The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.
PLoS One. 2019 Jan 25;14(1):e0210913. doi: 10.1371/journal.pone.0210913. eCollection 2019.
Given the inherent characteristics of the Hajj pilgrimage, the event is a risk for tuberculosis (TB) infection. Early diagnosis and appropriate management of TB cases by knowledgeable and skilled healthcare workers (HCWs) are key in improving patients' outcome and preventing transmission during the Hajj mass gathering and globally.
We conducted a cross-sectional study to assess knowledge, attitude and practice (KAP) of HCWs deployed during the 2016 Hajj regarding TB and its management using an anonymous self-administered questionnaire.
Data was collected from 540 HCWs from 13 hospitals. HCWs originated from 17 countries and included physicians, nurses and other non-administrative HCWs. Nearly half of HCWs declared having experience dealing with TB patients. In general, HCWs had average knowledge (mean knowledge score of 52%), above average attitude (mean attitude score of 73%) and good practice (mean practice score of 85%) regarding TB, based on our scoring system and cut-off points. Knowledge gaps were identified in relation to the definition of MDR-/XDR-TB and LTBI, smear microscopy results, length of standard TB treatment for drug-sensitive TB, 2nd line anti-TB drugs, BCG vaccination, and appropriate PPE to be used with active PTB patients. Poor attitudes were found in relation to willingness to work in TB clinic/ward and to the management and treatment of TB patients. Poor practices were reported for commencing anti-TB treatment on suspected TB cases before laboratory confirmation and not increasing natural ventilation in TB patients' rooms. Age, gender, nationality, occupation, length of work experience and experience dealing with TB patients were associated with knowledge scores. Age and occupation were associated with attitude scores while length of work experience and occupation were associated with practice scores. There was a weak but statistically significant positive correlation between score for knowledge and attitude (rs = 0.11, p = 0.009) and attitude and practice (rs = 0.13, p = 0.002).
While the results of the study are encouraging, important knowledge gaps and some poor attitudes and practices regarding TB were identified among HCWs during Hajj. This calls for multifaceted interventions to improve HCWs KAP regarding TB including tailored, periodic TB education and training aimed at boosting knowledge and improving behaviour.
鉴于朝觐朝圣的固有特点，该活动存在感染结核病（TB）的风险。具有专业知识和技能的医护人员（HCWs）早期诊断和妥善管理结核病病例是改善患者预后和防止在朝觐期间和全球范围内传播的关键。
我们进行了一项横断面研究，使用匿名自我管理问卷评估了 2016 年朝觐期间部署的 HCWs 对结核病及其管理的知识、态度和实践（KAP）。
数据来自 13 家医院的 540 名 HCWs。HCWs 来自 17 个国家，包括医生、护士和其他非管理人员 HCWs。近一半的 HCWs 表示曾处理过结核病患者。根据我们的评分系统和截止值，HCWs 对结核病的总体知识（平均知识得分 52%）、态度（平均态度得分 73%）和实践（平均实践得分 85%）处于中等水平。在与 MDR-/XDR-TB 和 LTBI 的定义、涂片显微镜结果、药物敏感型结核病的标准结核病治疗时长、二线抗结核药物、卡介苗接种以及与活动性 PTB 患者一起使用的适当个人防护设备相关的方面，存在知识差距。在愿意在结核病诊所/病房工作、管理和治疗结核病患者方面，态度较差。在疑似结核病病例未经实验室确诊就开始抗结核治疗以及未增加结核病患者房间的自然通风方面，报告了较差的做法。年龄、性别、国籍、职业、工作经验年限和处理结核病患者的经验与知识得分相关。年龄和职业与态度得分相关，而工作经验年限和职业与实践得分相关。知识得分与态度得分之间存在微弱但具有统计学意义的正相关（rs = 0.11，p = 0.009），态度得分与实践得分之间也存在正相关（rs = 0.13，p = 0.002）。
尽管研究结果令人鼓舞，但在朝觐期间的 HCWs 中发现了重要的知识差距以及一些对结核病的不良态度和做法。这需要采取多方面的干预措施来提高 HCWs 对结核病的 KAP，包括针对结核病的定制、定期教育和培训，以提高知识和改善行为。
