Prevalence of Obesity and Lifestyle Risk Factors Following Two Years' COVID-19 Related Service Closure at Wellness Center, Primary Health Care.

Background: COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years' service closure. Methods: A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection. Results: A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg-1min-1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex. Conclusion: The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.

Utilization of the internet for physical activity and diet information and its influence on pregnant women's lifestyle habits in Qatar.

Background: Maintaining a healthy lifestyle during pregnancy is essential. With the increasing availability of the internet, pregnant women have access to a wealth of information related to physical activity (PA) and healthy diets. Objectives: The study aims to investigate the extent of internet usage by pregnant women attending antenatal clinics in Qatar to obtain information about PA and healthy diets, identify associated factors, and evaluate the impact of this information on their lifestyle habits. Methods: A cross-sectional study was conducted in six randomly selected public antenatal clinics in Qatar. Pregnant women aged ≥18 years in any trimester were recruited using a probability sampling technique. Data were collected through self-administered questionnaires. Descriptive and analytic statistics were employed for data analysis. Results: A total of 327 pregnant women (mean age of 29.5 years ± 4.0) completed and returned the questionnaire (response rate: 87.5%). Among the participants, 54.5% used the internet to obtain information about PA, while 72% sought online diet-related information. Factors such as age (26-35 years), tertiary education, employment status, and being primigravidae were associated with a higher likelihood of using the internet for healthy lifestyles information. Participants who reported using the internet for PA information a great deal were more likely to increase their PA during pregnancy compared to those who used it somewhat or very little (57.6, 26.8, and 5.0%, p < 0.001; respectively). Similarly, those who used the internet for diet information a great deal were more likely to increase their fruit and vegetable consumption compared to those who used it somewhat, or very little (84.2, 68.5, and 63.6%, p = 0.038; respectively). Also, participants who used the internet for diet information a great deal were more likely to decrease the amount of sugary and fatty foods they ate compared to women who used the internet somewhat or very little (61.4, 45.2, and 18.2%, p < 0.001; respectively) and (50.9, 30.4, and 18.2%, p = 0.001; respectively). Conclusion: Many pregnant women use the internet to access information about PA and diet, and greater use is associated with more positive lifestyle changes. This study provides useful information to consider when designing intervention programs for pregnant women about adopting and maintaining healthy lifestyles.

Scope and Predictors of Travel Medicine Practice among Primary Care Physicians in Qatar.

In an era of globalization, travel-related illnesses have become a focus of public health concern. Pretravel consultation is an effective measure to promote healthy travel. This study aimed to assess the scope of primary care physicians' (PCPs) practice of travel medicine (TM) in Qatar and its associated predictors. This was a cross-sectional study design. A structured questionnaire was used to collect data from all PCPs working in the 27 primary healthcare centers in Qatar. Descriptive and analytic statistics were used as appropriate, and a multivariable logistic regression model was constructed. Three hundred sixty-four PCPs participated in the study (response rate of 89.2%). Most PCPs (91.1%) provided pretravel consultations of which 72.7% provided less than 10 consultations per month. Overall, pretravel advice content and frequency including vaccine and malaria chemoprophylaxis recommendations were inadequate. Significant predictors of high frequency of pretravel consultations (≥10/month) included male PCPs (AOR 1.78, 95% CI: 1.01, 3.18), PCPs who had postgraduate training or experience in TM (AOR 2.74, 95% CI: 1.59, 4.72), and multilingual (speaking ≥3 languages) physicians (AOR 1.96, 95% CI: 1.12, 3.45). Frequently encountered post-travel illnesses included travelers' diarrhea, respiratory diseases, and fever. While, most PCPs provided pretravel consultations, the frequency and content of consultations were inadequate. Male PCPs, past training or experience in TM, and multilingual physicians were important predictors of providing a high frequency of pretravel consultation. The findings of this study identified several gaps in PCPs' TM practice. Specific measures should be designed and implemented to reduce the burden of travel-related illnesses and promote healthy travel.

