Knowledge, attitudes, and practices towards prevention and early detection of chronic kidney disease

The assessment of public perception towards chronic kidney disease in Jordan: a cross-sectional study

OBJECTIVES

Kidney diseases are considered silent killers due to the lack of well-defined symptoms. Public knowledge about chronic kidney disease (CKD) management has been shown to decrease the risk of CKD onset and progression to end-stage renal disease and renal failure. The main objective of this study was to assess the knowledge of kidney function, CKD symptoms, etiology, prevention and treatment in the general population.

METHODS

A cross-sectional study using a validated questionnaire was conducted in Jordan to assess public knowledge of CKD. Public knowledge of CKD was assessed using a questionnaire consisting of 32 knowledge questions, including risk factors, symptoms, treatment, protective measures and kidney function. The knowledge level was classified according to the total score: poor (0-50%), intermediate (51-70%) and good/high (71-100%). Multiple regression analysis was performed to compare knowledge scores (KS) and predict associations with the participants' baseline characteristics.

RESULTS

The level of knowledge about CKD among the 2181 participants was intermediate. The KS was significantly higher among participants with health issues such as hypertension, diabetes and heart problems, first-degree relatives working in the medical field, majors relevant to health, married, employed, highly educated, high-income and smokers. The main sources of knowledge about CKD were health professionals, TV shows, books and magazines. Multiple regression analysis showed an association between KS and age, sex, functional status, educational level and field, income, smoking status, having a family member/spouse work in the medical field, and knowledge source.

CONCLUSIONS

The public level of knowledge about CKD management is greatly influenced by participants' health and social factors. Thus, improving public knowledge and perception through education and the media will significantly reduce CKD prevalence and incidence.

Knowledge, Attitude, and Practice in Preventing Infection Among Patients With Cancer Receiving Chemotherapy

BACKGROUND

Oncology patients receiving chemotherapy are at a high risk for developing infections. Identifying factors that predict infection practices among these patients can help improve the quality of care provided.

PURPOSE

The purpose of this study was to evaluate the knowledge, attitudes, and practices related to infection prevention in oncology patients receiving chemotherapy.

METHODS

A cross-sectional study was conducted among 170 patients with cancer.

RESULTS

The majority of participants had a low to moderate level of knowledge, with high levels of attitude and practice related to infection prevention. Knowledge was a significant predictor of attitude and practice, while attitude was a predictor of infection prevention practices. Knowledge and attitude emerged as mutual predictors, which could explain 23% of the variation in practice toward infection prevention (R2 = 0.230, P = .00).

CONCLUSIONS

Findings indicated that both knowledge and attitude were powerful predictors of practice toward infection prevention.

Knowledge, attitude and practices towards prevention and early detection of chronic kidney disease and associated factors in Ethiopia: A cross-sectional study

Background

Early detection of chronic kidney disease (CKD) is important because it enables clinicians to initiate effective treatment, preventing loss of kidney function, and delaying or avoiding progression to kidney failure. This study was aimed to assess knowledge, attitude, and practices towards prevention and early detection of CKD and associated factors.

Methods

Institution based cross-sectional survey was done at Adama Hospital Medical College, Ethiopia, between November 24/2021 and December 24/2021 among 190 hypertensive patients. Data were entered into EpiData version 4.2.0.0 and analyzed by Statistical Package for Social Sciences (SPSS) version 23.

Result

The level of good knowledge, positive attitude, and good practice was 40.5%, 53.7%, and 47.4%, respectively. Government employed (AOR = 3.30, 95%CI: 1.38, 7.90), having an average monthly income of ≥3000 ETB (61.43 US dollars) (AOR = 2.95, 95%CI: 1.31, 6.66), and having a duration of ≥4 years since diagnosis of hypertension (AOR = 2.37, 95%CI: 1.11, 5.06) were factors significantly associated with good knowledge. Government employed (AOR = 2.56, 95%CI: 1.12, 5.87), having duration of hypertension ≥4 years since diagnosis (AOR = 2.16, 95%CI: 1.07, 4.36) were factors significantly associated with positive attitude. Government employed (AOR = 4.16, 95%CI: 1.38, 12.58), having an average monthly income of ≥3000 ETB (61.43 US dollars) (AOR = 6.74, 95%CI: 2.93, 15.52), having good knowledge towards prevention and early detection of CKD (AOR = 2.57, 95%CI: 1.14, 5.80) were significantly associated with good practice.

Conclusions

The level of good knowledge, positive attitude, and good practice towards was low. Educational programs on these issues are required to minimize the burdens.

COVID-19-related fear and anxiety in a sample of patients with type 2 diabetes: a cross-sectional study in Iran after several peaks of the pandemic

Purpose

The aim of this study was to assess COVID-19-related anxiety, and fear burden in diabetic patients, as a risk group for severe COVID-19.

Methods

A cross-sectional online survey conducted on 111 type 2 diabetes mellitus (T2DM) patients referred to a Diabetes clinics of Royan institute, and 155 healthy controls recruited from normal population using a snowball sampling technique. Fear of COVID-19 Scale (FCV-19 S) and Coronavirus anxiety scale (CAS) were used.

Results

The total score of coronavirus fear in T2DM patients was 15.79 (6.39) and in healthy controls 15.48 (5.97) (p = 0.696). The total score of coronavirus fear in T2DM patients was 15.79 (6.39) and in healthy controls 15.48 (5.97) (p = 0.696). Correlation matrix between coronavirus anxiety and fear scores in these samples confirmed that in T2DM participants CAS was significantly positively associated with FCV-19 (r = 0.407, p = 0.000). There was also statistically and positively significant correlation between CAS and FCV-19 in healthy subjects (r = 0.495, p = 0.000).

Conclusion

The present study revealed that the level of fear and anxiety from COVID-19 was almost the same in a sample of Iranian T2DM patients and healthy controls. The pandemic with several peaks in the country cannot cause an increased anxiety and fear from COVID-19, especially in patients with diabetes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01353-8.

Exploring patient delay in people with chronic kidney disease: A cross-sectional study

To examine the factors that contribute to patient delays among individuals with chronic kidney disease (CKD) and offer insights to help develop specific risk management strategies. Conducted as a cross-sectional study between September 2021 and April 2022, this study used a convenient sampling technique to select 245 individuals diagnosed with CKD from a Grade 3 Class A hospital located in Shanxi Province. These individuals were chosen as the subjects of the study. The research participants underwent an investigation using several assessment tools, including socio-demographic information questionnaire, medical behavior, the social support rating scale, the simplified coping style questionnaire, and the General Self-efficacy Scale. The study revealed that 35.4% of individuals with CKD experienced patient delay (the interval between the initial onset and the time of seeking medical attention being longer than or equal to 3 months). Through a multifactorial logistic regression analysis, it was determined that various factors independently influenced patient delay in patients with CKD. These factors included the level of knowledge about CKD, educational level, frequency of attending physical examinations, severity of initial symptoms, social support, self-efficacy, positive coping, and negative coping. Numerous factors contribute to the Patient Delay. To effectively enhance awareness and coping abilities regarding CKD in high-risk groups, it is essential to implement focused and continuous interventions throughout the medical seeking process.

