Assessment Awareness of Breast Cancer Signs, Risk Factors, and Barriers: An Online Cross‑Sectional Study in Syria

Background: According to the World Health Organization (WHO), breast cancer (BC) is women's most common type of cancer. In LAMICs, breast cancer incidence is low. However, a lack of information about the signs and symptoms of breast cancer potentially results in the disease's progression to life-threatening stages.This study aimed to determine the levels of breast cancer symptom awareness among Syrian women and to identify the variables associated with a high level of awareness.   Methods: From 3 September 2022 to 27 September 2022, Syrian women participated in an online cross-sectional survey to measure their knowledge about breast cancer, risk factors, and symptoms. This survey was derived from previous research that included a comprehensive, authorized scale. The admission requirement was 18-year-old or older Syrian women from all Syrian governorates. The questionnaire was divided into two portions; the first component included sociodemographic characteristics. Based on the original BCAM scale, the second portion assessed the participant's knowledge of breast cancer symptoms, risk factors, and obstacles. Using the IBM SPSS V. 28.0 software, descriptive and multivariate logistic regression analyses were performed on the data.   Results: Among 1305 study participants, the mean age and standard deviation of the individuals were 30.7 and 11.2, respectively. Students constituted almost three-quarters (75.2%) of the study respondents. The average level of knowledge about risk factors was higher among women with chronic diseases (Mean = 4.44, SD = 2.176), whereas jobless people had a higher average level of information regarding obstacles than other subgroups of practical circumstances. In addition, single women scored higher on the barrier comprehension scale than other marital status groups (mean=3.34, SD=2.32). Only two variables, including age and educational level, were statistically significant in predicting an acceptable degree of knowledge of the risk factors for breast cancer. Participants with a PhD were more aware than other educational subgroups (P-value 0.05; OR =6.186). Participants with a PhD. are projected to be 6.18 times more aware of breast cancer risk factors than those with lower levels of education. Women with chronic conditions were 1.84 times more likely than others to be aware of breast cancer barriers.    Conclusion: Our findings indicate that Syrian females have a poor to moderate knowledge of breast cancer symptoms, risk factors, and barriers. It is proposed that more breast cancer awareness campaigns be conducted and that yearly screening programs be improved to combat the late detection of this illness. Social media and television might be effective venues for raising awareness of breast self-examination and early identification of symptoms

Assessment of Syrian Obstetric Care Providers Knowledge, Attitude, and Practice Towards Preconception Care and Associated Factors: An online Cross-Sectional Study

Background: Preconception care was instituted in 2013 by the World Health Organization (WHO) to promote more attention to pregnant women by medical staff. Preconception care attempts to optimize pregnancy outcomes and promote health by managing and treating variables that influence it. Obstetric care providers in LAMICs have been reported to have low levels of preconception care awareness. This study investigates the Knowledge, attitudes, and practice-related features of obstetric care providers in Syria's public health institutions about preconception care.   Methods: A cross-sectional study was undertaken in Syria between 6 September 2022 and 7 October 2022 to evaluate obstetric care providers' Knowledge, attitudes, and practice at public health institutions regarding preconception care and related concerns. The questionnaire was designed using a validated scale from a prior study conducted in Ethiopia. The inclusion criteria for study participants were obstetricians and gynaecologists, midwives and residents, and nurses of Obstetrics and Gynecology. There were six sections in the questionnaire (sociodemographic information, Knowledge, practice attitude, additional factors associated with Preconception practice, and related actual & potential access to resources). The data were subjected to descriptive and multivariate logistic regression analysis using the IBM SPSS V. 28.0 software.   Results: The mean age of 499 participants was 31.8 (SD = 9.7). Most participants were female (81.8%) and physicians (60%). 91.4% of respondents were deemed knowledgeable about preconception care. the most identified question (96.2%) was (Women intending pregnancy should be encouraged to defer pregnancy until they have reduced their drug, alcohol, and cigarette usage). (24.8%) participants regularly queried their patients about their reproductive life plan, with women aged 18 to 49 being the most often questioned group (92.3%). Only 18.6% of physicians routinely informed their patients about environmental dangers and contaminants. In addition, 53.5% of responders inquired about the patient's surgical and medical histories. 29.7% of participants strongly agreed that PCC provides an opportunity to improve the health of couples, particularly women, whereas 18.2% are certain that PCC does not belong to their scope of duties. Knowledge was more likely to be poor among participants who had never seen a doctor practicing PCC than among those who had (OR=2.81, P value = 0.026). Participants who did not get training on reproductive life plan examination throughout their practice time were less knowledgeable than those who did (OR = 2.91, P value= 0.04).    Conclusion: Our results have shown that obstetric care providers in Syria have good Knowledge of and low to moderate practice and attitude towards preconception care. Improving access to training, carrier development, Internet, and library services is vital to improving PCC training. It is recommended that extra platforms be made accessible to obstetric care providers during their training to assist them in becoming preconception carers and in raising awareness about the significance of preconception care

