Cross-sectional pilot study to assess primary healthcare workers\u2019 knowledge of nonalcoholic fatty liver disease in a marginalized community in Mexico

Paulina Vidal-Cevallos,Rafael Cardoso-Arias,Omar Procopio-Mosso,Ana L Ordóñez-Vázquez,Misael Uribe,Norberto C Chávez-Tapia

doi:10.1038/s41598-021-91199-y

Paulina Vidal-Cevallos, Rafael Cardoso-Arias + Show 4 more

Open Access

https://doi.org/10.1038/s41598-021-91199-y

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Journal: Scientific Reports	Publication Date: Jun 8, 2021
Citations: 1	License type: open-access

Affiliation: Hospital Médica Sur

Abstract

The registered incidence of nonalcoholic fatty liver disease (NAFLD) in primary healthcare centers is lower than expected, suggesting a lack of awareness by primary care healthcare professionals. The implementation of educational tools for healthcare workers has been found to increase timely referral and treatment of patients. We aimed to determine healthcare workers’ knowledge of NAFLD to identify their educational needs in one marginalized region. We performed a cross-sectional survey of 261 healthcare professionals in Tlapa de Comonfort, Guerrero, Mexico from October 2019 to December 2019. We created a questionnaire that assessed domains most relevant to NAFLD knowledge. Two hundred and forty-six questionnaires were completed. Of the respondents, 38.3% were nurses and 63.4% were women. Most nurses identified NAFLD as a prevalent (89%) and preventable (93%) disease. Hypertension (33%) and obesity (84%) were recognized as risk factors. The associations between NAFLD and cancer, cirrhosis and cardiovascular disease were identified by 53%, 67% and 72% of respondents, respectively. The largest gaps were found in diagnostic workup, therapeutic approach and the current treatments. We identify modifiable knowledge gaps in NAFLD. Educational strategies for primary care workers could enhance the identification of patients with NAFLD and prevent complications.

Highlights

The registered incidence of nonalcoholic fatty liver disease (NAFLD) in primary healthcare centers is lower than expected, suggesting a lack of awareness by primary care healthcare professionals
In a study conducted in the United States, Hispanics of Mexican origin had a higher prevalence of NAFLD (33%) than Hispanics of other origins (Puerto Rican 18% and Dominican 16%, P < 0.01)[2]
Othersa 23 (9.3%) 33.2 ± 7.2 5 (21.7%) 5.8 ± 6.7. Another study[7] found that while 91% of primary healthcare workers recognize the relationship between metabolic syndrome and NAFLD, only 46% claim to have conducted an evaluation for NAFLD in high-risk patients

Summary

Introduction

The registered incidence of nonalcoholic fatty liver disease (NAFLD) in primary healthcare centers is lower than expected, suggesting a lack of awareness by primary care healthcare professionals. A study conducted by Polanco-Briceno et al.[6] with 152 primary care physicians demonstrated that up to 50% of the physicians were not familiar with the term nonalcoholic fatty liver disease, or the difference between steatosis and steatohepatitis, even though 58% of the physicians said they were attending patients with the diagnosis of NAFLD. Another study[7] found that while 91% of primary healthcare workers recognize the relationship between metabolic syndrome and NAFLD, only 46% claim to have conducted an evaluation for NAFLD in high-risk patients. The training of nursing staff through the implementation of educational tools has been found to increase detection, treatment and timely referral compared with a single intervention by general practitioners[8]

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