Health Care Centers In Kuwait Research Articles

Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait.

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. 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. 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%). 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.

Assessment of Patient Safety Culture in Primary Health Care Settings 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. 

Oral Cancer Knowledge, Attitudes and Practices among Primary Oral Health Care Dentists in Kuwait

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.

Job Satisfaction and Mental Health among Physicians in 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.

Oral Health Knowledge, Attitudes, and Perceptions of Pregnant Kuwaiti Women: A Qualitative Study.

Good oral hygiene is known to prevent maternal gingivitis, but little is known about Kuwaiti pregnant women's understanding and beliefs about maintaining and improving oral health during pregnancy. This qualitative study investigated perceptions, beliefs, and attitudes about oral health among Kuwaiti pregnant women and explored beliefs about maintaining and improving oral health during pregnancy. In-depth one-to-one interviews were conducted with a purposive sample of 19 Kuwaiti pregnant women across 7 government primary health care centers in Kuwait. A topic guide framed the questions, which explored pregnancy, oral health, oral health and pregnancy, oral health knowledge, and oral health behaviors. All interviews were digitally recorded, transcribed verbatim, and analyzed by thematic analysis. The key themes emerging from the data related to low oral health knowledge, unhelpful cultural beliefs concerning oral health during pregnancy, and lack of awareness about the effect of pregnancy on oral health. Pregnant women lacked motivation to seek dental care even when they considered dental treatment safe during pregnancy. Dentists' purported incorrect beliefs about providing dental treatment to pregnant women and the women's lack of motivation were identified as barriers to accessing oral health care and seeking oral health knowledge. Pregnant women in this study had not received the necessary oral health information to undertake appropriate oral health behaviors. Cultural beliefs and practices about oral health were identified that need to be tackled to improve and maintain positive oral health behaviors during pregnancy. Behavioral interventions must acknowledge the cultural sensitivity around beliefs during pregnancy and, as a first step, focus on correcting oral health knowledge among Kuwaiti pregnant women. Knowledge Transfer Statement: The results of this qualitative study can be used by oral health care workers and researchers to plan and design more targeted dental health education interventions with pregnant women. The information in this study might be helpful to public health decision makers to make more appropriate decisions about implementing dental health education with pregnant women.

Quality of Type II Diabetes Care in Primary Health Care Centers in Kuwait: Employment of a Diabetes Quality Indicator Set (DQIS).

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.

Awareness of HPV and Cervical Cancer Vaccine among PHC Physicians in Kuwait

Background: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women. Objective: The objective of this study was to evaluate primary care physicians’ knowledge regarding cervical cancer occurrence, screening and vaccination as well as HPV. Methods: This study was a cross-sectional survey that was conducted in the Capital primary health care centers in Kuwait. An anonymous self-administered questionnaire was distributed to all currently working physicians in the selected centers.It included data related to personal characteristics as well as physicians’ knowledge regarding cervical cancer epidemiology, risk factors, clinical features, screening and causative agents. Results: The response rate in this study was thus 60.7% with an overall percentage knowledge score of 63.4% ± 8.9% .The mean percentage knowledge score for different domains ranged from 58.5%±15.1 % to 69.2%±17.5%. Conclusion: Physicians’ knowledge regarding cervical cancer was fair. However, certain aspects of knowledge need enhancement.

Knowledge and perception of domestic violence among primary care physicians and nurses: A comparative study

IntroductionDomestic violence (DV) has a deteriorating influence on society by affecting victims, their children, families, and friends, as well as social and financial relationships. Primary care providers, including physicians and nurses, frequently are the first in the community to encounter the battered women. ObjectiveThe aim of this work was to compare the knowledge and perception of primary care physicians and nurses about DV. MethodsThis study was carried out in all primary health care centers in Kuwait. All physicians and nurses who were currently working in these centers during the study period were asked to complete a self-administered close-ended questionnaire that included personal and working conditions information. It included also knowledge about prevalence of DV, and four main aspects relevant to DV, namely deprivation, psychological, physical and sexual domains. A 5-point, Likert-scale was used to assess participant's answers for each item. ResultsThe response rate was 62.8% for physicians and 61.1% for nurses. The study revealed that the overall knowledge score was higher in physicians than nurses. Also, the scores for the individual domains were significantly higher for physicians than nurses except for psychological one. ConclusionOverall, primary care physicians and nurses had poor knowledge and many had negative perception regarding DV. Although physicians are somewhat more knowledgeable about DV, many more educational activities are needed.

