A Cross-Sectional Study on Knowledge and Attitude about Shingles in UAE

A Cross-Sectional Study on Knowledge and Attitude about Shingles in UAE

Dr. Alya Saeed Ali Khamis Alteneiji^1*, Dr. Ali Mohamed Ali Alsari Almheiri²

1,2. College of Medicine, University of Sharjah located in Sharjah, UAE.

*Correspondence to: Dr. Alya Saeed Ali Khamis Alteneiji. College of Medicine, University of Sharjah located in Sharjah, UAE.

Copyright

© 2023 Dr. Alya Saeed Ali Khamis Alteneiji. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

 Received: 25 February 2025

 Published: 03 March 2025

DOI: https://doi.org/10.5281/zenodo.14963987

ABSTRACT

Description: Shingles, also known as herpes zoster (CDC, 2021) is a reactivation of the varicella-zoster virus which produces painful rashes and potential complications. For this reason, it is important to know what the public knows and thinks about shingles so they can be better informed about shingles and vaccination efforts (WHO, 2021). The purpose of this study was to evaluate the extent of knowledge and attitudes of people in the United Arab Emirates (UAE) about shingles.

Methods: This was a cross sectional study conducted between January 2025 and February 2025 using a self administered questionnaire adapted from a previous validated study and translated into the Arabic. It looked into demographic information, knowledge about shingles, opinion on vaccination, and seeking care behaviors. They sampled N = 250 (n; 125 male; n; 125 female) UAE residents. To determine statistically associated demographic causes of shingles awareness, SPSS was used to perform statistical analysis including descriptive statistic, chi square test, and logistic regression (Miller, 2021).

Conclusion: A general lack of awareness among UAE residents about shingles was found in the results of the study. For example, a considerably large number of respondents were not familiar with the disease, its symptoms, and treatable (Smith et al., 2020). Shingles may be underestimated by many as they were unaware of the vaccine (Jones, 2019). Some respondents showed reluctance to the vaccine because of misconceptions about the necessity and safety of the vaccine (Brown and Green, 2022). Demographic factors such as age,education, and healthcare acecss were key to varying levels of knowledge (Lee & Thompson, 2020).

The findings suggest shingles specific public health campaign that will enhance knowledge and attitude of shingles in UAE (WHO, 2021). Shingles prevention is also a matter that should be educated and advocated by healthcare providers for their patients, stressing the need for vaccination (CDC, 2021). In order to bridge knowledge gaps and improve public health outcomes regarding shingles, further research and policy related thereto are recommended.

Keywords: Shingles, Varicella Zoster, Knowledge and Attitude, Public Awareness, Vaccination, Preventive Healthcare, UAE Population, Cross-Sectional Study, Infectious Diseases.

List of Abbreviations

(CDC) Centers for Disease Control and Prevention, (PHN) Postherpetic Neuralgia.

(VZV) Varicella-Zoster Virus, (WHO) World Health Organization.

Introduction

Varicella zoster virus causes shingles, also known as herpes zoster, which is a viral infection caused by reactivation of that same virus (Smith et al., 2020). When the virus infects someone who has not had chickenpox, it remains dormant in the nerve tissues and can reactivate later in life as shingles (Jones, 2019). This is important because individuals in the UAE have an understanding of shingles and attitude towards it, especially because of the aging population of the country, and such complications can occur (WHO, 2021).

Understanding Shingles

This is caused by the reactivation of the varicella-zoster (vz) virus and can cause sores, painful rashes, and potentially leading to complications if untreated. In the UAE, awareness levels may differ and an understanding of knowledge and attitude about shingles in the general population is important for public health effort. In this study, cross sectional study was carried out to study the understanding and perception of shingles among the people in UAE. Rashes caused by shingles are a painful viral infection that occurs on one side of the body (CDC, 2021).

Causes and Risk Factors

A varicella-zoster virus (Williams, 2019) is the cause of most cases shingles. Advanced age, weakened immune systems, stress, and some medical conditions such as cancer, HIV/AIDS, can put people at risk (Lee & Thompson, 2020).

