Indrio Flavia, Miqdady Mohamad, Al Aql Fahd, Haddad Joseph, Karima Berkouk, Khatami Katayoun, Mouane Nehza, Rahmani Aiman, Alsaad Sulaiman, Salah Mohamed, Samy Gamal, Tafuri Silvio
Department of Pediatric University of Bari Ospedale Pediatrico Giovanni XXIII Hospital, Via Amendola 270, 70126, Bari, Italy.
Hepatology & Nutrition Division, Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
BMC Pediatr. 2017 Oct 23;17(1):187. doi: 10.1186/s12887-017-0939-0.
Regional evidence-based guidelines for the prophylaxis and management of infantile colic are not available for the Middle East and North Africa (MENA) region. The Allied Against Infantile Functional GI Disorders (ACT) Working Group was created in January, 2015 to determine the knowledge gaps and the current management practices of infantile colic by physicians in the MENA region. The ACT group determined the need for a survey to address these questions. The objectives of the survey were to highlight current clinical practices on the management of infantile colic and to raise awareness on colic severity in the MENA region.
The ACT working group developed the survey which included respondent characteristics and closed questions on practice in colic prevention. The survey was subject to validation and ethics committee approval in all countries.
A total of 1628 physicians (mostly pediatricians (75.4%), neonatologists (2.4%) and general practitioners (19.8%)) responded to the survey. The 5 most represented countries were KSA (27.9%), Kuwait (22.1%), Morocco (13.8%), Lebanon (10.6%), and Iraq (7.4%). Most of the respondents (77.8%) practiced in governmental settings. A majority of respondents (91.7%) reported that colic is diagnosed predominantly by clinical examination. Above 63%, of pediatricians surveyed, believed that the colic prevalence rate was >40%, which is greater than the 20% rate reported in worldwide surveys. Yet, most of the responding physicians (73%) prefer to simply reassure parents rather than prescribe a therapeutic agent. Most physicians were either neutral (58%) or did not endorse (18.4%) colic prophylaxis. Of those who prescribed formulae for non-breastfed children, a majority (64.3%) chose "Comfort" formulae over hydrolyzed or lactose-free formulae or formulae with probiotics.
The results of this survey suggest that a substantial proportion of responding physicians from the selected MENA countries do not advocate for prophylaxis of colic. The findings of this survey suggest that more educational efforts are required to increase awareness of the strong body of evidence supporting the efficacy of probiotics in the prevention and management of infantile colic.
中东和北非（MENA）地区尚无基于循证医学的婴儿腹绞痛预防和管理指南。2015年1月成立了对抗婴儿功能性胃肠疾病联盟（ACT）工作组，以确定中东和北非地区医生在婴儿腹绞痛方面的知识差距和当前管理实践。ACT小组确定需要进行一项调查来解决这些问题。该调查的目的是突出婴儿腹绞痛管理方面的当前临床实践，并提高中东和北非地区对腹绞痛严重程度的认识。
ACT工作组开展了此项调查，内容包括受访者特征以及关于腹绞痛预防实践的封闭式问题。该调查在所有国家均经过了验证并获得伦理委员会批准。
共有1628名医生（主要是儿科医生（75.4%）、新生儿科医生（2.4%）和全科医生（19.8%））回复了该调查。回复人数最多的5个国家分别是沙特阿拉伯（27.9%）、科威特（22.1%）、摩洛哥（13.8%）、黎巴嫩（10.6%）和伊拉克（7.4%）。大多数受访者（77.8%）在政府机构执业。大多数受访者（91.7%）报告称，腹绞痛主要通过临床检查进行诊断。超过63%的受访儿科医生认为腹绞痛患病率>40%，这高于全球调查中报告的20%的患病率。然而，大多数回复的医生（73%）更倾向于简单地安抚家长，而不是开治疗药物。大多数医生对腹绞痛预防持中立态度（58%）或不支持（18.4%）。在为非母乳喂养儿童开配方奶粉的医生中，大多数（64.3%）选择“舒适型”配方奶粉，而非水解配方奶粉、无乳糖配方奶粉或含益生菌的配方奶粉。
本次调查结果表明，来自选定中东和北非国家的相当一部分回复医生不主张预防腹绞痛。该调查结果表明，需要开展更多教育工作，以提高对支持益生菌在预防和管理婴儿腹绞痛方面有效性的大量证据的认识。
