Effectiveness of a multicentre nasopharyngeal carcinoma awareness programme in Indonesia

Objective: To evaluate the effectiveness of a nasopharyngeal carcinoma (NPC) awareness programme on the short-term and long-term improvement of knowledge and referral of patients with NPC by primary healthcare centres (PHCCs) staff in Indonesia. Design: The NPC awareness programme consisted of 12 symposia including a Train-The-Trainer component, containing lectures about early symptoms and risk factors of NPC, practical examination and the referral system for NPC suspects. Before and after training participants completed a questionnaire. The Indonesian Doctors Association accredited all activities. Participants: 1 representative general practitioner (GP) from each PHCC attended an NPC awareness symposium. On the basis of the Train-The-Trainer principle, GPs received training material and were obligated to train their colleagues in the PHCC. Results: 703 GPs attended the symposia and trained 1349 staff members: 314 other GPs, 685 nurses and 350 midwives. After the training, respondents’ average score regarding the knowledge of NPC symptoms increased from 47 points (of the 100) to 74 points (p<0.001); this increase was similar between symposium and Train-The-Trainer component (p=0.88). At 1½ years after the training, this knowledge remained significantly increased at 59 points (p<0.001). Conclusions: The initial results of this NPC awareness programme indicate that the programme effectively increases NPC knowledge in the short and long term and therefore should be continued. Effects of the improved knowledge on the stage at diagnoses of the patients with NPC will still need to be scrutinised. This awareness programme can serve as a blueprint for other cancer types in Indonesia and for other developing countries

Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia

In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period

Delayed diagnosis of nasopharyngeal carcinoma in a patient with early signs of unilateral ear disorder

Nasopharyngeal carcinoma (NPC) is the most frequent head and neck malignancy in Indonesia. Misdiagnosis of NPC is common because of unspecific symptoms as unilateral ear complaint. This case reminds doctors of the early symptoms of NPC and of other factors which lead to misdiagnosis and addresses also patients and their families. Reported is a 44 years old man with unilateral ear disorder that had been treated by otorhinolaryngologists, an ophthalmologist, a neurologist, and dentist first, but diagnosed with nasopharyngeal carcinoma stage IVA (T4N1M0) one year later. NPC has unspecific early symptoms such as unilateral ear disorder. Primarily doctors, but also patients and their families should be aware of unilateral ear complaint.Keywords: misdiagnosis, nasopharyngeal carcinoma, unilateral ear disorders</p

The mean number of incorrect risk factors listed in the pre- and post-training assessments by GPs attending the PHCC and the symposium sessions.

<p>The mean number of incorrect risk factors listed in the pre- and post-training assessments by GPs attending the PHCC and the symposium sessions.</p

The mean number of accurately listed symptoms both pre and post training, by GPs attending the PHCC and the symposium sessions.

<p>The mean number of accurately listed symptoms both pre and post training, by GPs attending the PHCC and the symposium sessions.</p

The mean number of correctly identified risk factors listed in the pre- and post-training by GPs attending the PHCC and symposium sessions.

<p>The mean number of correctly identified risk factors listed in the pre- and post-training by GPs attending the PHCC and symposium sessions.</p

Study design.

<p>Study design.</p

The mean number of incorrect symptoms listed in the pre- and post-training assessments by GPs attending the PHCC and symposium training sessions.

<p>The mean number of incorrect symptoms listed in the pre- and post-training assessments by GPs attending the PHCC and symposium training sessions.</p

The probability (%) of correctly answering questions concerning youngest age of presentation and peak age of incidence.

<p>The probability (%) of correctly answering questions concerning youngest age of presentation and peak age of incidence.</p

Percentage of correct answers about the symptoms given by the GPs.

<p>a) Percentage of correct symptoms from the four different catagories given by GPs with less than 20 years of work experience. b) Percentage of correct symptoms from the four different catagories given by GPs with more than 20 years of work experience. (1) presence of tumour mass in the nasopharynx; (2) dysfunction of the eustachian tube, associated with the lateroposterior extension of the tumour to the paranasopharyngeal space; (3) skull-base erosion and palsy of the fifth and sixth cranial nerves, associated with the superior extension of the tumour; (4) neck masses.</p