Inthanomchanh Vongphoumy, Reyer Joshua A, Blessmen Joerg, Phrasisombath Ketkesone, Yamamoto Eiko, Hamajima Nobuyuki
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Provincial Health Department of Savannakhet Province, Savannakhet, Lao PDR.
Nagoya J Med Sci. 2017 Aug;79(3):299-311. doi: 10.18999/nagjms.79.3.299.
Snakebite is a neglected condition and a common public health problem in Lao People's Democratic Republic (Lao PDR), with a high incidence of up to 1,105 cases per 100,000 persons per year. Snakebite patients with systemic envenoming do not receive effective treatment at local health facilities. Healthcare providers have only limited knowledge in assessing and providing the correct treatment for venomous snakebites. A cross-sectional study was conducted among 119 healthcare providers in Savannakhet Province, Lao PDR, with respect to their socio-demographic characteristics, knowledge of snake identification, and management of snakebite. Data was analyzed using SPSS. Logistic regression was performed to estimate the odds ratios (OR) and 95% confidence intervals (CI) of adequate knowledge for treating snakebites among the healthcare providers. Among 119 participants, 27.7% and 45.4% had an adequate knowledge of snake identification and management of snakebites, respectively. Approximately 59% could correctly identify symptoms of envenomation, and 19.3% expressed confidence in treating snakebites. Study participants who had received training achieved significantly better snake identification results compared to those without training, with an OR of 2.54 (95% CI: 1.02-6.28). In particular, physicians achieved significantly better results compared to nurses in knowing how to manage snakebites, with an OR of 2.31 (95% CI: 1.04-5.12). Given the level of inadequate knowledge of snakebite management among healthcare providers in the province, more training in snakebite management is needed. University and Health Science Colleges should include snakebite management into the curriculum, to ensure that medical graduates have the appropriate knowledge and skills to treat snakebites.
蛇咬伤是老挝人民民主共和国（老挝）一个被忽视的疾病，也是一个常见的公共卫生问题，年发病率高达每10万人1105例。出现全身中毒症状的蛇咬伤患者在当地医疗机构无法获得有效治疗。医疗服务提供者在评估和提供正确的毒蛇咬伤治疗方面知识有限。在老挝沙湾拿吉省对119名医疗服务提供者进行了一项横断面研究，内容涉及他们的社会人口学特征、蛇类识别知识以及蛇咬伤的处理。使用SPSS软件对数据进行分析。进行逻辑回归分析以估计医疗服务提供者中具备治疗蛇咬伤足够知识的优势比（OR）和95%置信区间（CI）。在119名参与者中，分别有27.7%和45.4%具备足够的蛇类识别知识和蛇咬伤处理知识。约59%的人能够正确识别中毒症状，19.3%的人表示对治疗蛇咬伤有信心。接受过培训的研究参与者在蛇类识别方面的结果明显优于未接受培训者，OR为2.54（95%CI：1.02 - 6.28）。特别是，在知道如何处理蛇咬伤方面，医生取得的结果明显优于护士，OR为2.31（95%CI：1.04 - 5.12）。鉴于该省医疗服务提供者对蛇咬伤处理的知识水平不足，需要更多关于蛇咬伤处理的培训。大学和健康科学学院应将蛇咬伤处理纳入课程，以确保医学毕业生具备治疗蛇咬伤的适当知识和技能。
