Conocimientos, prácticas y actitudes del manejo programático de la tuberculosis en estudiantes de medicina de Colombia  <span class="so-article-trans-title" dir="auto"> Translated title: Knowledge, practices and attitudes of the programmatic management of tuberculosis among Colombian medical students </span>

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Abstract

RESUMEN: Introducción: La tuberculosis es una enfermedad infecciosa con alta carga de la enfermedad en Colombia, por lo que se espera que la educación médica sea estándar en todas las regiones y los estudiantes de medicina tengan competencias en el manejo operativo de la tuberculosis. Este estudio evaluó los conocimientos, actitudes y prácticas en tuberculosis en estudiantes de medicina de Colombia y los factores relacionados. Métodos: Cuestionario de evaluación de conocimientos, actitudes y prácticas en tuberculosis en estudiantes de medicina en Colombia, que cursaban semestre clínico y se encontraban inscritos en la reunión anual 2020 de la Asociación de Sociedades Científicas de Estudiantes de Medicina de Colombia (ASCEMCOL) para esTablecer el nivel de conocimientos en tuberculosis. Resultados: Se evidenció que los estudiantes de regiones con mayor carga de la enfermedad como el Eje Cafetero presenta puntajes más altos de forma diferencial a las otras regiones. Por otra parte, se observó que la experiencia propia del estudiante en el tamizaje para tuberculosis (prueba cutánea de la tuberculina PPD - Mantoux) y la experiencia en la atención de pacientes con tuberculosis en el entorno clínico están relacionadas a los conocimientos del manejo programático de la tuberculosis. Conclusión: El estudio demuestra bajo nivel de conocimientos, actitudes y prácticas del manejo programático de la tuberculosis en los estudiantes de medicina que cursaban semestres clínicos en Colombia.

Translated abstract

ABSTRACT: Background: The tuberculosis is an infectious disease with high disease burden in Colombia, so medical education is expected to be standard in all regions and medical students have competencies in the operative management of tuberculosis. This study evaluated the knowledge, attitudes, and practices in tuberculosis in medical students in Colombia and related factors. Methods: Questionnaire for the evaluation of knowledge, attitudes, and practices in tuberculosis in medical students in Colombia, who were in clinical semesters and were registered at the 2020 annual meeting of the Asociación de Sociedades Científicas de Estudiantes de Medicina de Colombia (ASCEMCOL) to establish the level of knowledge in tuberculosis. Result: The study found that students from regions with a higher burden of disease, such as the Eje Cafetero had higher scores that those from other regions. On the other hand, it was observed that the student´s own experience in tuberculosis screening (tuberculin skin test PPD - Mantoux) and the clinical experience in care patients with tuberculosis are related to the knowledge of the programmatic management of tuberculosis. Conclusions: The study shows a low level of knowledge, attitudes, and practices of programmatic management of tuberculosis in medical students in clinical semester in Colombia.

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Health care workers’ knowledge, attitudes and practices on tuberculosis infection control, Nepal

Anita Shrestha, Dipesh Bhattarai, Barsha Thapa … (2017)

Background Infection control remains a key challenge for Tuberculosis (TB) control program with an increased risk of TB transmission among health care workers (HCWs), especially in settings with inadequate TB infection control measures. Poor knowledge among HCWs and inadequate infection control practices may lead to the increased risk of nosocomial TB transmission. Methods An institution-based cross-sectional survey was conducted in 28 health facilities providing TB services in the Kathmandu Valley, Nepal. A total of 190 HCWs were assessed for the knowledge, attitudes and practices on TB infection control using a structured questionnaire. Results The level of knowledge on TB infection control among almost half (45.8%) of the HCWs was poor, and was much poorer among administration and lower level staff. The knowledge level was significantly associated with educational status, and TB training and/or orientation received. The majority (73.2%) of HCWs had positive attitude towards TB infection control. Sixty-five percent of HCWs were found to be concerned about being infected with TB. Use of respirators among the HCWs was limited and triage of TB suspects was also lacking. Conclusions Overall knowledge and practices of HCWs on TB infection control were not satisfactory. Effective infection control measures including regular skill-based training and/or orientation for all categories of HCWs can improve infection control practices in health facilities.

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Inequality in healthcare use among older people in Colombia

Jorge A García-Ramírez, Zlatko Nikoloski, Elias Mossialos (2020)

