Prevalence of serological markers and nucleic acid for blood-borne viral infections in blood donors in Al-Baha, Saudi Arabia.

INTRODUCTION: Data on blood-borne viral infections in some regions in Saudi Arabia remain scarce. This study investigates the prevalence of serological markers and nucleic acid for blood-borne viruses among blood donors in Al-Baha, Kingdom of Saudi Arabia. METHODOLOGY: In this cross-sectional study, 2,807 donors who donated blood between January 2009 and November 2011 were investigated for blood-borne viral serological markers including HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HIV, and anti-HTLVI/III in addition to viral nucleic acid. RESULTS: All donors were males between 16 to 66 years of age (mean: 31.5 ± 9.3 years). Viral nucleic acid and/or serological markers were detected in a total of 36 (1.3%) donors; of them, 26 (72.2%) had nucleic acid concomitant with serological markers, 6 (16.7%) had only viral nucleic acid, while 4 (11.1%) had only serological markers. Of all donors, 22 (0.8%) had HBsAg, 227 (8.0%) had anti-HBc, 157 (5.0%) had anti-HBs, 2,577 (91.8%) had no HBV markers, 2 (0.07%) had anti-HIV, 1 (0.04%) had anti-HCV, and 1 (0.04%) had anti-HTLVI/II. The donors who were born during HBV vaccination era showed no HBsAg (0.0%; p = 0.052), lower rates of anti-HBc (1.5%; p < 0.001) and anti-HBs (0.7%; p < 0.001), while the majority had no HBV markers (98.5%; p < 0.001). CONCLUSIONS: Combined viral nucleic acid and serological testing of donated blood enhances blood safety. The absence of HBV markers among donors suggests susceptibility or declined anti-HBs levels. Thus, HBV revaccination or a vaccine boost among adolescents and adults might be indispensable.

HIV knowledge and stigmatization among adolescents in Yemeni schools.

The number of assessments on HIV knowledge and stigmatization among adolescents in Yemen is still very limited. This cross-sectional study aimed to have a better understanding on the level of knowledge on HIV transmission and prevention. Also, this study explored the level of stigma and discrimination among students toward people living with HIV (PLWH). The study sample consisted of 2,274 male and female students (mean age 16.6 years) randomly selected from 27 high schools in Aden, Yemen. The results revealed low levels of knowledge on major prevention measures, such as condoms, where only 49.4% knew that condoms could protect from HIV infection; and high levels of misconceptions on the modes of transmission. In addition, the study revealed a high level of stigma and discrimination toward people living with HIV. The results would serve as a baseline for implementing a school-based educational program on HIV/AIDS.

Effect of breastfeeding on growth in Yemeni infants.

OBJECTIVE: To estimate the prevalence of effective breastfeeding (EBF) practice and its association with weight of young infants, mother's education, employment status, and parity. METHODS: The study is a cross-sectional, conducted in Dula Health Center in Sana'a city, the capital of Yemen during the year 2003. Six hundred and twenty-one mothers and their exclusively breastfed apparently healthy infants attended to the health center for immunization were enrolled in the study. Effective breastfeeding was evaluated according to the World Health Organization integrated management of childhood illnesses literature. Weight was measured using Seca scale. We conducted interview to investigate the age of the child, parity, employment status, and education of the mother. RESULTS: The mean age of infants was 49.7+/-16.8 days. The prevalence of EBF was 16.9% (n=105). Good positioning was observed in 26.7% (n=166), followed by good suckling in 23.7% (n=147) and finally by good attachment in 20.3% (n=126). The mean weight of EBF infants was 3.9+/-0.5 kg, whereas that of the ineffectively breastfed group was 3.5+/-0.5 kg (p<0.0001). The 2 groups were compared with gender and age matched. The mean weight of well-attached infants was 3.8+/-0.55 kg and for those with good suckling was 3.8 +/- 0.55 kg and for those with good positioning was 3.7+/-0.59 kg. No association was found between EBF with mother's education and employment status while parity was positively related to EBF rate. CONCLUSION: Prevalence of EBF is low. Infants with EBF are heavier than the ineffectively breast-fed infants.

Prevalence of hypocalcemia in children examined for serum calcium in Sana'a, Yemen.

OBJECTIVE: To estimate the prevalence of hypocalcemia in children examined for serum calcium. METHODS: A record-based study was carried out in the Specialized Pediatric Center in Sana'a city, Yemen during the 4 year period 1999 to 2003. Out of 90600 patients seen for different causes, 310 (0.34%) were subjected to serum calcium level examination. Data regarding age and gender were also collected. RESULTS: The median age of the patients was 5 months, with minimum age of one day and maximum age of 4 years. Prevalence of hypocalcemia among children examined for serum calcium was 58%, 60% of them were males and 40% were females. Age group of 0-1 months constituted 17.8% while the age group of 1-3 months constituted 17.2%. Patients with serum calcium level between 4-6 mg constituted 27.8% and less than 7.5 mg were 72.2%. CONCLUSION: Prevalence of hypocalcemia in children examined for serum calcium was high. Males were more affected than females and was more in neonates followed by age 1-3 months then age 3-6 months.

Chlamydia trachomatis infections among Yemeni school pupils in relation to environmental conditions.