Burnout syndrome among physicians working in primary health care centers in Kuwait

ObjectiveThe aim of the study was to reveal extent of burnout problem among primary care physicians and the socio-demographic factors affecting its occurrence. MethodsThe target population included all physicians working in these two health regions in Kuwait. Two hundred physicians working in the primary health care units in the selected regions agreed to participate in the study. A specifically designed questionnaire for this research was derived from Maslach Burnout Inventory (BMI). It included four domains, namely emotional exhaustion, depersonalization, personal accomplishment, and involvement. In addition, socio-demographic and work characteristics of physicians were studied and their association with burnout domains was illustrated. ResultsMore than half the sample was females (56%), in the age group 30–49 (56.5%) and of non-Kuwait nationality (51%). Emotional exhaustion and depersonalization had lower percentage scores than the positive ones namely, personal accomplishment, and involvement. Physicians had a mean percent score of 37.1+29.0% on the emotional exhaustion domain, 21.0+22.9% on the depersonalization domain, 63.2+26.3% on the personal accomplishment domain, and 46.2+29.9% on the involvement domain. The four domains of MBI were associated only with some of the studied socio-demographic and job characteristics of the studied physicians. Nationality, place of work, job and income had a significant association with emotional exhaustion, depersonalization, and personal accomplishment domains. ConclusionBurnout syndrome is relatively common among Kuwaiti physicians working at the primary care level. The syndrome is more common among non-Kuwaiti physicians, general practitioners, and those with lower income. There is a need for training the physicians about how to cope with stress at work.

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

BackgroundPeak expiratory flow meter (PEFM) is an easy to use, relatively cheap device that can be used for guiding management of bronchial asthma by the patients at home according to a preset plan by health care workers. ObjectiveThe aim of the study is to reveal the extent of knowledge and perception of nurses about PEFM and factors affecting their knowledge. MethodsOut of the total primary health care centers in Kuwait, 50% were randomly selected. Out of 699 nurses currently working in the selected centers, 516 nurses were interviewed for this study with an overall response rate of 73.8%. ResultsThe results of this study showed that nurses had a relatively low total knowledge score percent of 64.7 ± 7.3%. The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate (39.0 ± 24.1%). The highest percent knowledge score was that of benefits of use and content instructions for teaching patients (78.3 ± 19.5% and 78.1 ± 12.0%, respectively). Sociodemographic factors did not affect the total knowledge score. Receiving training, availability of PRFM in the health center and being responsible about taking the measurements for patients proved to significantly affect the level of knowledge of nurses. ConclusionTraining nurses about use of PEFM and providing primary health care centers with the devices would plan an important role to improve knowledge of nurses and hence improve domestic health care of patients with obstructive lung diseases.

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

BackgroundPeak expiratory flow meter (PEFM) may reduce diagnostic delay and improve decision-making in asthma by providing an objective assessment of their flow. Knowledge of nurses and physicians in primary health care can play an essential role to enhance the response of patients about the measurements of peak expiratory flow (PEF). ObjectiveThe aim of the study was to reveal the extent and pattern of knowledge and perception of physicians and nurses about PEFM. MethodsOut of the total primary health care centers in Kuwait; only 50% were randomly selected. A total of 895 physicians and nurses were interviewed out of 1324 individuals currently working in the selected centers for this study with an overall response rate of 74.4%. The questionnaire contained a knowledge section consisted of seven domains with a total of 41 questions. ResultsThe results of this study showed that physicians had a relatively higher total knowledge score percent than nurses (66.2 ± 10.5% compared with 64.7 ± 7.3%, P = 0.004). Physicians tended to have higher knowledge score for steps of use, defining normal values, and concepts of measurements domains of knowledge, while nurses had significantly higher score values for benefits of use, indicators of use, general concepts, and instructions for learning patients’ knowledge domains of PEFM. ConclusionDue to different patterns of knowledge and practice of nurses and physicians, training programs should be specifically tailored for each group to bridge the gap of knowledge and improve deficient practices.

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

BackgroundPeak expiratory flow meter (PEFM) may reduce diagnostic delay and improve decision-making in asthma by providing an objective assessment of their flow and hence identify air flow variability that is essential for management of air way diseases. ObjectivesThis study was designed to reveal extent of knowledge and perception of physicians about peak expiratory flow meter and factors affecting their knowledge. MethodsOut of the total primary health care centers in Kuwait; only 50% were randomly selected. Out of 625 physicians working in the selected centers, 469 physicians were interviewed with an overall response rate of 75.0%. ResultsThe results of this study showed that physicians had a relatively low total knowledge score percent of 66.2±10.5%. The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate (49.9±29.3%). The highest percent knowledge score was that of instructions for learning of patients about PEF (76.2±11.7%). Socio-demographic factors, receiving training, availability of PEF in the health center and being responsible about taking the measurements for patients showed inconsistent impact on the level of knowledge of physicians. ConclusionsFurther training of physicians about use of PEF and providing primary health care centers with PEF would play an important role to improve knowledge of physicians and hence improve domestic health care of patients with airway diseases.

