卫生工作者对转诊医院耐多药结核病控制和预防的知识和实践：一项横断面研究。
Knowledge and practice of health workers about control and prevention of multidrug-resistant tuberculosis in referral hospitals, Ethiopia: a cross-sectional study.
机构信息
Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
BMJ Open. 2019 Feb 19;9(2):e022948. doi: 10.1136/bmjopen-2018-022948.
OBJECTIVE
The aim of this study was to assess the knowledge and practice of health workers about multidrug-resistant tuberculosis (MDR-TB) prevention and control.
STUDY DESIGN AND SETTINGS
A cross-sectional study was conducted at Gondar University Referral Hospital and Felege Hiwot Referral Hospital.
PARTICIPANTS
Randomly selected health workers (ie, medical doctor, nurse, health officer, pharmacy, medical laboratory and midwifery) were the study participants.
OUTCOME MEASURES
The main outcomes were knowledge and self-reported practice of health workers about MDR-TB.
RESULTS
A total of 377 health workers (with a response rate of 93.7%) participated in the study. The majority of respondents were nurses (52.5%, n=198) and medical doctors (15.6%, n=59). The mean knowledge score was seven out of 10; 149 (39.5%) of respondents scored seven or more which was considered as good knowledge. MDR-TB knowledge of health workers was significantly associated with having a postgraduate degree (adjusted odds ratio (AOR)=5.78; 95% CI 2.33 to 14.33), taking infection prevention training (AOR=1.79; 95% CI 1.00, to 3.17) and having a history of tuberculosis (TB) (AOR=1.85; 95% CI 1.12, to 3.03). The mean self-reported practice score was four out of seven; one-fifth (19.6%) of respondents scored four or more which was considered as good practice. Self-reported practice of health workers was significantly associated with working at internal medicine (AOR=4.64; 95% CI 1.99, to 10.81) and paediatrics (AOR=3.85; 95% CI 1.11, to 13.34) wards, being in the age groups of 26-30 years (AOR=2.70; 95% CI 1.27, to 5.76), and 30 years and above (AOR=4.42; 95% CI 1.77, to 11.00).
CONCLUSIONS
This study found low knowledge and self-reported practice score among health workers. MDR-TB knowledge of health workers was significantly associated with educational status, infection prevention training and previous history of TB. This finding highlights the potential of providing MDR-TB training for health workers to increase their knowledge about MDR-TB.
目的
本研究旨在评估卫生工作者对耐多药结核病（MDR-TB）预防和控制的知识和实践情况。
研究设计和地点
横断面研究在贡德尔大学转诊医院和费莱盖·希沃特转诊医院进行。
参与者
随机选择的卫生工作者（即医生、护士、卫生官员、药剂师、医学实验室和助产士）为研究参与者。
主要结局指标
主要结局是卫生工作者对 MDR-TB 的知识和自我报告的实践情况。
结果
共有 377 名卫生工作者（应答率为 93.7%）参加了这项研究。大多数受访者是护士（52.5%，n=198）和医生（15.6%，n=59）。平均知识得分为 10 分中的 7 分；149 名（39.5%）受访者得分 7 分或以上，被认为具有良好的知识水平。卫生工作者对 MDR-TB 的知识与具有研究生学历（调整后的优势比（AOR）=5.78；95%置信区间（CI）2.33 至 14.33）、接受感染预防培训（AOR=1.79；95%CI 1.00 至 3.17）和有结核病（TB）病史（AOR=1.85；95%CI 1.12 至 3.03）显著相关。自我报告的实践评分平均为 7 分中的 4 分；五分之一（19.6%）的受访者得分 4 分或以上，被认为具有良好的实践水平。卫生工作者的自我报告实践与在内科（AOR=4.64；95%CI 1.99 至 10.81）和儿科（AOR=3.85；95%CI 1.11 至 13.34）病房工作显著相关，年龄在 26-30 岁（AOR=2.70；95%CI 1.27 至 5.76）和 30 岁及以上（AOR=4.42；95%CI 1.77 至 11.00）。
结论
本研究发现卫生工作者的知识和自我报告的实践评分较低。卫生工作者对 MDR-TB 的知识与教育程度、感染预防培训和既往结核病史显著相关。这一发现强调了为卫生工作者提供 MDR-TB 培训以提高他们对 MDR-TB 的认识的潜力。
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