Lubna Khalil Naaman
Background: Acute otitis media (AOM) among children is a very common condition and a leading cause of health care visits and antibiotic prescription.
Objectives: To assess the knowledge and practice of MOH primary care physicians regarding the diagnosis and treatment of AOM in children (6months-12 years), in Jeddah 2013.
Subjects and Methods: A descriptive cross sectional study design was adopted. It included a representative sample of PHC physicians working in MOH PHC centers in Jeddah, who are presented at the time of conducting the study. A self-administered questionnaire was used for data collection. It consisted of three parts; socio-demographic features of physicians, and their medical education in AOM in children, knowledge of infectious agents and risk factors of AOM in children, diagnosis of (AOM and OME) and treatment of AOM and the practice issues.
Results: The study included 203 primary health care physicians. Their age ranged between 25 and 60 years with a mean (SD) of 31.18 (7.96) years. Females represent 62.6% of them. Most of them (77.8%) were 12 Saudis and hold Bachelor degree (73.4%). Slightly more than half of PHC physicians (51.2%) knew correctly that Streptococcus pneumonia is a common causative agent for AOM whereas only 32%, 22.2% and 14.3% of them recognized correctly that Haemophilus influenza, viral agents and Moxarella catarrhalis are among common causative agents for AOM in children. , the most recognized risk factor for AOM among children by physicians was lack of maternal breastfeeding (68.5%), followed by attendance a day care (63.1%) and exposure to second hand tobacco smoke (53.7%). Only 46.3% of physicians disagreed correctly that all children with AOM should receive antimicrobial therapy and only 17.4% of them disagreed correctly that Amoxicillin continues to be as effective as any other oral antimicrobial agent for childhood AOM. Knowledge was significantly higher among family physicians, those having experience between 5 and 10 years, those seeing children 0-12 years and patients between 19 and 64 years in the their clinical practice and those read guidelines for management of AOM. Two-thirds of physicians agreed that pneumatic otoscopy can significantly enhance the diagnostic accuracy of acute otitis media and otitis media with effusion and Only 40% of them agreed that they comfortably using pneumatic otoscopy to diagnose otitis media. AOM practice score was significantly highest among physicians in the age group 40-49 years, females, physicians who had between 5 and 10 years of experience and Physicians 13 who attended lectures/conferences in the management of AOM had higher practice score than those who didn`t attend such activities.
Conclusion: The results of the present study revealed that overall knowledge and practice of primary health care physicians in Jeddah is suboptimal in some aspects concerning AOM and OME.