Abstract / Summary
Infantile epileptic spasms syndrome (IESS) is a severe developmental and epileptic encephalopathy in which diagnostic delays worsen neurodevelopmental outcomes. In Palestine, limited access to pediatric neurology services increases reliance on frontline physicians for early recognition. This study assessed the knowledge, attitudes, and practices regarding infantile spasms among pediatric and primary care physicians and residents in the West Bank, Palestine. A cross-sectional study was conducted between March and June 2026 among pediatricians, general practitioners, family medicine specialists, and residents in pediatrics or family medicine practicing in the West Bank. Data were collected using a structured, self-administered questionnaire assessing knowledge (20 items; range 0–20), attitudes (12 Likert-scale items; range 12–60), and clinical practices (10 scenario-based items; range 0–28). Knowledge was categorized as poor (≤ 50%), fair (> 50–70%), or good (> 70%). Participants were grouped into pediatrics, primary care, and resident categories. Analyses included independent samples t-tests, one-way ANOVA, Pearson correlations, and multiple linear regression. Of 419 participants, 48.7% demonstrated good knowledge, 53.0% held positive attitudes, and 52.5% exhibited good practices. The mean knowledge score (13.5 ± 5.0, 67.4%) fell significantly below the 70% adequacy benchmark ( p = .029). Pediatricians scored significantly higher than primary care physicians and residents on knowledge (15.8 vs. 11.6 vs. 13.3, p < .001), attitudes (44.5 vs. 40.7 vs. 41.2, p < .001), and practices (20.4 vs. 15.9 vs. 17.4, p < .001). Knowledge was strongly correlated with practices ( r = .645) and moderately with attitudes ( r = .380). Specialty group and male gender were the strongest independent predictors of all three scores. Lack of provider awareness was the leading perceived barrier to early diagnosis (37.7%). Physicians in the West Bank demonstrated suboptimal knowledge of infantile spasms, with notable gaps in etiology and prognosis. Primary care physicians and those without formal training were most affected. Our findings suggest that targeted continuing medical education programs, especially for primary care physicians and residents, have the potential to improve early recognition and management of infantile spasms in Palestine. Not applicable.