Renal stones, commonly referred to as kidney stones, are solid concretions or crystal aggregations formed in the kidneys from dietary minerals in the urine. They are a prevalent urological disorder affecting millions worldwide, leading to significant morbidity and healthcare costs. The condition can cause severe pain, hematuria, recurrent urinary tract infections, and in some cases, renal impairment. Factors such as dehydration, dietary habits, genetic predisposition, and certain medical conditions like hyperparathyroidism and obesity contribute to the development of renal stones.^1-4

The prevalence of renal stones is on the rise globally, with variations across different regions due to climatic, dietary, and lifestyle differences. In India, the incidence of renal stones is notably high, influenced by the hot climate, low fluid intake, and dietary patterns rich in oxalate and calcium. Despite the increasing incidence, public awareness and knowledge about renal stones remain inadequate, particularly in rural and semi-urban areas. This lack of awareness often leads to delayed diagnosis and treatment, exacerbating the condition and increasing the risk of complications.^5-9

District Bilaspur in Himachal Pradesh, like many other rural regions in India, faces significant challenges in healthcare access and education. Limited access to healthcare resources, traditional beliefs, and low levels of health literacy can hinder the timely recognition and management of renal stones. Understanding the level of awareness and knowledge about renal stones among the general public in Bilaspur is crucial for designing effective educational interventions that can improve health outcomes.

Research focusing on rural Indian settings is sparse, particularly concerning the public's understanding of renal stones. This study aims to address this gap by evaluating the awareness and knowledge levels of renal stones among the general population in Bilaspur. Identifying areas of misconception and knowledge deficits will enable the development of targeted public health strategies and educational initiatives to enhance community understanding of renal stones.

By providing an in-depth analysis of the current awareness levels, this study seeks to inform and guide future educational interventions aimed at early diagnosis and effective management of renal stones. This approach is essential to reducing the health burden associated with this condition and improving overall community health outcomes in Bilaspur. Through this research, we aim to contribute valuable insights into public health education and emphasize the need for focused awareness campaigns in areas with limited healthcare access.

Objectives of the Study:

The primary objective is to gauge awareness and knowledge about Renal Stones among general public of District Bilaspur ,Himachal Pradesh. 

• Research Approach -Descriptive

• Research Design-  Cross-sectional survey design

• Study area: District Bilaspur , Himachal Pradesh

• 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 Bilaspur Himachal Pradesh 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 Renal Stones , 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 Renal Stones 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 Renal Stones. 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 Bilaspur Himachal Pradesh 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 was maintained. 

The study assessed the socio-demographic characteristics and the awareness and knowledge of renal stones among the general public in District Bilaspur, Himachal Pradesh. A total of 400 participants were surveyed, providing a comprehensive view of the population's understanding of renal stones.

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

Table 2: Knowledge Regarding Symptoms of Renal Stones (N=400)

Table 3: Knowledge Regarding Causes and Risk Factors of Renal Stones (N=400)

Table 4: Knowledge Regarding Prevention of Renal Stones (N=400)

Table 5: Knowledge Regarding Treatment and Management of Renal Stones (N=400)

Table 6: Overall Knowledge Score Categories for Renal Stones (N=400)

The present study aimed to assess the awareness and knowledge of renal stones among the general public in District Bilaspur, Himachal Pradesh. The findings provide a comprehensive understanding of the current knowledge levels and highlight significant gaps that need to be addressed through targeted educational interventions.

The socio-demographic data collected from the 400 participants revealed a diverse and balanced sample. The age distribution was well-spread, with participants ranging from 18 to over 50 years. Notably, 31.5% of the participants were aged 18-30 years, 24.3% were aged 31-40 years, 22.3% were aged 41-50 years, and 23.0% were over 50 years old. The nearly equal gender distribution (49.3% male and 50.7% female) ensures a comprehensive understanding of renal stone awareness across both genders. Most participants were married (57.8%), reflecting the local demographic composition, and the majority practiced Hinduism (79.6%). Employment and educational status varied significantly, with 44.8% employed and 35.8% holding a graduate degree, ensuring the findings represent a wide spectrum of socio-economic backgrounds.

