randomly selected consenting practitioners were interviewed using a field-tested questionnaire. Nineteen percent had good overall knowledge, 49% and 80% prescribed antibiotics to diarrhoea and cholera patients, respectively, and 55% advised stool examination for every case. Qualified and Government physicians had better knowledge regarding diarrhoea [MBBS: odds ratio (OR) 5·96, P < 0·001; postgraduates: OR 9·33, P < 0·001; Government physicians: OR 11·49, P < 0·0001] and were less likely to prescribe antibiotics for all diarrhoea cases (MBBS: OR 0·30, P = 0·002; postgraduates: OR 0·20, P < 0·001; Government physicians OR 0·24, P < 0·029). Better knowledge was associated with a lower likelihood of prescribing antibiotics for diarrhoea (OR 0·72, P < 0·001), cholera (OR 0·78, P = 0·027) and investigative procedure (OR 0·85, P = 0·028). In the slums of Kolkata, diarrhoea-related knowledge and practice were poor with the exception of qualified physicians, hence an improvement in the knowledge of pharmacists and unqualified practitioners is necessary for the overall improvement of diarrhoeal management in these slums.
印度的腹泻管理实践不尽如人意，尤其是在贫民窟地区。由于缺乏有关印度医生腹泻相关知识和实践的信息，因此需要对加尔各答贫民窟的全科医生进行这项横断面研究，以评估医生关于腹泻的知识、态度和实践在分布和相互关系。总共采访了 264 名随机选择的同意参与的从业者，使用经过现场测试的问卷。19%的人腹泻相关知识总体较好，49%和 80%的人分别给腹泻和霍乱患者开了抗生素，55%的人建议对每个病例进行粪便检查。合格医生和政府医生对腹泻的了解更好[MBBS：比值比（OR）5·96，P < 0·001；研究生：OR 9·33，P < 0·001；政府医生：OR 11·49，P < 0·0001]，不太可能为所有腹泻病例开抗生素[MBBS：OR 0·30，P = 0·002；研究生：OR 0·20，P < 0·001；政府医生 OR 0·24，P < 0·029]。更好的知识与较少使用抗生素治疗腹泻（OR 0·72，P < 0·001）、霍乱（OR 0·78，P = 0·027）和调查程序（OR 0·85，P = 0·028）的可能性相关。在加尔各答的贫民窟中，腹泻相关知识和实践都很差，除了合格医生外，因此需要提高药剂师和不合格从业者的知识水平，以整体改善这些贫民窟的腹泻管理。
