越南一家综合医院结核病感染控制困难：医务人员结核病感染控制知识、态度和实践调查及潜伏性结核病感染筛查。
Difficulties in tuberculosis infection control in a general hospital of Vietnam: a knowledge, attitude, and practice survey and screening for latent tuberculosis infection among health professionals.
机构信息
Bach Mai Hospital, Hanoi, Vietnam.
Jichi Medical University, Center for Community Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
出版信息
BMC Infect Dis. 2019 Nov 8;19(1):951. doi: 10.1186/s12879-019-4593-z.
BACKGROUND
In Vietnam, a country with a high tuberculosis (TB) burden, health professionals in both TB-specialized and non-TB-specialized general hospitals have a high risk of acquiring TB. The aims of the present study were to clarify the difficulties in TB infection control at non-TB specialized hospitals and whether any associated risks of latent TB infection exist among health professionals in Vietnam.
METHODS
We conducted a cross-sectional study in a national tertiary and general hospital of Hanoi, Vietnam. Participants were health professionals, including physicians, nurses, and other health professionals. We assessed difficulties in TB infection control by conducting a knowledge, attitude, and practice (KAP) survey. We also collected data on the results of tuberculin skin tests (TSTs) conducted during health check-ups for hospital staff to determine whether health professionals had latent TB infection or TB disease. KAP scores were compared among health professional groups (physicians vs. nurses vs. other health professionals). Factors influencing knowledge scores were evaluated using multiple regression analysis.
RESULTS
A total 440 health professionals at the study site participated in the KAP survey, and we collected the results of TSTs from a total of 299 health professionals. We observed a high prevalence of latent TB infection (74.2%), especially among participants in the emergency department. Although participants had high KAP scores, some topics were less understood, such as symptoms and risks of TB, proper use of protective equipment such as N95 respirators, and preventing transmission by patients with confirmed or suspected TB. Factors influencing knowledge scores associated with TB were age, a belief that TB is the most important infectious disease, being a medical professional, having previously attended workshops or seminars, and knowing that Vietnam has a high burden of TB.
CONCLUSION
In a non-TB specialized hospital of Vietnam, we observed a risk of TB infection among health professionals and difficulties in properly controlling TB infection. Early awareness regarding patients with suspected TB, to apply proper measures and prevent transmission, and education regarding obtaining updated knowledge through scientific information are crucial to enhancing TB infection control in general hospitals of Vietnam.
背景
在结核病（TB）负担较重的越南，TB 专科医院和非 TB 专科医院的卫生专业人员都有感染 TB 的高风险。本研究旨在阐明非 TB 专科医院在控制 TB 感染方面存在的困难，以及越南卫生专业人员中是否存在潜伏性 TB 感染的相关风险。
方法
我们在越南首都河内的一家国家三级和综合医院进行了一项横断面研究。参与者为卫生专业人员，包括医生、护士和其他卫生专业人员。我们通过进行知识、态度和实践（KAP）调查来评估 TB 感染控制的困难。我们还收集了医院工作人员健康检查中进行的结核菌素皮肤试验（TST）结果，以确定卫生专业人员是否患有潜伏性 TB 感染或 TB 疾病。我们比较了不同卫生专业人员群体（医生与护士与其他卫生专业人员）之间的 KAP 评分。使用多元回归分析评估了影响知识评分的因素。
结果
共有 440 名来自研究地点的卫生专业人员参加了 KAP 调查，我们从 299 名卫生专业人员中收集了 TST 结果。我们观察到潜伏性 TB 感染的高患病率（74.2%），特别是在急诊科的参与者中。尽管参与者的 KAP 评分较高，但仍有一些主题理解不足，例如 TB 的症状和风险、N95 口罩等防护设备的正确使用，以及对确诊或疑似 TB 患者的传播预防。与 TB 相关的影响知识评分的因素包括年龄、认为 TB 是最重要的传染病、作为医疗专业人员、之前参加过研讨会或研讨会，以及知道越南的 TB 负担很重。
结论
在越南的非 TB 专科医院，我们观察到卫生专业人员感染 TB 的风险以及正确控制 TB 感染存在困难。早期对疑似 TB 患者的认识，采取适当的措施防止传播，以及通过科学信息获取最新知识的教育，对于提高越南综合医院的 TB 感染控制至关重要。
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