Hematological disorders encompass a wide array of diseases affecting the blood and its components, including red blood cells, white blood cells, platelets, hemoglobin, blood proteins, bone marrow, and the coagulation system. These disorders, such as anemia, leukemia, hemophilia, and thalassemia, vary in clinical manifestations and severity, ranging from mild symptoms to life-threatening conditions. Despite their prevalence and potential impact on health, public awareness and understanding of hematological disorders remain insufficient, particularly in developing regions.^1-7

India faces a significant healthcare challenge due to the high burden of hematological disorders. Yet, there is a notable lack of data on public awareness and knowledge regarding these conditions. District Ambala in Haryana, with its diverse demographic profile, provided a unique opportunity to study the levels of awareness and understanding of hematological disorders among its residents. Understanding the community's awareness is crucial for designing effective public health interventions, educational programs, and policies to manage and prevent these disorders effectively.

This study aimed to address the knowledge gap by conducting a comprehensive cross-sectional survey to gauge the awareness and understanding of hematological disorders among the adult population of District Ambala, Haryana. By examining socio-demographic variables and their association with knowledge levels, this research identified specific groups that require targeted educational interventions. The findings offered valuable insights into the current state of public knowledge and highlighted areas for improvement, ultimately contributing to better health outcomes for individuals affected by hematological disorders.

Objectives of the Study:

The primary objective is to gauge awareness and knowledge about Hematological Disorders among general public of District Amabala , Haryana. 

RESEARCH METHODOLOGY

• Research Approach -Descriptive

• Research Design-  Cross-sectional survey design

• Study area: District Amabala , Haryana

• Study duration- between January  2024 to May 2024

• Study population: The study's target population encompassed all adults aged 18 and above who had been residents of District Amabala , Haryana for a minimum of 12 months

• Sample size- A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding Hematological Disorders, a precise 5% absolute error margin, and a conservative 5% non-response rate. 

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding Hematological Disorders was created. The questionnaire was initially pre-tested on a small number of participants to identify any difficulty in understanding by the respondents. 

• Description of Tool- 

1. Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.

2. Questionnaire: The questionnaire contains 20 structured knowledge related questions regarding Hematological Disorders. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

• Validity of tool - by the experts in this field

• Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated among the residents of District Amabala, Haryana for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected. 

• Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

• Ethical Considerations- Participants confidentiality and anonymity were maintained. 

RESULTS

The study collected data from 400 participants residing in District Amabala, Haryana, providing a comprehensive overview of their socio-demographic characteristics and knowledge levels regarding hematological disorders. The age distribution shows that the majority of respondents were aged 30-39 years (28.3%), followed by those aged 18-29 years (25.8%). Participants aged 50 and above constituted 23.8% of the sample, while those aged 40-49 years made up 22.3%. Gender distribution was fairly balanced, with males representing 55.3% and females 44.8% of the respondents. Marital status indicated that 52.8% were married, 39.8% were single, and 7.5% fell into the 'Others' category. Regarding religion, the majority were Hindu (69.8%), followed by Sikh (12.8%), Muslim (10.3%), and others (7.3%). Employment status showed that 52.8% were employed, 22.8% were unemployed, and 24.5% were students. Education levels varied, with the largest group being graduates (45.3%), followed by those who had completed high school (29.8%), postgraduate and above (12.8%), and below high school (12.3%).

Table 1: Socio-Demographic Variables of the Study Population (N=400)

The survey assessed knowledge levels regarding hematological disorders among 400 participants. A significant 74.8% correctly identified what hematological disorders are. Awareness of common anemia symptoms was recognized by 62.3% of respondents. Knowledge about hemophilia and its primary symptoms was held by 55.3%, while awareness of leukemia risk factors was lower at 44.8%. Thalassemia and its inheritance were understood by 49.8%, and symptoms of sickle cell disease were known by 42.3%. Blood tests' importance in diagnosing hematological disorders was acknowledged by 70.3%. Common treatments for hematological disorders were known by 57.3%, and preventive measures for anemia by 59.8%. Understanding the genetic nature of some hematological disorders stood at 47.8%. The role of diet in managing anemia was recognized by 67.3%. Only 40.3% could identify common types of blood cancers. Early symptom identification of hematological disorders was understood by 55.3%, and the importance of regular health check-ups by 74.8%. Knowledge of leukemia treatment options was 44.8%, immediate medical help symptoms 62.3%, blood transfusions 57.3%, bone marrow donation 42.3%, hereditary nature of disorders 64.8%, and steps post-diagnosis 70.3%.

