Clinical features and outcome of human Mpox (Monkeypox) in Saudi Arabia: An observational study of travel-related cases.

BACKGROUND: The 2022 Monkeypox virus (Mpox) outbreak had involved multiple countries around the globe. Here, we report clinical features and outcome of human Mpox of the first cases in Saudi Arabia. METHODS: We obtained records of confirmed Mpox cases in Saudi Arabia from the public electronic health information system, Health Electronic Surveillance Network (HESN) and the healthcare providers completed a de-identified structured clinical data collection form. RESULTS: The reported seven cases were travel-related and all were males between 24 and 41 years of age (mean age + SD) was 30.14 (+ 6.69) years. Of the cases, three (43 %) had heterosexual contact and the others had other intimate encounters while traveling abroad. They presented with skin lesions (100 %), fever (86 %), and lymphadenopathy (71 %). The illness was mild to moderate, did not require antiviral medications, and lasted 7-15 days. The mean duration of skin rash (+ SD) was 10 (+ 2.68) days. Routine laboratory tests (CBC, BUN, serum electrolytes, and liver enzymes) were within normal limits, and initial screening for HIV was negative. Expanded contact tracing did not reveal secondary cases of Mpox in the community or the healthcare setting. CONCLUSION: The current study showed heterosexual transmission of Mpox and the clinical course was mild and non-complicated. Therefore, clinicians and public health professionals should consider Mpox among individuals presenting with skin rash especially in the context of the investigation of HIV and other sexually transmitted diseases.

Epidemiological and clinical features of COVID-19 patients in Saudi Arabia.

BACKGROUND: The aim of this study is to describe the clinical and demographic characteristics of COVID-19 patients, and the risk factors associated with death in Saudi Arabia to serve as a reference to further understand this pandemic and to help in the future decisions and control of this global crisis. METHODS: This multicenter, retrospective, observational, cross-sectional study was conducted on 240,474 patients with confirmed COVID-19 in Saudi Arabia. Data was collected retrospectively through the Health Electronic Surveillance Network at the Ministry of Health. Patients were classified based on their outcome as recovered, dead, or active with no definite outcome. We must specify the date period. RESULTS: As of 20th of June 2020, 79.7% of COVID-19 cases were young and middle-aged, ranging between 20-59 years. There was evidently a difference in the sex ratio, where males constituted 71.7% of cases. The majority were non-Saudi nationals, representing 54.7% of cases. Furthermore, the contraction of COVID-19 was travel-related in 45.1% of cases. Signs and symptoms were reported in 63% of cases, the most common of which were fever; 85.2%, and cough; 85%. Deaths occurred more frequently in patients 40-49 years, 50-59 years, and 60-69 years, representing 19.2%, 27.9%, and 21.3% of deaths, respectively. Additionally, the case fatality rate (CFR) was higher in older age-groups, reaching 10.1% in those ≥80 years. Moreover, the CFR of males was higher than that of females, with 0.95% and 0.62%, respectively. As for nationality, Saudis had a CFR of 0.46% versus 1.19% in non-Saudis. CONCLUSION: The total number of positive COVID-19 cases detected constitute 0.7% of the Saudi population to date. Older age, non-Saudi nationalities, being male, travelling outside Saudi Arabia, and the presence of symptoms, as opposed to being asymptomatic were considered risk factors and found to be significantly more associated with death in patients with COVID-19.

Treatment outcomes among tuberculosis patients in Jeddah, Saudi Arabia: Results of a community mobile outreach directly observed Treatment, Short-course (DOTS) project, compared to a standard facility-based DOTS: A randomized controlled trial.