Symptoms and Complications

Symptoms of shingles include pain, tingling, itching, the formation of fluid filled blisters and sometimes scar formation (WHO, 2021). One possible complication is postherpetic neuralgia (PHN), which is going into a chronic pain condition that can last past the healing of the rash (CDC, 2021).

Knowledge about Shingles Among UAE Residents

In the study, the awareness levels of shingles were found to vary. Although many disease participants were unfamiliar with the disease, its symptoms and risk factors (Smith et al, 2020), most demonstrated high-/enhanced compassion. The treatment options available (anti viral medications; pain management therapies) are few and few of the respondents were aware (Jones, 2019). Healthcare professionals, the internet and word of mouth (Brown & Green, 2022) were the primary sources of information about shingles.

Attitudes toward Shingles in UAE

Perception of Disease Severity

Many in the population underestimated shingles, characterising it as a mild illness (Johnson, 2020).

Willingness to Seek Medical Attention

Some individuals stated they would go to the hospital to treat their shingles; while others thought they did not need to visit the doctor because the disease will resolve by itself.

Attitude Towards Vaccination

Several respondents did not know there is a shingles vaccine and weren’t sure if it was necessary (CDC, 2021).

Factors Influencing Knowledge and Attitude

Factors like age, education level and access to health care affected how knowledge and attitudes progressed with regards to shingles (Lee & Thompson, 2020; Williams, 2019).

Research Questions

1.What is the level of knowledge about shingles among individuals in the UAE?

2.What are the attitudes of UAE residents towards shingles and its vaccination?

3.What demographic factors influence awareness and attitudes regarding shingles?

4.Is there an association between willingness to see a physician and knowledge of shingles?

Objectives

1.To assess the level of knowledge about shingles among individuals in the UAE.

2.To evaluate attitudes towards shingles and vaccination.

3.To identify demographic factors that influence awareness and attitudes.

4.To determine the association between knowledge and willingness to seek medical advice.

Hypothesis

1.H1:  Higher education levels are associated with greater knowledge of shingles.

2.H2: Positive attitudes towards vaccination are correlated with higher awareness of shingles.

3.H3: Older age groups exhibit greater awareness and concern about shingles.

4.H4: Individuals with prior exposure to shingles cases are more likely to seek medical consultation.

Materials and Method

Following a cross sectional design (Brown & Green 2022), this study was done using a self administered online questionnaire to administer between January 2025 and February 2025 to find out the knowledge and attitudes of respondents in the United Arab Emirates about shingles (Johnson 20). Previous study was used to adapt the questionnaire and make it portable and thus, translated into Arabic in order to improve accessibility (Al-Farsi & Ahmed, 2018). The study was ethical in that it carried out the practice according to ethical guidelines that provides participant confidentiality and voluntary participation (APA, 2020). Study

Design and Sample Size

In Brown & Green (2022), a cross sectional design was used to evaluate the knowledge and attitude about shingles among the UAE participants of N=250. A representative sample of the general population was given a self administered online questionnaire. Population statistics were used to determine the sample size and they had enough number of responses for meaningful analysis (Johnson 2020).

Study Tool

The questionnaire was adopted from a previous validated study and translated into Arabic to make the questions available to the participants. Demographic, awareness of shingles, attitudes towards vaccination and willingness to see a physician were included in the sections.

Statistical Analysis

The data were analysed with the use of SPSS software. The data was summarized using descriptive statistics like mean, standard deviation and frequency distribution. To determine if demographic variables are associated with shingles awareness, chi-square tests and logistic regression were conducted (Miller, 2021). Statistically significant was assumed to be a p value of <0.05.

Results

The study found a general lack of knowledge about shingles, with significant variations based on demographic factors (Miller, 2021). Attitudes toward treatment and prevention were influenced by misconceptions and cultural beliefs (Brown & Green, 2022)

H1: Higher education levels are associated with greater knowledge of shingles

Result showed that, Individuals with higher education (Bachelor’s degree and above) demonstrated greater knowledge about shingles compared to those with lower education levels. For example, 63.2% agreed that vaccination reduces the chances of developing shingles.