Prevalence and predictors of smoking cessation among smokers receiving smoking cessation intervention in primary care in Qatar: a 6-month follow-up study.

Objective: To estimate the rate and predictors of smoking cessation in smokers attending smoking cessation clinics in primary care settings in Qatar. Methods: A cross-sectional study was conducted among 759 smokers who had attended any of the 10 smoking cessation clinics in primary health care centers from January 2019 to June 2020. The sociodemographic, clinical, and smoking-related variables were assessed. Tailored behavioral and pharmacotherapy were delivered, and patients were interviewed at 6 months to estimate the 30-day point prevalence abstinence. To identify independent factors associated with smoking cessation, a multivariable logistic regression analysis was performed. Results: The mean age of participants was 40.6 (±11.3), majority being married, Arab and employed, and having a tertiary education. Almost half of the smokers (48.7%) received varenicline alone, 42.6% received NRT, and 31.8% received a combination of both. The selection of drug therapy was based on preferences, experiences, and history of previously encountered adverse effects. The overall 30-day quit rate at 6 months follow-up was 32.4%. About three-quarters (72.5%) of participants had at least one quit attempt and 12.5% had 3 or more attempts. Later age at smoking initiation, lower cigarette consumption at baseline, lower CO concentration at baseline, use of smoking cessation pharmacotherapy, having made fewer quit attempts and non-exposure to secondhand smoke among friends were identified as significant predictors of successful quitting at 6 months. Conclusion: The 30-day quit rate at 6 months follow-up (32.4%) is comparable to the worldwide figure. However, further efforts should be made to plan cost-effective tobacco dependence treatment taking into account predictors and at-risk groups.

A Sociodemographic Analysis of the Impact of COVID-19-Related Schools' Closure on the Diet and Physical Activity of Children and Adolescents in Qatar.

OBJECTIVES: To assess the impact of the COVID-19-related closure of government schools in Qatar on children and adolescents' dietary habits and physical activities and associated sociodemographic factors. METHODS: An analytical cross-sectional study was conducted between June and August 2022 utilizing the national electronic health records system in Qatar to extract a sampling frame of students enrolled in governmental schools, specifically targeting students in 3rd to 9th grades, stratified by sex and developmental stage. A stratified sampling technique was employed to randomly select a proportionate number of students from each stratum, and data were collected through telephone interviews with the parents of selected students. RESULTS: A total of 1546 interviews were completed by the end of the study. Of the included sample, 845 (54.7%) were between 8 and 11 years of age (middle childhood), while the rest were 12-15 years old (young teens and teenagers). Male to female ratio was almost 1:1. We found a significant decrease in the intake of vegetables, increases in the intake of soft drinks, fried food, fast food, and sweets, and a reduction in physical activity during schools' closure compared to before. Higher parental educational levels, maternal employment, and having a positive family history of obesity and/or overweight in first-degree relatives were significantly associated with adverse lifestyle changes during schools' closure. CONCLUSION: The trends of lifestyle changes reported in this study during the periods of COVID-19-related schools' closure were found to be going in a health-compromising direction. These results underscore the importance of implementing targeted interventions to promote healthy lifestyles during such disruptions and emphasize the need to address lifestyle changes beyond emergencies and outbreaks to mitigate potential long-term health consequences, including the increased risk of non-communicable diseases.

Primary care physicians' knowledge of travel vaccine and malaria chemoprophylaxis and associated predictors in Qatar.