The Awareness, Prevalence, and Risk Factors of Chronic Kidney Disease Among Diabetes Mellitus and Hypertensive Patients in the Aseer Region, Saudi Arabia

Background and objective Given its ever-increasing burden, chronic kidney disease (CKD) represents a significant public health threat. CKD is characterized by a gradual alteration in the kidney's normal glomerular filtration rate, which results in the progressive loss of kidney function over a period of time ranging from a few months to years. Diabetes mellitus (DM) and hypertension (HTN) are well-known risk factors for developing CKD and end-stage renal failure. In light of this, this study aimed to assess the awareness, prevalence, and risk factors of CKD in patients with diabetes and those with HTN in the Aseer region, the Kingdom of Saudi Arabia. Methods A correlational cross-sectional study was conducted among a sample of people across Saudi Arabia. The data collection was conducted via an online questionnaire circulated on social media platforms. The study questionnaire included socioeconomic and demographic information and medical history of DM, HTN, and CKD. Also, patients' awareness of and attitude towards CKD were assessed. Results A total of 301 diabetic or hypertensive patients fulfilling the inclusion criteria completed the study questionnaire. Of them, 174 (57.8%) were aged less than 55 years, while 127 (42.2%) were aged more than 55 years; 200 (66.4%) patients were males. A total of 94 (31.2%) study patients were diabetic, 64 (21.3%) were hypertensive, and 143 (47.5%) were both diabetic and hypertensive; 226 (75.1%) study patients had an overall good awareness of CKD while only 75 (24.9%) showed a poor awareness level. Higher awareness was associated with patients' age, education, and having CKD, DM, or HTN (p<0.05). Conclusion Our findings revealed that CKD was not common among study patients, and its prevalence was found to be less than estimated based on many studies in the literature. Also, diabetic and hypertensive patients showed a higher than satisfactory level of awareness of CKD, especially young patients with high levels of education.

The relationship between diabetes-related knowledge and kidney disease knowledge, attitudes, and practices: a cross-sectional study

BACKGROUND

Diabetes mellitus (DM) is one of the main noncommunicable diseases encountered in primary health care clinics. DM is considered one of the most common causes of chronic kidney disease (CKD). In this study, we aimed to assess the knowledge, attitudes, and practices (KAP) of patients with DM on the early detection and prevention of CKD, determine its relationship with other variables, and examine the relationship between KAP scores for the prevention and early detection of CKD and the Michigan Diabetic Knowledge Test.

METHODS

We collected data from 2 Nablus primary healthcare centers using a questionnaire that contains three sections: sociodemographic section, questions related to DM, and CKD screening index, which is formed of three scales. We used the Michigan Diabetic Knowledge Test (MDKT) to assess the knowledge of diabetic patients.

RESULTS

The study was carried out among 386 diabetic patients with a mean age of 57.62 ± 12.4 years (ranging from 28 to 90). The median (interquartile range) was 11 (8-14) for the knowledge scale, 56 (52-59) for the attitude scale, and 30 (26-33) for the practice scale. In the multiple linear regression, only patients under 55 years old (p = 0.012), with normal BMI (p = 0.030), high educational level (p < 0.001), high monthly income (p = 0.020), and MDKT test score (p = 0.007) were significantly associated with higher knowledge score. Furthermore, patients who were over or equal to 55 years old (p = 0.007), had a high monthly income (p = 0.016), used a single oral diabetic drug (p = 0.003), had a total number of medications less than 4 (p = 0.010), and had a high knowledge and MDKT test were significantly associated with a higher attitude score. Finally, a patient with normal BMI (p = 0.002), city residency (p = 0.034), high educational level (p = 0.003), less frequent tobacco use (p < 0.001), last HbA1c (p = 0.023) and greater knowledge, attitude, and MDKT score were significantly associated with better practices toward CKD prevention and early detection.

CONCLUSION

Regarding KAP analysis, higher practice scores for the prevention and early detection of CKD were significantly associated with patients with normal BMI, being city residents, high educational level, less tobacco use, last HbA1c below 7, and higher knowledge, attitude, and MDKT score.

Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait

OBJECTIVES

To assess perceived fear and to evaluate the level of knowledge, attitude, and prevention practices (KAP) regarding COVID-19 infection among patients with diabetes mellitus (DM) attending primary healthcare centers (PHCs) in Kuwait. This will help evaluate gaps and provide appropriate support to limit the spread of COVID-19 infection in high-risk patients.

METHODS

A descriptive cross-sectional study was carried out using a self-administered questionnaire. All patients aged 18 years or older attending for follow-up or newly diagnosed with type 1 or type 2 diabetes were eligible to participate in the study. Patients waiting for their regular follow-up appointments at the PHCs were invited verbally to take part in the study. The study excluded patients under the age of 18 and those with significant cognitive or physical impairment that might interfere with independent self-care behavior. The questionnaire included 57 items. The data were analyzed using descriptive statistics.

RESULTS

A total of 294 questionnaires were distributed to patients at PHCs in three health districts (Hawally, Capital, and Farwaniya) in Kuwait; 251 patients agreed to participate in the study, yielding a response rate of 85.4%. The study showed that most patients had moderate knowledge (71.1%) of COVID-19. The majority of correctly responded questions were about the mode of COVID-19 transmission, the most common clinical presentations, and at-risk people. On the other hand, 83.7% (n = 210) identified common cold symptoms (stuffy nose, runny nose, and sneezing) as COVID-19 symptoms. More than half of the patients (n = 146, 58.2%) were unable to identify uncommon COVID-19 symptoms, such as diarrhea and skin rash or discoloration. Most patients had a positive attitude (90.9%) and good prevention practices (83.6%). The overall fear score of the participating patients was 21.6 ± 6.5 (61.7%).

CONCLUSIONS

Regardless of the positive attitude and good preventive practices of the patients, they had moderate knowledge levels about COVID-19. This indicates that there are significant knowledge gaps that still need to be filled. Different strategies can be used for this purpose, such as social media and public information campaigns. Supporting psychological well-being is vital for at-risk patients during a pandemic.

Factors associated with refusal of preventive therapy after initial willingness to accept treatment among college students with latent tuberculosis infection in Shandong, China

BACKGROUND

Preventive therapy of latent tuberculosis infection (LTBI) is an important component of tuberculosis (TB) control. Research on acceptance of TB preventive therapy (TPT) is an important topic. Current studies focus on acceptability and compliance. However, it is unclear whether LTBI patients will start TPT after accepting treatment. The study assessed the factors associated with TPT refusal after initial willingness to accept treatment.

METHODS

Data were derived from a baseline survey of prospective study of LTBI treatment among college students in Shandong Province, China. A total of 723 students initially willing to accept TPT were included in the analysis. Stepwise logistic regression was used to explore the individual- and family-level characteristic variables that factors associated with TPT refusal after initial willingness to accept treatment.

RESULTS

Of the 723 LTBI college students who initially had acceptance willingness, 436 (60.3%) finally refused TPT. At the individual level, non-medical students were more likely to refuse TPT [odds ratio (OR) = 4.87, 95% confidence interval (CI): 3.10-7.67)], as were students with moderate physical activity (OR = 1.45, 95% CI: 1.04-2.04). Students with boarding experience (OR = 0.49, 95% CI: 0.31-0.78) and a high level of knowledge about TB (OR = 0.97, 95% CI: 0.95-0.99) were less likely to refuse TPT. At the family level, those with high father's educational level (OR = 1.50, 95% CI: 1.07-2.10) or high household income (OR = 1.80, 95% CI: 1.20-2.71) were more likely to refuse TPT after initially accepting treatment.

CONCLUSIONS

Factors associated with TPT refusal after initial willingness to accept treatment, such as personal (type of students, physical activity, boarding experiences, knowledge of TB) and family characteristics (father's education level, household income) among college student with LTBI, might help identify persons for whom tailored interventions could improve the start of LTBI treatment.

Knowledge, Attitudes, and Practices of High-Risk Patients towards Prevention and Early Detection of Chronic Kidney Disease (CKD) in Saudi Arabia

CONTEXT

Chronic kidney disease (CKD) is characterized by the presence of kidney damage or decreased kidney function. In the Kingdom of Saudi Arabia, the prevalence of CKD is at 5.7%, which represents a high burden on health care systems.

AIMS

This study aimed to assess the knowledge, attitudes, and practices of high-risk patients towards prevention and early detection of chronic kidney disease in Saudi Arabia.

SETTING AND DESIGN

Descriptive cross-sectional study in Saudi Arabia.

METHODS AND MATERIAL

This study was designed using a newly developed instrument, the CKD Screening Index. It was conducted from December 2021 to May 2022 by a self-administered questionnaire. The questionnaire has three parts: socio-demographic data, clinical factors, and the CKD screening index tool.

STATISTICAL ANALYSES USED

Independent t-test, One-Way ANOVA, LSD, Games-Howell tests.

