# Enhancing knowledge of vascular pythiosis: Impact of a self-paced online course among Thai learners

## TL;DR

An online course improved knowledge about a deadly but underrecognized disease, vascular pythiosis, among Thai learners.

## Contribution

A self-paced online course was developed and shown to effectively enhance knowledge of vascular pythiosis in Thailand.

## Key findings

- Participants showed significant knowledge improvement, with posttest scores nearly doubling pretest scores.
- Higher educational levels correlated with better scores, but all groups showed comparable knowledge gains.
- Participants scored lowest in diagnostic investigation, highlighting a critical knowledge gap.

## Abstract

Pythiosis caused by Pythium insidiosum, is a rare but deadly infectious disease that is often underrecognized. The disease has high morbidity and mortality rates, particularly in vascular forms where surgical resection is necessary. A previous study demonstrated low awareness and knowledge of vascular pythiosis among Thai medical personnel. There is an urgent need to improve disease recognition given that vascular pythiosis is very prevalent in Thailand.

This study aimed to enhance knowledge and disease recognition about vascular pythiosis among Thai medical personnel and the public through a self-paced, asynchronous, open-access online course. The course included seven video lessons and was available from February to July 2023. Participants’ knowledge was assessed using pretest and posttest analysis.

A total of 428 participants completed the course. Participants showed significant knowledge improvement, with mean posttest scores substantially higher than pretest scores, 6.77 vs. 3.46 (p-value < 0.01). Higher educational level had a positive impact with higher pretest and posttest scores, but the delta scores between the posttest and pretest of all groups were comparable. Moreover, 80% of participants demonstrated knowledge gain. However, participants of all groups scored the lowest on the posttest in diagnostic investigation field.

Very low pretest scores underline the neglected problem of vascular pythiosis. This asynchronous online course successfully enhanced participants’ knowledge about vascular pythiosis. Future efforts should focus on collaborative initiatives at the government and university levels to emphasize disease recognition.

Human pythiosis is an infectious disease caused by a fungal-like organism, Pythium insidiosum. The vascular form is the deadliest manifestation compared to cutaneous and ocular pythiosis. Thailand has reported the highest number of vascular pythiosis cases globally. However, vascular pythiosis remains primarily recognized by medical personnel in specialized fields. Achieving a definitive diagnosis remains challenging, and rapid diagnostic tests are currently under the research. This reflects a bidirectional dilemma—diagnostic challenges contribute to high case fatality rates, while under-recognition further delays diagnosis. This study aimed to enhance disease recognition and knowledge of vascular pythiosis among both medical professionals and the general public in Thailand through a self-access online course, conducted by experts with clinical and research experiences in the disease. The online course serves as a foundation step in addressing the knowledge gap and establishing an educational resource on vascular pythiosis in Thailand. Knowledge gain was assessed through a pretest-posttest comparison. The results highlighted the issue of neglect and provided valuable data to support the development of future educational initiatives, with contents adaptable to different target audiences.