Are Mid-Level Health Providers Prepared for Diabetic Peripheral Neuropathy Screening? - A cross-sectional study from South India.

Background: Diabetic Peripheral Neuropathy is a common yet often underdiagnosed complication of diabetes. This study aimed to evaluate the knowledge, perception and practice of regarding Diabetic Peripheral Neuropathy in the South Indian state of Karnataka. Methods: This cross-sectional study was conducted among 260 Community Health Officers (CHO) employed in Ayushman Arogya Mandirs of the district. Data were collected using a structured questionnaire that covered details of CHOs, training of DPN, knowledge, practice, and perceptions of DPN and its screening, as well as barriers encountered during screening of the condition. Results: Among the 260 participants, 77.3% and 22.6% were females and males. The mean age of the participants was 30.9 years. We found that 66.5% of the participants had moderate knowledge regarding DPN. The majority (76.1%) of participants did not have equipment to screen for neuropathy. Though all of them received training on NCD, 11.5% received training on DPN. Overall, 82% of the participants, of whom 23.5% strongly agreed and 58.5% agreed that they were confident in their ability to screen for DPN. Around 43.5% responded that they currently screen for DPN. Lack of screening equipment was one of the main barriers to the screening of DPN. Conclusion: The study showed a moderate level of knowledge regarding DPN. Nearly half of the participants never screened for DPN routinely, which is driven largely by insufficient in-service training and a critical shortage of screening equipment. Integrating structured DPN training into their education curriculum and ensuring the availability of equipment at the centres represent high-priority policy interventions to reduce the burden of preventable diabetic complications.