RESULTS

Knowledge of kidney function had a significant difference across patient groups with varying employment status. Monthly income is a significant factor for the patient attitude on healthcare towards preventing kidney disease. On the other hand, educational level significantly affects the overall attitude of patients towards preventing kidney disease.

CONCLUSION

Understanding knowledge, attitudes, and practices associated with CKD is vital to informing optimal policy and public health responses in the country.

Development and psychometric evaluation of an instrument to assess Knowledge, Attitude and Practice of Family Caregivers at Preventing Pressure Injuries (KAP-PI) in Indonesian community-dwelling older adults

Background

The prevalence of pressure injuries among community-dwelling older adults in countries worldwide is still a serious problem. In Indonesia, older adults mostly rely on family members for (medical) care. Therefore, involving family members in the prevention and treatment of pressure injuries (PIs) could potentially decrease its prevalence rates. However, family members are usually not trained for such tasks. Hence, it is essential to first get more insight into the current state of affairs on family members’ knowledge, attitude and actual practice of preventing PIs. Due to the lack of an existing instrument to measure knowledge, attitude and practice of family caregivers in preventing PIs, this study focuses on the development and evaluation of psychometric properties of such an instrument.

Methods

Three phases of instrument development and evaluation were used, including item generation, instrument construction and psychometric testing of the instrument. A total of 372 family caregivers of community-dwelling older adults who randomly selected participated in this study. Principal factor analysis, confirmatory factor analysis and Cronbach’s alpha were performed to evaluate factor structure and internal consistency of the Knowledge, Attitude and Practice of Family Caregivers at Preventing Pressure Injuries (KAP-PI) instrument.

Results

The final version of the KAP-PI-instrument consists of a 12-item knowledge domain, a 9-item attitude domain, and a 12-item practice domain with Cronbach’s Alpha values of 0.83, 0.93 and 0.89, respectively. The instrument appeared to be both reliable and valid.

Conclusion

The KAP-PI instrument can be used in family nursing or community nursing practice, education, and research to assess knowledge, attitude and practice of pressure injury prevention of family caregivers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-00957-4.

Chronic kidney disease awareness among the general population: tool validation and knowledge assessment in a developing country

Introduction

Good knowledge and early identification of chronic kidney disease (CKD) can help in preventing disease progression in its early stages and reducing undesired outcomes. The aim of the current study was to assess the level of public knowledge about CKD, determine predictors of better knowledge, and to construct and validate a CKD knowledge scale for public health assessment and research use.

Methods

A community-based cross-sectional study was conducted using an electronic self-administered questionnaire. All people living in Lebanon and being 18 years of age and above were considered eligible for recruitment. CKD knowledge was assessed by a 37-item scale that was constructed by principal component analysis and then validated. The score of the CKD knowledge scale was computed from the extracted factors. A multivariable binomial logistic regression model evaluated the sociodemographic and clinical predictors of the knowledge score.

Results

A total of 1308 participants were included. The scale items converged over 9 factors with Eigenvalue greater than 1 and explaining 53.26% of the total variance, and the total scale had a high Cronbach’s alpha of 0.804. All items of the scale significantly correlated with the full scale with correlation coefficients ranging from 0.082 to 0.558. The ROC curve analysis determined an optimal cutoff point of better knowledge at 47.5 with 70.6% sensitivity and 44.2% specificity. The CKD knowledge score had a median of 51.00 (IQR 47.00–55.00). Higher knowledge score was significantly associated with old age (ORa = 1.018, 95% CI 1.006–1.030, P = 0.003),, occupation (ORa = 3.919, 95% CI 2.107–7.288, P <  0.001), and recent renal function assessment (ORa = 2.314, 95% CI 1.532–3.495, P <  0.001). However, a lower knowledge score was significantly associated with lower level of education (ORa = 0.462, 95% CI 0.327–0.653, P <  0.001).

Conclusion

A reliable tool to assess public knowledge and awareness about CKD was developed and validated. The overall knowledge was good, however, important gaps in CKD awareness were detected in some areas and subpopulations. Therefore, public health stakeholders need to implement targeted CKD educational activities to minimize the disease burden.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12882-022-02889-2.

Public Awareness of Chronic Kidney Disease in Jazan Province, Saudi Arabia-A Cross-Sectional Survey

Chronic Kidney Disease (CKD) is a significant public health concern worldwide and many people continue to ignore their early warning symptoms. The present study assessed the level of knowledge about CKD the awareness of the risk factors and the awareness of the complications associated with CKD, among the general population of Jazan Province, Saudi Arabia. 440 residents of Jazan Province participated in an online cross-sectional survey during a seven-month period from November (2020) to July (2021). Data was collected using a validated 73-item self-report survey. More than half of the respondents were males (n = 286; 65%) with an age ranging from 18 to 59 years, and a mean age of 32.66 years (SD ± 10.83). A very low percentage of the sample (27.3%; 7.5%, 9.3%) demonstrated good knowledge, a high level of awareness of the risk factors, and a high level of awareness of the complications associated with CKD, respectively. Participants’ knowledge was significantly associated with being a student or being employed (Government/private employee) (χ2 = 29.90; p < 0.001), having completed graduate studies (χ2 = 63.86; p < 0.001), residing in urban areas (χ2 = 138.62; p < 0.001), belonging to the age group (18−39 years), and having no co-morbidities (χ2 = 24.55; p < 0.001). Positive and significant correlations were also noted between the knowledge score and the awareness of risk factor score (r = 0.42; p < 0.01), as well as the awareness of complications score (r = 0.25; p < 0.01). These findings warrant an urgent need for extensive CKD educational initiatives concentrating on improving the general knowledge and awareness of the public towards CKD.

The Act of Prevention: Knowledge, Attitudes, and Perception Among Caretakers of Kidney Disease Patients in Rural Wardha District of Central India

Background

There is a continual rise in the prevalence of non-cancerous conditions such as chronic kidney disease (CKD) owing to an enormous load of diabetes, hypertension, and vascular diseases. A positive attitude and healthy lifestyle for CKD prevention can only be followed when the masses are well aware and educated about the disease. This study aimed to compare, correlate, and evaluate the distribution of knowledge, attitudes, and perceptions among relatives or caretakers of patients with kidney disease or at risk of the disease.

Methodology

This cross-sectional study aimed at obtaining data on the knowledge, attitudes, and perceptions using the Chronic Kidney Diseases Screening Index questionnaire from the relatives of CKD patients. All data were computed and analyzed using SPSS version 28.0 (IBM Corp., Armonk, NY, USA).

Results

The majority of the relatives of CKD patients had poor knowledge (63.6%) and poor attitude (51.6%) levels. On the contrary, most respondents had good practices (52.8%) level toward the risk for CKD. A significant correlation was noted between education and knowledge (p < 0.050). A significant association was also observed between education and occupation with attitude (p < 0.001 and p < 0.050, respectively). Additionally, a significant association was noted between age and perception (p < 0.001).

Conclusions

Informed and well-educated populations are less prone to acquire or progress to CKD. From this study, we can understand the need for improvement in public knowledge, which has the potential to help in saving the lives of many patients progressing toward end-stage renal diseases.

Correlations between uncertainty in illness and anxiety, depression and quality of life in patients receiving maintenance haemodialysis: A cross-sectional study

Aim

To investigate the uncertainty in illness, anxiety, depression and quality of life in patients receiving maintenance haemodialysis and confirm the correlations between these variables.

Design

A cross‐sectional study was conducted among 396 patients receiving maintenance haemodialysis in four tertiary hospitals in China.

Methods

Uncertainty in illness was measured by Mishel's uncertainty in illness scale. The scores of self‐rating anxiety scale, self‐rating depression scale and medical outcomes study short form 36 were collected and compared with available norms. The Pearson correlation coefficient was calculated to investigate the correlation between uncertainties in illness with these vital variables.

Results

The mean score of uncertainty in illness was 78.16 out of 160. Compared with the norm, patients receiving maintenance haemodialysis had a statistically significantly lower score of depression and higher scores of most domains of quality of life. Uncertainty in illness is corrected with anxiety, depression positively and with quality of life negatively.

