Olakunle Olarewaju Sunday, Oladimeji Olanrewaju, Olalekan Adebimpe Wasiu, Olugbenga-Bello Adenike, Akinleye Callistus, Oluwatoyin Olarewaju Abiodun
Department of Community Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo State.
Clinical Sciences Department, Management Sciences for Health, Abuja, Nigeria.
Pan Afr Med J. 2014 May 8;18:32. doi: 10.11604/pamj.2014.18.32.3553. eCollection 2014.
Equipping medical graduates with the competence to manage tuberculosis is not just imperative but also urgent as the diseases have been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS) which forms the basis of this study.
A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms and management of tuberculosis under DOTS.
More than half of the respondents (i.e. 69%) had poor knowledge on TB disease. Only 33.6% mentioned sputum smear as the best tool of diagnosing TB according to guideline. Poor knowledge was also exhibited when asked of various categories under DOTS treatment regimen, as 46.1% correctly mentioned cat 1 and 2. Minority 18.7% and 6.7% had complete knowledge of 6 months duration for new TB cases and 8 months for re-treatment cases respectively. Less than one tenth, i.e. 4.6% and 2.9% could correctly defined what is called a new TB case and re-treatment cases according to standard guideline.
The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guideline into existing undergraduate medical education curriculum as well as students rotation through activities in DOTS clinic.
鉴于结核病一直被列为尼日利亚发病和死亡的主要原因之一,培养医学毕业生管理结核病的能力不仅势在必行,而且刻不容缓。然而,尚未针对本科最后一年医学生对直接观察治疗短程疗法(DOTS)下结核病诊断和管理各方面知识进行基线研究,本研究即基于此展开。
对尼日利亚三所医学院的总共241名本科最后一年医学生进行了访谈。问题评估了他们对DOTS下结核病各种传播方式、症状及管理的知识。
超过一半的受访者(即69%)对结核病知识掌握较差。只有33.6%的人根据指南提到痰涂片是诊断结核病的最佳工具。当被问及DOTS治疗方案的各类情况时,知识掌握也较差,46.1%的人正确提到了第1类和第2类。少数人(18.7%和6.7%)分别完全知晓新结核病病例疗程为6个月、复治病例疗程为8个月。不到十分之一的人(即4.6%和2.9%)能根据标准指南正确定义什么是新结核病病例和复治病例。
该研究揭示了尼日利亚本科最后一年医学生在结核病知识和管理实践方面存在严重不足。迫切需要将国家结核病指南纳入现有的本科医学教育课程,并让学生参与DOTS诊所的活动。