Berg-Johnsen Anna, Hådem Synne Osaland, Tamrakar Dipesh, Harstad Ingunn
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NO 7489 Trondheim, Norway.
Department of Community Program, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.
J Clin Tuberc Other Mycobact Dis. 2020 Jul 8;20:100173. doi: 10.1016/j.jctube.2020.100173. eCollection 2020 Aug.
Tuberculosis (TB) remains a major health problem worldwide, including in Nepal where around 33,000 new cases of TB were diagnosed in 2018 and 5400 patients died. There are challenges in the diagnostic process, treatment, and follow-up. Deaths, increased transmission and development of multi- drug resistant TB could be the consequences. Young doctors play an important role in this struggle, and therefore, their knowledge of and attitudes towards TB are crucial.
We surveyed medical interns in Nepal regarding their knowledge, attitude and practices on TB and their adherence to the National Tuberculosis Programmes' guidelines. The objective was to determine the associations between TB knowledge, and attitude and the factors that influence them.
A WHO cross-sectional questionnaire template was modified and piloted. It was distributed anonymously among medical interns at three private medical colleges. Statistical analyses were performed to establish possible associations between TB knowledge and attitude, and the investigated variables, and to investigate differences between the medical colleges.
Of 270 interns, 185 (69%) interns were included. The mean knowledge score was 13,3 (SD: 2,12) of a maximum of 19. The possible attitude scores ranged from zero to 14 points, whereas the mean attitudes score was 9,4 (SD: 1,89). Some unacceptable attitudes and knowledge gaps were identified, including disease detection and management. There was an association between the knowledge score and attitude score and between the number of TB patients seen and knowledge/attitude.
The surveyed interns had an adequate level of TB related knowledge, and acceptable attitudes. However, some unacceptable knowledge gaps and attitudes were detected. This survey underlines the considerable need of closing these knowledge gaps, and improving the attitudes, for which it is important for medical students to practice at a TB clinic and see a certain number of TB patients.
结核病仍然是全球主要的健康问题，在尼泊尔也是如此，2018年约有33000例新的结核病病例被诊断出来，5400名患者死亡。在诊断过程、治疗和随访方面存在挑战。可能会导致死亡、传播增加以及耐多药结核病的出现。年轻医生在这场斗争中发挥着重要作用，因此，他们对结核病的知识和态度至关重要。
我们对尼泊尔的医学实习生进行了关于他们对结核病的知识、态度和实践以及他们对国家结核病规划指南的遵守情况的调查。目的是确定结核病知识、态度之间的关联以及影响它们的因素。
对世界卫生组织的横断面调查问卷模板进行了修改和试点。该问卷在三所私立医学院的医学实习生中匿名分发。进行统计分析以确定结核病知识和态度之间以及调查变量之间可能存在的关联，并调查医学院之间的差异。
在270名实习生中，有185名（69%）实习生被纳入。最高分为19分，平均知识得分为13.3（标准差：2.12）。可能的态度得分范围为0至14分，而平均态度得分为9.4（标准差：1.89）。发现了一些不可接受的态度和知识差距，包括疾病检测和管理方面。知识得分与态度得分之间以及看过的结核病患者数量与知识/态度之间存在关联。
接受调查的实习生具有足够的结核病相关知识水平和可接受的态度。然而，发现了一些不可接受的知识差距和态度。这项调查强调了弥补这些知识差距和改善态度的迫切需求，对于医学生来说，在结核病诊所实习并接触一定数量的结核病患者很重要。