Assessment Knowledge, Attitude, and Practice Toward Tuberculosis Among Syrian People: An online cross-sectional study

Background: TB was reported to have the highest mortality rate among other infectious diseases in 2018 worldwide. Syria and other low-income countries have a higher incidence rate of TB in comparison to high-income countries. Stigma toward TB is extremely high in low-income countries like Syria, and these stigma delays patients from seeking healthcare facilities. Our purpose in this study is to assess the Syrian's knowledge, attitudes, and practices toward TB and understand their Practice related to this disease.    Methods: An online cross-sectional questionnaire was distributed between15 September 7 October 2022, among Syrians to assess their knowledge, attitudes, and practices toward TB. This questionnaire was adapted from a published study, and the inclusion criteria were all male and female Syrian citizens aged 18 or above. The survey was divided into four questions: the first section assessed sociodemographics, and the other sections were about knowledge, attitude, and practices, respectively. Using IBM SPSS V. 28.0, the data were submitted to descriptive and multivariate logistic regression analyses.   Results: About (38.6%) of the 1407 participants in this research were male. The research participants' knowledge scores indicated that 78.1% have excellent knowledge. However, 54.1% of interviewees agreed that shaking someone's hand may transmit tuberculosis. Regarding attitude, more than two-thirds (85.7%) of the participants in the survey had an optimistic outlook. Accordingly, most participants (81.3%) had effective TB preventive and control practices. Participants aged 61 to 70 had more TB knowledge than other age groups (P value<0.05; mean=6.63, SD=1.13). Participants with chronic illness had a more positive attitude toward tuberculosis than those without (P value<0.05) (mean=2.17, SD=0.63). Participants with a university degree demonstrated more TB practice than those with lower levels of education (mean=6.17, SD=0.85). Participants with a university degree were expected to have 4.38 times more TB knowledge than those without formal education (P 0.05). Participants with a university degree were projected to practice tuberculosis 10.63 times more often than those without education (P 0.001).   Conclusion: Our results indicate that there is poor knowledge regarding the route of transmission of TB; therefore, more efforts should be made to raise awareness about TB transmission, as understanding these facts is a crucial aspect in mitigating the incidence of TB. Consequently, individuals reported poor practices toward TB; for that reason, educating individuals about good practices toward TB should take priority in Syria as war has destroyed the understructure of the healthcare system