BACKGROUND: In an era of globalization, travel-related illnesses have become a focus of public health concern, especially in the Arab region where travel health services are insufficient and not well-established. This study was conducted to assess travel vaccine and malaria chemoprophylaxis knowledge and associated predictors among primary care physicians (PCPs) in Qatar. METHODS: This was a cross-sectional study. A structured questionnaire was used to collect data from all physicians working at all 27 primary healthcare centers from March 1st to May 31st 2020. Knowledge scores were computed and a multivariable linear regression model was built to identify predictors of higher knowledge. RESULTS: A total of 364 PCPs participated (response rate of 89.2%). Participants' mean age was 44.5 (±7.8) with 59.1% being males. Their overall mean knowledge score was 9.54/16 (±3.24). Significant predictors of higher knowledge included: aged 40-49 years (1.072; 95% CI: 0.230, 1.915) , had medical degree from non-Arab countries (0.748; 95% CI: 0.065, 1.432) , had training in TM (1.405; 95% CI: 0.407, 2.403), and provided ≥10 consultations/ month (2.585; 95% CI:1.294, 3.876) . Online information was the main reported resource of travel medicine consultation. CONCLUSIONS: The overall PCPs' mean percentage knowledge score of travel medicine was 59.6% (±20.3). A high volume of pretravel consultation, prior training, middle age group, and medical degree from non-Arab countries were significant predictors of higher knowledge. Continuing education and training provided by recognised international institutions for all PCPs is highly recommended to narrow the gap in travel medicine knowledge.

Satisfaction of primary care physicians towards initiation of phone consultations during the COVID-19 pandemic management in Qatar: a cross-sectional study.

OBJECTIVES: To assess primary care physicians' satisfaction towards initiation of phone consultation during COVID-19 pandemic management in Qatar and to identify the factors associated with dis/satisfaction. DESIGN: A cross-sectional web-based survey was conducted from 1 June to 30 July 2020. SETTING: All the available 27 public primary healthcare centers in Qatar at the time of the study. PARTICIPANTS: Two hundred ninety-four primary care physicians working in the publicly run primary healthcare corporation in Qatar. PRIMARY OUTCOME MEASURES: Overall satisfaction of primary care physicians with the initiation of phone consultation during the COVID-19 pandemic in Qatar and their satisfaction towards each aspect of this management. RESULTS: Two hundred thirty-nine primary care physicians participated in the survey with a response rate of 53.1%. Overall, about 45% and 21% of respondents agreed that COVID-19 disease management has highly impacted and very highly impacted their daily practice, respectively. More than half of the physicians (59.9%) indicated being satisfied/highly satisfied with the initiation of telephone consultation service. On the other hand, few physicians were satisfied (14.3%) or highly satisfied (3.4%) with conducting telephone consultations with patients who lack previous electronic medical records. Also, only 20.3% and 3.8% of physicians were satisfied and highly satisfied with the lack of physical examination in telephone consultations, respectively. On bivariate analysis, primary care physicians' age was significantly associated with the perceived level of impact of COVID-19 management on daily practice (P = 0.03). There was no significant association between participants' characteristics and the level of satisfaction toward telephone consultations. On the other hand, there was a statistically significant association between physicians' age (p = 0.048) and gender (p = 0.014) and their level of satisfaction toward communication and support.

Reliability of online pregnancy-related information and associated feelings of worry among expectant women in Qatar.

BACKGROUND: Although the internet can be a source of reassurance and clarification for expectant women, it could cause concerns or feelings of worry when reading about pregnancy-related information. This research study sought to assess feelings of worry and perceived reliability of online pregnancy-related information and the associated factors among expectant women attending antenatal clinics at primary healthcare centers in Qatar. METHODS: A cross-sectional study design was used. The participants were recruited through a systematic random sampling technique. A self-administered questionnaire was used to collect data from the participants. Descriptive and analytic statistics were used as appropriate. RESULTS: A total of 327 expectant women completed the questionnaire. Most were aged between 26-34 years (74.1%), held a college/university degree (76.4%), and were multigravidas (73.1%). About one-third of the women (31.2%) reported feeling worried due to information they read online. They coped with these feelings by consulting their antenatal care provider at their next appointment (51.0%) or by talking with relatives and friends (47.0%). Most participants (79.2%) considered online pregnancy-related information to be reliable or highly reliable. Holding a college/university degree and being primigravidae were factors significantly associated with a high perception of reliability of online pregnancy information. CONCLUSION: Although online pregnancy information caused feelings of worry for some expectant women, most perceived such information to be reliable. Thus, antenatal care providers should guide expectant women on how to access high-quality web-based information.

