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Congenital Cytomegalovirus Knowledge, Practices, and Beliefs Among Primary Care Physicians and Newborn Hospitalists
Megan H Pesch1, Kathleen M Muldoon2
1University of Michigan and CS Mott Children's Hospital, Ann Arbor, MI, USA.
Insights
Pediatric providers show limited knowledge and comfort in screening for congenital cytomegalovirus (cCMV), despite agreement on its importance. Enhanced education is needed for better infant care and management of cCMV.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Congenital cytomegalovirus (cCMV) impacts 1 in 200 infants in the US.
- Mandatory newborn cCMV screening is implemented in 9 states.
- Increased diagnoses necessitate knowledgeable healthcare providers for ongoing infant care.
Purpose of the Study:
- To assess pediatric provider knowledge, practices, and beliefs regarding cCMV.
- To identify gaps in understanding and clinical application of cCMV screening and management.
Main Methods:
- A survey was distributed to 103 pediatricians and newborn hospitalists in Michigan.
- Participants regularly cared for infants and were questioned on cCMV knowledge, practices, and beliefs.
Main Results:
- Providers demonstrated low knowledge of cCMV presentation and sequelae, with varied understanding of screening standards.
- Most providers rarely screened for cCMV but agreed on the importance of testing, especially for infants with failed hearing screens.
- A significant majority (81%) were uncomfortable diagnosing and managing cCMV, with 72% feeling their training was insufficient.
Conclusions:
- Pediatric primary care and hospitalist providers exhibit inconsistent knowledge, infrequent screening practices, and low comfort levels with cCMV.
- There is a clear need for educational initiatives and professional support to improve cCMV care for infants.
Background:
Congenital cytomegalovirus (cCMV) affects 1 in every 200 United States infants, at present there are 9 states which mandate newborn cCMV screening. With more infants being diagnosed, more children will need continuing care from providers who are knowledgeable about cCMV.
Objectives:
To examine pediatric provider knowledge, practices, and beliefs around cCMV.
Methods:
Primary care and newborn hospitalist pediatricians (N = 103) from Michigan, who "regularly care for infants" were invited to participate in a survey about their cCMV-related knowledge, clinical practices, and beliefs.
Results:
Respondents had low knowledge of typical cCMV presentation and sequelae, with mixed knowledge of screening and testing standards. Most (68%) reported rarely/never screening for cCMV, though 71% strongly agreed/agreed that primary care providers should test for cCMV. Most (90%) strongly agreed/agreed that infants who fail/refer on their newborn hearing screen should be tested for cCMV, yet 81% expressed not being comfortable diagnosing and managing cCMV. Most (72%) felt that cCMV was not sufficiently covered in their medical training; almost all respondents endorsed interest in learning more.
Conclusions:
Primary care and newborn hospitalists in this study expressed mixed knowledge about, infrequent practice of and low comfort with screening and caring for children with cCMV. This may present a prime opportunity for education and clinician support by professional organizations.
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