Sensibilidad del test de diagnóstico rápido SARS-CoV-2 Panbio en Atención Primaria / Sensitivity of the Panbio COVID-19 rapid antigen detection test in primary care

Introducción y objetivos: los pediatras de Atención Primaria necesitamos técnicas de diagnóstico rápido (TDR) fiables para prevenir la propagación de la enfermedad COVID-19 mediante un cribado temprano y eficaz a la espera de una vacuna. El objetivo de este trabajo fue evaluar como novedad en Atención Primaria, tanto en adultos como niños, sintomáticos y contactos asintomáticos, la sensibilidad (S) de los test de antígeno SARS-CoV-2 Panbio del laboratorio Abbott respecto a la reacción en cadena de la polimerasa (PCR).Pacientes y métodos: se incluyeron 591 pacientes (222 menores de 14 años) (249 sintomáticos y 342 contactos). Se calculó la sensibilidad (S) y la especificidad (E) junto con sus intervalos de confianza (IC) del 95%. La independencia de los dos resultados ha sido analizada mediante el test de McNemar.Resultados: la S del test en adultos fue del 81% (IC 95%: 66,16-96,34) y en niños del 80% (IC 95%: 34,94-100) dentro de los 5 primeros días. En contactos se evaluó la S en los cinco primeros días, en adultos (68%; IC 95%: 51,13-86,37), del 5.º al 9.º día (85%) y en niños (66%; IC 95%: 30,31-100). El tipo de contacto más frecuente fue domiciliario en un 52% de los casos. La E fue 100% en todos los casos.Conclusiones: el test rápido de antígeno SARS-CoV-2 Panbio puede ser útil para diagnóstico de adultos y niños los primeros cinco días de inicio de síntomas, así como entre el 5.º y 9.º día tras el contacto con positivo COVID-19 confirmado, pendiente de interpretar en futuros estudios. (AU)

Introduction and objectives: primary care paediatricians need reliable rapid diagnostic techniques (RDTs) to prevent the spread of coronavirus disease 19 (COVID-19) through early and effective screening while awaiting a vaccine. The objective of this study was to evaluate the sensitivity (Sen) of the Abbott laboratory SARS-CoV-2 Panbio antigen test, newly introduced in primary care, in both adults and children (symptomatic and asymptomatic contacts) in comparison to the polymerase chain reaction (PCR) test.Sample and methods: the study included 591 patients (222 aged less than 14 years) from 7 primary care centres; of who 249 were symptomatic and 342 asymptomatic contacts. We calculated the Sen and specificity (Spe) with their 95% confidence intervals (CIs). We assessed the independence of the two results with the McNemar test.Results: the Sen of the test within 5 days from onset was 81% in adults (95% CI, 66.16-96.34) and 80% in children (95% CI: 34.94-100). In contacts, we assessed the Sen within 5 days, in adults (68%; 95% CI: 51.13- 86.37), in 5 to 9 days (85%) and in children (66%; 95% CI: 30.31-100). The most frequent source of exposure were household contacts (52% of the cases). The Spe was 100% in every case.Conclusions: the Panbio SARS-CoV-2 rapid antigen test can be useful for diagnosis in adults and children within 5 days of onset, and from days 5 to 9 in contacts of confirmed COVID 19 cases. Further studies are required for adequate interpretation of the latter result. (AU)

Experiencia en la implementación del programa de educación para la salud Si es urgente para ti, ¿es urgente para mí? / Experience in the implementation of the health education programme If it is urgent for you, is it urgent for me?

Objetivo: analizar la experiencia que supone la implementación de un programa de educación para la salud pediátrico en Atención Primaria. Material y métodos: estudio observacional y retrospectivo. Emplazamiento: cinco centros de salud urbanos y semiurbanos. Participantes: gestantes en el último trimestre de su gestación y sus parejas. Se desarrollaron seis talleres de 90 minutos: uno sobre el uso racional de los Servicios de Urgencias Pediátricas, y otros cinco sobre el manejo de los problemas de salud más frecuentes del niño: fiebre, infecciones respiratorias agudas (IRA), gastroenteritis aguda (GEA), lesiones de la piel y traumatismos, heridas, quemaduras y esguinces. Se han analizado datos epidemiológicos, nivel de conocimientos previos, control de asistencia y grado de satisfacción. Resultados: acudieron a los talleres el 44,21% de la población universo de gestantes. Las mujeres fueron más participativas que sus parejas varones. La mayoría eran primerizas, con estudios universitarios, trabajando de forma activa y españolas. La edad media fue de 34,53 años. Se detectaron más carencias formativas en padres primerizos, menores de 30 años, con estudios no universitarios y en algunos centros de salud. Los talleres sobre la fiebre e infecciones respiratorias fueron los de mayor asistencia. El desarrollo fue ameno y participativo. Generó un nivel de satisfacción muy alto y comentarios positivos. Conclusiones: se propone el empleo de este tipo de programas para mejorar la preparación de los futuros padres respecto a los cuidados de los problemas de salud de sus hijos y al uso adecuado de los servicios sanitarios

Objective: to analyse our experience in the implementation of a health education programme in the Primary Care Paediatrics setting. Materials and methods: observational and retrospective study. Setting: five primary care centres in urban and semi-urban areas. Participants: pregnant women in the third trimester of gestation and their partners. We held six 90-minute workshops: one on the appropriate use of paediatric emergency services and another five on the management of the most common health problems in children: fever, acute respiratory tract infections (ARTIs), acute gastroenteritis (AGE), skin lesions and traumatic injuries, burns and sprains. We analysed epidemiological data, the baseline level of knowledge, attendance and degree of satisfaction with the intervention. Results: of the total universe of pregnant women, 44.21% attended the workshops. Women attended more frequently than their male partners. Most women were primiparous, had attended university, were currently employed and of Spanish nationality. Their mean age was 34.53 years. We found greater gaps in knowledge in attendees that were going to be parents for the first time, aged less than 30 years, without a college education and receiving care in specific primary care centres. The workshops with the highest attendance were those on fever and respiratory tract infections. The workshops were designed to be entertaining and interactive. Participants reported a high level of satisfaction and gave positive feedback. Conclusions: we propose the use of this type of programmes to better prepare parents-to-be to manage potential health problems in their children and make appropriate use of health care services

A survey of management of congenital nasolacrimal duct obstruction by pediatric primary health care providers in Spain.

PURPOSE: To survey the management of congenital nasolacrimal duct obstruction (CNLDO) by pediatric primary health care providers in Spain. METHODS: This was a descriptive study using a web-based questionnaire to evaluate the perceptions of the members of the Pediatric Primary Care Society in Castilla-León, Spain (APAPCYL), regarding management of CNLDO. The questionnaire contained 14 direct questions and was sent by e-mail to all the pediatricians. All the responses were analyzed by the frequency of occurrence and percentages. RESULTS: Ninety physicians responded to the questionnaire. Massage 2 or 3 times a day was the initial treatment advised by 60.47% of pediatricians. Nearly half of the pediatricians recommended continuing massage until symptoms resolved. Fewer than 50% of children required referral to an ophthalmologist. Reasons for an ophthalmic consult included persistence of symptoms among 87.21% of pediatricians and parental/guardian request among 10.5% of pediatricians. According to 45.6% of pediatricians, their knowledge about CNLDO is limited, and 92.2% would like to receive further training on CNLDO. CONCLUSIONS: Massage was the main initial treatment for managing CNLDO among pediatricians. The outcomes of this survey indicated that massage fails in fewer than 50% of patients and an ophthalmic referral is required for these cases.