E O Dantas1, C S Aranda2, A M Rêgo Silva3, F S Tavares4, J F Severo Ferreira5, M A de Quadros Coelho6, L C de Siqueira Kovalhuk7, P Roxo Júnior8, E C Toledo9, A C Porto Neto10, H M C de Sousa Vieira11, O A Takano12, F A Nobre2, F Sano13, V Nudelman14, V S de Farias Sales15, G R Silva Segundo16, H T Villar Guedes17, E Félix2, S M B Marques17, J T L Mazzucchelli2, N F Wandalsen18, J A Pinto19, I C D Paes Barreto20, M R Silva21, V E V Rullo21, J M Franco22, E Damasceno2, K Fahl14, M I de Moraes-Pinto2, D L Del Nero23, L S L Moraes12, A Condino-Neto24, M M Vilela25, H Góes26, K L Schisler27, E Miranda28, E S Goudouris29, B T Costa Carvalho2. 1. Federal University of São Paulo, São Paulo, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. Electronic address: ellendantas@ig.com.br. 2. Federal University of São Paulo, São Paulo, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 3. Federal University of Pernambuco, Recife, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 4. University Hospital of Brasília and Children's Hospital of Brasília, Brasília, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 5. Albert Sabin Children's Hospital, Fortaleza, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 6. State University of Montes Claros, Montes Claros, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 7. Federal University of Paraná, Curitiba, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 8. Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 9. Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 10. University Hospital São Vicente de Paulo, Passo Fundo, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 11. Joana de Gusmão Children's Hospital, Florianópolis, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 12. Faculty of Medicine and University Hospital Júlio Muller, Federal University of Mato Grosso, Cuiabá, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 13. Nipo Brasileiro Hospital, São Paulo, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 14. Hospital Israelita Albert Einstein, São Paulo, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 15. Federal University of Rio Grande do Norte, Natal, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 16. Federal University of Uberlândia, Uberlândia, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 17. State University of Piauí, Teresina, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 18. Faculty of Medicine of ABC, Santo André, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 19. Federal University of Minas Gerais, Belo Horizonte, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 20. University Center of Pará, Belém, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 21. Pediatrics Department, Medicine Course of Lusiada University Center (UNILUS), Santos, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 22. Federal University of Sergipe, Aracajú, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 23. Hospital do Servidor Público Municipal, São Paulo, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 24. Institute of Biomedical Sciences, University of São Paulo, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 25. Pediatrics Department, University of Campinas Medical School, Campinas, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 26. Private office, Macapá, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 27. Hospital Ministro Costa Cavalcanti, Foz do Iguaçu, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 28. Children's Hospital Cosme e Damião, Rondônia, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil. 29. Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Complexo Hospitalar Universitário Professor Edgar Santos - Federal University of Bahia, Salvador, Brazil.
Abstract
BACKGROUND: PIDs are a heterogeneous group of genetic illnesses, and delay in their diagnosis is thought to be caused by a lack of awareness among physicians concerning PIDs. The latter is what we aimed to evaluate in Brazil. METHODS: Physicians working at general hospitals all over the country were asked to complete a 14-item questionnaire. One of the questions described 25 clinical situations that could be associated with PIDs and a score was created based on percentages of appropriate answers. RESULTS: A total of 4026 physicians participated in the study: 1628 paediatricians (40.4%), 1436 clinicians (35.7%), and 962 surgeons (23.9%). About 67% of the physicians had learned about PIDs in medical school or residency training, 84.6% evaluated patients who frequently took antibiotics, but only 40.3% of them participated in the immunological evaluation of these patients. Seventy-seven percent of the participating physicians were not familiar with the warning signs for PIDs. The mean score of correct answers for the 25 clinical situations was 48.08% (±16.06). Only 18.3% of the paediatricians, 7.4% of the clinicians, and 5.8% of the surgeons answered at least 2/3 of these situations appropriately. CONCLUSIONS: There is a lack of medical awareness concerning PIDs, even among paediatricians, who have been targeted with PID educational programmes in recent years in Brazil. An increase in awareness with regard to these disorders within the medical community is an important step towards improving recognition and treatment of PIDs.
BACKGROUND: PIDs are a heterogeneous group of genetic illnesses, and delay in their diagnosis is thought to be caused by a lack of awareness among physicians concerning PIDs. The latter is what we aimed to evaluate in Brazil. METHODS: Physicians working at general hospitals all over the country were asked to complete a 14-item questionnaire. One of the questions described 25 clinical situations that could be associated with PIDs and a score was created based on percentages of appropriate answers. RESULTS: A total of 4026 physicians participated in the study: 1628 paediatricians (40.4%), 1436 clinicians (35.7%), and 962 surgeons (23.9%). About 67% of the physicians had learned about PIDs in medical school or residency training, 84.6% evaluated patients who frequently took antibiotics, but only 40.3% of them participated in the immunological evaluation of these patients. Seventy-seven percent of the participating physicians were not familiar with the warning signs for PIDs. The mean score of correct answers for the 25 clinical situations was 48.08% (±16.06). Only 18.3% of the paediatricians, 7.4% of the clinicians, and 5.8% of the surgeons answered at least 2/3 of these situations appropriately. CONCLUSIONS: There is a lack of medical awareness concerning PIDs, even among paediatricians, who have been targeted with PID educational programmes in recent years in Brazil. An increase in awareness with regard to these disorders within the medical community is an important step towards improving recognition and treatment of PIDs.