Knowledge, Attitudes, and Practices of Refugee Care Providers and Medical Students in Massachusetts with Respect to Strongyloidiasis and Schistosomiasis.
Baumont, Monique S.
- Every year, increasing numbers of refugees are resettled in the United States. Many face high burdens of parasitic disease due to their country of origin and exposures during migration. Among resettled refugees, the parasitic diseases strongyloidiasis and schistosomiasis account for substantial disability and complications. The Centers for Disease Control and Prevention (CDC) have issued comprehensive ... read moreguidelines for post-arrival presumptive treatment (PT) of schistosomiasis and strongyloidiasis. Nonetheless, large numbers of refugees remain undiagnosed or untreated in the US, and studies have revealed large gaps between CDC guidelines and clinical practice. Although PT is a cost-effective and safe option for addressing parasitic diseases, refugees may undergo complicated, invasive, and expensive diagnostic tests in the US. It is essential to understand the knowledge, attitudes, and practices (KAP) of clinicians and future clinicians with respect to strongyloidiasis, schistosomiasis, and PT to improve health outcomes. Qualitative interviews were conducted with 6 clinicians in Massachusetts and KAP surveys were administered to 50 students from a Boston-area medical school. Interview data suggest that negative attitudes are not responsible for low rates of PT use, but rather, that clinicians lack sufficient knowledge about and comfort with PT. The medical student surveys indicated that knowledge of parasitic disease concepts and PT is quite low among students, and that knowledge is a better indicator of one’s likelihood to presumptively treat than attitudes. Integrating PT into medical school curricula and increasing clinicians’ access to resources about PT may help alleviate the demonstrated knowledge gap.read less