Impact of health education on knowledge and attitudes of Saudi paramedical students toward HIV/AIDS.

OBJECTIVE: To assess the impact of health education on the knowledge and attitudes of paramedical students in Saudi Arabia toward HIV/AIDS. METHODS: We carried out an interventional study on a sample selected from students of health institutes and health colleges in Saudi Arabia during the calendar year 2002-2003. RESULTS: The intervention shows a positive effect on students' knowledge regarding means of transmission of HIV and means of protection from HIV/AIDS. Furthermore, it has a positive impact on students' attitudes toward accepting discussion of AIDS topics with others, acceptance of home care for HIV infected family member and acceptance of HIV-infected individual's right at work. Preference of confidentiality was also significantly increased after intervention. CONCLUSION: Health education intervention has a positive impact on students' knowledge and attitudes towards HIV/AIDS and we recommend a nationwide health education program on HIV/AIDS.

Mortality among tuberculosis patients in Saudi Arabia (2001-2010).

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) still contributes to deaths in Saudi Arabia, among both Saudis and non-Saudis. Exploring the trend of deaths caused by TB and determinants associated with high fatality rate among TB patients is considered as a part of monitoring and evaluation of the performance of National Tuberculosis Control Program to help planners improve policies and procedures used to achieve the targets of TB control. DESIGN AND SETTINGS: The current study is a retrospective one, which used the official notifications of NTP in Saudi Arabia over a period of 10 years (2001-2010). METHODS: A 10-year retrospective study included all TB cases registered in Saudi Arabia with known outcome of survival or death while under anti-TB therapy covering the period January 1, 2001, to December 31, 2010. RESULTS: Mortality among TB patients show a declining trend among Saudis starting from the year 2003 (7.2%6.1%) and a stagnant trend among non-Saudis. Saudi nationality was associated with higher fatality rate compared to non-Saudis (6.4% and 5.4%, respectively). Mortality was positively correlated with advancing age, male sex among Saudis (7.3% compared to 5.3% among females), and female sex among non-Saudis (6% compared to 5% among males), prior history of anti-TB therapy, smear positivity, and human immunodeficiency virus (HIV) seropositivity. CONCLUSIONS: We recommend WHO to modify the definition of death among TB patients. We recommend NTP in Saudi Arabia to adopt and implement International Classification of Diseases (ICD10) for TB patients' registration, improve health care services provided for elderly, monitor and strengthen NTP performance to decrease defaulter and early detect and treat patients, initiate a collaborative TB/HIV activities, and screen all suspected TB patients for HIV. In addition to these, more extended research has to be initiated concerning delayed diagnosis and comorbidities with TB.

Tuberculosis trends in Saudis and non-Saudis in the Kingdom of Saudi Arabia--a 10 year retrospective study (2000-2009).

BACKGROUND: Tuberculosis (TB) remains a public health problem in the Kingdom of Saudi Arabia (KSA), which has a very large labour force from high TB endemic countries. Understanding the epidemiological and clinical features of the TB problem, and the TB burden in the immigrant workforce, is necessary for improved planning and implementation of TB services and prevention measures. METHODS: A 10 year retrospective study of all TB cases reported in KSA covering the period 1st January 2000 to 31st December 2009. Data was obtained from TB reporting forms returned to the Ministry of Health. Data were then organised, tabulated and analysed for annual incidence rates by province, nationality, country of origin and gender. RESULTS: There was an annual increase in the number of TB cases registered from 3,284 in 2000 to 3,964 in 2009. Non-Saudis had nearly twice the TB incidence rate compared to Saudis (P = <0.05). All but four provinces (Najran, Riyadh, Makkah, Tabuk) showed decreasing TB incidence rates. The highest rates were seen in the 65+ age group. In the 15-24 year age group the incidence rate increased from 15.7/100,000 in 2000 to 20.9/100,00 in 2009 (P = <0.05). The incidence of TB in Saudi males was higher than Saudi females. Conversely, for non-Saudis the TB incidence rates were significantly higher in females compared to males. CONCLUSIONS: Despite significant investments in TB control over 15 years, TB remains an important public health problem in the KSA affecting all age groups, and Saudis and non-Saudis alike. Identification of the major risk factors associated with the persistently high TB rates in workers migrating to KSA is required. Further studies are warranted to delineate whether such patients re-activate latent Mycobacterium tuberculosis (M.tb) infection or acquire new M.tb infection after arrival in KSA. Appropriate interventions are required to reduce TB incidence rates as have been implemented by other countries.

Tuberculosis trends in the Kingdom of Saudi Arabia, 2005 to 2009.

PURPOSE: Policymakers should know the distribution and determinants of tuberculosis (TB) over time. This is especially true for the Kingdom of Saudi Arabia (KSA), a country at increased risk for TB transmission because of mass gatherings (e.g., Hajj) and a large number of immigrant workers. METHODS: Using national TB notification data reported from 13 provinces from 2005 through 2009, trends in annual TB incidence were calculated by nationality, age, and gender. RESULTS: Compared with Saudis, non-Saudis had a 2-fold greater TB incidence rate each year. In 2009 among all KSA provinces, Makkah had the greatest proportion of non-Saudis (38%), the greatest number of TB cases (1648), and the highest TB incidence rate (26 per 100,000). We observed significantly increasing yearly trends of TB incidence among Saudis in the Najran province (21.3%) and in Riyadh (8.5%). Conversely, we observed a significantly decreasing yearly trend among non-Saudis in Baha (23.1%), Hail (17.4%), and the Eastern region (22.6%). CONCLUSIONS: Disparate KSA regional and longitudinal TB trends existed from 2005 through 2009, by nationality. We recommend a review of all TB policies in KSA that addresses screening for latent TB infection and drug resistance. Additionally, we recommend a new TB public health education program.

Knowledge and attitudes of paramedical students in Saudi Arabia toward HIV/AIDS.

OBJECTIVES: The present study aimed to build a baseline profile for knowledge and attitudes of Saudi paramedical students toward human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). METHODS: The study was a cross-sectional one conducted on a sample selected from health institutes and colleges in Saudi Arabia during the calendar year 2002/2003. RESULTS: A high percentage of students correctly perceive the risk presented by HIV/AIDS. Extramarital sex and unprotected sex were the most frequently mentioned risky behaviors. Misconceptions and lack of knowledge regarding transmission of HIV/AIDS were reported. Lack of knowledge on the means of individual protection, means of protection of infants of HIV/AIDS-infected mothers and means of protection of HIV/AIDS-infected individual's wife was observed. While friends were the main source of information among male students, booklets were the main source of information among females. More than two-thirds of students were willing to be tested for HIV. We observed negative attitudes toward discussing AIDS topics with others, home-care for HIV/AIDS individuals and HIV/AIDS-infected individual's right at work. CONCLUSION: We found lack of knowledge regarding HIV/AIDS transmission and means for prevention in addition to unfavorable attitudes towards HIV/AIDS individuals. We recommend an evaluation of HIV/AIDS information in the curricula of health institutes and health colleges in addition to conduction of a nationwide health education campaign on HIV/AIDS.