Knowledge, Attitudes, and Practices Regarding Travel Medicine Among Primary Healthcare Physicians in Jeddah, Saudi Arabia: A Cross-Sectional Study.

INTRODUCTION: Travel medicine competency among primary healthcare physicians (PCPs) is essential for preventing travel-related morbidity in Saudi Arabia, which hosts over 10 million pilgrims annually for Hajj and Umrah. This study comprehensively evaluated knowledge, attitudes, and practices (KAP) regarding travel medicine among PCPs in Jeddah, the primary gateway for international pilgrims. Methods A cross-sectional survey was conducted among PCPs across Jeddah's healthcare clusters between February and April 2025. We used a validated 29-item questionnaire assessing demographics (8 items), knowledge (11 items), attitudes (5 items), and practices (5 items). Scores were normalized to 0-100 scales with adequacy defined as ≥80%. Due to non-normal distributions (Shapiro-Wilk p<0.001), we employed Mann-Whitney U and Kruskal-Wallis tests for comparisons, Pearson correlations for associations, and ordinary least squares (OLS) regression for multivariate analysis. Binary logistic models were designated exploratory due to rare adequacy events. Results Among 199 physicians with complete data (97.5% completion rate from 204 respondents, representing 49.6% of the target sample and 25.8% of the population), mean scores were: knowledge 52.22±13.59 (95% CI: 50.32-54.12), attitudes 61.78±15.63 (95% CI: 59.60-63.96), and practices 39.56±18.85 (95% CI: 36.93-42.19). Only 7.5% (15/199) demonstrated adequate knowledge, 16.1% (32/199) showed positive attitudes, and 4.0% (8/199) exhibited good practices. Overall, KAP adequacy ≥80% was achieved by 1.0% (2/199). Merely 8.0% (16/199) had received formal travel medicine training. In OLS models, formal training was the strongest predictor of knowledge (β=0.71, +35.13 points, 95% CI: 30.90-39.36, p<0.001), while board certification best predicted practice quality (β=0.64, +24.41 points, 95% CI: 18.69-30.13, p<0.001). Physicians with one to two years of experience showed significant deficits in knowledge and practice domains. Inter-domain correlations were weak (r=0.062-0.217). Internal consistency varied: knowledge α=0.64, attitudes α=0.22, practices α=0.43. Conclusions Primary healthcare physicians in Jeddah demonstrate substantial gaps in travel medicine competency, with particularly low practice implementation rates. The dramatic effectiveness of formal training, despite reaching only 8% of physicians, indicates significant potential for improvement through systematic educational interventions. Priority should target junior physicians, MBBS-only practitioners, and specific competency gaps in malaria prophylaxis and travel health counseling.