Benign Prostatic Hyperplasia (BPH) is a common condition that affects the prostate gland in men, particularly as they age. Characterized by an enlargement of the prostate gland, BPH can lead to significant urinary symptoms, including increased frequency and urgency of urination, nocturia, and difficulty in starting and maintaining a steady stream of urine. While BPH is not cancerous, its symptoms can severely impact the quality of life, causing discomfort and inconvenience to those affected.^1-6

The prevalence of BPH increases with age, with studies showing that approximately 50% of men in their 50s and up to 90% of men over the age of 80 experience some symptoms related to BPH. Despite its high prevalence, public awareness and understanding of BPH remain limited. This lack of awareness can result in delayed diagnosis and treatment, leading to unnecessary suffering and the potential for more severe complications, such as urinary tract infections, bladder stones, and renal dysfunction.^7-9

In rural and semi-urban areas, such as District Bilaspur in Himachal Pradesh, India, the challenge of raising awareness about BPH is even more pronounced. Factors such as limited access to healthcare resources, traditional beliefs, and low levels of health literacy can impede the timely recognition and management of BPH. Understanding the level of awareness and knowledge about BPH among the general public in Bilaspur is crucial for designing effective educational interventions that can improve health outcomes.

Previous studies have highlighted the importance of public health education in managing chronic conditions like BPH. However, there is a paucity of data specifically addressing the awareness and knowledge of BPH in rural Indian settings. This study aims to fill this gap by assessing the awareness and knowledge levels of BPH among the general public in Bilaspur. By identifying gaps in knowledge and misconceptions, this study seeks to inform public health strategies and educational programs tailored to enhance the understanding of BPH. Such initiatives are essential for promoting early diagnosis and treatment, ultimately reducing the burden of BPH on the healthcare system and improving the quality of life for affected individuals.

By providing a detailed analysis of the current state of awareness, this study aims to lay the foundation for future interventions that can mitigate the risks associated with delayed treatment of BPH, ensuring better health outcomes for the community. Through this research, we seek to contribute to the body of knowledge on public health education, emphasizing the need for targeted awareness campaigns in regions with limited access to medical information.

Objectives of the Study:

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

• RESEARCH METHODOLOGY

• 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  Benign Prostatic Hyperplasia, 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 Benign Prostatic Hyperplasia 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 Benign Prostatic Hyperplasia. 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, as well as the awareness and knowledge of Benign Prostatic Hyperplasia (BPH) 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 BPH.

The socio-demographic profile of the study population is summarized in Table 1. The age distribution revealed that 31.0% of the participants were between 18-30 years old, 24.3% were aged 31-40 years, 21.5% fell within the 41-50 year range, and 23.3% were over 50 years old. The gender distribution was nearly equal, with 50.5% male and 49.5% female participants. Regarding marital status, the majority were married (59.0%), followed by single individuals (37.5%) and others (3.5%). In terms of religion, most participants were Hindu (83.0%), followed by Muslims (6.3%), Sikhs (7.5%), and others (3.2%). Employment status showed that nearly half of the participants were employed (49.3%), with the remainder being unemployed (26.0%) or students (24.7%). Educational attainment varied, with 13.2% having education below high school, 26.2% completing high school, 36.0% holding a graduate degree, and 24.5% having postgraduate or higher education. This diverse socio-demographic profile provided a broad perspective on the awareness levels within the community.

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

Table 2 highlights the participants' knowledge regarding the symptoms of BPH. A significant portion of the population had heard of BPH (79.5%) and knew what BPH stands for (71.8%). Additionally, 74.8% of participants could identify frequent urination as a symptom of BPH, 71.0% recognized difficulty in starting urination, and 69.3% were aware that a weak urine stream is a symptom of BPH. These findings suggest a relatively high level of awareness regarding the common symptoms associated with BPH.

Table 2: Knowledge Regarding Symptoms of Benign Prostatic Hyperplasia (N=400)

Table 3 presents the knowledge regarding the causes of BPH. Participants' awareness that BPH is related to aging was fairly high (62.0%). Knowledge about other risk factors was moderate, with 53.8% aware that family history can increase BPH risk, 52.5% knowing that obesity can elevate the risk, 51.3% understanding that lack of physical activity is a risk factor, and 49.5% aware that diabetes can contribute to BPH. These results highlight the need for increased education on the various risk factors associated with BPH.

Table 3: Knowledge Regarding Causes of Benign Prostatic Hyperplasia (N=400)

Table 4 shows the participants' awareness of the complications arising from BPH. Awareness was moderate regarding complications such as urinary tract infections (60.3%), bladder stones (57.5%), and kidney damage (55.8%). However, awareness of the complications of untreated BPH was significantly lower (39.3%), and only 46.3% of participants knew that certain medications can affect BPH symptoms. This indicates a gap in knowledge regarding the potential severity of untreated BPH and the influence of medications on the condition.

Table 4: Knowledge Regarding Complications of Benign Prostatic Hyperplasia (N=400)

Table 5 details the participants' knowledge about the diagnosis and treatment of BPH. Awareness of the PSA (Prostate-Specific Antigen) test was 53.3%, and knowledge of the digital rectal examination (DRE) was 50.3%. Awareness that medications can treat BPH was 48.5%, while knowledge of surgical treatment options was 46.0%. Additionally, 43.0% of participants knew that lifestyle changes could help manage BPH symptoms. These findings suggest a need for improved education on the various diagnostic and treatment options available for BPH.