Knowledge of Cancer Among Syrians: A Cross-Sectional Study

Background:  The worldwide burden of cancer continues to rise, mainly due to global demographic changes and an increase in cancer-causing habits, such as smoking, epically in low-income countries. The Syrian National Cancer Registry (SNCR)estimates that 17,599 new cancer cases were diagnosed before the start of the war in 2011. According to statistics from the Al Bairouni 2020 hospital-based registry, which includes data on more than 60% of Syrian cancer patients, the number of cancer diagnoses has been rising in Syria. There is no research conducted in Syria to determine people’s knowledge about cancer and risk factors, symptoms, and signs. This research aims to determine how well-informed Syrians were on the following topics:(i) the age-related risk and prevalence of cancer; (ii) cancer signs and symptoms; and (iii) cancer risk factors. In addition, determining how well-informed different demographic categories.   Method: This is a cross-sectional study which was conducted in Syria. Participants who were eligible to participate in the study who were residents of Syria irrespective their age or gender. The instrument of survey was a structured questionnaire the content of which was adapted from the validated cancer awareness measure (CAM) the cam was translated to Arabic and a scoring system was applied to the questionnaire. The questionnaire was distributed via several social media platforms.   Results: A total of 1463 participants completed the questionnaire. There were 768 respondents (52.5%) said that there is no relation between age and cancer. Almost all the participants (85.6%) thought that the breast cancer is the most common cancer among women, while around half of the participants (55.1%) reported that the prostate cancer was the most common cancer among males. The most frequently reported cancer symptom was unexplained weight loss (73.2%), followed by unexplained swelling/lump (66.5%). The level of knowledge about cancer signs/symptoms among the participants were good in 623 (42.6%), fair in 594 (40.6%), and poor in 246 (16.8%). The most commonly recognized risks of cancer were smoking (83.5%).   Conclusion: According to this research, taking into consideration the war and the bad economic situation that Syria is facing, Syrians’ knowledge towards cancer is acceptable. However, it is not meeting the ideal expectations. More research should be held to dig deeper into this issue

A Cross-Sectional of Syrians' Knowledge of Diabetes Mellitus and Hypertension Management

Background: Diabetes and hypertension are the two most common types of non-communicable diseases (NCDs) impacting people globally. There is no prior research on the Syrian population's knowledge and treatment of hypertension and diabetes, so it is crucial to assess how the Syrian population acknowledges and perceives these illnesses. This research intends to assess the level of hypertension and diabetes-related awareness, knowledge, attitude, and practices among Syrian individuals.    Methods: A cross-sectional study was conducted between 1 August and 25 August 2022 to assess adult awareness, knowledge, attitude, and behavior about hypertension and diabetes. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were Syrian residents older than 18 who presently live in Syria. On the questionnaire, there were four sections: sociodemographics information, WHO STEPS survey instrument on knowledge of and lifestyle determinants for hypertension and diabetes, respondents' knowledge of and comprehension of hypertension and diabetes, and respondents' awareness of these disorders.   Results: Among 976 participants, (65.8%) were females. Participants reported hypertension caused by (90.1%) stress, (78.2%) old age, (69%) anxiety, and (38.6%) drug usage. High salt consumption (87%), genetics (82.1%), and obesity (78%) are all risk factors for hypertension. In addition, minimizing salt consumption (92.4%), regular exercise (87.2%), and avoiding anxiety (85%) are preventative measures for hypertension. Participant answers to hypertension consequences were (75.8%) foot ulcer and (74%) eyesight loss. Primary and middle school educational status participants had greater hypertension knowledge (92.3%) than other educational levels. Alcohol use was linked to hypertension knowledge (P < 0.05). Participants whose lifestyles did not include alcohol use had a higher hypertension knowledge level (90.3%). Participants with a family history of diabetes have a greater knowledge of hypertension (92%) than those without (66.9%). Almost age groups have shown good knowledge of diabetes, especially participants aged above 55 (93.8%). However, most individuals have examined blood pressure (82.3%), whereas fewer than half had screened for blood sugar (64.4%). 82.2% of individuals check their blood pressure frequently, whereas 6.2% monitor their blood sugar. Men have a higher hypertension knowledge than females (mean=8.39, SD=2.02), P-value< 0.05, and knowledge of hypertension among participants was shown to be higher among those in good income status than other economic levels (mean=8.34, SD=1.98), P-value< 0.05. Participants between the ages of 40 and 55 showed better knowledge of diabetes compared to other age groups (mean=11.32, SD=2.54), P-value< 0.05; as well, men demonstrated greater knowledge of diabetes than females (mean=10.76, SD=2.79), P-value< 0.05.   Conclusion: Our results demonstrated that the Syrian population has a good to moderate understanding of hypertension and diabetes. However, there is still a shortage of standardized, regular screening practices. Since individuals remain involved in unhealthy lifestyle habits, it is vital to provide accurate information about hypertension and diabetes