OBJECTIVE: This study is aimed at establishing the prevalence of Chlamydia trachomatis infections among school pupils in Sana'a, Republic of Yemen, and to explore the association of infection with environmental and social factors. METHODS: A total of 787 school children, 529 boys and 258 girls, were randomly selected for enrollment in this study. Four hundred and twenty-nine were from 4 schools in Sana'a city, and 358 from 3 rural schools around Sana'a, Republic of Yemen. Questionnaire forms were filled in for each child to investigate environmental and social factors. Sera were tested for anti Chlamydia trachomatis IgG antibodies using enzyme-linked immunosorbent assay CTM-IgG . RESULTS: An overall rate of infection of 45.9% was determined. The rate of infection among rural pupils (73.2%) was higher (P<0.0001) than that among urbanones (23.1%). The rate of infection was found significantly (P<0.001) inversely correlated with age of the pupils. Environmental factors which were found to influence the infection rate were; rural residence, unplastered walls, mud floor, lack of stand pipe water, lack of latrine and presence of animals within dwelling with odds ratio of 9.1, 6.3, 6.1, 5.2, 3.7, 3.5 and 1.7. Also, the male sex and illiteracy of the parents has been found to be risk factors for infection. CONCLUSION: Prevalence of Chlamydia trachomatis infection was found to be high. The prevalence correlates inversely with age. Rural residence, environmental conditions and social factors were risk factors for infections. Yemen could be identified as a trachoma endemic area, which should be targeted by the control programs.

Clinical and experimental evaluation of the effect of Khat-induced myocardial infarction.

OBJECTIVE: To evaluate the effect of Khat-induced myocardial infarction (MI) in Yemen. METHODS: One hundred and twenty patients with MI, admitted to Al-Thawra Hospital, Sana'a City, Yemen, during the year 2001 and 120 volunteer controls were collected for this study. On the other hand, we used 48 adult male rabbits for this study and divided it into 8 groups. Each group was consist of 6 animals; group I was used as normal control, group II was given adrenaline 60 g/kg intravenous infusion, group III and IV were given Khat 1g/kg once daily for 2 months, group V and VI were given Khat 1g/kg 3 times daily for 2 months, group VII and VIII were given Khat extract equivalent to 1g/kg intravenous infusion, 4 hours after the last dose of Khat and adrenaline 60 g/kg intravenous infusion was given to groups IV, VI and VIII. The animals were killed by decapitation. Blood samples were collected from each rabbit for determination of their creatinine kinase-iso enzyme (CK-MB) lactate dehydrogenase (LDH) and serum glutamic-oxaloacetic transaminase enzymes. Also, hearts were dissected out rapidly for histopathological study. RESULTS: Seventy-nine percent of patients with MI were Khat chewers and only 20.8% were non-Khat chewers. Experimental study shows that Khat in a dose of 1g/kg 3 times a day for 2 months, Khat extract equivalent to 1g/kg intravenous infusion alone and in combination with adrenaline 60 g/kg intravenous infusion significantly increased cardiac enzymes (CK-MB, aspartate transaminase, LDH), also, the histopathological study for the same groups revealed multiple areas of infarction. CONCLUSION: The present study has demonstrated that Khat chewing may be considered as a risk factor for the occurrence of MI especially in persons who are susceptible to the disease. It is therefore, recommended that Khat chewing should be avoided in persons who have any cardiovascular problems.

Coverage and perceptions of Medical Sciences students towards hepatitis B virus vaccine in Sana'a City, Yemen.

OBJECTIVE: The present study was conducted to estimate vaccination coverage against hepatitis B virus and the perceptions of 1198 medical sciences students in Sana'a City, Yemen. METHODS: Only those who practice clinical training or are in contact with body fluids were included. The students were enrolled in the Faculty of Medicine and Health Sciences, Sana'a University, Republic of Yemen. Data was collected from 1999-2000. Arabic pre-tested questionnaire forms were completed by 840 students at a response rate of 70.6%. RESULTS: The study revealed a reported vaccination rate of 29.5%. The rate among Faculty of Medicine and Health Sciences students was 32.3%, whereas only 21.3% among the students of High Institute of Health Sciences. Students of dentistry attained the highest rate of vaccination (38.8%), while nursing students of the High Institute of Health Sciences achieved the lowest rate (17.1%). Rate of vaccination (46.6%) among female students was significantly higher than male students (22.3%) with a P- value of 0.0001. Medical assistants of the High Institute of Health Sciences scored the best (56%) in terms of knowledge, medical laboratory sciences students achieved the highest (43.6%) in attitude and dentistry students had the highest scores (35.5%) in practices. The mean knowledge of females and males was comparable, however, females achieved higher attitudes and practices. Final stage students attained better attitude scores than the pre-final and intermediate students. CONCLUSION: Vaccination coverage of medical sciences students in Sana'a City, Yemen is low. Knowledge of medical assistants is the best, attitude of medical laboratory sciences students and practices of dental students is the highest. Attitudes and practices of female students are better than that of males.

Rate and risk factors of surgical site infections with antibiotic prophylaxis.

OBJECTIVE: This study is aimed at determining the incidence of surgical site infections, with antibiotic use. Furthermore, to correlate infection with type of operations, length of intervention, number of stitches, pre-operative hospitalization, age and sex of the patient. METHODS: All Yemeni patients (N=601) who underwent surgical intervention, with preoperative antibiotic prophylaxis, at Al-Kuwait University Hospital, Sana'a, Republic of Yemen, during 1st August 2000 through to 30th November 2000 were followed up until stitch removal or discharge. Data was registered in a spreadsheet and processed statistically by statistical package for social sciences 10.0. RESULTS: Overall incidence of surgical site infections was 2.2%, 0.5% in clean operation, 2.8% in clean contaminated, 9.1% in contaminated and 2.3% in dirty operations. Surgical site infections were found positively correlated with duration of operation (P=0.015) and number of stitches (P=0.017), but insignificantly associated with sex, age, type of operation and pre-operative hospitalization. CONCLUSION: In conclusion, surgical site infections, with antibiotic use, were found low. Higher number of stitches and longer duration of operation were the risk factors.