Barriers and limitations for undergoing mammography screenings among Kuwaiti women (aged 40–69) attending primary health care centers

Objectives: To assess perceived fear and to evaluate the level of knowledge, attitude, and prevention practices (KAP) regarding COVID-19 infection among patients with diabetes mellitus (DM) attending primary healthcare centers (PHCs) in Kuwait. This will help evaluate gaps and provide appropriate support to limit the spread of COVID-19 infection in high-risk patients. Methods: A descriptive cross-sectional study was carried out using a self-administered questionnaire. All patients aged 18 years or older attending for follow-up or newly diagnosed with type 1 or type 2 diabetes were eligible to participate in the study. Patients waiting for their regular follow-up appointments at the PHCs were invited verbally to take part in the study. The study excluded patients under the age of 18 and those with significant cognitive or physical impairment that might interfere with independent self-care behavior. The questionnaire included 57 items. The data were analyzed using descriptive statistics. Results: A total of 294 questionnaires were distributed to patients at PHCs in three health districts (Hawally, Capital, and Farwaniya) in Kuwait; 251 patients agreed to participate in the study, yielding a response rate of 85.4%. The study showed that most patients had moderate knowledge (71.1%) of COVID-19. The majority of correctly responded questions were about the mode of COVID-19 transmission, the most common clinical presentations, and at-risk people. On the other hand, 83.7% (n = 210) identified common cold symptoms (stuffy nose, runny nose, and sneezing) as COVID-19 symptoms. More than half of the patients (n = 146, 58.2%) were unable to identify uncommon COVID-19 symptoms, such as diarrhea and skin rash or discoloration. Most patients had a positive attitude (90.9%) and good prevention practices (83.6%). The overall fear score of the participating patients was 21.6 ± 6.5 (61.7%). Conclusions: Regardless of the positive attitude and good preventive practices of the patients, they had moderate knowledge levels about COVID-19. This indicates that there are significant knowledge gaps that still need to be filled. Different strategies can be used for this purpose, such as social media and public information campaigns. Supporting psychological well-being is vital for at-risk patients during a pandemic.

The aim of this study was to investigate current prescribing and dispensing practices at primary healthcare centers in Kuwait and compare them with those reported in other countries. This was a descriptive, quantitative and cross-sectional study involving 50 primary healthcare centers across five governorates of Kuwait. The sample was determined in accordance with the recommendations of the World Health Organization on methodology. Healthcare centers were stratified according to governorates and selected by systematic random sampling. Prescribing indicators were investigated in each healthcare center by collecting data on 100 prescriptions for all age groups, determining consultation time and dispensing time for 50 patients, and interviewing 30 patients for an evaluation of dispensing practices. Data were collected prospectively using systematic random sampling. Our findings showed that the mean (standard deviation) number of drugs prescribed per prescription was 2.9 (1.2), 17.7% [95% confidence interval (CI) 17.1-18.4%] of drugs were prescribed by generic name, 39.1% (95% CI 37.8-40.5%) of prescriptions involved an antibiotic, and 9.1% (95% CI 8.9-9.4%) of prescriptions were for an injection. The mean (SD) consultation and dispensing times were 2.8 (1.9) min and 54.6 (33.5) s, respectively. Of the drugs prescribed, 97.9% (95% CI 97.4-98.3%) were actually dispensed, and 66.9% (95% CI 65.5-68.3%) were adequately labeled. In total, 26.9% (95% CI 24.7-29.2%) of patients demonstrated adequate knowledge of all drugs dispensed for them. Our findings indicate problem areas in prescribing and dispensing practices at the healthcare centers in Kuwait. Cost-effective, multifaceted interventions to improve current prescribing and dispensing practices are needed.