Knowledge of Colorectal Cancer Among Syrians: A Cross-Sectional Study

  Background: The incidence of colorectal cancer is the second highest among women and the third highest among males. Screening for the disease has resulted in a significant decrease in both the prevalence and death rate of colorectal cancer (CRC) during the last two decades. Research has indicated that people unaware of the dangers of colorectal cancer may not participate in diagnostic procedures, which delays detection and reduces the likelihood of survival. Aim: This cross-sectional research seeks to examine the level of knowledge of CRC risk factors in Syria and the variables correlated with a greater level of awareness. Methods: An online cross-sectional study was conducted from 1 to 25 August 2022 to assess the Syrians' degree of awareness of Colorectal Cancer risk factors in Syria and the characteristics associated with a high level of understanding. The survey is based on another study, and the sample inclusion criteria of study participants were Syrian nationals aged 18 or older from all Syrian governorates. The questionnaire included 35 questions divided into 3 sections, sociodemographic variables such as (age, sex, marital status, educational level, occupation…etc.), evaluation of participant knowledge of colorectal cancer risk factors such as (alcohol consumption, Red meat consumption, lack of fiber in the diet, obesity, and old age), and symptoms such as (blood in stool, abdominal pain, constipation, change in defecation habits, general tiredness, unexplained weight loss). Results: Among 702 Syrian national participants, (n=430, 61.3%) were females, and (n=272, 38.7%) males. Only (n=67, 9.5%) participants have a chronic disease. Most participants have shown good knowledge of colorectal cancer symptoms (n=301, 42.9%), and (n=297, 42.3%) participants have shown moderate knowledge of colorectal cancer symptoms. Only (n=123, 17.6%) participants have shown a good understanding of colorectal cancer risk factors, whereas (n=293, 41.7%) have demonstrated poor knowledge. Educational level was related to greater knowledge of colorectal cancer risk factors (P-value 0.05). No correlation was found between other variables and a good awareness of colorectal cancer symptoms and risk factors (P-value > 0.05). Ph.D. degree of educational level (OR = 15.41, 95% CI: 1.211–196.16; P-value<0.05) was associated with good awareness of colorectal cancer symptoms and Widowers' marital status (OR = 7.351, 95% CI: 1.22–44.285; P-value<0.05) was associated with good awareness of colorectal cancer risk factors. Most participants were somewhat confident in their ability to recognize colorectal cancer symptoms (43.60%), whereas just 4.60 % of people were highly confident in their ability to recognize them. Only (24.10%) The participants were not confident in identifying colorectal cancer symptoms. Conclusion: According to our findings, there is insufficient understanding of the colorectal cancer symptoms and risk factors that contribute to the disease's development in patients and its detection in its late stages. Consequently, there is a greater need to increase colorectal cancer awareness and education programs on the disease's signs and symptoms and its risk factors. It may be possible to minimize the frequency of advanced cases of colorectal cancer by increasing the number of screening programs for colorectal cancer in Syria. &nbsp

Syrian Health Providers' Knowledge of Palliative Care: An Online Cross‑Sectional Study in Syria