Table 5: Knowledge Regarding Diagnosis and Treatment of Benign Prostatic Hyperplasia (N=400)

Table 6 categorizes the overall knowledge scores of the participants regarding BPH. A significant portion of the population demonstrated high knowledge levels, with 25.5% falling into the Very Good category (scores between 16-20) and 29.5% in the Good category (scores between 12-15). The Fair category (scores between 8-11) included 26.5% of respondents, while 18.5% had Poor knowledge (scores below 8). These results underscore the variability in knowledge levels within the community and highlight the areas where educational interventions are most needed.

Table 6: Overall Knowledge Score Categories for Benign Prostatic Hyperplasia (N=400)

The present study aimed to assess the awareness and knowledge of Benign Prostatic Hyperplasia (BPH) among the general public in District Bilaspur, Himachal Pradesh. The results provide a detailed understanding of the current levels of knowledge and highlight significant gaps that need to be addressed through targeted educational interventions.

The socio-demographic data collected from the 400 participants reveal a diverse and balanced sample. The age distribution showed a wide range of participants, with 31.0% aged 18-30 years, 24.3% aged 31-40 years, 21.5% aged 41-50 years, and 23.3% over 50 years. This range ensures that the findings are representative of different age groups within the population. The nearly equal gender distribution (50.5% male and 49.5% female) provides a comprehensive understanding of BPH awareness across both genders. The majority of participants were married (59.0%), and the predominant religion was Hinduism (83.0%), reflecting the local demographic composition. Employment and educational status varied, with significant portions being employed (49.3%) and having at least a high school education (63.7%).

The knowledge of BPH symptoms among the participants was relatively high. As shown in Table 2, 79.5% had heard of BPH, and 71.8% knew what BPH stands for. Awareness of specific symptoms was also substantial, with 74.8% identifying frequent urination, 71.0% recognizing difficulty in starting urination, and 69.3% aware of a weak urine stream. These findings indicate that basic awareness of BPH symptoms is relatively good among the general public. However, the data also suggest that there is room for improvement, particularly in recognizing all symptoms consistently.

Table 3 highlights the participants' understanding of the causes of BPH. While 62.0% knew that BPH is related to aging, awareness of other risk factors was moderate. Only 53.8% were aware that a family history can increase BPH risk, 52.5% knew about the impact of obesity, 51.3% recognized the role of physical inactivity, and 49.5% were aware of the contribution of diabetes. These findings underscore the need for increased education on the various risk factors associated with BPH, as a comprehensive understanding of these factors is crucial for effective prevention and management.

The knowledge of BPH complications, as shown in Table 4, was moderate. Awareness that BPH can cause urinary tract infections (60.3%), bladder stones (57.5%), and kidney damage (55.8%) was evident, but knowledge about the complications of untreated BPH was significantly lower (39.3%). Additionally, only 46.3% of participants knew that certain medications can affect BPH symptoms. This gap in understanding the potential severity of untreated BPH and the role of medications highlights the critical need for educational programs that emphasize the importance of early treatment and the potential consequences of neglecting BPH.

Table 5 details the knowledge about the diagnosis and treatment of BPH. Awareness of the PSA test (53.3%) and digital rectal examination (50.3%) was moderate. However, only 48.5% knew that medications can treat BPH, and 46.0% were aware of surgical treatment options. Knowledge of lifestyle changes as a management strategy was even lower (43.0%). These findings suggest that while there is some awareness of diagnostic procedures, the understanding of treatment options and lifestyle management is insufficient. This gap could lead to delayed treatment and poor management of BPH, underscoring the need for comprehensive educational initiatives.

The overall knowledge scores, categorized in Table 6, reveal significant variability in the participants' understanding of BPH. While 25.5% demonstrated very good knowledge (scores between 16-20) and 29.5% had good knowledge (scores between 12-15), a considerable portion (26.5%) had fair knowledge (scores between 8-11), and 18.5% 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 BPH.

The findings of this study underscore the critical need for targeted educational interventions to improve public awareness and knowledge of BPH in Bilaspur. Public health campaigns should focus on increasing awareness about the symptoms, causes, complications, and treatment options for BPH. 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 BPH, and the potential complications of untreated BPH.

In conclusion, this study provides valuable insights into the knowledge and awareness of BPH among the general public in Bilaspur. The results highlight significant gaps in understanding, particularly regarding the causes, complications, and treatment options for BPH. Addressing these gaps through targeted health education initiatives is essential for improving early diagnosis and treatment, thereby enhancing health outcomes and quality of life for individuals affected by BPH. Further research is needed to evaluate the effectiveness of these interventions and to explore innovative methods for disseminating health information in rural and semi-urban areas. By analyzing our findings, it is evident that while basic awareness is relatively high, detailed knowledge about BPH remains insufficient, emphasizing the need for continuous public health education. The insights gained from this study can inform future public health strategies aimed at improving the overall health literacy of the population.

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