Bongomin Felix, Nantale Ritah, Baluku Joseph Baruch, Odongo Tobius, Katusabe Shamim, Oyoo Nixson, Muddu Martin, van Rhijn Norman, Denning David W
Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
IJID Reg. 2025 Feb 19;14:100603. doi: 10.1016/j.ijregi.2025.100603. eCollection 2025 Mar.
Chronic pulmonary aspergillosis (CPA) often mimics pulmonary tuberculosis (PTB), leading to misdiagnosis and inappropriate management. We aimed to determine the baseline knowledge, practices, and self-rated confidence of health care workers (HCWs) regarding CPA in Uganda.
Between January and April 2024, we conducted a cross-sectional survey involving HCWs at four public health facilities in Uganda currently enrolling patients with current or previously treated for PTB into a cohort study aimed at establishing the incidence of CPA. Data on sociodemographic characteristics, awareness, knowledge, practices regarding CPA, PTB, and finger-prick tests for point of care testing were collected using semi-structured questionnaires. Adequate knowledge was defined as a score of ≥80%.
A total of 110 HCWs participated, predominantly males (61, 57.5%), with a mean age of 38.8 years. Although most HCWs had heard of aspergillosis (78, 82.1%), only 23 (21.7%) demonstrated adequate knowledge about CPA. In addition, 25 (28.7%) reported encountering a patient with CPA in the past year, with 41 (47.1%) never routinely screening for CPA. Confidence in managing CPA was low among HCWs, with 29 (29.8%) expressing no confidence. Furthermore, only 22 (20.8%) had adequate knowledge about PTB. Referral hospital practice was significantly associated with higher odds of adequate CPA knowledge (adjusted odds ratio: 6.69, 95% confidence interval: 1.67-26.82, = 0.007).
There are significant gaps in awareness, knowledge, and practices of HCWs in Uganda related to CPA and PTB. Strategies to enhance training, guideline dissemination, and diagnostic capacity are essential to improve the management of these respiratory conditions and reduce misdiagnosis.
慢性肺曲霉病（CPA）常与肺结核（PTB）相似，导致误诊和不恰当的治疗。我们旨在确定乌干达医护人员对CPA的基线知识、实践和自我评估的信心。
在2024年1月至4月期间，我们对乌干达四个公共卫生机构的医护人员进行了一项横断面调查，这些机构目前正在将现患或既往接受过PTB治疗的患者纳入一项旨在确定CPA发病率的队列研究。使用半结构化问卷收集有关社会人口学特征、对CPA、PTB的认识、知识、实践以及即时检验的指尖采血检测的数据。充分知识定义为得分≥80%。
共有110名医护人员参与，其中男性居多（61名，57.5%），平均年龄为38.8岁。虽然大多数医护人员听说过曲霉病（78名，82.1%），但只有23名（21.7%）对CPA有充分的了解。此外，25名（28.7%）报告在过去一年中遇到过CPA患者，41名（47.1%）从未常规筛查CPA。医护人员对管理CPA的信心较低，29名（29.8%）表示没有信心。此外，只有22名（20.8%）对PTB有充分的了解。转诊医院的实践与获得充分的CPA知识的较高几率显著相关（调整后的优势比：6.69，95%置信区间：1.67 - 26.82，P = 0.007）。
乌干达医护人员在与CPA和PTB相关的认识、知识和实践方面存在重大差距。加强培训、指南传播和诊断能力的策略对于改善这些呼吸道疾病的管理和减少误诊至关重要。