Determinants of overall knowledge and health behaviours in relation to hepatitis B and C among ever-married women in Pakistan: evidence based on Demographic and Health Survey 2017-18

Background

In 2019, around 5 million and 10 million people were affected by hepatitis B virus (HBV) and hepatitis C virus (HCV) respectively in Pakistan. On World Hepatitis Day 2019, Pakistan’s Government announced the Prime Minister’s Plan to eliminate HBV and HCV from the country by 2030. In order to achieve this goal, adequate knowledge about HBV and HCV regarding mode of transmission, symptoms of the disease, and awareness about available treatments and vaccines is imperative. The present study aims to investigate the determinants related to overall knowledge about and behaviour in relation to HBV and HCV amongst married women in Pakistan.

Methods

Secondary data analysis was carried out using the Pakistan Demographic and Health Survey (PDHS) 2017–18. A series of questions regarding women’s knowledge about how to avoid HBV and HCV and their health behaviour in relation to HBV and HCV were posed to 12,364 ever-married women of reproductive age (15–49 years). Bivariate and multivariable logistic and linear regression was applied to examine the effects of sociodemographic characteristics and covariates on women’s overall knowledge and health behaviour regarding HBV and HCV.

Results

The findings highlight that the majority of women (88.3%) have heard of HBV and HCV. Nonetheless, only 34.8% had comprehensive knowledge about how to avoid HBV and HCV. Few women (11.3%) had been tested for HBV or HCV during the year preceding the survey. Furthermore, the results indicate that women living in urban areas, being older, and having more than 10 years of schooling, reported better knowledge and health behaviours regarding HBV and HCV.

Conclusion

This study provides evidence that women’s sociodemographic characteristics create differences in their overall knowledge about and attitudes towards HBV and HCV. This research emphasized that there is a need to create awareness about the causes and prevention of HBV and HCV in order to achieve the goal of eliminating these diseases in Pakistan by 2030.

Parental Knowledge, Attitude, and Practice on Tobacco Use, Smoking Cessation, and Children's Environmental Tobacco Smoke Exposure

Background: Environmental tobacco smoke (ETS) exposure in children ranks one of the major public health problems in our time. Poor parental knowledge, attitude, and practice (KAP) on ETS often contribute to worse exposure of the kids. Thus, we aimed to document parental KAP regarding tobacco use, smoking cessation and children's ETS exposure, and to analyse how knowledge and attitude relate to practice.

Methods: Self-administered KAP questionnaires were distributed to smoking parents recruited from the pediatric unit at the Prince of Wales Hospital, which provides pediatric service to a population of 1.2 million in Hong Kong. The 60-item questionnaire had a range of 0–38 for knowledge, 0–44 for attitude, and 0–40 for practice. Descriptive analyses were performed for KAP response, regression analyses were performed for the exploration of associations and identification of predictive indicators.

Results: 145 smoking parents (mean age: 38.0 ± 6.7 yrs.; male: 85.5%) were included. Less than half (39.3%) of them reported a smoke-free policy at home. Among those parents who had private cars, less than half (45.2%) of them had smoke-free policy in their car that they never smoked in the car. Only 25.5% of the participants correctly answered ≥70% of the knowledge questions, and 11.8 % of the participants gave favorable responses to ≥70% of the attitude questions. The total knowledge and the total attitudes score were positively associated (r = 0.49, 95% CI: 0.35–0.79, p < 0.001), yet they were only modestly correlated with parental practice on children's ETS exposure. By multivariate regressions, potential predictive factors for more favorable parental KAP included higher household income, lower parental nicotine dependence level and breastfeeding practice.

Conclusions: Parental KAP related to tobacco use and children's ETS exposure needs improvement to address the significant gap between recommended and actual practice. The weak association between knowledge and practice suggested that parental education alone is not adequate to combat ETS exposure in children.

Knowledge, attitude and practice towards hepatitis B infection among high school students in Asante Mampong, Ghana

BACKGROUND

Hepatitis B virus (HBV) infection is a serious global public health problem, with significant morbidity and mortality from acute and chronic complications. Increasing awareness and improving knowledge of HBV helps reduce the risk of the disease. Although many studies have been conducted on HBV in Ghana, few have focused on examining knowledge, attitude and preventive practices among adolescents towards the disease.

OBJECTIVE

The objective of this study was to assess HBV knowledge, attitude and practice (KAP) among adolescents in high schools in the Asante Mampong Municipality in the Ashanti Region of Ghana.

METHODS

A descriptive cross-sectional study was conducted among 398 adolescents from six senior high schools within the Asante Mampong Municipality. Data was collected using a 30-item structured questionnaire. Each item had two response options: "Yes" and "No". A scoring system was generated and respondents were given a score on each item answered. A positive response to an item was scored 1 point and a negative response was scored 0. Scores were then summed up and averaged to give the mean knowledge, attitude and practice scores.

RESULTS

The majority of the respondents were male (60%), between 15 and 17 years (45%), Christian (93%) and in their first year of study. The adolescents had basic knowledge, positive attitude, and poor practices towards HBV. There was no significant relationship between the demographic variables of the respondents and KAP mean scores.

CONCLUSION

There is the need to introduce health education and awareness programs in schools within the Asante Mampong Municipality to improve students' level of knowledge of HBV. Countrywide studies examining KAP towards HBV infection among adolescents are also warranted.

Multidisciplinary Team Care Delays the Initiation of Renal Replacement Therapy in Diabetes: A Five-year Prospective, Single-center Study

Objective Although recent reports have highlighted the benefits of multidisciplinary team care (MTC) for chronic kidney disease (CKD) in slowing the progress of renal insufficiency, its long-term effects have not been evaluated for patients with diabetes mellitus (DM). We compared the renal survival rate between MTC and conservative care (CC). Methods In this five-year, single-center, prospective, observational study, we examined 24 patients (mean age 65.5±12.1 years old, men/women 18/6) with DM-induced CKD stage ≥3 in an MTC clinic. The control group included 24 random patients with DM (mean age 61.0±12.8 years old, men/women 22/2) who received CC. MTC was provided by a nephrologist and medical staff, and CC was provided by a nephrologist. Results In total, 10 MTC and 20 CC patients experienced renal events [creatinine doubling, initiation of renal replacement therapy (RRT), or death due to end-stage CKD]. During the five-year observation period, there were significantly fewer renal events in the MTC group than in the CC group according to the cumulative incidence method (p=0.006). Compared to CC, MTC significantly reduced the need for urgent initiation of hemodialysis (relative risk reduction 0.79, 95% confidence interval [CI] 0.107-0.964). On a multivariate analysis, MTC (hazard ratio [HR], 0.434, 95% CI 0.200-0.939) and the slope of the estimated glomerular filtration rate during the first year (HR, 0.429 per 1 mL/min/m²/year, 95% CI 0.279-0.661) were negatively associated with renal events. Conclusion MTC for DM-induced CKD is an effective strategy for delaying RRT. Long-term MTC can demonstrate reno-protective effects.

Intention-Based Critical Factors Affecting Willingness to Adopt Novel Coronavirus Prevention in Pakistan: Implications for Future Pandemics

Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind's survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, a representative sample of 931 Pakistanis filled in an online questionnaire. However, only 828 questionnaires were found to be complete and valid for path modeling analysis. The core findings are as follows: Firstly, peer groups' beliefs, self-efficacy, perceived risk, pandemic knowledge, ease of pandemic prevention adoption, and risk-averse behavior are revealed as driving forces of the individuals' willingness to adopt pandemic prevention. Contrastingly, a lack of trust in political will and mythical attitude towards pandemics are uncovered as inhibitors. Nevertheless, moral values depict a neutral role. Secondly, the peer groups' beliefs are highest ranked, followed by the lack of trust in political will and a mythical attitude towards pandemic prevention. Finally, moral values are determined as the lowest-ranked critical factor. Based on these results, the government should promote awareness campaigns on lethality and fatality of the pandemic at both centralized and decentralized levels to win people's trust at the grass-roots level and overcome the mythical attitude of individuals at all societal levels. Besides, access to personal protective gears should be made feasible since an easier pandemic prevention adoption would increase the individuals' willingness to adopt such preventative measures.

