Physician Perspectives on Vaccination and Diagnostic Testing in Children with Gastroenteritis: A Primary Care Physician Survey

Abstract
Objectives: Gastroenteritis remains a common paediatric illness. Little is known about physician knowledge of enteric pathogen diagnostic tests. At the time of study conduct, Alberta lacked a publicly funded rotavirus vaccination program and knowledge of primary care physician perspectives was lacking. We sought to ascertain diagnostic testing methods and to understand knowledge and perceptions regarding enteric pathogen vaccination. Methods: A 30-item electronic survey was distributed across Alberta’s five health care zones. The survey was developed by virology, microbiology, paediatrics, family medicine and public health experts. Participants were members of Alberta’s Primary Care Networks, the TARRANT network and The Society of General Pediatricians of Greater Edmonton. Study outcomes included: (1) physician knowledge of available diagnostic tests, (2) perspectives regarding stool sample collection and (3) support for an enteric vaccine program. Results: Stool culture was reported as the test to identify parasites (47%), viruses (74%) and Clostridium difficile (67%). Although electron microscopy and enzyme immunoassay were used to identify viruses in Alberta during the study period, only 20% and 48% of respondents respectively identified them as tests employed for such purposes. Stool testing was viewed as being inconvenient (62%; 55/89), whereas rectal swabs were thought to have the potential to significantly improve specimen collection rates (82%; 72/88). Seventy-three per cent (66/90) of the respondent physicians support the adoption of future enteric pathogen vaccines. Conclusions: Simplification of diagnostic testing and stool sample collection could contribute to improved pathogen identification rates. Implementation of an enteric vaccine into the routine paediatric vaccination schedule is supported by the majority of respondents.
Description
This is a pre-copyedited, author-produced version of an article accepted for publication in Paediatrics & Child Health following peer review. The version of record:
Arissa J. Sperou, BHSc MSc, James A. Dickinson, MBBS PhD, Bonita Lee, MD MPH, Marie Louie, MD, Xiao-Li Pang, MD PhD, Linda Chui, PhD, Otto G. Vanderkooi, MD, Stephen B. Freedman, MDCM MSc, on behalf of the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE); Physician perspectives on vaccination and diagnostic testing in children with gastroenteritis: A primary care physician survey. Paediatr Child Health 2017 pxx078. doi: 10.1093/pch/pxx078
Is available online at: https://academic.oup.com/pch/article-abstract/doi/10.1093/pch/pxx078/3869645/Physician-perspectives-on-vaccination-and
Keywords
Diagnostic testing, Gastroenteritis, Primary care, Vaccination
Citation
Sperou, A. J., Dickinson, J. A., Lee, B., Louie, M., Pang, X., Chui, L., . . . Freedman, S. B. (2017). Physician perspectives on vaccination and diagnostic testing in children with gastroenteritis: A primary care physician survey. Paediatrics & Child Health. doi:10.1093/pch/pxx078