Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montreal, Canada.
J. D. MacLean Centre for Tropical Diseases at McGill University, Montreal, Canada.
Am J Trop Med Hyg. 2022 Jul 5;107(2):359-366. doi: 10.4269/ajtmh.22-0109. Print 2022 Aug 17.
In Canada, a substantial proportion of migrants come from strongyloidiasis-endemic regions. Systematic screening for Strongyloides is not performed in immunocompromised patients in whom this infection could be potentially fatal. We aim to assess the level of Strongyloides awareness and knowledge among Canadian physicians caring for immunocompromised patients and identify factors currently associated with screening. Using an online survey distributed through Canadian medical associations, we collected information on physicians' demographics, practice setting, overall awareness and knowledge of Strongyloides, and current practices. Descriptive analysis and logistic regression models were performed to identify the factors associated with Strongyloides screening. Nineteen national and provincial medical associations agreed to participate. Between November 2020 and August 2021, 368 of 5,194 (7%) physicians that were contacted responded to our survey. Quebec (46%) and Ontario (24%) were the most responsive. Sixty-nine percent of respondents practiced medicine in academic settings. Infectious disease (ID) specialists/medical microbiologists (38%) followed by nephrologists (33%) were the most represented. Most respondents (95%) had heard about Strongyloides. However, 36% of non-ID specialists considered themselves unfamiliar. Forty percent of respondents did not or rarely performed screening for strongyloidiasis in high-risk populations. Screening was associated with younger-aged physicians (odds ratio [OR] 2.35; 95% confidence interval [CI] 1.07-5.18), physicians who frequently served migrants (OR 3.33; 95% CI 1.44-7.66), or those who had training in global health and ID/medical microbiology (OR 3.71; 95% CI 1.21-11.34 and OR 46.42; 95% CI 15.89-135.59, respectively). Our survey suggests a general lack of knowledge of Strongyloides among Canadian physicians that is associated with low rates of screening in high-risk populations.
在加拿大，大量移民来自旋毛虫病流行地区。在免疫功能低下的患者中，不会对这种感染进行系统筛查，因为这种感染可能是致命的。我们旨在评估加拿大免疫功能低下患者的医生对旋毛虫病的认识和了解程度，并确定目前与筛查相关的因素。我们通过加拿大医学协会在线调查，收集了医生的人口统计学、实践环境、对旋毛虫病的整体认识和了解以及当前实践情况的信息。进行描述性分析和逻辑回归模型，以确定与旋毛虫病筛查相关的因素。19 个国家和省级医学协会同意参与。在 2020 年 11 月至 2021 年 8 月期间，联系的 5194 名医生中有 368 名（7%）回应了我们的调查。魁北克（46%）和安大略省（24%）的回复率最高。69%的受访者在学术环境中行医。传染病（ID）专家/医学微生物学家（38%）和肾病学家（33%）的代表性最高。大多数受访者（95%）听说过旋毛虫病。然而，36%的非 ID 专家认为自己不熟悉。40%的受访者没有或很少对高危人群进行旋毛虫病筛查。筛查与年轻医生（优势比[OR]2.35；95%置信区间[CI]1.07-5.18）、经常为移民服务的医生（OR 3.33；95%CI 1.44-7.66）或接受过全球健康和 ID/医学微生物学培训的医生相关（OR 3.71；95%CI 1.21-11.34 和 OR 46.42；95%CI 15.89-135.59）。我们的调查表明，加拿大医生普遍缺乏对旋毛虫病的认识，这与高危人群筛查率低有关。