Background: Dental unit water lines (DUWLs) can harbor microbial contamination, posing risks for cross-infection to patients and dental staff. This study assessed the prevalence of bacterial contamination in DUWLs at primary healthcare centers in Kuwait during 2022–2023 and examined variation by year, governorate, and sampling outlet. Methods: A retrospective cross-sectional analysis was conducted using 3,290 water test results from six governorates. Data were obtained from the Environmental Health Department, Ministry of Health, and analyzed using STATA 17. Contamination was defined as a total plate count (TPC) >100 CFU/mL or presence of coliforms, Escherichia coli, Pseudomonas aeruginosa, or fecal streptococci. Descriptive and logistic regression analyses were performed. Results: Overall contamination prevalence was 16.8%. Rates were higher in 2023 (19.8%) than in 2022 (13.7%), and higher in Mubarak Al-Kabeer governorate (23%) and cup filler outlets (18.9%). Logistic regression showed significantly increased odds of contamination in 2023 (OR = 1.6; 95% CI: 1.3–2.0), Mubarak Al-Kabeer (OR = 1.4; 95% CI: 1.1–1.9), and cup fillers (OR = 1.3; 95% CI: 1.1–1.6). P. aeruginosa was detected in 1.3% of samples. Conclusion: One in six DUWL samples exceeded Kuwait’s strict microbial safety threshold. Findings highlight spatial and procedural variations in contamination and underscore the need for enhanced disinfection protocols, preventive maintenance, and targeted staff training to ensure waterline safety.

Background: Dental unit water lines (DUWLs) can harbor microbial contamination, posing risks for cross-infection to patients and dental staff. This study assessed the prevalence of bacterial contamination in DUWLs at primary healthcare centers in Kuwait during 2022–2023 and examined variation by year, governorate, and sampling outlet. Methods: A retrospective cross-sectional analysis was conducted using 3290 water test results from six governorates. Data were obtained from the Environmental Health Department, Ministry of Health, and analyzed using STATA 17. Contamination was defined as a total plate count (TPC) > 100 CFU/mL or presence of coliforms, Escherichia coli, Pseudomonas aeruginosa, or fecal streptococci. Descriptive and logistic regression analyses were performed. Results: Overall contamination prevalence was 16.8%. Rates were higher in 2023 (19.8%) than in 2022 (13.7%) and higher in Mubarak Alkabeer governorate (23%) and cup filler outlets (18.9%). Logistic regression showed significantly increased odds of contamination in 2023 (OR = 1.6; 95% CI: 1.3–2.0), Mubarak Alkabeer (OR = 1.4; 95% CI: 1.1–1.9), and cup fillers (OR = 1.3; 95% CI: 1.1–1.6). P. aeruginosa was detected in 1.3% of samples. Conclusions: One in six DUWL samples exceeded Kuwait’s strict microbial safety threshold. Findings highlight spatial and procedural variations in contamination and underscore the need for enhanced disinfection protocols, preventive maintenance, and targeted staff training to ensure waterline safety.

Background:Oral cancer signifies a public health concern of international importance. Early detection of oral cancer can improve the prognosis and the 5-year survival rate.Objective:The aim of this study was to assess the level of oral cancer knowledge, opinion, attitudes and practices among dentists working at the primary oral health care centers in Kuwait.Methods:In this cross-sectional study, self-reported questionnaire was distributed to the dentists working at the primary oral health care centers in Kuwait. A total of 289 dentists participated in the present study. The questionnaire included 23- questions on oral cancer knowledge, opinion, attitudes and practices.Results:The mean age of the dentists was 35.2 ± 10.9 years. Approximately, all dentists (99.7%) were aware of the major risk factors that were most likely associated with oral cancer. Overall, majority of the participants knew the most common form of oral cancer (80.6%), most common site (80.3%) and the likely lesions associated with oral cancer occurrence (87.9%). A large number of dental practitioners (81%) would routinely refer a patient with a suspicious lesion to a specialist. Nearly one-third (32%) reviewed their patients’ oral cancer risk factors. Approximately two-thirds (62%) assessed the use of tobacco in their practice. Almost, all (92.4%) were interested in attending continuing education courses on oral cancer.Conclusions:Majority of the participants presented good knowledge about various aspects of oral cancer. More continuing education programs on risk factors and diagnosis of oral cancer should be organized to train the dentists. Oral cancer screening should be a routine procedure for the high risk patients at the primary oral health care centers in Kuwait.


