ABSTRACT
The objective of this study was to determine how clinicians make use of the modern multiplex PCR assays (MPAs) to manage patients hospitalized for community-acquired pneumonia (CAP). We studied the use of MPAs in 1648 patients hospitalized for CAP over a 3-year period at the moment of the setup of the new PCR assay. We observed that the use of MPAs for the identification of multiple respiratory pathogens marks a radical change in the investigation of CAP etiology. Surprisingly, the contribution of MPAs to the medical decision-making process varies drastically according to the units of care.
Subject(s)
Clinical Decision-Making/methods , Multiplex Polymerase Chain Reaction , Pneumonia/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Community-Acquired Infections/diagnosis , Community-Acquired Infections/etiology , Community-Acquired Infections/therapy , Cross-Sectional Studies , Female , France , Humans , Male , Middle Aged , Pneumonia/diagnosis , Pneumonia/etiology , Retrospective Studies , Young AdultABSTRACT
INTRODUCTION: The prevention of sanitary risks related to traveling in the tropics implies delivering a large amount of information to travelers. The objective of our study was to assess the knowledge acquired by travelers during a pre-travel consultation. METHODS: A before and after study was conducted among 202 travelers having consulted at the Tours international vaccine center. We used self-administrated questionnaires (score out of 100 marks) concerning diet, hygiene, anti-vectorial prevention (AVP), and sexual-transmitted infections (STI). The scores obtained before and after consultation were compared globally and for each topic. RESULTS: The travelers' global knowledge had improved after consultation (66.1 vs. 75.5%; P < 0.0001) as well as for each topic. The most important improvement concerned hygiene (+12.5%; P < 0.0001) and the lowest concerned STI (+5.8%; P < 0.0001). The multivariate analysis revealed that not having searched for information before consulting was the main factor associated with global knowledge improvement (P < 0.0001) (unplanned professional traveling compared to humanitarian mission prepared ahead of departure time). The recommendations for diet were less well acquired in travelers > 50 years of age than in those < 30 years of age (P < 0.002). CONCLUSION: A specialized pre-travel consultation improves the travelers' knowledge for the main prevention measures but does not allow them to acquire all required knowledge. Taking into account the travelers' initial knowledge and their ability to learn could improve the impact of the pre-travel consultation.
Subject(s)
Counseling , Health Education , Health Knowledge, Attitudes, Practice , Infection Control , Travel , Tropical Medicine/education , Adolescent , Adult , Aged , Animals , Commerce , Diet , Disease Vectors , Female , France , Health Literacy , Humans , Hygiene , Information Seeking Behavior , Male , Medical Missions , Middle Aged , Risk , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control , Students/psychology , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: The 2010-2014 HIV/AIDS French program recommends using HIV rapid diagnostic tests in family practice. Our aim was to assess the acceptability and feasibility of the RDT in family practice in France. METHODS: The first part of this study was to determine the opinions of family practitioners (FPs) concerning the news guidelines for screening and the possible use of rapid HIV tests in their practice. The second part was a feasibility study of the actual use of rapid HIV tests given to FPs during six months. The third part was a qualitative analysis of experience feedback to determine the impediments to using rapid HIV tests. RESULTS: Seventy-seven percent of the 352 FPs interviewed were favorable to rapid HIV tests use. The three main impediments were: misinterpretation of test result, complexity of quality control, and lack of training: 23 of the 112 FPs having volunteered to evaluate the rapid HIV tests followed the required training session. Sixty-nine tests were handed out, and three rapid HIV tests were used; the qualitative study involved 12 FPs. The participants all agreed on the difficult use of rapid HIV tests in daily practice. The main reasons were: too few opportunities or requests for use, complex handling, difficulties in proposing the test, fear of having to announce seropositivity, significantly longer consultation. CONCLUSION: Although FPs are generally favorable to rapid HIV tests use in daily practice, the feasibility and contribution of rapid HIV tests are limited in family practice.