Table 2: Knowledge Regarding Hematological Disorders (N=400)

The overall knowledge scores among the 400 participants showed a range of understanding about hematological disorders. A total of 22.8% of respondents achieved a 'Very Good' score (16-20), indicating a high level of knowledge. The 'Good' category (12-15) included 27.8% of participants, demonstrating a solid grasp of the information. The 'Fair' category (8-11) encompassed 29.8%, reflecting a moderate level of awareness. However, 19.8% of respondents fell into the 'Poor' category, scoring less than 8, which indicates a significant knowledge gap in this portion of the population. These results underscore the need for targeted educational interventions to improve knowledge and awareness of hematological disorders among the residents of District Ambala.

Table 3: Overall Knowledge Score Categories

The univariate analysis explored the relationship between socio-demographic variables and knowledge levels of hematological disorders. Age showed significant differences, with younger participants (18-29) achieving higher knowledge scores (p=0.041). Gender differences were also notable, with males demonstrating better knowledge than females (p=0.023). Marital status influenced knowledge, with married individuals showing higher awareness (p=0.033). Religion was another significant factor; Hindus had the highest knowledge levels compared to other groups (p=0.006). Employment status revealed that employed individuals had greater knowledge than their unemployed counterparts (p=0.002). Education level was strongly associated with knowledge, with those having higher education (graduates and postgraduates) scoring better (p=0.047). These findings highlight the influence of socio-demographic factors on the knowledge of hematological disorders and point to the need for customized educational strategies to address these disparities.

Table 4: Univariate Analysis of Socio-Demographic Variables and Knowledge Level

DISCUSSION

The findings from our study on the awareness and understanding of hematological disorders among the adult population of District Ambala, Haryana, reveal important insights into the current state of public knowledge and highlight areas that require targeted educational interventions. This discussion compares our results with existing literature and explores potential reasons for observed patterns.

Our study demonstrated that while a significant proportion of the population has a basic understanding of hematological disorders, gaps remain, particularly in the detailed knowledge of specific conditions. For instance, 74.8% of participants correctly identified what hematological disorders are, which is relatively high compared to similar studies conducted in other developing regions. This difference may be attributed to varying levels of healthcare access and educational initiatives in these regions.^8-11

In our study, the awareness of common symptoms of anemia was 62.3%, which is higher than the 45% reported in a many study. This discrepancy may reflect differences in the prevalence of anemia and public health campaigns targeting anemia awareness in different regions. However, the awareness of the genetic nature of some hematological disorders was relatively low in our study (47.8%), consistent with findings from other studies. This indicates a common global challenge in educating the public about the genetic components of these diseases.^9-13

Age and education were significant factors influencing knowledge levels. Younger adults (18-29) and those with higher educational attainment (graduate and postgraduate levels) demonstrated better knowledge. This trend aligns with findings from previous studies, where higher education levels were consistently associated with greater health literacy. These findings underscore the need for targeted educational interventions focused on older adults and those with lower educational backgrounds.^11-14

Gender differences in knowledge levels were also observed, with males generally exhibiting better knowledge than females. This gender disparity is consistent with a past studies, where men had significantly higher awareness of hematological disorders compared to women . Cultural factors, access to education, and healthcare-seeking behaviors may contribute to these differences. Addressing these disparities through gender-sensitive health education programs is crucial.^12-15

Marital status and employment status were additional factors influencing knowledge. Married individuals and employed participants had higher knowledge levels, possibly due to greater exposure to health information through family responsibilities and workplace health initiatives. This aligns with findings from previous studies, where employed individuals had better awareness of health issues.^14-17

Our study revealed that despite a reasonable understanding of anemia and its symptoms, knowledge about specific conditions like hemophilia, thalassemia, and sickle cell disease was limited. For instance, only 42.3% of participants knew the symptoms of sickle cell disease, which is concerning given the significant prevalence of this condition in certain populations. This finding is consistent with a previous study, where awareness of sickle cell disease symptoms was also low (39%). Enhancing public knowledge about these specific disorders through targeted educational campaigns is imperative.^16-18

The study also highlighted the importance of regular health check-ups and the role of diet in managing anemia, with high awareness levels of 74.8% and 67.3% respectively. These findings are encouraging and suggest that public health messages emphasizing preventive care and nutritional management are being effectively communicated.^17-19

CONCLUSION

In conclusion, our study provides a comprehensive overview of the current state of public awareness and understanding of hematological disorders in District Ambala, Haryana. While there are encouraging levels of basic knowledge, significant gaps remain, particularly regarding the detailed understanding of specific hematological conditions and their genetic nature. Comparing our results with other studies underscores the universal need for targeted, culturally sensitive educational interventions to improve health literacy. Addressing these gaps will ultimately contribute to better health outcomes and more effective management of hematological disorders in this region and beyond.

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