The general practitioner facing acute infant bronchiolitis: multicenter study in Tunis

The acute bronchiolitis in infants (ABI) constitutes a health problem, responsible for a congestion of the care system, particularly emergencies. This study aims to assess the knowledge, attitudes, and the frontline general practitioners' behavior, and describe the availability of the base pediatric equipment in health centers, in Tunis. Cross-sectional descriptive survey was conducted in 2013 at 50 health centers in the region with physicians, conducted by selfadministered anonymous questionnaire and a data sheet detailing the equipment at the health center. Seizure and data analysis is made by Epi Info 6. The responder doctors have over 20 years of seniority for 64% of them and have all received training in ABI. In knowledge 75 to 80% master the definition of the ABI and the main criteria of severity, but only 35% identified less than 3 months of age as a risk factor and less than half provide prevention tips. Regarding the physicians behavior, chest X-ray and kinesitherapy continues to be prescribed in respectively 23 and 37% of cases, the same applies for corticoid (25%). Nasopharyngeal desobstruction is only recommended in 60% of cases. In regard to the health centers equipment, they were judged satisfactory overall, except for the absence of oxygen sources in 66% of them. Acute Bronchiolitis in infants remains over-medicated at the level of frontline medical consultation in Tunis. It is necessary to revise the terms of skills updating of the general practitioners in care and prevention, conduct and disseminate easy and attractive communication tools (brochures and posters) and implement seasonal data collection of this disease in sentinel sites.