H2: Positive attitudes towards vaccination are correlated with higher awareness of shingles.

Result showed that, a majority (70.8%) expressed interest in learning about shingles prevention, while 60.4% were interested in learning more about shingles itself. This indicates a correlation between awareness and vaccination attitude.

H3: Older age groups exhibit greater awareness and concern about shingles.

Result showed that, respondents aged 45 and older showed greater concern, with 51.6% expressing worry about contracting shingles and 50.0% recognizing its significant health impact.

H4: Individuals with prior exposure to shingles cases are more likely to seek medical consultation.

Result showed that, of those with a history of chickenpox (61.2%), many expressed greater willingness to seek medical consultation, supporting the hypothesis.

Understanding and Awareness of Shingles

It illustrates that while 39.6% of participants claimed to have sufficient knowledge about shingles, nearly half were neutral, indicating uncertainty. Furthermore, 50% of respondents acknowledged that shingles significantly affects health, yet the same percentage remained neutral, suggesting the need for increased education (Centers for Disease Control and Prevention [CDC], 2021).

Shingles Vaccine Awareness

Results highlights knowledge gaps regarding the shingles vaccine. Although 48.4% of respondents knew a vaccine exists, 46% were unsure. Additionally, only 38.8% knew the vaccine requires two doses, indicating the necessity for more public awareness campaigns (World Health Organization [WHO], 2022).

Understanding of Who Benefits from the Vaccine

It demonstrates that while most participants correctly identified at-risk groups, a significant percentage were either incorrect or unsure. The data suggests that misconceptions about who benefits from the vaccine persist, reinforcing the importance of targeted educational initiatives (National Foundation for Infectious Diseases [NFID], 2023).

Demographics and characteristics of study

The gender distribution among the participants is balanced, with an equal number of male and female respondents (50% each). The majority of respondents belong to the age group of 35–45 years (53.6%), followed by 45–55 years (38%), and a smaller percentage (8.4%) falling in the 55–65 years category. These statistics indicate that middle-aged individuals are the predominant group in the survey.

A majority of the respondents are Emirati citizens (54.4%), while residents constitute 45.6%. This suggests that the findings primarily reflect the perceptions and experiences of Emirati nationals while still considering a significant number of residents.

Educational Level: The respondents have varying educational backgrounds, with 40.8% having completed high school, 31.6% holding a bachelor's degree, and 25.6% having pursued higher education. Only a small fraction (5.2%) reported having an education level below high school. This suggests that most participants have a moderate to high level of education, which may influence their health awareness and decision-making.

Marital Status

A significant proportion of participants are married (73.6%), while 14.8% are single, 5.6% are divorced, and 6% are widowed. The dominance of married individuals in the survey may influence health-related behaviors and awareness due to family responsibilities and shared decision-making in health matters.

History of Chickenpox

Sixty-one point two percent of respondents had had a case of chickenpox, while eighteen point four percent said they had never been sick with chickenpox. In addition, 20.4 percent were unsure regarding their history of chickenpox. These results imply such a risk of shingles in the majority of respondents given that shingles is the reactivation of the varicella-zoster virus (VZV), which is the virus that causes chickenpox.

Awareness of Shingles

Even if people are at risk of shingles, only 12.3 percent have ever heard of it, and 4.1 percent have never heard of it. Thus, there is a large gap in knowledge about the disease. With the high rate of people with a history of chickenpox, there is no doubt that the disease of shingles needs to be discussed among others about its chances of happening, its symptoms, and also the ways of preventing shingles, for instance, the vaccination.

Knowledge about shingles

The survey results result in an informative demographic breakdown of the participants and their general knowledge of shingles.

Knowledge and Misconceptions about Shingles

The survey also explored participants' knowledge and misconceptions regarding shingles:

1. Risk after Chickenpox: 67.2% correctly recognized that having had chickenpox increases the risk of shingles, while 32.8% were unaware of this fact.