 Background Patient safety is critical component of health care quality. We aimed to assess the awareness of primary healthcare staff members about patient safety culture and explore the areas of deficiency and opportunities for improvement concerning this issue.
 Methods: This descriptive cross sectional study surveyed 369 staff members in four primary healthcare centers in Kuwait using self-administered “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 276 participants (response rate = 74.79%).
 Results: Five safety dimensions with lowest positivity (less than 50%) were identified and these are; the non – punitive response to errors, frequency of event reporting, staffing, communication openness, center handoffs and transitions with the following percentages of positivity 24%, 32%, 41%, 45% and 47% respectively. The dimensions of highest positivity were teamwork within the center’s units (82%) and organizational learning (75%).
 Conclusion: Patient safety culture in primary healthcare settings in Kuwait is not as strong as improvements for the provision of safe health care. Well-designed patient safety initiatives are needed to be integrated with organizational policies, particularly the pressing need to address the bioethical component of medical errors and their disclosure, communication openness and emotional issues related to them and investing the bright areas of skillful organizational learning and strong team working attitudes. 

Knowledge, attitude and practice of nurses toward peak expiratory flow meter in primary health care centers in Kuwait

Knowledge, attitude and practice of physicians toward peak expiratory flow meter in primary health care centers in Kuwait

Knowledge, attitude and practice of physicians and nurses toward peak expiratory flow meter in primary health care centers in Kuwait

Background: In 2010, the American Diabetes Association adopted the use of the Glycosylated hemoglobin (A1C) test to diagnose diabetes, with a threshold of ≥6.5%. Objective: The aims of this study was to evaluate physicians’ knowledge regarding A1C as a diagnostic and monitoring test for type 2 diabetes mellitus (T2D) in primary health care (PHC) centers in Kuwait. Methods: This study was a cross-sectional survey that was conducted in Capital PHC centers in Kuwait using a selfadministered questionnaire that was distributed to all currently working physicians in the selected centers. Beside personal characteristics and working conditions, the questionnaire included 10 questions that were related to monitoring value of A1C and 10 questions related to its diagnostic value. Results : The response rate in this survey was 69.9%. The median of the overall knowledge score related to diagnostic value of Hb AC1 was three out of ten while this for monitoring value was 6 out of ten. Higher median knowledge scores of diagnostic value of A1C were significantly encountered among those who had any certificate in diabetes, specialized course or lectures in diabetes, those who were aware of general diabetes management and ADA 2010 guidelines and those who requesting A1C to diagnose new diabetic patients . Conclusions: The results showed that physicians’ knowledge and awareness about A1C as a diagnostic test were much lower than that about its monitoring value of T2D.

Motivators and barriers to mammography screening uptake by female health-care workers in primary health-care centres: a cross-sectional study

Objective: To determine the prevalence of metabolic syndrome among hypertensive patients using the criteria of the National Cholesterol Education Program’s Adult Treatment Panel III in a primary care health center in Kuwait. Subjects and Methods: A population of 250 Kuwaiti hypertensive patients (129 males and 121 females) over the age of 40 were screened for metabolic syndrome by determining body mass index (BMI), waist circumference, levels of fasting plasma glucose and fasting plasma lipids (serum triglycerides, total cholesterol and high-density lipoprotein cholesterol). The study was carried out in the Mishref Family Practice Health Center, Kuwait, from January to July 2001. Results: The total number of patients who met the criteria for metabolic syndrome was 85 (34%), 55% of them were males and 45% females. Prevalence of the syndrome was 28.2% among 40- to 55-year-olds and 41.9% in those above the age of 55 years. Among the 250 hypertensive patients, type II diabetes mellitus was found in 52.8% (54% males and 46% females), impaired fasting glucose in 8% (70% males and 30% females), high plasma triglycerides in 44.8% (53% males and 47% females) and low high-density lipoprotein cholesterol in 63.2% (54% males and 46% females). Obesity measured as BMI = 30 kg/m² was noted in 46% (43% males and 57% females) and increased waist circumference in 58% (44% males and 56% females). Conclusion: The prevalence of metabolic syndrome is high among hypertensives attending primary health care centers in Kuwait.