Awareness of renal stone symptoms among the participants was relatively high. As shown in Table 2, 77.3% had heard of renal stones, and 73.0% knew that renal stones can cause severe pain. Additionally, 68.5% of participants were aware that renal stones can cause blood in urine, 64.8% recognized frequent urination as a symptom, and 59.8% knew that renal stones can cause nausea and vomiting. These findings indicate that basic awareness of renal stone symptoms is relatively good among the general public. However, there is still room for improvement, particularly in recognizing all symptoms consistently.

Table 3 highlights the participants' understanding of the causes and risk factors of renal stones. While 70.3% knew that dehydration can cause renal stones, awareness of other risk factors was moderate. For instance, 67.8% were aware that a high oxalate diet can increase the risk, 65.3% knew about the impact of a family history, 62.3% recognized the role of obesity, and 60.8% were aware that certain medications can increase the risk. These findings underscore the need for increased education on the various risk factors associated with renal stones, as a comprehensive understanding of these factors is crucial for effective prevention and management.

The knowledge of renal stone prevention, as shown in Table 4, was moderate. Awareness that drinking plenty of fluids can prevent renal stones was 57.8%, and 55.8% knew that a balanced diet can help in prevention. Additionally, 52.8% were aware that regular exercise can prevent renal stones, 49.8% knew about the importance of avoiding high oxalate foods, and 47.8% recognized that reducing salt intake can help prevent the condition. These findings indicate a need for improved public education on lifestyle modifications that can prevent renal stones.

Table 5 details the knowledge about the treatment and management of renal stones. Awareness of over-the-counter pain relievers for managing symptoms was 44.8%, and 43.3% knew that medical procedures can treat severe renal stones. Additionally, 40.3% were aware that drinking water helps pass small stones, 38.3% knew about medications that can help dissolve stones, and 34.8% were aware that surgical intervention might be necessary for severe cases. These findings suggest that while there is some awareness of treatment options, comprehensive knowledge about all available treatments is insufficient.

The overall knowledge scores, categorized in Table 6, reveal significant variability in the participants' understanding of renal stones. While 22.8% demonstrated very good knowledge (scores between 16-20) and 28.3% had good knowledge (scores between 12-15), a considerable portion (29.8%) had fair knowledge (scores between 8-11), and 19.3% had poor knowledge (scores below 8). These results highlight the disparities in knowledge levels within the community and indicate that a substantial number of individuals lack essential information about renal stones.

The findings of this study align with previous research indicating a general lack of awareness and knowledge about renal stones in rural and semi-urban areas. Similar studies conducted in different regions have also highlighted the gaps in understanding the causes, symptoms, prevention, and treatment of renal stones, underscoring the need for widespread public health education.^10-12

The study underscores the critical need for targeted educational interventions to improve public awareness and knowledge of renal stones in Bilaspur. Public health campaigns should focus on increasing awareness about the symptoms, causes, risk factors, preventive measures, and treatment options for renal stones. Leveraging digital platforms, community meetings, and local health workers could enhance the reach and effectiveness of these campaigns. Educational programs should emphasize the importance of early diagnosis and treatment, the role of lifestyle changes in managing renal stones, and the potential complications of untreated renal stones

In conclusion, the study provides valuable insights into the awareness and knowledge of renal stones among the general public in Bilaspur, Himachal Pradesh. Despite a relatively high level of basic awareness, there is a critical need for comprehensive education on the condition's various aspects. The variability in knowledge levels underscores the importance of targeted educational interventions to improve public health literacy. By addressing these gaps through well-designed public health campaigns and educational programs, it is possible to promote early diagnosis, effective management, and prevention of renal stones, ultimately enhancing health outcomes and quality of life for the affected individuals in the community. The study lays the groundwork for future interventions and highlights the necessity of continuous public health education in rural and semi-urban areas to ensure better health awareness and management of common conditions like renal stones.

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5. Johns Hopkins Medicine. Kidney stones. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/kidney-stones

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