Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 16;24(1):2235.
doi: 10.1186/s12889-024-19658-5.

Assessing the knowledge, attitude, and practice of frontline physicians in Egyptian university hospitals regarding pharyngitis and acute rheumatic fever: a cross-sectional study that calls for action

Kerollos Abdelsayed  1   2   3 , Hossam Tharwat Ali  4   5 , Mohamed Basyouni Helal  6 , Ahmed Assar  6 , Maysa Madany  2   3 , Mohamed Diaa Gabra  2   3 , Ahmed Abdelrahman  2   3 , Yomna Goudy  2   3 , Ahmed Dandrawy  2   3   7 , Ziad Ashraf Soliman  2   3 , Heba M Qubaisy  8 , Ghada M M Shahin  9 ; ARF –RHD Prevention Group; Parvin C Azimullah  10
Collaborators, Affiliations

Assessing the knowledge, attitude, and practice of frontline physicians in Egyptian university hospitals regarding pharyngitis and acute rheumatic fever: a cross-sectional study that calls for action

Kerollos Abdelsayed et al. BMC Public Health. .

Abstract

Background: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major public health issues. Although the primary and secondary prevention of RHD through appropriate management of bacterial pharyngitis and ARF are well-described in the literature, few studies address the knowledge, attitude, and practice (KAP) of developing countries. We aimed to evaluate the KAP of the frontline physicians in Egyptian university hospitals regarding pharyngitis and ARF.

Methods: We employed a cross-sectional design between September 1st, 2022, and January 31st, 2023 using a self-administered questionnaire in 21 Egyptian universities. The questionnaire was developed based on previous studies and recent guidelines and included four domains: sociodemographic data, knowledge, attitude, and practice regarding pharyngitis and ARF. We utilized both online (Google Forms) and paper surveys. Frontline physicians, including interns, residents, and assistant lecturers, were conveniently invited to participate. Furthermore, with the help of participating phycisians in recruiting their colleagues, we utilized the snowball method. Data were analyzed using IBM SPSS version 27 software.

Results: The final analysis included 629 participants, of whom 372 (59.1%) were males and 257 (40.9%) had direct contact with ARF patients. Most participants (61.5%) had a fair knowledge level while 69.5% had a fair level of practice regarding ARF and pharyngitis. Higher satisfactory knowledge levels were noted regarding pharyngitis (17.1% vs. 11.3%; p-value: 0.036) and ARF (26.8% vs. 18%; p-value: 0.008) among physicians dealing directly with ARF cases compared to physicians in departments not dealing directly with ARF cases. Physicians in Cairo region universities had significantly higher levels of satisfactory knowledge about ARF compared to Delta and Upper Egypt region universities (p = 0.014). Delta region universities showed significantly lower levels of practice compared to Cairo and Upper Egypt region universities (p = 0.027). The most frequently recognized barriers against health promotion were low socioeconomic status (90.3%) and lack of adequate public education (85.8%).

Conclusions: Despite the fair knowledge and practice levels towards bacterial pharyngitis and ARF among participants, many gaps were still identified that might contribute to RHD prevalence. Educational interventions should be implemented by updating the local guidelines in Egypt for diagnosis and management based on the most recent guidelines.

Keywords: Acute rheumatic fever; Attitude; Knowledge; Pharyngitis; Practice; Rheumatic heart disease.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The structure of the questionnaire; domains, categories, subcategories, and questions
Fig. 2
Fig. 2
Details of the included and excluded participants
Fig. 3
Fig. 3
Percentages of knowledge and practice levels among the participants
See this image and copyright information in PMC

References

    1. Kotit S, Phillips DIW, Afifi A, Yacoub M. The, “Cairo Accord”- Towards the Eradication of RHD: an update. Front Cardiovasc Med. 2021;8(July):1–17. - PMC - PubMed
    1. Sayed AK, Se’eda H, Eltewacy NK, El Sherif L, Ghalioub HS, Sayed A, et al. Awareness of rheumatic heart disease in egypt: a national multicenter study. J Cardiovasc Dev Dis. 2021;8(9):1–9. - PMC - PubMed
    1. Noubiap JJ, Agbor VN, Bigna JJ, Kaze AD, Nyaga UF, Mayosi BM. Prevalence and progression of rheumatic heart disease: a global systematic review and meta-analysis of population-based echocardiographic studies. Sci Rep. 2019;9(1):1–14. 10.1038/s41598-019-53540-4 - DOI - PMC - PubMed
    1. Ghamari SH, Abbasi-Kangevari M, Saeedi Moghaddam S, Aminorroaya A, Rezaei N, Shobeiri P, et al. Rheumatic heart disease is a neglected disease relative to its burden worldwide: findings from global burden of disease 2019. J Am Heart Assoc. 2022;11(13):e025284. 10.1161/JAHA.122.025284 - DOI - PMC - PubMed
    1. Abul-Fadl A, Mourad M, Ghamrawy A, Sarhan A. Trends in Deaths from Rheumatic Heart Disease in the Eastern Mediterranean Region: Burden and Challenges. J Cardiovasc Dev Dis. 2018;5(2):32. Available from: https://www.mdpi.com/2308-3425/5/2/32. - PMC - PubMed

Publication types

LinkOut - more resources