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The general practitioner facing acute infant bronchiolitis: multicenter study in Tunis
Insights
Acute bronchiolitis in infants (ABI) is over-treated by frontline doctors in Tunis. Improving general practitioner training and communication tools is crucial for better care and prevention of this common infant illness.
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.
Background:
The acute bronchiolitis in infants (ABI) constitutes a health problem, responsible for a congestion of the care system, particularly emergencies.
Objectives:
This study aims to assess the knowledge, attitudes, and the frontline general practitioners' behavior, and describe the availability of the base pediatric equipment in health centers, in Tunis.
Methods:
Cross-sectional descriptive survey was conducted in 2013 at 50 health centers in the region with physicians, conducted by selfadministered anonymous questionnaire and a data sheet detailing the equipment at the health center. Seizure and data analysis is made by Epi Info 6.
Results:
The responder doctors have over 20 years of seniority for 64% of them and have all received training in ABI. In knowledge 75 to 80% master the definition of the ABI and the main criteria of severity, but only 35% identified less than 3 months of age as a risk factor and less than half provide prevention tips. Regarding the physicians behavior, chest X-ray and kinesitherapy continues to be prescribed in respectively 23 and 37% of cases, the same applies for corticoid (25%). Nasopharyngeal desobstruction is only recommended in 60% of cases. In regard to the health centers equipment, they were judged satisfactory overall, except for the absence of oxygen sources in 66% of them.
Conclusion:
Acute Bronchiolitis in infants remains over-medicated at the level of frontline medical consultation in Tunis. It is necessary to revise the terms of skills updating of the general practitioners in care and prevention, conduct and disseminate easy and attractive communication tools (brochures and posters) and implement seasonal data collection of this disease in sentinel sites.
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