Perceptions of chronic kidney disease among at-risk adults in rural Guatemala

This qualitative study explores perceptions of chronic kidney disease (CKD) among adults with abnormal estimated glomerular filtration rate (eGFR) in Guatemala, where the burden of CKD is rising. Qualitative semi-structured interviews were conducted with 39 individuals screened for CKD and found to have abnormal eGFR (defined as <90 mL/min/1.73 m2, per Kidney Disease Improving Global Outcomes [KDIGO] guidelines). Interviews occurred in participants' homes in Spanish or Kaqchikel Mayan. Interview notes were coded for dominant themes through an inductive approach. Interviewees had limited awareness of diabetes and hypertension as CKD risk factors, but appreciated the progressive nature of the disease. While most reported willingness to pursue renal replacement therapies, if necessary, they anticipated economic and geographic barriers. Public health interventions should focus on the association between diabetes, hypertension, and CKD. Improvement of primary care and screening infrastructure is imperative in CKD prevention in low- and middle-income countries (LMICs).

Knowledge towards Prevention and Early Detection of Chronic Kidney Disease and Associated Factors among Hypertensive Patients at a Chronic Illness Clinic of Jimma Town Public Hospitals

BACKGROUND

Morbidity and mortality due to chronic kidney disease are increasing among hypertensive patients in Sub-Saharan Africa. The majority of hypertensive patients with chronic kidney disease are not diagnosed at an early stage because of poor knowledge. However, to the best of our knowledge, there is no study conducted in Ethiopia about knowledge of hypertensive patients towards prevention and early detection of chronic kidney disease. Thus, the aim of this study was to assess knowledge towards prevention and early detection of chronic kidney disease and associated factors among hypertensive patients at Jimma town public hospitals, Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted among 332 hypertensive patients using an interviewer-administered questionnaire and medical record reviewing from April 5 to May 21, 2019. Study participants were selected using simple random sampling. Data were collected by using a standardized questionnaire. Data were entered into Epidata version 3.1 and analyzed by SPSS version 23. Descriptive statistics and bivariable and multivariable logistic regression were applied. To identify factors, a 95% confidence level and P value of less than 0.05 were considered.

RESULTS

Over half (59.6%) were males, and the mean (±SD) age of participants was 54.92 (12.91) years. Among the total participants, more than half of them (47.9%) had good knowledge. Attending secondary education (AOR = 2.9, P = 0.014), higher education (AOR = 5.4, P = 0.001), working in private sectors (AOR = 4.3, P = 0.001), taking three and above drugs per day (AOR = 0.55, P = 0.016), and having a family history of kidney disease (AOR = 2.3, P = 0.012) were significantly associated with knowledge. Conclusion and Recommendation. Near to half of the study participants had good knowledge towards prevention and early detection of chronic kidney disease. Attending secondary education and above, working in private sectors, taking three and above drugs per day, and having a family history of kidney disease were independent predictors of knowledge. Hypertensive patients should be encouraged to be aware of risk factors of CKD, and health care providers should educate hypertensive patients about the prevention and early detection of chronic kidney disease.

Knowledge and Practices towards Prevention and Early Detection of Chronic Kidney Disease and Associated Factors among Hypertensive Patients in Gondar Town, North West Ethiopia

BACKGROUND

Chronic kidney disease is a global health problem with serious adverse effects, including kidney failure, cardiovascular disease, and premature death. Improving awareness and practice on the impact, prevention, and early detection of chronic kidney disease will reduce the significant economic and public health burden.

METHODS

A cross-sectional study was conducted to determine knowledge and practice towards prevention and early detection of chronic kidney disease and its associated factors among hypertensive patients in Gondar town in 2019. The study included hypertensive patients visiting health institutions from February to March 2019. Data was collected using a semistructured questionnaire and individuals who fulfilled our inclusion criteria were selected using a systemic random sampling technique. Epi Info software version 7 was used for data entry, and SPSS version 20 was used for descriptive and logistic regression analysis.

RESULT

Out of a total of 442 participants, 434 completed the questionnaire, with a response rate of 98.1%. Of the total, 298 (68.7%) had good knowledge of chronic kidney disease with a mean knowledge score of 8.78 ± 2.80 and 210 (48.4%) had good practice with mean practice score of 6.58 ± 1.61. Educational status, residence, and duration of hypertension were significantly associated with the knowledge and practice scores of the participants in the multivariate logistic regression analysis.

CONCLUSION

More than half of the participants had good knowledge about chronic kidney disease and its risk factors. However, the level of preventive practice among participants was low. The educational status, residence, and duration of hypertension were significantly associated variables with knowledge and practice scores in multivariate logistic regression.

Knowledge, attitudes and practices towards COVID-19 among young adults with Type 1 Diabetes Mellitus amid the nationwide lockdown in India: A cross-sectional survey

AIMS

To assess knowledge, attitude, and practices (KAP) of young adults with type 1 diabetes mellitus (T1DM) towards COVID-19 amid nationwide lockdown in India.

METHODS

We conducted a cross-sectional web-based survey among young adults with T1DM (aged 18-30 years) in the North, Central, South, and West zones of India. It consisted of fifteen, five and eight questions pertaining to knowledge, attitude, and practices towards COVID-19, respectively. Certain questions relevant to T1DM were also incorporated.

RESULTS

After exclusion, 212 participants were included (mean age = 25.1 ± 4.3 years; M:F = 10:11). The overall correct rate of the knowledge questionnaire was 83% (mean total knowledge score = 12.4 ± 1.9). Most (74%) had an average knowledge score (mean ± 1SD). Higher educational status, urban residence, and being married were associated with better knowledge scores; however, only urban residence was found to be statistically significant on multinomial logistic regression. Most (88%) felt that being a patient of T1DM, they were at higher risk of getting infected with COVID-19. At the same time, 98% were confident about self-protection. Fifty-one percent of respondents had left home amid lockdown mostly to procure insulin/injection needles/syringes/glucometer strips from the pharmacy. However, all were maintaining proper hand hygiene and majority were following routine dietary advice (95%) and administering prescribed insulin doses (99%). Seventy-two participants (34%) had experienced one or more episodes of hypoglycemia since the commencement of lockdown.

CONCLUSIONS

Young adults with T1DM have average knowledge, positive attitude, and healthy preventive practices towards COVID-19. Awareness campaigns targeted towards rural communities and providing doorstep delivery of insulin/needles/syringes may be more rewarding.

Knowledge, attitude, and practices toward chronic kidney disease among care providers in Jimma town:cross-sectional study

BACKGROUND

Chronic kidney disease (CKD) is a common and growing health problem that requires adequate Knowledge by health care providers to reduce the progress of the disease. Thus, this study aimed to assess the care provider's Knowledge, attitude, and practices toward CKD.

METHOD

A cross-sectional study conducted among 326 care providers at Jimma University Specialized hospital and three medium to higher clinics found in Jimma Town. Collected data entered into Epi-Data version 3.1 and exported to SPSS version 21 for windows for data analysis. Descriptive statistics and generalized linear modal used to analyze the data.

RESULT

The mean age and service year of the participants were 29.68(±4.877) and 4.28(±4.561), respectively. The overall weighted Knowledge, attitude, and practice score of the study participant were 9.0971(8.77, 9.42), 2.53(2.4, 2.65), 10.14(9.94, 10.33) respectively. Over half of the care providers had the awareness to use eGFR to assess kidney function and patient referral to Nephrologists. Also, many care providers knew the five-stage of CKD and the risk factors of CKD, such as diabetes, long-term alcohol consumption, anemia, and cardiovascular disorders, respectively. Care providers had an understanding of late detection, and referral of CKD would increase kidney disease complications. Besides, 275(84.4%) of them are worried about treatment costs related to CKD. Over half of the care providers, 238(73.0%), believed that the Ethiopian ministry of health gave less attention to the problem. Furthermore, 234(71.8%) are interested in studying more on CKD management. Majority 256(78.5%), very likely or likely refer the patient to senior physician and Nephrologist.

