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Linares-Rufo M, Bermudez-Marval H, García-Bertolín C, Santos-Galilea J, Balsa-Vázquez J, Pérez-Tanoira R, Santos-Larrégola L, Cuadros-González J, Rojo-Marcos G, Ramos-Rincón JM. Perspectives of primary care physicians in Spain on malaria: a cross-sectional survey and retrospective review of cases. Malar J 2024; 23:7. [PMID: 38178126 PMCID: PMC10768253 DOI: 10.1186/s12936-023-04826-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND In Spain, the risk of imported malaria has increased in recent years due to the rise in international travel and migration. Little is known about the knowledge, information sources, clinical practice, and specific needs of primary care physicians (PCPs) concerning malaria despite the pivotal role played by these professionals in managing the health of tourists. The objective of this study was to assess the knowledge, attitudes, and practices of PCPs in Spain regarding malaria. METHODS This research analyses data from (1) a cross-sectional nationwide survey assessing the knowledge and attitudes of PCPs regarding malaria, and (2) a retrospective review of 373 malaria cases appearing in primary care medical records (PCMRs) in the Madrid area over the past 15 years to determine how cases were documented, managed, or characterized in the primary care setting. RESULTS The survey findings reveal a modest level of self-perceived familiarity with malaria (221/360, 57.6%), even though 32.8% of the practitioners reported having delivered care for confirmed or suspected cases of the disease, these practitioners had greater knowledge of malaria (80.4%) compared to physicians who reported not having delivered care for malaria (19.6%, p < 0.001). Ten percent of the survey participants did not know the name of the mosquito that transmits malaria, and only 40.7% would promptly request malaria testing for a traveller with symptoms after a trip to an endemic area. Responses provided by younger PCPs varied to a greater extent than those of their more experienced colleagues regarding prevention practices and patient management. A review of PCMRs showed that only 65% of all patients were recorded as such. Among those registered, only 40.3% had a documented malaria episode, and of those, only 16.6% received proper follow-up. Only 23.7% of the patients with a PCMR had a record that specifically indicated travel to an endemic country or travel classified as visiting friends and relatives (VFR). CONCLUSIONS The findings of this study underscore the critical role of PCPs in the field of travel medicine, particularly given the increase in imported malaria cases. These results highlight the need for targeted training in travel medicine and the need to ensure optimal patient education in care settings.
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Affiliation(s)
- Manuel Linares-Rufo
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
- Foundation iO, Madrid, Spain.
| | - Harold Bermudez-Marval
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Carlos García-Bertolín
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | - Javier Balsa-Vázquez
- Internal Medicine Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Ramón Pérez-Tanoira
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
- Biomedicine and Biotechnology Department, University Alcalá de Henares, Alcalá de Henares, Madrid, Spain
| | | | - Juan Cuadros-González
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
- Biomedicine and Biotechnology Department, University Alcalá de Henares, Alcalá de Henares, Madrid, Spain
| | - Gerardo Rojo-Marcos
- Internal Medicine Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - José-Manuel Ramos-Rincón
- Clinical Medicine Department, Miguel Hernández of Elche University, Elche, Alicante, Spain
- Internal Medicine Department, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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Riccò M, Zaniboni A, Satta E, Baldassarre A, Cerviere MP, Marchesi F, Peruzzi S. Management and Prevention of Traveler's Diarrhea: A Cross-Sectional Study on Knowledge, Attitudes, and Practices in Italian Occupational Physicians (2019 and 2022). Trop Med Infect Dis 2022; 7:370. [PMID: 36422921 PMCID: PMC9692574 DOI: 10.3390/tropicalmed7110370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 07/29/2023] Open
Abstract
Even though Italian Occupational Physicians (OP) are increasingly involved in the managing of overseas workers, their knowledge, attitudes, and practices (KAP) in travel medicine are mostly undefined. We, therefore, permed a KAP study specifically targeting the management of travelers' diarrhea (TD) by OP. A total of 371 professionals (43.4% males; mean age 40.8 ± 10.9 years) completed in 2 rounds (2019 and 2022) a specifically designed web questionnaire that inquired participating OP on their knowledge status (KS), risk perception, and management of TD through pre- and post-travel advice and interventions. Multivariable odds ratios (aOR) for predictors of a better knowledge status were calculated through regression analysis. Eventually, the majority of participants (53.4%) had participated in the management of cases of TD in the previous months, but only 26.4% were reportedly involved in pre-travel consultations. The overall knowledge status was unsatisfying (potential range: 0-100%, actual average of the sample 59.6% ± 14.6), with substantial uncertainties in the management of antimicrobial treatment. Interestingly, only a small subset of participants had previously prescribed antimicrobial prophylaxis or treatment (3.5% and 1.9%, respectively). Main effectors of a better knowledge status were: having a background qualification in Hygiene and Public Health (aOR 14.769, 95%CI 5.582 to 39.073), having previously managed any case of (aOR 3.107, 95%CI 1.484 to 6.506), and having higher concern on TD, reported by acknowledging high frequency (aOR 8.579, 95%CI 3.383 to 21.756) and severity (aOR 3.386; 95%CI 1.741 to 6.585) of this disorder. As the adherence of participating OP to official recommendations for TD management was unsatisfying, continuous Education on Travel Medicine should be improved by sharing up-to-date official recommendations on appropriate treatment options for TD.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Department of Public Health, AUSL-IRCCS di Reggio Emilia, I-42122 Reggio Emilia, Italy
| | - Alessandro Zaniboni
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy
| | - Elia Satta
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy
| | - Antonio Baldassarre
- Department of Experimental and Clinical Medicine, University of Florence, I-50134 Florence, Italy
| | | | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, I-42016 Guastalla, Italy
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