Background Since the early 1990s, Colombia has made great strides in extending healthcare coverage to its population. In order to measure the impact of these efforts, it is important to assess whether the introduction of universal health coverage has translated into equitable access to healthcare in the country, particularly for the elderly. Thus, in this study we assessed the inequality in utilization of health services among elderly patients in Colombia. In addition, we identified the determinants of healthcare utilization. Methods We analyzed the 2015 Colombian health, well-being and aging study (SABE). To classify determinants of healthcare use into predisposing, enabling and need factors, we employed the Anderson framework of healthcare utilization. Use of outpatient, inpatient and preventive health services constituted the dependent variables. We performed multivariate logistic regressions, estimated concentration indexes (CI) and performed decomposition analyses of the CIs to determine the contribution of various determinants to inequality of healthcare utilization. Results The study sample included 23,694 adults over 60-years-old. Wealth quintile, urban dwelling, health insurance type and multimorbidity predicted the utilization of all types of healthcare services except for hospitalization. Aside from inpatient care, pro-rich inequality in utilization of healthcare services was present. Wealth quintile and type of health insurance were the largest contributors to pro-rich inequality in use of preventive services. Conclusions While there has been progress in health insurance coverage for the elderly in Colombia, there are still equality challenges in the delivery of healthcare, especially for preventive and outpatient care. These inequalities are driven by individual characteristics such as wealth, urban residence, type of health insurance carried, and presence of multimorbidity. To address this issue, the Colombian health system should extend health insurance coverage to uninsured populations, as well as reduce barriers of access to healthcare services among poorest and the rural population receiving subsidized insurance.

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Potential of DosR and Rpf antigens from Mycobacterium tuberculosis to discriminate between latent and active tuberculosis in a tuberculosis endemic population of Medellin Colombia

Leonar Arroyo, Diana Marín, Kees Franken … (2018)

Background Tuberculosis (TB) remains one of the most deadly infectious diseases. One-third to one-fourth of the human population is estimated to be infected with Mycobacterium tuberculosis (Mtb) without showing clinical symptoms, a condition called latent TB infection (LTBI). Diagnosis of Mtb infection is based on the immune response to a mixture of mycobacterial antigens (PPD) or to Mtb specific ESAT-6/CFP10 antigens (IGRA), highly expressed during the initial phase of infection. However, the immune response to PPD and IGRA antigens has a low power to discriminate between LTBI and PTB. The T-cell response to a group of so-called latency (DosR-regulon-encoded) and Resuscitation Promoting (Rpf) antigens of Mtb has been proved to be significantly higher in LTBI compared to active TB across many populations, suggesting their potential use as biomarkers to differentiate latent from active TB. Methods PBMCs from a group LTBI (n = 20) and pulmonary TB patients (PTB, n = 21) from an endemic community for TB of the city of Medellín, Colombia, were in vitro stimulated for 7 days with DosR- (Rv1737c, Rv2029c, and Rv2628), Rpf- (Rv0867c and Rv2389c), the recombinant fusion protein ESAT-6-CFP10 (E6-C10)-, or PPD-antigen. The induced IFNγ levels detectable in the supernatants of the antigen-stimulated cells were then used to calculate specificity and sensitivity in discriminating LTBI from PTB, using different statistical approaches. Results IFNγ production in response to DosR and Rpf antigens was significantly higher in LTBI compared to PTB. ROC curve analyses of IFNγ production allowed differentiation of LTBI from PTB with areas under the curve higher than 0.70. Furthermore, Multiple Correspondence Analysis (MCA) revealed that LTBI is associated with higher levels of IFNγ in response to the different antigens compared to PTB. Analysis based on decision trees showed that the IFNγ levels produced in response to Rv2029c was the leading variable that best-classified disease status. Finally, logistic regression analysis predicted that IFNγ produced by PBMCs in response to E6-C10, Rv2029c, Rv0867c (RpfA) and Rv2389c (RpfA) antigens correlates best with the probability of being latently infected. Conclusions The Mtb antigens E6-C10, Rv2029c (PfkB), Rv0867c (RpfA) and Rv2389c (RpfA), may be potential candidates to discriminate LTBI from PTB. Electronic supplementary material The online version of this article (doi: 10.1186/s12879-017-2929-0) contains supplementary material, which is available to authorized users.

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Journal

Journal ID (publisher-id): eg

Title: Enfermería Global

Abbreviated Title: Enferm. glob.

Publisher: Universidad de Murcia (Murcia, Murcia, Spain )

ISSN (Electronic): 1695-6141

Publication date (Print and electronic): 2023

Volume: 22

Issue: 71

Pages: 454-478

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[2] Cali Valle del Cauca orgnameUniversidad Icesi orgdiv1Facultad de Ciencias de la Salud Colombia

[1] Cali orgnameFundación Valle del Lili orgdiv1Centro de Investigaciones Clínica (CIC) Colombia sofia.montes@ 123456fvl.org.co

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Publisher ID: S1695-61412023000300015 Publisher ID: S1695-6141(23)02207100015

DOI: 10.6018/eglobal.554191

SO-VID: f78d2088-23ca-4ddb-8d04-e817d07ac994

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

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Date accepted : 18 April 2023

Date received : 16 January 2023

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Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 25

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Conocimientos, prácticas y actitudes del manejo programático de la tuberculosis en estudiantes de medicina de Colombia Translated title: Knowledge, practices and attitudes of the programmatic management of tuberculosis among Colombian medical students

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Most cited references 25

Health care workers’ knowledge, attitudes and practices on tuberculosis infection control, Nepal

Inequality in healthcare use among older people in Colombia

Potential of DosR and Rpf antigens from Mycobacterium tuberculosis to discriminate between latent and active tuberculosis in a tuberculosis endemic population of Medellin Colombia

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