Understanding Osteomyelitis in Saudi Arabia’s Adult Population: A Nationwide Cross-Sectional Study of Knowledge and Attitudes

Yousef M Alammari,1 Abdullah Alghamdi,1 Abdulwahed A Alotay,1 Abdulrahman Alanazi,1 Mohammad Alhajery,1 Rayan A Qutob,1 Tariq Yousef Alhomoud,2 Osama Thamer Al-Ahmari,3 Ammar Yasser AL Qahtani,3 Muath Alamri,3 Muthana Saleh Alamri,3 Assaf Shabib Alotaibi,3 Faris Al Murdhi,3 Faris Sultan Almohammed,3 Meshal Alzakari31Department of Internal Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia; 2Department of Orthopedic Surgery, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia; 3College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi ArabiaCorrespondence: Meshal Alzakari, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia, Email [email protected]: Osteomyelitis (OM) is a severe bone infection causing progressive destruction. This nationwide cross-sectional study evaluated public knowledge and attitudes regarding OM among Saudi Arabian adults to identify sociodemographic gaps and guide targeted health education.Methods: Saudi residents aged ≥ 18 years completed a validated electronic survey. Knowledge was evaluated using a 7-item score (good awareness defined as ≥ 60% correct). Bivariate testing and multivariable binary logistic regression were conducted using SPSS version 26 (significance set at p ≤ 0.05).Results: Among 1206 respondents (97.0% Saudi; 58.7% bachelor’s degree), overall awareness was low, with only 38.4% demonstrating good knowledge. Key misconceptions included misclassifying OM as autoimmune (25.3%) or contagious via blood transfusion (26.0%). Multivariable regression revealed that younger age (18– 29 years: aOR = 6.85, 95% CI: 2.38– 19.72, p < 0.001) and bachelor’s education (aOR = 1.42, 95% CI: 1.10– 1.83, p = 0.007) were independent predictors of good awareness. Most participants recognized OM as a serious condition (73.4%) and agreed early detection prevents complications (86.2%).Conclusion: Public awareness of osteomyelitis in Saudi Arabia is markedly low, particularly among older adults and individuals without higher education. Targeted educational strategies integrated into primary healthcare and diabetic foot screening programs are urgently needed.Keywords: osteomyelitis, bone infection, Saudi Arabia, knowledge and attitudes, multivariable analysis, primary care education