2015 年布隆迪地区医院全科医生在预防宫颈癌方面的知识和实践：一项横断面研究。
Knowledge and practices of general practitioners at district hospitals towards cervical cancer prevention in Burundi, 2015: a cross-sectional study.
机构信息
Faculty of Medicine, Community Medicine Department, University of Burundi, Bujumbura, Burundi.
Faculty of Medicine and health sciences, Global Health Institute, University of Antwerp, Antwerp, Belgium.
出版信息
Global Health. 2018 Jan 16;14(1):4. doi: 10.1186/s12992-018-0321-5.
BACKGROUND
Well-organized screening and treatment programmes are effective to prevent Invasive Cervical Cancer (ICC) in LMICs. To achieve this, the World Health Organization (WHO) recommends the involvement of existing health personnel in casu doctors, nurses, midwives in ICC prevention. A necessary precondition is that health personnel have appropriate knowledge about ICC. Therefore, to inform policy makers and training institutions in Burundi, we documented the knowledge and practices of general practitioners (GPs) at district hospital level towards ICC control.
METHODS
A descriptive cross-sectional survey was conducted from February to April, 2015 among all GPs working in government district hospitals. A structured questionnaire and a scoring system were used to assess knowledge and practices of GPs.
RESULTS
The participation rate was 58.2%. Majority of GPs (76.3%) had appropriate knowledge (score > 70%) on cervical cancer disease; but some risk factors were less well known as smoking and the 2 most important oncogenic HPV. Only 8.4% of the participants had appropriate knowledge on ICC prevention: 55% of the participants were aware that HPV vaccination exists and 48.1% knew cryotherapy as a treatment method for CIN. Further, 15.3% was aware of VIA as a screening method. The majority of the participants (87%) never or rarely propose screening tests to their clients. Only 2 participants (1.5%) have already performed VIA/VILI. Wrong thoughts were also reported: 39.7% thought that CIN could be treated with radiotherapy; 3.1% thought that X-ray is a screening method.
CONCLUSION
In this comprehensive assessment, we observed that Burundian GPs have a very low knowledge level about ICC prevention, screening and treatment. Suboptimal practices and wrong thoughts related to ICC screening and treatments have also been documented. We therefore recommend an adequate pre- and in-service training of GPs and most probably nurses on ICC control before setting up any public health intervention on ICC control.
背景
在中低收入国家，组织良好的筛查和治疗计划可有效预防浸润性宫颈癌（ICC）。为实现这一目标，世界卫生组织（WHO）建议在 ICC 预防中纳入现有卫生人员——包括医生、护士和助产士。一个必要的前提是卫生人员对 ICC 有适当的了解。因此，为了向布隆迪的政策制定者和培训机构提供信息，我们记录了地区医院级别的全科医生（GP）在控制 ICC 方面的知识和实践情况。
方法
2015 年 2 月至 4 月，对所有在政府地区医院工作的全科医生进行了一项描述性的横断面调查。使用结构化问卷和评分系统评估 GP 的知识和实践情况。
结果
参与率为 58.2%。大多数 GP（76.3%）对宫颈癌疾病有适当的知识（得分>70%）；但一些危险因素的了解程度较低，如吸烟和两种最重要的致癌 HPV。只有 8.4%的参与者对 ICC 预防有适当的了解：55%的参与者知道 HPV 疫苗的存在，48.1%的人知道冷冻疗法是 CIN 的一种治疗方法。此外，15.3%的人知道 VIA 作为一种筛查方法。大多数参与者（87%）从不或很少向他们的客户建议筛查试验。只有 2 名参与者（1.5%）已经进行了 VIA/VILI。也报告了错误的想法：39.7%的人认为 CIN 可以用放疗治疗；3.1%的人认为 X 射线是一种筛查方法。
结论
在这次全面评估中，我们发现布隆迪的 GP 在 ICC 预防、筛查和治疗方面的知识水平非常低。还记录了与 ICC 筛查和治疗相关的次优做法和错误观念。因此，我们建议在制定任何关于 ICC 控制的公共卫生干预措施之前，对 GP 进行充分的职前和在职培训，可能还需要对护士进行培训。
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