CONCLUSION

Care providers showed enough Knowledge, a favorable attitude, and practice toward CKD.

Dietary Habit and Other Risk Factors of Chronic Kidney Disease Among Patients Attending Dessie Referral Hospital, Northeast Ethiopia

Background

In low- and middle-income countries, the burden of chronic kidney disease (CKD) is rising due to poor access to early detection and management services. In Ethiopia, little is known about the context-specific risk factors and their magnitude, particularly the dietary habit of patients is not studied. Therefore, this study aimed to identify the dietary and other risk factors of CKD in Northeast Ethiopia.

Methods

We conducted a facility-based unmatched case–control study utilizing quantitative method of data collection. Data were collected on a total of 66 cases and 134 controls using structured questionnaire and anthropometric measurements. Dietary habit was assessed using the Diet History Questionnaire (DHQ). Medical history, patient chart review and physical examination were employed to collect other relevant information. To identify independent predictors of CKD, we conducted a multivariable logistic regression analysis.

Results

About 54.5% cases and 46.3% of controls were female, while 40.9% of cases and 38.8% of controls were within the age group of 36–55. All cases and 128 (95.5%) controls consumed meat in the last year. Forty-six (69.7%) cases and 74 (55.2%) controls use palm oil as the main cooking oil. History of hypertension (adjusted odds ratio (AOR)=2.39; 95%CI: 1.17–4.89), anemia (AOR=2.38; 95%CI: 1.04–5.42), palm oil use (AOR=2.10; 95%CI: 1.01–4.35) and family history of CKD (AOR=8.77; 95%CI: 3.73–20.63) were significantly associated with the risk of having CKD.

Conclusion

Meat consumption and use of palm oil are higher among patients with CKD than controls. History of hypertension, anemia, family history of CKD and palm oil consumption were found to be risk factors for CKD. Dietary counseling interventions and dietary modifications might help in CKD prevention. Furthermore, routine urinalysis and estimation of glomerular filtration rate (GFR) for all hospitalized patients with hypertension and anemia could help to detect CKD at an earlier stage for a better prognosis.

Tuberculosis knowledge and attitude among non-health science university students needs attention: a cross-sectional study in three Ethiopian universities

Background

Ethiopia is among the 14 high TB, TB/HIV and MDR-TB burden countries globally. Prior studies indicate students attending universities in Ethiopia may be at increased risk for active tuberculosis (TB) relative to the general population, mainly due to the dramatic increase in expansion of the enrollment scale of universities.This study sought to gain insight about non-health science university students’ TB knowledge and attitudes to help develop a strategy for TB education in this population.

Methods

A cross-sectional study was conducted from October to December 2018 among non-health science university students at three eastern Ethiopia public universities. Participants were considered having ‘good’ knowledge on TB when they correctly mentioned the communicability, means of transmission and prevention methods of TB and recognized modern medicine as the best treatment for TB. Participants were considered as having ‘acceptable’ attitude towards TB when they indicated they would seek immediate care for TB diagnosis, not hide a TB diagnosis and feel compassion to help people with TB.

Results

A total of 1720 non-health science university students participated. Only 614 (35.7%) of the students had ‘good’ knowledge on TB. This differed significantly between universities, with students from Haramaya and Dire Dawa universities more likely to have ‘good’ TB knowledge than their counterparts from Jigjiga University [COR (Crude Odds Ratio):1.62 and 1.94, respectively; and 95% Confidence Interval (CI): (1.236, 2.079) and (1.511, 2.483), respectively]. Only a third of students, 555 (32.3%) mentioned ‘bacteria’ as causing TB, and 836 students (48.6%) had ever heard of Multi Drug Resistant-TB (MDR-TB). An ‘acceptable’ attitude towards people with TB was observed in 666 students (38.7%). Even though 739 students (43%) felt compassion and desire to help TB patients, 213 (12%) and 382 (22%) mentioned they fear and tend to stay away from TB patients, respectively.

Conclusions

The present study revealed that non-health science university students lack important TB knowledge and have misconceptions about TB in eastern Ethiopia. University administrators and other stakeholders striving against TB should provide due attention to university settings and consider development of student education programs to improve awareness and knowledge of TB disease.

Pre-existing chronic kidney disease and acute kidney injury among critically ill patients

BACKGROUND

The impact of pre-existing chronic kidney disease (CKD) and acute kidney injury (AKI) on health outcomes in critically ill patients is unclear. Yet, CKD complicated by AKI in critically ill patients is common.

OBJECTIVES

To compare risk of death within one-month of admission in critically ill patients with and without pre-existing CKD who developed AKI.

METHODS

A multicenter retrospective comparative study using medical records review was conducted. Study participants consisted of 826 adult patients who received mechanical ventilation for at least 6 h in the critical care units from January 2012 to December 2017. Assessment of kidney function was established by serum creatinine. Severity and staging of AKI were defined using RIFLE criteria: Risk, Injury, Failure, Loss and End stage of renal disease. Chronic kidney disease was defined as eGFR > 60 ml/mg/1.73 m² on admission.

RESULTS

Pre-existing CKD was present in 55% of patients and 7% had AKI within 7 days of admission. The overall mortality rate among these patients was 87.3%. The mortality rate was highest in patients with CKD (70.1%) followed by that of patients without pre-existing CKD but with AKI (20.7%) and that of patients with pre-existing CKD (7.1%) and AKI. Risks associated with mortality were APACHE II score (1.03; 95% CI 1.02-1.05;(P<0.001) and AKI (1.68; 95% CI 1.12-2.5;P<0.01) in patients with pre-existing CKD. Only APACHI-II (1.03; 95% CI 1.0-1.1; p < 0.001) was predictive of death in patients without pre-existing CKD.

CONCLUSION

Pre-existing comorbid CKD increases risks of death among critically ill patients compared to patients without CKD and regardless of whether they develop AKI or not. Early identification of CKD and recognition of the risk for mortality among these patients may result in earlier intervention that could reduce mortality.

Development and validation of knowledge, attitude and practice questionnaire for prevention of respiratory tract infections among Malaysian Hajj pilgrims

Background

Hajj pilgrimage faces numerous challenges including a high prevalence of respiratory tract infection as well as its prevention strategies. The aim of this study was to develop and validate a questionnaire to evaluate knowledge, attitude and practice (KAP) towards respiratory tract infections (RTIs) prevention among Malaysian Hajj pilgrims.

Methods

This study was conducted among Malaysian Umrah pilgrims in Malaysia from Kuala Lumpur and Kelantan. The questionnaire then underwent a series of validation process that included content, face validity and exploratory part. Item response theory (IRT) analysis was utilized for the validation of the knowledge domain. The attitude and practice were validated using the exploratory factor analysis (EFA).

Results

The validation process resulted in a questionnaire that comprised of four main sections: demography, knowledge, attitude, and practice. Following IRT analysis of the knowledge domain, all items analyzed were within the acceptable range of difficulty and discrimination. The Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) was 0.72 and 0.84 for attitude and practice domain respectively and Bartlett’s test of Sphericity for both domains were highly significant (P < 0.001). The factor analysis resulted in two factors with total of 12 items in attitude domain, and 2 factors with total of 13 items in the practice domain with satisfactory factor loading (> 0.3). The Cronbach’s alpha for reliability of the knowledge, attitude and practice domains all showed acceptable values of > 0.6 (0.92, 0.77 and 0.85).

Conclusion

The findings of this validation and reliability study showed that the developed questionnaire had a satisfactory psychometric property for measuring KAP of Malaysian Hajj pilgrims.

Socioeconomic Determinants of Knowledge of Kidney Disease Among Residents in Nigerian Communities in Lagos State, Nigeria

Objectives

We sought to estimate the knowledge, sociodemographic determinants, and risk-inducing lifestyles of kidney disease (KD) among Nigerians living in Lagos State.

