Knowledge, Attitude and Practice of General Practitioners Regarding Typhoid Fever

Background: Typhoid fever is a very common infectious disease in the tropics, particularly in India with a hugely devastating mortality and morbidity fig ures. It is expected that a better understanding of the knowledge, attitude and practice of the primary care physicians should be there, in general, practitioners toward typhoid fever. Materials and Methods: The study was a non-parametric prospective non-interventional research work carried out in five places in Bihar and West Bengal, viz, Kishanganj, Raiganj, Bardhaman, Siliguri, and Kolkata. The study was performed for a period of 6-month from January 2015 to July 2015. The participants for the study are medical graduates mostly as full-time general practitioners mostly working in slum urban and rural set ups, and having no medical postgraduate qualification whatsoever. The whole study was divided into three phases - Phase 1, Phase 2, and Phase 3. Results: About 81% of the general practitioners diagnose typhoid most of the time by clinical examination alone, without taking any support from any laboratory investigation. 83% of our general practitioners give supportive care most of the time. 65% of the general practitioners most of the time and 26% always, that is 91% highly prefer to apply empirical antibiotic. 93% of general practitioners always 5% most of the time order for Widal test. Again only 3% of general practitioners order for blood culture and that also occasionally, while 97% never do so. Some often noteworthy findings in our study include 92% of general practitioners do not use thermometer, 69% do not count pulse rate, 88% do not even think of brady/tachycardia, 86% do not inspect tongue, 98% do not inspect rose spots, 77% do not palpate abdomen and 65% do not look for hepatosplenomegaly. Conclusion: The diagnosis and treatment of our general practitioners do tally with the expected norms of a general practitioner in the Indian subcontinent. However, they should improve attitude and give more importance to clinical skills.

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