For each provider, a score for each scenario was computed and then totaled for all scenarios. Analyses using chi-square or Fishers’ exact tests were conducted to determine if there were differences between knowledge based on various provider characteristics including, but not limited to, provider type, provider specialty, and service branch and whether a provider recently (previous 2 months) had education in management of TD. For the scenarios ANOVA or Student’s t-test was used to evaluate differences
in the total scenario score by multiple category or dichotomous groups of provider characteristic. Statistical significance for all associations was set at the p < 0.05 level (two-tail). Analysis was performed using Stata Version 10 (StataCorp, College Station, TX, USA). These MAPK inhibitor click here data were collected in an anonymous manner and obtained under a protocol exempted from IRB review as determined by the Naval Medical Research Unit No. 3, Cairo, Egypt Institutional
Review Board. A total of 117 providers responded to the survey. The majority of respondents were physicians (74%) followed by independent duty corpsmen or medics (12%) (Table 1). There was a variety of training backgrounds with operational specialties (general medical officers and flight surgeon/undersea medicine officers) making up 37% and primary care (family physicians, pediatrics, and internal medicine) accounting for 40%
of the total respondents (Table 1). All respondents report having deployed at least once while 36% were currently deployed overseas in Iraq, and the median number of prior deployments of providers completing the survey was two [interquartile range (IQR) 1–3]. The majority of respondents (77%) were correctly able to identify the definition of TD (Table 2). However, only 24% of providers thought that the most common cause of TD was due to bacterial organisms, while 30% believed it was viral in nature. Respondents also incorrectly believed that norovirus was the most common cause of watery diarrhea (31%) while only 25% thought it was ETEC. Nearly half of providers correctly thought Shigella spp. (30%) or Campylobacter spp. (14%) were the most common cause of dysentery, although roughly one third (30%) thought Succinyl-CoA ETEC was the primary cause of dysentery. Evaluation of provider responses to scenario-based questions showed a range of responses for clinical scenarios. The five most frequent management choices for each scenario are shown in Table 3. For the scenario describing mild TD with no activity limitations, most providers (49%) chose oral rehydration therapy alone, while almost 7% felt that IV hydration was appropriate in this situation. For mild diarrhea with some limitations, the most common response (18% of providers) was IV hydration alone.