Primary healthcare physicians' satisfaction towards work safety and personal protective equipment during the COVID-19 pandemic in Qatar: A cross-sectional study.

BACKGROUND: During COVID-19 pandemic, healthcare workers are experiencing unprecedented pressure from stressors including enormous workload, virus exposure, and inadequate PPE. This study aimed to assess primary healthcare physicians' satisfaction towards work safety and personal protective equipment and their predictors during early stages of COVID-19 pandemic in Qatar. METHODS: A cross-sectional web-based survey was conducted in 27 primary healthcare centers in Qatar from 1st June to 30 July 2020. Descriptive and analytical statistics were used when appropriate. A multivariable linear regression analysis was done to identify predictors of satisfaction among participants. RESULTS: A total of 262 participants completed the questionnaire with a response rate of 58.2%. 51.9% were males and 68.3% were family physicians. Only 14.9% and 17.2% of respondents were satisfied or highly satisfied about the overall safety of work and the clinical guidelines on the use of PPE in the context of COVID-19 respectively. Participants who were general practitioners were significantly more likely to be satisfied with maintaining work safety and local PPE guidelines compared to family physicians by 2.93 scores (95% CI 1.43, 4,43 p -value <0.001), and 2.82 scores (95% CI 1.19, 4,44 p -value 0.001) respectively. Also, physicians who had more than ten years of experience in practice were significantly more likely to be satisfied with the PPE use guidelines compared to those who had fewer years of experience by 1.93 scores (95% CI 0.45, 3.41 p -value 0.011). CONCLUSION: Overall satisfaction of participants with the safety of work and PPE clinical practice guidelines was low.

Spectrum of COVID-19 clinical characteristics among patients presenting to the primary healthcare in Qatar during the early stages of the pandemic: a retrospective multicentre cross-sectional study.

OBJECTIVES: To describe clinical characteristics and laboratory investigations of patients with COVID-19 diagnosed in primary care in Qatar and to assess predictors of hospitalisation. DESIGN: A retrospective cross-sectional study. SETTING AND PARTICIPANTS: 3515 confirmed patients with COVID-19 diagnosed in any of the 27 primary healthcare centres in Qatar between 9 April 2020 and 30 June 2020. MAIN OUTCOME MEASURES: Demographic characteristics, comorbidities, contact tracing, clinical and laboratory data, in addition to patient disposition at the time of diagnosis RESULTS: Mean age of patients was 35.5 years (±14.7). 2285 patients (65.0%) were males, 961 patients (27.3%) had a history of concomitant comorbidity and 640 patients (18.2%) were asymptomatic. Adult patients (19-64 years old) were more likely to report symptoms than children or elderly. Fever and cough were the most frequently documented symptoms affecting 1874 patients (46.7%) and 1318 patients (37.5%), respectively. Most patients had normal vital signs at presentation; however, patients who were subsequently hospitalised had higher median temperature than non-hospitalised patients (37.7°C, IQR: 37.0°C-38.4°C, and 37.2°C, IQR: 36.8°C-37.8°C, respectively). Hospitalised patients had significantly higher C reactive protein (CRP) (median CRP: 20 mg/L, IQR: 5.0-61.2 mg/L) than non-hospitalised patients (median CRP: 4.6 mg/L, IQR: 1.7-11.50 mg/L), and lower median absolute lymphocyte count (1.5×103/µL, IQR: 1.1×103/µL-2.1×103/µL, and 1.8×103/µL, IQR: 1.3×103/µL-2.4×103/µL, respectively). Predictors of hospitalisation were increasing age (adjusted OR (AOR): 2.614, 95% CI 1.281 to 5.332 for age between 50 years and 64 years, and AOR: 3.892, 95% CI 1.646 to 9.204 for age ≥65 years), presence of two or more comorbidities (AOR: 2.628; 95% CI 1.802 to 3.832) and presence of symptoms (AOR: 1.982: 95% CI 1.342 to 2.928). CONCLUSION: The majority of COVID-19 cases diagnosed in primary healthcare in Qatar were symptomatic. Most cases had normal vital signs and laboratory results at presentation. Predictors of hospitalisation were increasing age, the presence of symptoms and having two or more comorbidities.

