Knowledge of healthcare providers on Down syndrome in children: a cross-sectional study in Rwanda

Abstract

INTRODUCTION: Down syndrome (DS) is a set of birth defects caused by the presence of extra genetic material in the form of chromosome number 21. Clinical studies have indicated that children with DS are frequently at risk of particular issues such as undernutrition or obesity compared to their peers without DS. This study aimed to assess Knowledge among Rwandan professionals´ health caregivers on Down syndrome in children. METHODS: this study was quantitative cross-sectional, utilized simple random sampling, and was conducted on 337 healthcare providers: nurses, midwives, and nutritionists caring for children with DS. The study was conducted on 9 hospitals and 70 health centers in Kigali City province and in the eastern province of Rwanda. The outcome variable of interest was the knowledge score. The outcome variable, knowledge score, was measured from 11 maximum items adapted in a previous study on knowledge of Down syndrome in children. Each reported item was based on binary responses and was scored 1 for yes and 0 for no. We did the score summation of the self-reported 11 knowledge items; the total knowledge score was the sum of responses to the 11 knowledge questions. The knowledge score was grouped into three categories. Participants with scores ranging from 7 to 10 were categorized as having a high knowledge score, indicating that these individuals possessed a significant understanding of the subject. Conversely, participants with scores ranging from 5 to 6.9 are considered to have a moderate knowledge score. Participants with scores from 0 to 5 are deemed to have poor Knowledge. We used descriptive chi-square, and we performed a multivariate logistic regression model to identify predictors of high knowledge. RESULTS: most of our participants had poor to moderate knowledge in DS; the participants with poor knowledge scores less than 50% were 128 (38%), and those with moderate between 50-69% were 131(39%). The mean of knowledge was 57.57. The multivariate logistic analyses revealed that being female was associated with a high knowledge score compared to males, with an AOR of 2.30 (CI: 1.41 - 3.76) with a p-value of 0.002. Being under 30 years old was also associated with a high knowledge score compared to participants 50 years and above, with AOR 3.11 (CI: 1.12 - 8.60) with a p-value of 0.030. Having 2-5 years of experience working in services was associated with a high knowledge score compared to those with one year or less of experience with the AOR, which was 2.55 (CI: 1.10 - 6.20) with a p-value of 0.028. Being a nutritionist was associated with a high knowledge score compared to being a midwife, with an AOR of 0.29 (CI: 0.12 - 0.71) with a p-value of 0.007. Furthermore, working in neonatology service was associated with a higher knowledge score than working in maternity services, with an AOR of 2.00 (CI: 1.41 - 4.76) with a p-value of 0.002.