Background: Palliative care is a method to alleviate pain and enhance the quality of life for patients suffering from the consequences of a life-threatening illness. The knowledge of palliative care among healthcare professionals is poor; therefore, training programs are needed to offer patients appropriate treatment and improve their health. In Syria, as palliative care programs are rarely applied, we aim to evaluate the knowledge regarding palliative care among healthcare workers.   Methods: This is an online cross-sectional study conducted between July 24 and August 28, 2022 to measure palliative care knowledge and its applications among Syrian healthcare workers. The questionnaire for the study was designed in light of a previous study, and the inclusion criteria were Syrian healthcare workers, including physicians and nurses, as well as medical and nursing students. The four sections of the questionnaire included sociodemographic information in the first part, while the second, third, and fourth parts assessed experience, knowledge, and attitude toward palliative care among healthcare workers, respectively. Data were analyzed in IBM SPSS V. 28.0 using descriptive and multivariate logistic regression analysis.   Results: Among 602 participants, 66.2% of participants were females. Most respondents were medical students (72.9%), while residents and nurses or nursing students represented 18.8% and 8.3%, respectively. The majority of participants (84%) answered the question about pain treatment goals correctly, while a small percentage (5.3%) answered the question about whether or not long-term opioid use is addictive correctly. No significant difference in the overall knowledge score was shown among geographical areas, genders, and different specialties. Regarding the knowledge questions related to palliative care, only 14 participants were considered knowledgeable. The three most responses that received agreement regarding the attitudes towards palliative care were “Pain relievers should be given as needed to terminally ill patients” (89.7%), “Spiritual care must include counseling for the terminally ill patient” (84.3%), “Patients have the right to determine their own degree of psychosocial intervention” (81%).  A significant difference existed between urban and rural residents in terms of the attitude score. When comparing first-year students to those in their fifth year, students in their fifth year were 8.06 times more likely to have a positive attitude.       Conclusions: Our results demonstrated that healthcare professionals have inadequate knowledge about palliative care. There is an urgent need to introduce palliative care to the health system in Syria in order to improve the quality of life of these patients in their terminal stages of illness and to provide care for patients who need it

Knowledge of Cholera Among Syrians: A Cross-Sectional Study

Background: Cholera is a communicable acute bacterial infection caused by a gram-negative bacterium that is Vibrio Cholera. Worldwide, is estimated that an incidence of 1.3–4.0 millions of cholera infection, leading to 21,000–143,000 deaths annually. Prevention of cholera require a proactive approach rather than reactive, as it`s identified to be the best strategy to decrease the cholera spreading risk in given population or community. Recently WHO warned that, the cholera spreading risk in Syria is very high, which linked to drinking of untreated water and food contamination.   Aim: we conducted this study with aiming to assess the level of knowledge, attitude and practice regarding risks of cholera infection, preventive measures and preparedness among community in Syria. Consequently, recommending suitable measures based on study results.   Methods: An online cross-sectional study was conducted in Syria to assess knowledge, attitude, and practice regarding cholera and cholera vaccine among general population in Syria. The inclusion criteria for participation were Syrian nationality aged 18 or more, male or female, from all governorates of Syria, never have cholera previously, and were willing to participate. The questionnaire was consisting of four sections. The first section was about sociodemographic data. The second section evaluated respondents' self-reported knowledge on cholera and divided into two parts (2a: Knowledge on cholera, its prevention and treatment. 2b Knowledge on cholera vaccine). The third section evaluated respondents’ self-reported practice relating to cholera and its vaccine, this section divided into two parts (3a: Practice relating cholera and its treatment/management. 3b: Practice relating cholera vaccine. The fourth section inquired respondents’ attitude toward cholera and cholera vaccine. 52.9% thought that cholera outbreaks happen in summer seasons.   Results: Among 1563 Syrian national participants, (n=982, 62.8%) were females, and (n=581, 37.2%) males. 60.9% of respondents did not recognize the cholera in the first place. Passing watery stool was the most recognized symptom of cholera with 50.3%, severe dehydration with 31.1%, and repeated vomiting with 10.3%. Lack of safe drinking water was recognized as the most common cause for cholera. Most respondents (54.1%) have chosen IV saline as the treatment of choice for cholera. 85.3% of respondents are with providing health care to the infectants in health centers.   Conclusion: According to our findings, there is insufficient understanding of the cholera symptoms and risk factors. The need for better understanding of such common outbreaks is essential to counter them. Consequently, there is a greater need to increase cholera awareness and education programs on the disease's signs and symptoms and its risk factors. &nbsp

