Awareness, Attitude and Health Practices Among Parents of Children with Ear Infection: A National Study in Saudi Arabia (Preprint)
Authors: Algamdi Saleh Saad , Alkhalifah Mutasim Hussain , Shawosh Mohammed H. , Alshehri Khalid Ali , Alghamdi Hajar Fahad , Alzahrani Khalid Abdullah , Mukhtar Abdel Moniem 
Published: November 2018

BACKGROUND

Otitis media (OM) is a very common childhood problem. It is inflammation of the middle ear usually caused by viral or bacterial infection. Otitis media is a main cause of antibiotic use in children. The primary treatment for acute otitis media (AOM) is watchful waiting: 80% of cases resolve without intervention. Southeast Asia, the Western Pacific region, and Africa have the highest prevalence of OM. Prevalence studies on OM are scant in Saudi Arabia. Only a few studies have been conducted in some cities.

OBJECTIVE

The aim of this study was to determine the knowledge, attitude, and health-seeking practices of parents with regard to OM.

METHODS

A national study was conducted September 19, 2018–October 9, 2018 in the Kingdom of Saudi Arabia. Data were collected using an electronic online questionnaire. It was culturally adopted, validated, and translated into Arabic. Items on the questionnaire included demographics, knowledge, attitude, and health practices about ear infection among parents of children <5 years old. The calculated representative sample size of the Saudi population was 9600 individuals (95% confidence interval and 1% margin of error). The aim was for 10,000 responses. Stratified sampling was used with each administrative area considered as independent strata. Statistical analysis was conducted using Excel software (Microsoft, Redmond, WA). Data were coded, grouped, arranged, and cleaned. Statistical Package for Social Sciences (version 23.0; Armonk, NY: IBM Corporation) was used for data analysis.

RESULTS

This study included 10,004 participants. Most were females. The mean age was 37.93 years (standard deviation, 10.20 years). Overall, 81.9% of parents were knowledgeable about ear infection. Parents who were knowledgeable about ear infections were significantly older (P = .005), female (P < .001), had a higher education level (P < .001), were married (P < .001), had a monthly income of 10,000–20,000 Saudi riyals (P < .001), and lived in the Al-Baha region (P < .001). The scores of 90.0% of parents indicated they had a good attitude about ear infection; and 58.6% of parents believed that ignorance is why children do not go to a healthcare facility for ear infection treatment. Parents with positive overall health practices represent 81.2%. Parents with good health practices were significantly associated with female sex (P = .009), higher education level (P < .001), being married (P < .001), a monthly income of 5000–1000 Saudi riyals (SR; P < .001), and living in the Al-Baha region (P < .001).

CONCLUSIONS

Knowledge, attitude, and health-seeking practices in Saudi Arabia were overall adequate. However, more integrated educational materials are needed for the general population. The development of a broad national awareness program, especially in low socioeconomic areas, could significantly contribute to the early detection and management of OM.