Physicians’ knowledge, attitudes and practices on nuclear medicine in Cameroon: implications for medical education and health system planning in low- and middle-income countries

Abstract

INTRODUCTION: Nuclear medicine has become a cornerstone of modern healthcare. Nuclear medicine services in Cameroon ceased in 2019, leaving critical diagnostic and treatment gaps. This study assessed physicians' knowledge, attitudes, and practices (KAP) toward nuclear medicine to guide service restoration. METHODS: We conducted a web-based cross-sectional survey of 230 Cameroonian physicians from October 1 to December 30, 2022. A structured, pretested questionnaire explored awareness, knowledge, perceptions, and practices related to nuclear medicine. Data were analysed descriptively. RESULTS: The survey included 51 (22.2%) general practitioners, 80 (34.8%) residents, and 99 (43.0%) specialists. Most respondents had less than 10 years of professional experience (205; 89.1%) and were based in the Centre (104; 45.2%) or Littoral (57; 24.8%) regions. General medicine (65; 28.3%) and internal medicine (38; 16.5%) were the most represented specialties. Among respondents, 219/230 (95.2%) had heard of nuclear medicine, mainly through medical education (70/219; 32.0%). Practical exposure was limited, with 37/230 (16.1%) having visited a nuclear medicine unit, 57/230 (24.8%) having seen a nuclear medicine report, and 61/230 (26.5%) having recommended an examination. Misconceptions were frequent, with 126/230 (54.8%) considering nuclear medicine a branch of radiotherapy-oncology, 166/230 (72.2%) misidentifying equipment, and 61/230 (26.5%) believing it could be substituted by other modalities. Regarding perceptions of risk, 102/230 (44.4%) considered nuclear medicine risk-free, 76/230 (33.0%) perceived it as risky, and 52/230 (22.6%) were uncertain. Almost all respondents (228/230; 99.1%) supported re-establishing nuclear medicine services in Cameroon, 221/230 (96.1%) endorsed its inclusion in medical curricula, and 189/230 (82.2%) believed it would reduce costly medical referrals abroad. CONCLUSION: There is limited knowledge and practice of nuclear medicine among Cameroonian physicians, representing the primary barrier to nuclear medicine integration. Targeted and strengthening medical education, investing in infrastructure, and promoting research are essential to support the integration and scale-up of nuclear medicine services in the country and comparable settings.