Діагностика та лікування скарлатини: обізнаність українських лікарів

Abstract

In recent years, the incidence of scarlet fever has been increasing in Ukraine and in the world. Timely diagnosis is important to reduce the transmission of the pathogen, while timely and rational treatment reduces the frequency of the complications. Aim - to assess the knowledge of doctors regarding the diagnosis and treatment of scarlet fever, and to identify problems that arise in the management of patients with scarlet fever, in particular, when providing medical care at the primary level. Materials and methods. A sociological study was conducted by anonymously surveying doctors using Google Form in April-September 2023. We studied the awareness of Ukrainian doctors about the diagnosis and treatment of scarlet fever in children. The survey involved 100 doctors with different experiences and specializations. Results. 83% of doctors who participated in the survey work at the primary level of medical care. It was estimated that 48% of doctors consulted patients with scarlet fever rarely and only 4% of them dealt with such patients 2-3 times a week. Therefore, only one-third of the physicians, who took part in the survey, feel confident about the diagnosis of scarlet fever. A rapid test for qualitative detection of Group A Streptococcus antigen was used by 42% of doctors in their practice, whereas 50% of physicians did not have the ability to perform this test. 56% of doctors feel confident while prescribing treatment. More than half of the surveyed physicians (60%) prescribe the first choice antibiotics (amoxicillin or penicillin). Regarding the terms of isolation of patients with scarlet fever, the answers were different, only 24% of doctors answered correctly. Complications were observed by 22% of doctors. It was found that 34% of the respondents used the invalid order of the Ministry of Health of Ukraine No 354 from 2009 in their practice, whilst the minority relied on clinical Duodecim protocols and UpToDate (7% and 11% respectively). Conclusions. After analyzing the survey results, several problems, that need to be solved, have been identified: insufficient awareness of doctors with scarlet fever and its diagnosis due to the infrequent patient visits; and unavailability of rapid tests for qualitative detection of Group A Streptococcus antigen. A significant percentage of doctors (62%) do not use updated valid guidelines regarding treatment and, as a result, the physicians do not always prescribe antibiotic therapy adequately and conduct anti-epidemic measures appropriately enough. All these identified problems point to the need for constant updating of knowledge in everyday medical practice. No conflict of interests was declared by the authors.