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乌干达高负担、低资源环境中医疗从业者对蛇伤管理的认知及相关因素

Healthcare practitioners' knowledge of snakebite management and associated factors in high-burden, low-resource settings in Uganda.

机构信息

Department of Disease Control and Environmental Health, School of Public Health, Makerere University, 7072, Kampala, Uganda.

Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, D-20359, Hamburg, Germany.

出版信息

Trans R Soc Trop Med Hyg. 2023 Aug 3;117(8):569-579. doi: 10.1093/trstmh/trad015.

Abstract

BACKGROUND

Snakebites cause significant morbidity and mortality in Uganda. Effective management of snakebites requires knowledge of the appropriate first aid measures, as well as knowledge of the appropriate antivenom to use, but little is known about familiarity with effective snakebite management techniques and associated factors among healthcare practitioners (HCPs) in Uganda.

METHODS

In May 2022, we collected data on sociodemographic characteristics, knowledge of snakebite first aid, envenomation signs, diagnosis and antivenom administration among 311 HCPs from two snakebite high-incidence districts in Uganda using a semi-structured questionnaire.

RESULTS

Of the 311 HCPs, 64.3% had ever treated snakebite cases, 87.1% were confident to provide supportive treatment, but only 9.6% had ever been trained on snakebite management. Overall, 22.8% of HCPs had high knowledge of snakebite management. Higher education (at least degree vs certificate; PR=2.21 95% CI 1.508 to 4.56), older age (30-45 vs <30 y; PR=1.97, 95% CI 1.22 to 3.21) and previous training (PR=1.82, 95% CI 1.08 to 3.05) were associated with high knowledge of snakebite diagnosis and management.

CONCLUSIONS

Overall, knowledge of snakebite management was limited. Training, level of education and age of the HCP all had an impact on knowledge. Deliberate efforts are required to increase HCPs' knowledge of snakebite case care in high-burden regions to manage incident cases.

摘要

背景

在乌干达,蛇咬伤会导致严重的发病率和死亡率。有效管理蛇咬伤需要了解适当的急救措施,以及使用适当的抗蛇毒血清,但人们对乌干达医疗保健提供者(HCP)对有效蛇咬伤管理技术的熟悉程度及其相关因素知之甚少。

方法

2022 年 5 月,我们使用半结构化问卷,在乌干达两个蛇咬伤高发地区收集了 311 名 HCP 的社会人口统计学特征、蛇咬伤急救知识、中毒迹象、诊断和抗蛇毒血清管理数据。

结果

在 311 名 HCP 中,64.3%的人曾治疗过蛇咬伤病例,87.1%的人有信心提供支持性治疗,但只有 9.6%的人曾接受过蛇咬伤管理培训。总体而言,22.8%的 HCP 对蛇咬伤管理有较高的认识。较高的教育程度(至少是学位而非证书;PR=2.21 95%CI 1.508 至 4.56)、年龄较大(30-45 岁与<30 岁;PR=1.97,95%CI 1.22 至 3.21)和先前的培训(PR=1.82,95%CI 1.08 至 3.05)与对蛇咬伤诊断和管理的高知识相关。

结论

总体而言,对蛇咬伤管理的了解有限。培训、教育程度和 HCP 的年龄都对知识有影响。在高负担地区,需要有针对性地努力提高 HCP 对蛇咬伤病例护理的知识,以管理发病病例。

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