Pattern of internet use for pregnancy-related information and its predictors among women visiting primary healthcare in Qatar: a cross-sectional study.

BACKGROUND: Internet usage has been steadily increasing and the available online information for pregnant women today is immense. OBJECTIVE: This study aimed to investigate the prevalence of women who search for information relating to pregnancy on the internet and to identify predictors of this behavior among expecting women visiting primary health care (PHC) centers in Qatar. METHODS: A cross-sectional study was conducted at the antenatal clinics of six PHC centers in Qatar from June 1 to December 31, 2019. Pregnant women were recruited through a systematic random sampling technique. Participants were interviewed using a structured questionnaire. Descriptive and analytic statistics were used when appropriate. A multivariable logistic regression analysis was constructed to identify the predictors of internet use for pregnancy-related information. RESULTS: The study included 403 pregnant women (response rate: 87.9%). Most of them were in the 26-35 years age category (71.5%), in the second trimester (55.5%), and had 1-2 children at home (51.5%). The internet was the most common source (81.1%) of pregnancy-related information. The access to online information was mainly through websites (67.3%), mobile applications (48.3%), and social media platforms (39.7%). The most frequently searched topics online were fetal development (74.3%), diet during pregnancy (53.6%), and management of health problems (39.6%). The multivariable regression model identified the age group 26-35 years (AOR: 4.93; 95% CI: 2.14, 11.38), Arabs (AOR: 4.12; 95% CI: 2.03, 8.36), tertiary education (AOR: 5.22; 95% CI: 1.78, 15.33), being a housewife (AOR: 6.37; 95% CI: 1.44, 28.19), or employed (AOR: 5.56 95% CI: 1.31, 23.63), and having up to 2 children as independent predictors of internet use for pregnancy-related information. CONCLUSION: The internet was a commonly used source of health information among pregnant women in Qatar. Internet use was significantly associated with the age group of 26-35 years, Arabs, higher level of education, being employed or a housewife, and having up to two children.

Knowledge, Attitude, and Training of Health-Care Workers and Preparedness of Hospital Emergency Departments for the Threat of Communicable Diseases at Mass Gathering Events in Qatar: A Cross-Sectional Study.

OBJECTIVE: This study aimed to assess the knowledge, attitude, and training of health-care workers (HCW), and their perception of the preparedness of hospitals for communicable disease (CD) threats during mass gathering (MG) events. METHODS: This was a cross-sectional study conducted from June 1 to July 31, 2019, of doctors and registered nurses working in the emergency departments (EDs) of 5 main hospitals in Qatar. A self-administered online survey was used for data collection. RESULTS: The overall mean knowledge score about CD threat among study participants was 75.0% (SD ± 18.1). The majority of the participants had a favorable attitude toward CD preparedness during MG events. The participants achieved high scores in attending workshops on triaging, first aid, and infection control. Study participants as well had favorable perceptions about the current preparedness of their respective hospitals to respond to CD outbreaks in MG events. CONCLUSIONS: The participants were knowledgeable about the risk of CD outbreaks during MG events (eg, Federation of International Football Association (FIFA) World Cup games 2022) and had a favorable attitude and necessary training to respond to such outbreaks. Regular practice drills are necessary to ensure that all members of the workforce are knowledgeable of the necessary actions to take in emergent high-risk situations.

