DIABETIC RETINOPATHY AND ITS SCREENING: KNOWLEDGE AND PRACTICE OF PRIMARY HEALTH CARE PHYSICIANS WORKING AT DIFFERENT PRIMARY HEALTH CARE CENTERS OF ALAHSA DISTRICT OF SAUDI ARABIA

Abstract

Background: Diabetic retinopathy, a leading cause of blindness among the working class of people is fast emerging as one of the major cause of overall blindness. Study suggests an overall global prevalence of diabetic retinopathy to be 22.27%. Diabetic Retinopathy, the most common cause of blindness among the working age group, is preventable which can be prevented by early diagnosis and proper treatment. The key to reducing blindness due to retinopathy is early detection and treatment. The success of screening process to detect diabetic retinopathy especially at the primary level depends on the level of knowledge and pattern of practice of the primary health care physicians on diabetic retinopathy and its screening. The role of the physicians working at the primary health care centers is vital for early detection of diabetic retinopathy. The present study was a primary health care centers' based study in which the knowledge and practice of all the primary health care physicians was assessed regarding the knowledge and practice towards diabetic retinopathy and its screening. Materials and Methods: It was a cross sectional survey conducted at the Primary Health Centers of Al Ahsa region of Saudi Arabia. The study population was all the physicians working at different Ministry of Health operated Primary Health Care centers of Al Ahsa region of Saudi Arabia. The study sample was calculated by Epi info software assuming that 40% of the primary health care physicians will have the poor knowledge about diabetic retinopathy and its screening.To achieve this at the 95% of condence interval with an acceptable error of 5%, at least 350 physicians were needed .The sampling was done by random sampling from the list of all the physicians working at the Primary Health care centers of Al Ahsa district. The selected participants were sent an e mail and were requested to ll the google form with the questionnaires to answer. The data were collected on a pretested, pre designed questionnaires which were made available to the participants on google form (online). The collected data were cleared, coded, entered and analyzed by the SPSS version 26. Descriptive statistics were presented using counts, proportions (%), mean ± standard deviation whenever appropriate. The association of demographic characteristics of the participants with the knowledge and practice pattern towards diabetic retinopathy and its screening were performed using chi square test. .Ap-value cut off point of 0.05 at 95% CI was used to determine statistical signicance. The correct answer of the questionnaire was awarded 1 mark while the incorrect answer with 0 mark. The mean of the marks was the cutoff point demarcating the good knowledge with poor knowledge. The score above the mean was considered as good knowledge. Results:Atotal of 293 subjects participated in this study. The mean age of the participants was 35.94 years.The majority of the participants were female (55.3%). Eighty seven percent (N=255) were married while 11.3% were unmarried and 1.7% were divorced. Almost forty ve percent of the participants (44.7%) were family physician (resident) followed by those who were resident physician (33.8%) and those who were specialist in family medicine (13.7%).. More than forty three percent (43.3%) of the participants had family history of diabetes. The mean knowledge score of the participants was 3.95. Almost sixty percent of the participants (59.7%) were having good knowledge about the diabetic retinopathy. The level of good knowledge was signicantly higher among the female participants than those of males. As the qualication of the participants increased ,Higher percentage of post graduate participants had good knowledge about the diabetic retinopathy as compared to those with bachelor degree and diploma holder (74.19% vs.56.42% vs.54.94%, P =0.045). Those participants who had family history of diabetes were hsaving better knowledge about diabetic retinopathy as compared to thopse who did not have (59.05% vs.54.21, P=0.032).