Knowledge of primary care nurses regarding domestic violence

IntroductionDomestic violence (DV) against women has been identified as a serious public health problem. Primary care nurses usually play an important role in managing battered women. They must be equipped with the necessary knowledge, training and experience. ObjectiveThe aim of this work was to study the knowledge and perception of primary care nurses about DV. MethodsThis study was carried out in all primary health care centers in Kuwait. All nurses who were currently working in these centers during the study period were asked to complete a self-administered close-ended questionnaire that included personal and working conditions information. It included also knowledge about prevalence of DV, and four main aspects relevant to DV, namely deprivation, psychological, physical and sexual domains. A 5-point, Likert-scale was used to assess participant's answers for each item. For each participant, the scores were summed and categorized into high and low considering the median as the cutoff level. ResultsOut of 1617 nurses currently working in primary care, 988 returned the filled questionnaire with a response rate of 61.1%. The study revealed that nurses’ knowledge about the prevalence of DV were poor. A large group of nurses had negative perception to DV particularly regarding deprivation aspect. Nearly all nurses agreed about statements of physical and sexual domains. Psychological items scores came in between deprivation in one side and physical and sexual aspects in the other side. After adjustment for confounding, only female gender remained as a significant factor associated with high knowledge and perception scores. About a third of the participating nurses received their knowledge and instructions about DV from scientific formal sources as medical schools, training courses and conferences. The majority of them indicated that they were willing to receive training or guidelines instructions in the different topics for management of DV in the future. ConclusionOverall, primary care nurses had poor knowledge regarding DV. Although female nurses are somewhat more knowledgeable about DV, many more educational activities are needed.

Evaluation of drug use practices at primary healthcare centers of Kuwait

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.

Prevalence And Factors Associated With Diabetic Retinopathy, A Multi-Centric Study In Kuwait

Background: Diabetic retinopathy (DR) remains one of the major causes of vision loss and blindness in young adults despite the availability of effective treatment. Objective: To determine the prevalence of DR among adult diabetic patients attending primary health care centers in Kuwait and to identify factors that could be associated with DR. Methods: The current study is a part of a larger multi-centric one. The first phase of the study is a cross sectional one to determine the prevalence of DR among diabetic patients attending the selected primary health care centers. The second one was a nested case-control study, whereas all patients with DR (case group n = 216) were compared with all other diabetic patients without DR (control group n = 488) to determine the associated factors with cases. A pre-designed questionnaire included socio-demographic, clinical data, in addition to health care characteristics and personal practice. Basic univariate analyses were followed by multiple logistic regression analysis. Results: The prevalence of DR among adult diabetic patients attending primary health care centers was 43.6%. Of the personal factors examined, age was the only significant determinant of DR (OR = 2.2, 95% CI: 1.1 – 5.2) and (OR = 4.6, 95% CI: 2.0 – 11.0) for age groups 50 – 59 and > 60 as compared with those 20 years as compared with Keywords: Diabetic retinopathy - prevalence - associated factors

Factors Associated With Progression Of Diabetic Retinopathy, A Multi-Centric Study In Kuwait

Background: Diabetic retinopathy (DR) is a progressive sight threatening diabetic complication. The prognosis seems to be related to largely modifiable risk factors. Objectives: The aim of the study was to identify factors that could be associated with progression of DR. among adult diabetic patients attending primary health care centers in Kuwait. Methods: The current study is a part of a larger multi-centric one that included 704 diabetic patients. A nested case-control study was used whereas all patients with proliferative diabetic retinopathy (PDR) (case group, n = 33) were compared with all other diabetic patients with non-proliferative diabetic retinopathy (NPDR) (control group, n = 183) to determine the associated factors with cases. A pre-designed questionnaire included socio-demographic, clinical data, laboratory investigations, in addition to health care characteristics and personal practice. Basically univariate analyses were followed by multiple logistic regression analysis. Results: Out of 704 diabetic patients participated in the study 216 were diagnosed as having DR with an overall 30.7% prevalence rate. Among 216 patients with DR, 33 were diagnosed as PDR (4.7%) and 183 were diagnosed as NPDR (26.0%). Of the personal factors examined, nationality was the only significant determinant of PDR (OR = 0.8, 95% CI: 0.71 – 0.9). Among clinical factors, patients with type 2 – insulin treated diabetes were more prone to have PDR as compared to type 1 (OR = 1.2, 95% CI: 1.1 – 1.4). Duration of diabetes > 20 years was a significant predictor of PDR (OR = 1.3, 95% CI: 1.1 – 1.5). Also, poor hyperglycemia and hypertension were significantly modifiable risk factors (OR = 1.2, 95% CI: 1.1 – 1.3) and (OR = 1.2, 95% CI: 1.1 – 1.4) respectively. Ex-smoking was significantly associated with PDR (OR = 8.3, 95% CI: 3.3 – 23.8). Conclusion: Hyperglycemia and hypertension are the strongest modifiable risk factor for PDR. Patients with longer duration of diabetes particularly those with type 2-insulin treated diabetes were more prone for PDR and should be regularly screened for DR. Keywords: Diabetic retinopathy - progression - associated factors