Perceived Barriers to Colorectal Cancer Screening among Eligible Adults in Qatar and the Associated Factors: A Cross- Sectional Study

BACKGROUND: In Qatar, colorectal cancer (CRC) is the second most common cancer and is projected to be more than triple by 2035. Therefore, CRC periodic screening is vitally important because early detection will improve the success of treatment. In 2016, Qatar established a population-based screening program for CRC targetting average-risk adults. This study aimed to determine the perceived barriers to undergo CRC screening in eligible adults in Qatar and the associated factors. METHODS: This was a cross-sectional study of individuals aged 50-74 years who have been never screened, across six primary health centers between September 2018 and January 2019. A non-probability sampling method was used to recruit participants. Participants were interviewed using a structured questionnaire. Descriptive and analytic statistics were applied. RESULTS: A total of 188 individuals participated in the study. The mean age of the participants was 58.3 (SD ±6.4) years. Most participants were females (54.5%) and non-Qatari Arabs (54.3%). The top five reported barriers to CRC screening were: not at risk due to absence of symptoms (60.6%), not at risk due to absence of family history (55.1%), not at risk due to adopting a healthy lifestyle (52.7%), lack of time (41%), and lack of reminders by healthcare workers (39.4%). Bivariate analyses identified statistically significant associations between certain barriers and female gender, nationality, and educational level (primary school and below). CONCLUSION: The present study identified several barriers to undergoing CRC screening among eligible adults in Qatar. Such results provide a basis for tailoring of future educational campaigns that are relevant, specific, and appealing to such a cohort.
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Mental health literacy in Arab states of the Gulf Cooperation Council: A systematic review.

BACKGROUND: Mental health literacy (MHL) has been relatively neglected, despite the increase of mental health illnesses worldwide, as well as within the Middle East region. A low level of MHL may hinder public acceptance of evidence-based mental health care. AIM: This systematic review aims to identify and appraise existing research, focusing on MHL among adults in the Gulf Cooperation Council (GCC) countries. METHODS: A systematic search of electronic databases (PubMed, PsychInfo, and Medline) was carried out from database inception to July 2019, in order to identify peer-reviewed journal articles that investigated MHL in the GCC countries. Studies were eligible for inclusion if they were: cross-sectional studies, reported in English, targeted adults (aged 18 and above), conducted in any of the GCC countries, include at least one outcome measure of the main components of MHL: knowledge of mental illnesses and their treatment, stigmatizing attitudes towards mental illnesses, and seeking help for self and offering help. RESULTS: A total of 27 studies (16,391 participants) were included. The outcome across studies varied due to disparity in the tested populations. Findings show that limited MHL was observed among participants, even health care professionals. Results also show a high cumulative level of stigma and negative attitude towards mental health illness in the public. Negative beliefs and inappropriate practices are common, as well. The majority of studies yielded a moderate to high risk of bias. CONCLUSION: This work indicates that research on MHL must be tackled through well-designed large-scale studies of the public. Campaigns to promote early identification and treatment of mental illness is also encouraged to improve overall level of MHL in the general population of the GCC region. Registration number: PROSPERO 2018 CRD42018104492.

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar.

BACKGROUND: Potentially inappropriate medications (PIMs) often lead to sub-optimal or poor health outcomes in older adults. OBJECTIVE: The objective of this study was to determine the prevalence and predictors of PIM prescription among older adults in Qatar. PATIENTS AND METHODS: This was a cross-sectional, retrospective study using data from the electronic medical records of Qatari patients (age ≥ 65 years) attending the 23 primary healthcare (PHC) centers in Qatar from April 1, 2017 to September 30, 2017. PIMs were identified based on the Beers 2015 criteria: (1) medications to avoid for many or most older adults, and (2) medications to be used with caution in older adults. Descriptive statistics were used to estimate the prevalence of PIM prescription; multivariable logistic regression analysis was performed to identify predictors of PIM prescription among the study population. RESULTS: 5639 older adults were included with a mean age of 72.8 (± 6.5) years; 53.8% were females. The prevalence of PIMs that should be avoided was 60.7%, with the most prevalent ones being gastrointestinal (84.2%), pain (49.9%), and central nervous system (10.4%) drugs. Most patients (61.1%) were prescribed one PIM, 26.9% two PIMs, and 12.0% three or more PIMs. The prevalence of PIMs that should be used with caution was 40.6%, with diuretics (83.1%), antidepressants (25.7%), and antiplatelets (18.3%) as the most prevalent drug classes. Multivariable logistic regression showed female gender, polypharmacy, and certain comorbidities to be significant predictors of PIM prescription. CONCLUSIONS: Older adults attending Qatar's 23 PHC centers are prescribed a high number of PIMs. Because of the high risk of PIM prescription, the practice of medication reconciliation should be strengthened and reinforced.

