Knowledge of General Practitioners Regarding Autism Spectrum Disorders in Karachi, Pakistan

Background: In most developing countries, including Pakistan, the level of knowledge, attitude and practices of physicians regarding Autism Spectrum Disorders (ASDs) are unknown. General Practitioners (GPs) constitute the backbone of health care system in Pakistan. 

Objectives: To assess knowledge of GPs in Karachi, the largest city in Pakistan, regarding ASDs

Methods: During June-August, 2007, we conducted a survey of 347 GPs practicing in Karachi.  We administered a questionnaire to collect information regarding demographics, knowledge, attitude and practices of the GPs toward ASD.  Data were doubly entered into a database and analyzed.  We characterize the GPs who participated in this survey.  We also used multiple logistic regression models to identify factors associated with knowledge of GPs about autism.

Results: Of 347 GPs interviewed, 69% were male. These physicians had a mean of 40.5 years and treated on average 44 patients per day. About 42% reported that they had heard of the term “autism”.  After adjusting for year of graduation in a multivariate logistic regression model, factors that were significantly associated with knowledge about autism include:  a) physician who practiced in a major Karachi hospital [AOR=2.39, 95% CI (1.21, 4.70)]; b) physicians who had completed a psychiatry rotation in medical college [AOR = 2.61, 95% CI (1.26, 5.43)]; c) physicians who had undergone a rotation in internal medicine [AOR = 1.98, 95% CI (1.14, 3.45)]; and d) physicians who had undergone a rotation in pediatrics [AOR = 2.91, 95% CI (1.68, 5.04)].

Conclusions: Our findings indicate that majority of the GPs practicing in Karachi lack knowledge about autism.  Continuing medical education and further training regarding autism during medical school should be strongly encouraged.  This could raise awareness among the medical community which could ultimately lead to a better identification of autistic children and perhaps meeting their special needs in Karachi, Pakistan.