Alvarez-Hernandez Gerardo, Ernst Kacey, Acuña-Melendrez Natalia Haydee, Vargas-Ortega Anabel Patricia, Candia-Plata Maria Del Carmen
Department of Medicine and Health Sciences, University of Sonora, Mexico; Hermosillo, Sonora, México, C.P. 83000.
Epidemiology and Biostatistics Department, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States 85724.
Trans R Soc Trop Med Hyg. 2018 Mar 1;112(3):109-114. doi: 10.1093/trstmh/try030.
Rocky Mountain spotted fever (RMSF) is a tick-borne disease with a high case-fatality rate unless diagnosed promptly and treated timely with doxycycline. Physician knowledge about presentation and treatment can improve outcomes of RMSF in endemic regions, such as Sonora in northern Mexico, where RMSF has caused 1348 non-fatal cases and 247 deaths from 2003 to 2016.
A cross-sectional study was conducted with 343 physicians working in medical facilities in Sonora, Mexico. A 25-item questionnaire explored physician knowledge of clinical, epidemiological and preventive aspects of RMSF.
Only 62% of physicians agreed that doxycycline should be used as the first choice treatment for children under 8 years with suspected RMSF. Additionally, 40% of primary care physicians correctly identified the time to initiate doxycycline, and 32% correctly identified the case-fatality rate of untreated RMSF in all patients.
Inadequate medical knowledge may adversely affect how patients infected with Rickettsia rickettsii are diagnosed and treated. Educational programs that improve the risk perception and medical knowledge about RMSF should be targeted at physicians most likely to have initial contact with diseased patients.
落基山斑疹热（RMSF）是一种蜱传疾病，若不及时诊断并用强力霉素及时治疗，病死率很高。在墨西哥北部的索诺拉等流行地区，医生对该病临床表现和治疗方法的了解可改善落基山斑疹热的治疗效果，2003年至2016年期间，落基山斑疹热在该地区已导致1348例非致命病例和247例死亡。
对在墨西哥索诺拉医疗设施工作的343名医生进行了一项横断面研究。一份包含25个条目的问卷探讨了医生对落基山斑疹热临床、流行病学和预防方面的了解。
只有62%的医生同意，对于疑似落基山斑疹热的8岁以下儿童，应将强力霉素作为首选治疗药物。此外，40%的初级保健医生正确确定了开始使用强力霉素的时间，32%的医生正确确定了所有患者中未经治疗的落基山斑疹热的病死率。
医学知识不足可能会对感染立氏立克次体的患者的诊断和治疗产生不利影响。应针对最有可能首先接触患病患者的医生开展提高对落基山斑疹热风险认知和医学知识的教育项目。