Health Care Provider Burnout in Syria During COVID-19 Pandemic's Omicron Wave

Background: Healthcare workers have dealt with a range of psychological problems during the COVID 19 epidemic, including sadness, mental discomfort, anxiety, and poor sleep. Burnout is a state of prolonged work stress-related psychological, emotional, and physical stress brought on by emotional weariness, depersonalization, and decreasing professional success. The goal of this study was to find out how many healthcare workers burned out during the Omicron wave of the COVID-19 pandemic and to find out what factors put them at risk for this psychological effect.   Methods: This cross-sectional research was performed in Syria during the current Omicron wave of COVID-19 pandemic to evaluate the Burnout experienced by Syrian physicians who treat COVID-19 patients. The inclusion criteria were all Syrian healthcare workers who treated COVID-19 patients the current Omicron wave of COVID-19. The data was collected between April 3 and March 20, 2022. We investigated whether the questionnaire used was valid and understandable to the participants.   Results: A total of (729) healthcare providers inquired in our study; however, 30 participants were disqualified because their answers were not fully completed. The overall age of the participants was 31±9, and the ratio of males to females was almost equal. The majority (47.5%) of the sample study's participants are residents, and 72.8% of the participants carried for COVID19 patients. The prevalence of high level of burnout among the sample study was 41.6%. Compared to men (22.3%), women were much more likely (27.9%) to report experiencing a high degree of emotional exhaustion, also the participants who carried for COVID19 patients were much more likely (30.1%%) to report experiencing a high degree of emotional exhaustion compared to others, which individuals who carried for COVID19 patients were 1.76 times more likely than participants who did not carry for COVID19 patients to experience severe burnout (OR:1.766, 95%CI:1.2-2.4, P-value<0.001).   Conclusion: Our research found severe burnout among Syrian health care providers during the omicron wave of COVID19, with clinicians carrying COVID19 patients being considerably more likely to express high burnout than others. For this reason, it is imperative that we collaborate with international humanitarian organizations to provide a suitable psychiatric environment for Syrian physicians and provide practical recommendations to address this important concern

Assessment Syrian Population Knowledge, Attitudes and Perceptions Towards Stroke: A Cross-Sectional Study from Syria

Background: Based on the stroke mortality rate, Syria was ranked 98th worldwide in 2020. Approximately 80% of strokes are avoidable by managing well-known modifiable risk factors, such as diabetes, hypertension, and cardiovascular disease. Due to the high prevalence of several modifiable risk factors for stroke in Syria, it is necessary to increase Syrians' understanding of strokes and encourage people to engage in healthy practices to eradicate these risk factors. This research aimed to evaluate the knowledge, attitudes, and health-related perceptions of adult Syrians about stroke.   Methods: This cross-sectional research was conducted between 2 September and 10 October 2022 among Syrians using an online survey to measure their knowledge, attitudes, and practices regarding stroke. This questionnaire was derived from a previously published article, and the inclusion criteria for this research were all Syrian residents aged 18 or older. The questionnaire utilized for this study consisted of three major sections: socio-demographic data, knowledge of stroke, and attitudes and perceptions about stroke.   RESULTS: 53.3 % of the 1,143 research participants were female. Most respondents (94.3%) recognized the brain as the organ impacted by stroke. Hypertension was the stroke's most identifiable cause and risk factor (72.8% and 73.6%, respectively). 72.8 % of participants recognized hypertension and atherosclerosis as causes of stroke. 94.3 % of survey participants accurately identified the oranges impacted by the stroke; however, only 50.1% properly identified the warning symptoms. 61.4 % of participants utilize the Internet as a source of stroke-related information. 22.3% of individuals aged 21 to 30 had identified at least one stroke warning sign. 12.58% of individuals with a high socioeconomic position have shown a solid understanding of stroke risk factors. Females were projected to be 1.55 times more knowledgeable about stroke warning signs than men (P value<0.05). It was expected that participants who believed that stroke is avoidable would be 2.2 times more knowledgeable about stroke warning signals than those who disagreed (P value<0.05). Participants who identified more than four causes of stroke were expected to have 14.77 times more knowledge of stroke risk factors than those who did not (P value<0.05).   Conclusion: Our research shows that although knowledge of stroke risk factors and symptoms is moderate to good, there is still a lack of perceptions toward this disease. Hopefully, this will encourage hospitals and other medical groups to continue their awareness-raising campaigns about the dangers of this illness. Stroke prevention and community response may be greatly enhanced by raising public consciousness of the condition and fostering individual agency in coping with it