Knowledge of Primary Care Physicians Regarding Domestic Violence.

Introduction: Domestic violence (DV) is considered as one of the most frequent forms of gender-based violence. Since primary care physicians frequently are the first in the community to encounter the battered woman, they must be equipped with the necessary knowledge, training and experience. Objective: The aim of this work was to study the knowledge and perception of primary care physicians about DV. Methods: This study was carried out in all primary health care centers in Kuwait. All physicians who were currently working in these centers during the study period were asked to complete a self-administered close-ended questionnaire that included personal and working conditions information. It included also Knowledge about prevalence of DV, and 4 main aspects relevant to DV, namely deprivation, psychological, physical and sexual domains. A 5-point, Likert-scale was used to assess participant’s answers for each item. For each participant, the scores were summed and categorized into high and low considering the median as the cutoff level. Results: Out of 900 physicians currently working in primary care, 565 returned the filled questionnaire with a response rate of 62.8%. The study revealed that physicians’ knowledge about the prevalence of DV were poor. A large group of physicians had negative perception to DV particularly regarding deprivation aspect. Nearly all physicians agreed about statements of physical and sexual domains. Psychological items scores came in between deprivation in one side and physical and sexual aspects in the other side. After adjustment for confounding, only female gender and family physicians (FPs)/specialists remained as significant factors associated high knowledge and perception score. Less than a third of the participating physicians received their knowledge and instructions about DV from scientific formal sources as medical schools, training courses and conferences. The majority of them (>80%) indicated that they were willing to receive training or guidelines instructions in the different topics for management of DV in the future. Conclusion: Overall, primary care physicians had poor knowledge regarding DV. Although female doctors and FPs are somewhat more knowledgeable about DV, many more educational activities are needed.

Prevalence And Factors Associated With Chronic Diabetic Complications Among Patients Attending Primary Health Care, A Multi-Centric Study In Kuwait

Background: A substantial proportion of patients with diabetes develop long-term macrovascular and microvascular complications. Many risk factors have identified for development and progression of these complications. Objectives: The aim of the present study was to determine the prevalence of these complications among adult diabetic patients attending primary health care centers in Kuwait and to identify factors that could be associated with especially those factors that can be considered avoidable. Methods: This study was carried out in five primary health care centers representing the five health regions in Kuwait. The sample included 704 adult diabetic patients who had been diabetic for at least 2 years. The first phase of study was a cross sectional study to determine the prevalence of chronic diabetic complications. The second one was a case-control study, whereas all patients with chronic diabetic complications (case group, n = 434) were compared to diabetic patients free from chronic complications (control group, n = 270) to determine the associated factors with cases. Analysis was initially carried out based on a series of univariate comparisons followed by multiple logistic regression analysis. Results: Out of 704 diabetic patients 61.6% n= had one or more chronic diabetic complications. Cardiovascular complications were diagnosed in 30.3%, nephropathy in 12.4%, neuropathy in 32.1%, lower limb complications in 21.9%, and retinopathy in 30.7% of patients. Logistic regression analysis revealed that age, nationality, type and duration of diabetes, glycemic control, hypertension, obesity, physical exercises, and compliance with diet recommendations were proved as significant predictors of these complications. Conclusion: The high economic burden raised by diabetes and its complications challenges the Kuwaiti health care system to prevent the development and progression of diabetic complications. The study identified a group of predictor factors as hypertension and hyperglycemia, enhancement of patient’ compliance with regular follow-up visit, the role of health care providers in supplying patients with health information groups of patients who needed priorities of screening programs for development of complication. Keywords: chronic diabetic complications - prevalence - associated factors

Prevalence of Metabolic Syndrome among Hypertensive Patients Attending a Primary Care Clinic in Kuwait

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.