Objectives: To measure the level of job satisfaction among primary health care physicians Ministry of Health (MOH) Primary Healthcare Center (PHC) physicians, to evaluate the physicians’ mental health, and to assess their associated factors. Study Setting: Kuwait Ministry of Health, Primary Care Centers. Study Design: Cross-sectional study. Data Collection: The study was conducted from July to September, 2017. Of 746 questionnaires distributed to all PHC physicians in the MOH, 417 questionnaires were completed. Information was collected on socio-demographic characteristics, work and health-related factors, job satisfaction (using the Warr-Cook-Wall job satisfaction scale), and mental health (using General Health Questionnaire). Principal Findings: Of participants, 40.8% were male, and 24.9% were Kuwaitis. Median overall job satisfaction was 71.4%. There were significant differences in overall job satisfaction with the physician rank (p = 0.008) and governorate (p = 0.05). The GPs were moderately satisfied with work surroundings; work freedom; recognition; degree of responsibility; salary; opportunity to use abilities; attention given to suggestions; relationship with hospital physicians, colleagues, and fellow workers; relations between management and workers; working hours; and the amount of variety in their job, but more satisfied with their immediate supervisors. Conclusions: Job satisfaction of PHC physicians is critical for the improvement of health systems. This study showed that GPs (General Practitioners) were more satisfied overall than previously reported studies done in Kuwait. They were moderately satisfied with their salary and the amount of variety in work.

Diabetes Mellitus is one of the major public health challenges, affecting more than 347 million adults worldwide. The impact of diabetes necessitates assessing the quality of care received by people with diabetes, especially in countries with a significant diabetes burden such as Kuwait. This paper aimed at piloting an approach for measuring Type II diabetes care performance through the use of a diabetes quality indicator set (DQIS) in primary health care. The DQIS for Kuwait was adapted from that developed by the National Diabetes Quality Improvement Alliance and the International Diabetes Federation. Five key care domains/measures were employed: (1) Blood glucose level measurement, (2) Cholesterol level measurement, (3) Blood pressure measurement, (4) Kidney function testing and (5) Smoking status check. The sample included the four major primary health care centers with the highest case load in Kuwait City, 4,241 patients in 2012 and 3,211 in 2010. Findings revealed the applicability and utility of employing performance indicators for diabetes care in Kuwait. Furthermore, findings revealed that many of the primary health care centers have achieved noteworthy improvement in diabetes care between 2010 and 2012, with the exception of smoking status check. The DQIS can help policymakers identify performance gaps and investigate key system roadblocks related to diabetes care in Kuwait.

Background Breast cancer affects women's lives worldwide, yet early detection is an effective strategy for reducing mortality. The participation of women in mammography screening is linked to their knowledge, attitudes and perceived barriers. Objectives Our study aims to assess mammography screening uptake and barriers among women attending primary healthcare centres (PHCs) in northern Palestine. Methods Using an interviewer administered questionnaire, we used a cross-sectional study design to determine mammography screening uptake, knowledge and barriers among 357 women attending PHCs in Northern Palestine between December 2018 and March 2019. Results The mean age was 50 years. The majority (69.2%) were considered to have adequate knowledge about breast cancer and mammography screening. Mammography screening uptake among the participants was 37%. Almost 85% of the women had a positive attitude towards breastfeeding as a prophylaxis factor against breast cancer, while the most frequent barrier to mammography screening was that the participants believed they did not have any symptoms (28.6%), followed by 22.1% of them who did not want to know if they had breast cancer. Conclusion The findings of this study highlighted the low mammography uptake among Palestinian women despite the adequate knowledge of those women and the fully accessible and free screening programme. Hence, interventional strategies should be implemented at several levels to enhance mammogram uptake.