Methods

We conducted a cross-sectional descriptive study to assess the level of knowledge of KD and its associated sociodemographic factors of individuals living in urban and semi-urban communities of Lagos State, Nigeria. It is hoped that the results of this study will help to inform preventive modalities. We used a pretested, structured questionnaire to draw information from 1171 Nigerians aged ≥ 15 years.

Results

The mean age of respondents was 33.5±11.1 years. In our cohort, 72.4% of respondents were knowledgeable of KD, with media as their major source of information (41.6%). Knowledge of KD was significantly associated with age (p = 0.044), education (p < 0.001), marital status (p < 0.001), and place of residence (p = 0.048). The established KD risk-inducing lifestyle factors were habitual use of herbal supplements, significant alcohol consumption, and diabetes (p < 0.050). Significant predictors of knowledge of KD included primary education (Odds ratio (OR) = 0.367, 95% confidence interval (CI): 0.11–1.22; p =0.102), secondary education (OR = 0.296, 95% CI: 0.17–0.51; p < 0.001), Igbo ethnic group (OR = 1.471, 95% CI: 0.99–2.17; p = 0.047), and place of residence (OR = 1.332, 95% CI: 1.00–1.77; p = 0.048). Age 30–39 years (OR = 0.749, 95% CI: 0.48–1.18; p = 0.214), 40–49 years (OR = 1.083, 95% CI: 0.69–1.69; p = 0.727), and not working (OR = 1.178, 95% CI: 0.88–1.57; p < 0.269) were non-significant predictors of knowledge of KD.

Conclusions

Our cohort had inadequate knowledge of linking risk-inducing lifestyles to KD development. Effective measures and efforts should be made to create awareness and educate the general population on KD and prevention measures related to risk-inducing lifestyles to reduce the burden of KD among Nigerians.

Management of Type 2 Diabetes and Chronic Kidney Disease in Fiji in 2018: Knowledge, Attitude, and Practice of Patients

OBJECTIVE

The aim was to identify the level of knowledge, attitude, and practice (KAP) in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) at Sigatoka Subdivisional Hospital (SSH) in 2018 since no studies have been done on this issue so far in Fiji.

METHODS

A quantitative, cross-sectional study including 225 patients was carried out July 1, 2018, through August 31, 2018, using a validated self-structured questionnaire. Fijians, aged 30 years or above, with confirmed T2D and CKD who were attending the Special Outpatient Department (SOPD) at SSH, were included in the study using a purposive sampling method to identify eligible participants. Data was gathered by a questionnaire that covered questions related to each aspect of KAP.

RESULTS

The relation of native Fijians (i-Taukei) to Fijians of Indian descent (FID) was approximately 1:1. The majority of participants had high levels of knowledge, attitude, and practice (61.8%, 63.6%, and 88.4%, respectively). However, a few areas of low knowledge were evident, such as the relation between high blood pressure and renal status in people with diabetes and the need for renal transplant in end-stage kidney disease (ESKD) abroad. Low attitude was apparent for the impact and management of diabetic kidney disease (DKD). Low practice was evident regarding clinic attendance, self-monitoring, and opting for non-medical treatment.

CONCLUSIONS

The majority of T2D patients with CKD had a high level of knowledge, but weaknesses were observed in the self-management of CKD and clinic attendance. This information should be considered by clinicians and policy-makers to improve management and treatment of CKD in T2D.

Determinants of knowledge, attitude and practice in patients with both type 2 diabetes and chronic kidney disease in Fiji

Background: In Fiji, Type 2 diabetes mellitus (T2DM) and Chronic kidney disease (CKD) are amongst the top four causes of premature mortality, disability and death. This study aims to identify the determinants of knowledge, attitude and practice (KAP) in T2DM patients with CKD in Fiji in 2018. Methods: A cross-sectional study was conducted at Sigatoka Sub-divisional Hospital (SSH) in Fiji in July-August, 2018 using a self-structured questionnaire to test KAP of 225 patients. The inclusion criteria were confirmed T2DM patients (Fijian citizens) with CKD, aged 30 years or above and attending Special Out-Patient's Department (SOPD) at SSH. Independent t-test and ANOVA was used to test differences between demographic variable and practice score while non-parametric tests were used for knowledge and attitude. Spearman correlation and multiple linear regressions were conducted. All tests were set at 5% level of significance. Results: From 249 questionnaires distributed, 225 responded thus response rate was 95%. The mean KAP level was high: knowledge, 23.3/30 (SD±3.25); attitude, 23.1/30 (SD±2.73) and practice, 7.1/10 (SD±2.04). A high level of knowledge was seen in those with university-level education (p<0.001), unemployed (p=0.05) and high average monthly income (p=0.03). Those aged 61-70 years had a 0.53-point lower attitude score (p=0.05) than other age categories, while those >70 years had a 1.78-point lower attitude score (p=0.01) than other age categories. Fijians of Indian descent (FID) had lower attitude (p=0.002) and higher practice (p=0.001) scores. Conclusion: Patients with both T2DM and CKD at SSH have high levels of KAP. The determinants of KAP have been shown and thus, this study identified high-risk groups for low KAP, which can become the focus of future public health intervention.

Patient Awareness, Prevalence, and Risk Factors of Chronic Kidney Disease among Diabetes Mellitus and Hypertensive Patients at Jimma University Medical Center, Ethiopia

Background

There is an alarming rise of chronic kidney disease (CKD) prevalence globally, which is associated with significant morbidity and mortality necessitating special attention as one of the major public health problems. The burden of CKD disproportionately impacts low-income countries like Ethiopia where hypertension and diabetes mellitus, the two most important risk factors for CKD growth rate, are greatest.

Objective

The aim of this study is to assess patient awareness, prevalence, and risk factors of chronic kidney disease among hypertensive and diabetes mellitus patients.

Methods

Hospital based cross-sectional study design was conducted at Jimma University Medical Center among adult (≥18 years) hypertensive and diabetes mellitus patients. Informed written consent was obtained from each participant and data was collected by interview and chart review; blood and urine samples were collected for CKD screening. Glomerular filtration rate (GFR) was estimated from serum creatinine using CKD epidemiology collaboration (CKD-EPI) equation, and CKD was defined using estimated GFR (e-GFR) and albuminuria. Multivariate logistic regression was used to identify independent predictors of CKD and p-value <0.05 considered statistically significant.

Result

Mean (±SD=standard deviation) age of participants was 54.81 ± 12.45 years and 110 (52.9%) of them were male. Only 59 (28.4%) of the participants had awareness about CKD and its risk factors. The prevalence of CKD was 26% (95% CI; 20.3%-31.8%). Factors associated with chronic kidney disease were uncontrolled blood pressure (adjusted odds ratio (AOR)=2.22,95% CI=1.01-4.76), fasting blood sugar ≥ 150 mg/dl, (AOR=3.70,95% CI=1.75-7.69), angiotensin converting enzyme inhibitors (ACEIs) nonusers, (AOR=4.35 ,95% CI=1.96-10.0), poor knowledge of CKD (AOR=3.69, 95% CI=1.48-9.20), and long duration of hypertension (AOR=4.55, 95%CI=1.72-11.11).

Conclusion

Our study found out low level of patient awareness and high prevalence of CKD. The predictors of CKD were uncontrolled blood pressure, fasting blood sugar> 150 mg/dl, long duration of hypertension, ACEIs nonusers, and poor knowledge about CKD.

Development and psychometric testing of the Knowledge, Attitudes and Practices (KAP) questionnaire among student Tuberculosis (TB) Patients (STBP-KAPQ) in China

BACKGROUND

TB outbreaking in schools is extremely complex, and presents a major challenge for public health. Understanding the knowledge, attitudes and practices among student TB patients in such settings is fundamental when it comes to decreasing future TB cases. The objective of this study was to develop a Knowledge, Attitudes and Practices Questionnaire among Student Tuberculosis Patients (STBP-KAPQ), and evaluate its psychometric properties.

