Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh 23111, Indonesia; Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh 23111, Indonesia; Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh 23111, Indonesia.
Department of Microbiology, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim State Islamic University of Malang, Malang, East Java 65144, Indonesia.
Acta Trop. 2020 Jun;206:105450. doi: 10.1016/j.actatropica.2020.105450. Epub 2020 Mar 16.
The current re-emergence of human monkeypox (HMPX) is a global concern for endemic and non-endemic countries, but healthcare workers in some regions, like Asia, have less experience with identifying and treating HMPX cases. This study aimed to assess the confidence and its predictors in HMPX case management among general practitioners (GPs), the frontline doctors in Indonesia, and to explore their perspectives on HMPX. Between May and July 2019, GPs in Indonesia completed an online-based survey. The questionnaire collected information on GPs' confidence, perspective, sociodemographic, workplace and professional characteristics, exposure to HMPX information and knowledge on HMPX. A logistic regression analysis was employed to explore the explanatory variables influencing the confidence and the perspective. We included 395 GPs in our analysis (77.4% out of 510 responses received) of which 10.1% and 34.9% were classified having good confidence using an 80% and 70% cut-off for confidence score, respectively. In the adjusted analysis, receiving information about HMPX during medical training was the only variable significantly associated with good confidence (adjusted odds ratio 2.74, 95% confidence interval 1.57 to 4.78 and p < 0.001). Approximately 73.6% and 77.9% of GPs agreed that HMPX is an important infectious disease and it has potential to detrimentally impact the Indonesian economy, respectively. In addition, 88.8% of GPs suggested that the disease should be incorporated into the National Medical Curriculum of Indonesia. In conclusion, in case of HMPX outbreak, majority of the GPs in Indonesia seem to be less confident in diagnosing and treating cases, using their current knowledge, skills and their workplace facilities. Therefore, a systematic strategy to improve their confidence in managing HMPX is required.
当前，人类猴痘（HMPX）的再次出现引起了流行地区和非流行地区国家的全球关注，但亚洲等地区的医疗保健工作者在识别和治疗 HMPX 病例方面经验较少。本研究旨在评估印度尼西亚初级保健医生（GP）对 HMPX 病例管理的信心及其预测因素，并探讨他们对 HMPX 的看法。2019 年 5 月至 7 月，印度尼西亚的 GP 完成了一项在线调查。问卷收集了 GP 对 HMPX 的信心、看法、社会人口学、工作场所和专业特征、接触 HMPX 信息以及 HMPX 知识等信息。采用逻辑回归分析探讨影响信心和看法的解释变量。我们对 510 份回复中收到的 395 名 GP 进行了分析（77.4%），其中 10.1%和 34.9%的 GP 信心得分分别达到 80%和 70%的截断值，被归类为具有良好信心。在调整分析中，在医学培训期间收到关于 HMPX 的信息是唯一与良好信心显著相关的变量（调整后的优势比 2.74，95%置信区间 1.57 至 4.78，p<0.001）。大约 73.6%和 77.9%的 GP 分别认为 HMPX 是一种重要的传染病，它有可能对印度尼西亚经济产生不利影响。此外，88.8%的 GP 建议将该疾病纳入印度尼西亚国家医学课程。总之，在 HMPX 爆发的情况下，印度尼西亚的大多数 GP 似乎对使用其当前的知识、技能和工作场所设施来诊断和治疗病例缺乏信心。因此，需要制定一项系统的战略来提高他们对 HMPX 的管理信心。
