Care for Acute Otitis Media in Children by General Practitioners in North Benin in 2017

M. Flatin, S. Hounkpatin, C. Attinsounon, Abdou Zulkif Toungou, F. Bouraima, Alexis do Santos Zounon, F. Avakoudjo, W. Adjibabi
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Abstract

Introduction: Acute otitis media (AOM) is a common childhood infection, subject to a wrongful prescription of antibiotics. The objective of this work was to evaluate the practices of general practitioners of North-Benin, in term of caring AOM in children. Methods: This was a cross-sectional, descriptive survey based on a telephone interview questionnaire with 112 general practitioners working in North Benin in 2017. The collected data were analyzed using EpiData Analysis and Open Epi software. The Khi2 test was used for comparisons. The significance threshold adopted was 0.05. Results: Of the 145 general practitioners listed, 112 participated in the survey for a participation rate of 77.2%. The mean age was 32 ± 6 years with a sex ratio of 4.04 and the median duration of seniority in the medical practice was 4 years with extremes of 1 and 32 years. Three main clinical signs suggestive of the diagnosis were, according to the respondents, otalgia (107; 95.5%), otorrhea (86; 76.8%) and fever (77; 68.8%). Tympanum inflammation and middle ear effusion association was considered as a diagnostic criterium by 17.9% of doctors. Therapeutic recommendations were known by 15 doctors (13.4%). Systematic antibiotic therapy was advocated by 86 doctors (76.8%). The main reasons for systematic antibiotics were the frequent use of antibiotics by parents in the self-medication (63 cases or 74.4%), the difficulty of following up the child (55 cases or 64 per cent) and the fear of the locoregional or systemic spread of infection (40 cases or 46.5%). The amoxicillin-clavulanic acid combination was prescribed as first-line by 68 respondents (62.4%). Forty doctors (36.7%) prescribed third-generation cephalosporins as second-line therapy. Systemic rhinopharyngeal disinfection was performed by 23 doctors (20.5%). In case of therapeutic failure, the opinion of an ENT doctor was requested by 66 general practitioners or 58.9% of the cases. Conclusion: It is necessary that Beninese medical companies develop national recommendations for managing the acute otitis media and ensure their diffusion through continuous medical training.
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2017年贝宁北部全科医生对儿童急性中耳炎的护理
简介:急性中耳炎(AOM)是一种常见的儿童感染,受到错误的抗生素处方。这项工作的目的是评估贝宁北部全科医生在照顾儿童AOM方面的做法。方法:采用横断面描述性调查方法,对2017年在贝宁北部工作的112名全科医生进行电话访谈问卷调查。使用EpiData Analysis和Open Epi软件对收集的数据进行分析。采用Khi2检验进行比较。采用的显著性阈值为0.05。结果:145名全科医生中,有112名参与调查,参与率为77.2%。平均年龄为32±6岁,性别比为4.04,从业年资中位数为4年,极值为1年和32年。据应答者称,提示诊断的三个主要临床体征是:耳痛(107;95.5%),耳漏(86;76.8%)和发热(77;68.8%)。17.9%的医生将鼓室炎症和中耳积液关联作为诊断标准。15名医生(13.4%)知道治疗建议。86名医生(76.8%)主张系统抗生素治疗。使用系统抗生素的主要原因是家长自行给药时频繁使用抗生素(63例,74.4%)、患儿随访困难(55例,64%)和担心感染局部或全身扩散(40例,46.5%)。68名应答者(62.4%)将阿莫西林-克拉维酸联合处方为一线。40名医生(36.7%)将第三代头孢菌素作为二线治疗。全身性鼻咽消毒23例(20.5%)。在治疗失败的情况下,有66名全科医生(58.9%)要求耳鼻喉科医生的意见。结论:贝宁医疗公司有必要制定管理急性中耳炎的国家建议,并通过持续的医疗培训确保其传播。
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