METHODS

This study was conducted in three stages: item construction, pilot testing in 10 student TB patients and psychometric testing, including reliability and validity. The item pool for the questionnaire was compiled from literature review and early individual interviews. The questionnaire items were evaluated by the Delphi method based on 12 experts. Reliability and validity were assessed using student TB patients (n = 416) and healthy students (n = 208). Reliability was examined with internal consistency reliability and test-retest reliability. Content validity was calculated by content validity index (CVI); Construct validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA); The Public Tuberculosis Knowledge, Attitudes and Practices Questionnaire (PTB-KAPQ) was applied to evaluate criterion validity; As concerning discriminant validity, T-test was performed.

RESULTS

The final STBP-KAPQ consisted of three dimensions and 25 items. Cronbach's α coefficient and intraclass correlation coefficient (ICC) was 0.817 and 0.765, respectively. Content validity index (CVI) was 0.962. Seven common factors were extracted by principal factor analysis and varimax rotation, with a cumulative contribution of 66.253%. The resulting CFA model of the STBP-KAPQ exhibited an appropriate model fit (χ2/df = 1.74, RMSEA = 0.082, CFI = 0.923, NNFI = 0.962). STBP-KAPQ and PTB-KAPQ had a strong correlation in the knowledge part, and the correlation coefficient was 0.606 (p < 0.05). Discriminant validity was supported through a significant difference between student TB patients and healthy students across all domains (p < 0.05).

CONCLUSIONS

An instrument, "Knowledge, Attitudes and Practices Questionnaire among Student Tuberculosis Patients (STBP-KAPQ)" was developed. Psychometric testing indicated that it had adequate validity and reliability for use in KAP researches with student TB patients in China. The new tool might help public health researchers evaluate the level of KAP in student TB patients, and it could also be used to examine the effects of TB health education.

Knowledge, attitudes and practices of hypertensive patients towards prevention and early detection of chronic kidney disease: a cross sectional study from Palestine

BACKGROUND

Hypertension is the second most common cause of chronic kidney disease (CKD). Therefore, the aims of the study were to assess the knowledge, attitudes and practices (KAP) of hypertensive patients towards prevention and early detection of CKD, and to determine the clinical and socio-demographic factors, which affect the KAP regarding prevention of CKD.

METHODS

A cross-sectional study was held using the CKD screening Index to assess the KAP of 374 hypertensive patients who were selected from multiple primary healthcare centers in Nablus, Palestine. The CKD Screening Index is formed of three scales. First, the knowledge scale was a dichotomous scale of 30 items, while the attitude scale used 5-point Likert-type scale for 18 items and finally the practice scale was measured using 4-point Likert-type scale for 12 items. Multiple linear regression analysis was used to determine the association between clinical and socio-demographic factors and practices.

RESULTS

In total, 374 hypertensive patients participated in the study. The mean age of participants was 59.14 ± 10.4 years, (range 26-85). The median (interquartile range) of the knowledge, attitude, and practice scores of hypertensive patients towards prevention and early detection of CKD were 20 (16-23), 69 (65-72), and 39 (36-42), respectively. In multiple linear regression analysis, patients age < 65 years (p < 0.001) and patients with high education level (p = 0.009) were the only factors significantly associated with higher knowledge scores. Additionally, patients age < 65 years (p = 0.007), patients with high income (p = 0.005), and patients with high knowledge score (p < 0.001) were the only factors significantly associated with higher attitude scores. Furthermore, regression analysis showed that patients with higher total knowledge (p = 0.001) as well as higher total attitudes scores towards CKD prevention (p < 0.001), male gender (p = 0.048), and patients with normal body mass index (BMI) (p = 0.026) were statistically significantly associated with higher practice score towards CKD prevention.

CONCLUSIONS

Among hypertensive patients, higher scores for total knowledge and attitudes toward prevention, male sex, and normal BMI were associated with modestly higher scores for prevention practices. Finally the findings may encourage healthcare workers to give better counseling to improve knowledge.

Under-diagnosed chronic kidney disease in Jordanian adults: prevalence and correlates

BACKGROUND

Jordan has no relevant database or registry by which chronic kidney disease (CKD) would be early identified. The purpose of the present study is to uncover the prevalence of CKD in a national sample of Jordanian patients at high risk and examine the association of CKD with demographic and clinical factors.

METHODS

This is a cross-sectional, correlational study that involved 540 outpatients at high risk for CKD. Demographic and clinical data were obtained in the period from September 2013 to March 2014. Prevalence of CKD was defined based on the National Kidney Foundation Kidney Disease Outcomes Quality Initiative Classification of CKD using estimated glomerular filtration rate. Associations of CKD and demographic and clinical factors were examined using bivariate analysis.

RESULTS

The majority of the sample were females (64%), their mean age (±SD) was 55.0 ± 12.5 years, their mean eGFR (±SD) was 116.0 ± 47.5. One third of patients had eGFR of 23.5%, 5.4%, 0.7% and 0.7% which corresponds with mild, moderate, severe and very severe reduction in eGFR, respectively. Ageing, being male, unemployment, packs/years of smoking, co-morbidities [hypertension (HTN), diabetes mellitus (DM) and cardiovascular disease] and low high density lipoprotein (HDL) correlated positively with development of CKD.

CONCLUSION

This study demonstrates a high rate of under-diagnosed CKD among Jordanians. Several demographic and clinical factors are linked with the development of CKD. Policymakers and healthcare providers need to establish an evidence-based practice project to prevent and screen for CKD in Jordan.

Exercise Self-Efficacy Scale: Validation of the Arabic Version Among Jordanians With Chronic Diseases

This study assessed the psychometric properties of the Arabic version of Exercise Self-Efficacy scale (ESE-A) among Jordanian outpatients with a variety of chronic diseases using descriptive cross-sectional design. Participants’ scores of ESE-A significantly correlated with their reported weekly exercise frequency ( r = .23, p< .001), duration ( r = .31, p< .001), and evaluation of their physical exercise ( r = .39, p< .001). The construct validity was tested using exploratory factor analysis, which retained all items, and the scree plot showed one meaningful factor with an eigenvalue of 10.38 and an explained variance of 57.7%. Furthermore, Cronbach’s alpha was .89 and split-half coefficient was .83 indicating that the ESE-A is a reliable scale. The ESE-A was found to be a robust measure to evaluate exercise self-efficacy among Arabic patients with chronic diseases. Arabic researchers interested in exercise self-efficacy are invited to utilize the ESE-A in their studies to confirm its psychometric properties.

Enhancing Knowledge, Beliefs, and Intention to Screen for Prostate Cancer via Different Health Educational Interventions: a Literature Review

BACKGROUND

Prostate cancer is one of the most common cancers affecting men globally, constituting the sixth leading cause of cancer related death in males, and the eleventh leading cause of death from cancer in all age groups. In Jordan, prostate cancer is the third most common cancer in the male population, accounting for one third (6.2%) of cancer related deaths and in 2010 alone, 218 (9.4%) new cases were identified.

OBJECTIVE

To assess the effectiveness of different health education interventions aimed at enhancing knowledge, beliefs and intention to screen for prostate cancer.

MATERIALS AND METHODS

A literature search from January 2000 to April 2015 was conducted using the key words "prostate disease," "educational program," "knowledge," "prostate cancer," "demographic factors and prostate cancer," "knowledge and prostate cancer," "education for patients with prostate cancer," "factors that affect intention to screen," "knowledge, beliefs, and intention to screen for prostate cancer," "impact of prostate educational program on beliefs," and "impact of educational program on intention to screen."

RESULTS

Majority of studies reviewed indicated that men had low levels of knowledge regarding prostate cancer, and mild to moderate beliefs with good intention to screen for prostate cancer.

CONCLUSIONS

Most studies indicated that men's knowledge levels about prostate cancer were poor and they had mild to moderate beliefs and intentions to screen for prostate cancer. Therefore, development of an assessment strategy based on the Health Belief Model seems essential. An effectively designed and implemented educational program can help identify the needs and priorities of the target population.