INTRODUCTION: Tuberculosis (TB) remains a global public health threat affecting people in many developing countries, including the Kingdom of Saudi Arabia. Maintaining a long-term treatment regimen has always been the cornerstone of successful treatment outcomes among tuberculosis patients. In the Jeddah region, the National Tuberculosis Control and Prevention Program is now treating TB patients by means of a community mobile outreach team approach.The objective of this study was to compare the effectiveness of the community mobile outreach approach in improving treatment outcomes (success rate) among local tuberculosis patients with those being treated with a facility-based directly observed treatment, short-course (DOTS). STUDY DESIGN: Our study consisted of a two-sample, parallel design [1:1], statistician -blind randomized control trial with 200 newly diagnosed, TB patients as subjects. SETTING/PARTICIPANTS: The patients had all presented at the Madain Alfahd Primary Health Care Center, Jeddah. Between Nov 2017 and Nov 2018, a total of 221 TB patients were screened of whom 200 were randomly selected using randomly generated sequences. INTERVENTION: Patients in the intervention sample group were treated by means of mobile outreach teams with oral anti-TB treatment under the DOTS, and control group patients were given the traditional facility-based DOTS treatment according to the WHO recommendations and national guidelines. MAIN OUTCOME: The primary outcome was the level of overall treatment success rate. It was finally determined and compared in the two sample groups using chi-square analysis and relative risk assessment. RESULTS: In the analysis stage, 97 patients were in the intervention group, while the control group consisted of 76. The overall response rate was 86.5% (173/200). We found that the percentage of overall treatment success rate among the patients served by the mobile outreach team was 97%, compared to 76% in the non-mobile team treated patients. The relative risk of treatment success rate among the intervention group was 1.27 (95% CI = 1.13-1.43) times greater than that amongst the control group. Log-rank test (log-rank statistics = 18.91; p < 0.001) identified a significant difference in the default rate after six months of treatment. CONCLUSION: This study has shown that a mobile outreach DOTS approach is an effective and acceptable strategy for treating TB patients. It also provides important data on the efficacy of using mobile outreach teams to improve TB treatment outcomes in Jeddah. Our results provide evidence and highlight the positive and significant impact of mobile outreach teams in mitigating TB recurrence rates and in improving TB treatment outcomes.Clinical Trial Registration: Clinicaltrials.gov: NCT03787914.

2014 MERS-CoV outbreak in Jeddah--a link to health care facilities.

BACKGROUND: A marked increase in the number of cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection occurred in Jeddah, Saudi Arabia, in early 2014. We evaluated patients with MERS-CoV infection in Jeddah to explore reasons for this increase and to assess the epidemiologic and clinical features of this disease. METHODS: We identified all cases of laboratory-confirmed MERS-CoV infection in Jeddah that were reported to the Saudi Arabian Ministry of Health from January 1 through May 16, 2014. We conducted telephone interviews with symptomatic patients who were not health care personnel, and we reviewed hospital records. We identified patients who were reported as being asymptomatic and interviewed them regarding a history of symptoms in the month before testing. Descriptive analyses were performed. RESULTS: Of 255 patients with laboratory-confirmed MERS-CoV infection, 93 died (case fatality rate, 36.5%). The median age of all patients was 45 years (interquartile range, 30 to 59), and 174 patients (68.2%) were male. A total of 64 patients (25.1%) were reported to be asymptomatic. Of the 191 symptomatic patients, 40 (20.9%) were health care personnel. Among the 151 symptomatic patients who were not health care personnel, 112 (74.2%) had data that could be assessed, and 109 (97.3%) of these patients had had contact with a health care facility, a person with a confirmed case of MERS-CoV infection, or someone with severe respiratory illness in the 14 days before the onset of illness. The remaining 3 patients (2.7%) reported no such contacts. Of the 64 patients who had been reported as asymptomatic, 33 (52%) were interviewed, and 26 of these 33 (79%) reported at least one symptom that was consistent with a viral respiratory illness. CONCLUSIONS: The majority of patients in the Jeddah MERS-CoV outbreak had contact with a health care facility, other patients, or both. This highlights the role of health care-associated transmission. (Supported by the Ministry of Health, Saudi Arabia, and by the U.S. Centers for Disease Control and Prevention.).