KNOWLEDGE, AWARENESS, AND HEALTHCARE-SEEKING BEHAVIOR TOWARD NECROTIZING FASCIITIS AMONG THE GENERAL POPULATION IN SAUDI ARABIA: A CROSS-SECTIONAL STUDY

Abstract

Background: Necrotizing fasciitis (NF) is a rapidly progressive and life-threatening soft tissue infection in which delayed recognition and treatment significantly worsen clinical outcomes. While public awareness of NF has been explored, the relationship between knowledge and healthcare-seeking behavior remains insufficiently understood.

Objective: To assess levels of knowledge, awareness, and attitudes toward NF and to examine their association with healthcare-seeking behavior, with a particular focus on the risk of delayed care among the general population in Saudi Arabia.

Methods: A cross-sectional, questionnaire-based study was conducted among adults in Saudi Arabia using a convenience sampling approach. The survey instrument was adapted from previously published studies and extended to include items assessing healthcare-seeking behavior and the risk of delayed care. Knowledge scores were categorized into good and poor levels. A proxy indicator for delayed healthcare-seeking behavior was constructed based on responses reflecting perceived urgency and understanding of appropriate management. Descriptive statistics, chi-square tests, and multivariable logistic regression analysis were performed.

Results: A total of 384 participants were included. Overall awareness of NF was moderate; however, detailed knowledge remained limited. Poor knowledge was significantly associated with a higher risk of delayed healthcare-seeking behavior (p < 0.001). Participants with poor knowledge had more than fourfold higher odds of delayed care compared to those with good knowledge (AOR = 4.10, 95% CI: 2.45–6.85).

Conclusion:  Despite moderate awareness, substantial gaps persist in detailed knowledge and behavioral readiness regarding NF. Lower knowledge levels were strongly associated with delayed healthcare-seeking behavior, underscoring the need for targeted educational interventions that promote early recognition and timely healthcare utilization to improve clinical outcomes.