URINARY TRACT INFECTION IN WOMEN: KNOWLEDGE AND PRACTICE OF PHYSICIANS WORKING AT THE PRIMARY HEALTH CARE CENTERS OF ALAHSA DISTRICT OF SAUDI ARABIA

Background: Urinary tract infection (UTI) .a condition which involves any part of the urinary tract., Is a major public health problem throughout the world. UTI is associated with significant morbidity which may affect the quality of life of the affected women. If not controlled properly, it can lead to more serious conditions which can be fatal to the life. This condition is also reported to be the most common condition attending the outpatient department. UTI can affect both sexes but its prevalence among women is higher than their male counterpart. At least half of the adult women are supposed to have more than one UTI in their life time. The roe of primary health care physicians and family physicians is crucial in optimizing the management of UTIs and preventing the complications related to it. Family physician and Genral physician are the first in a line of Health care service at the primary health care centers. The play a crucial role for the prevention , management ,referral and follow up of the cases suffering from UTIs. Studies have shown that lack of general physicians' time, lack of depth of knowledge and miscommunication between patients and General physicians and non availability of previous antibiotic therapy has played an adverse effect on the management of UTIs. The present study will be conducted in Al Ahsa region of Saudi Arabia to assess the Knowledge, attitude and practice of the family and general physicians working at different primary health care centers. Materials And Methods: It was a cross sectional survey. 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 which was at least 150 physicians. The sampling was done by stratified sampling.The data were collected on a pretested, pre designed and self-administered 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 towards UTI among women was performed using chi square test. .A p-value cut off point of 0.05 at 95% CI was used to determine statistical significance. Results: A total of 150 physicians working at different primary health care centers p participated in this study The mean age of the participants was 36.13 years. The majority of the participants were female (56.0%). Thirty-four percent of the participants were graduate while 44.7% were postgraduate diploma and 21% were postgraduate degree holder. Thirty-four percent of the participants were residents while 45.3% were general physicians and 14.7% were family physician specialist and only 6% were family physician consultant. Majority of the physicians (75.3%) working at the primary health care centers located in the urban area. The mean score of knowledge was 5.84. Majority of the participants (56.7 %() had good know ledge regarding the UTI. The knowledge regarding the Urinary tract infections clinical features, causative organism and epidemiology of the female physicians was significantly higher than their male counterpart (63.10% vs. 48.48, P=0.05). As educational level increased the knowledge regarding UTI also increased. The physician with post graduate degree had higher knowledge than those with diploma and graduate degree (65.62% vs.59.70 vs.47.59, P=0.02).). The family physician specialist had better knowledge regarding UTI than general physician family physician consultant and family physician resident but it was not statistically significant. The mean practice score was 2.38. Fiftysix percent of the physician had poor practice while only 44% had good practice. The good practice score towards the management of UTI was higher among the male physician as compared to their counterpart female but it was not statistically significant (49.23 % vs.40.47% n, P=0.27). The good practice towards the management of UTI was higher among the physician with graduate degree than those with postgraduate diploma and postgraduate degree but it was not statistically significant (60.78% vs.49.25% vs.37.5%, P=0.481). The good practice towards UTI was higher among the consultant family physician than the specialist family physician, resident family physician and the general physician but it was statistically insignificant (66.66%vs.22.72%vs.44.12%vs.49.02%, P=0.092). The good practice score was higher among the physician living in the urban area than those living in rural area but again it was not statistically significant (45.13% vs.40.54% , P=0.385). Conclusion:The present study has provided valuable information on the knowledge and practice of the physicians working at different primary health care center. It showed overall moderate level of knowledge regarding the UTI among them but the clinical practice towards the management of UTI has been lacking. It is recommended that clear guidelines should be established for the diagnosis, treatment, and follow-up of female UTIs at the primary health level, which should be designed according to up-to-date sources.