The general practitioner facing acute infant bronchiolitis: multicenter study in Tunis

Area of Science:

• Pediatrics
• Public Health
• General Practice

Background:

• Acute bronchiolitis in infants (ABI) significantly burdens healthcare systems, particularly emergency departments.
• Effective management and prevention strategies are essential to alleviate this burden.

Purpose of the Study:

• To evaluate the knowledge, attitudes, and practices of frontline general practitioners regarding ABI in Tunis.
• To assess the availability of essential pediatric equipment in primary healthcare centers.

Main Methods:

• A cross-sectional descriptive survey was conducted in 2013 across 50 health centers in Tunis.
• Data were collected using self-administered anonymous questionnaires for physicians and a data sheet for health center equipment.
• Statistical analysis was performed using Epi Info 6.

Main Results:

• Most surveyed physicians (64%) had over 20 years of experience and received ABI training.
• While 75-80% understood ABI definition and severity criteria, only 35% identified young age as a risk factor, and less than half offered prevention advice.
• Over-prescription of chest X-rays (23%), kinesitherapy (37%), and corticosteroids (25%) was noted. Nasopharyngeal desobstruction was recommended in 60% of cases.
• A significant deficiency was the absence of oxygen sources in 66% of health centers.

Conclusions:

• Acute bronchiolitis in infants is frequently over-medicated in primary care settings in Tunis.
• There is a need to update general practitioner training on ABI care and prevention.
• Dissemination of accessible communication materials and implementation of seasonal surveillance are recommended.