Paragonimiasis: A knowledge and awareness survey of clinicians in southern Nigeria on a neglected tropical disease

Abstract

Context: Paragonimiasis is one of the re-emerging neglected tropical diseases endemic in southern Nigeria. Its symptomology is similar to that of tuberculosis resulting in frequent cases of misdiagnosis

Objective: To determine the knowledge of clinicians in one of the endemic states in southern Nigeria on the cause and transmission of paragonimiasis.

Methods: A questionnaire based, descriptive cross-sectional study was conducted among Resident doctors in the departments of Internal medicine, Paediatrics, family medicine, community health and Obstetrics and gynaecology practising in University of Uyo Teaching Hospital. The doctors were consecutively recruited during their weekly academic training meetings in February 2020. Data was analysed using Stata version 10.

Results: A total of 61 respondents filled the questionnaires out of which 45 (73.8%) doctors admitted to have heard about the disease previously and the commonest source was from medical school in 29 (60.4%) of the respondents.  Forty five (73.4%) respondents correctly identified the causative agent of paragonimiasis as a helminth. The top three symptoms identified by respondents were haemoptysis 37 (60.7%), cough 37 (60.7%) and chest pain 30 (49.2%). Seventeen (27.9%) respondents could correctly identify the sequelae of paragonimiasis. The confirmatory investigations requested for were stool analysis, sputum analysis by six (28%) and five (23.8%) respondents respectively. Nineteen (31.1%) respondents knew the correct mode of transmission and 23 (37.7%) respondents knew that paragonimiasis mimics TB. Only 3 (15%) respondents knew praziquantel as drug of choice. The majority 43 (70.5%) had never treated the condition. Only 21 (34.4%) of the respondents had a good level of knowledge of the symptoms of paragonimiasis.

Conclusion: This study has identified a knowledge gap in the aetiology, route of transmission, diagnosis, treatment and complications of paragonimiasis among clinicians in an endemic area in southern Nigeria. We therefore recommend intensified efforts in training clinicians and other health workers on the aetiology and diagnosis of paragonimiasis through regular continuous medical education of their professional associations, departmental academic programs and update courses of the various postgraduate colleges in order to prevent misdiagnosis and delayed treatment of patients with paragonimiasis.