Correction: Prevalence of polypharmacy and the association with non-communicable diseases in Qatari elderly patients attending primary healthcare centers: A cross-sectional study.

[This corrects the article DOI: 10.1371/journal.pone.0234386.].

Colorectal cancer awareness and its predictors among adults aged 50-74 years attending primary healthcare in the State of Qatar: a cross-sectional study.

OBJECTIVE: The current study aimed to assess the awareness of colorectal cancer (CRC) symptoms and risk factors among the at-risk population visiting the primary healthcare (PHC) centres in Qatar. The secondary objective was to assess the differences in awareness among population subgroups. DESIGN: A cross-sectional study design was employed. SETTING: The study was conducted across six PHC centres in Qatar. PARTICIPANTS: Patients, or their accompanying people, aged 50-74 years and Arabic or English speakers, were recruited from the main waiting areas of the selected PHC centres. DATA COLLECTION AND ANALYSIS: Participants were interviewed using the validated Bowel/Colorectal Cancer Awareness Measure questionnaire. A non-probability convenient sampling technique was applied to recruit participants. Descriptive and analytic statistics were used when appropriate. A multivariate linear regression model was constructed to identify the independent predictors of CRC awareness. RESULTS: The study includes 448 participants (response rate=87%). The mean age of the participants was 58.48 years (SD ±6.37). The mean awareness score among the participants was 3.63/9 (SD ±2.7) for CRC symptoms and 5.43/11 (SD ±3.3) for CRC risk factors. The overall mean awareness score was 9.03/20 (SD ±5.5). Multivariate linear regression identified the female gender (2.52 (95% CI 1.15 to 3.88)), non-Qatari Arab (2.91 (95% CI 1.64 to 4.18)) or non-Arab nationalities (1.76 (95% CI 0.28 to 3.24)), and tertiary education (4.10 (95% CI 2.55 to 5.66)) as independent predictors of higher CRC awareness. CONCLUSION: In general, the awareness of CRC symptoms and risk factors was low among the at-risk population in Qatar. Specifically, the regression analysis showed men, Qataris, and those with no formal education had low awareness of CRC symptoms and risk factors. Such results emphasise the importance of tailoring future educational campaigns that are relevant, specific and appealing to such cohort.

Prevalence of polypharmacy and the association with non-communicable diseases in Qatari elderly patients attending primary healthcare centers: A cross-sectional study.

BACKGROUND: Polypharmacy has become a global public health concern particularly in the elderly population. The elderly population is the most susceptible to the negative effects of polypharmacy due to their altered pharmacokinetics and decreased drug clearance. Therefore, polypharmacy can lead to poor health status and higher rates of morbidity and mortality. OBJECTIVE: The objective of this study was to determine the prevalence of polypharmacy (≥ 5 drugs) and its association with non-communicable diseases (NCDs) in elderly (≥65 years) Qatari patients attending Primary Healthcare (PHC) centers in Qatar. METHODS: A retrospective cross-sectional analysis was conducted using the Electronic Medical Record (EMR) database of all PHC centers in Qatar for six months (April-September 2017). RESULTS: Out of 5639 patients screened, 75.5% (95% CI: 74.3-76.6) were exposed to polypharmacy. Females were 1.18 times more likely to have polypharmacy compared to males (95% CI: 1.03-1.34). The multivariate analysis identified having hypertension (AOR 1.71; 95% CI: 1.38-2.13), diabetes (AOR 2.38; 95% CI: 1.97-2.87), dyslipidemia (AOR 1.29; 95% CI: 1.06-1.56), cardiovascular disease (AOR 1.56; 95% CI: 1.25-1.95) and asthma (AOR 1.39; 95% CI: 1.13-1.72) to be independent parameters associated with polypharmacy. Also, the Body Mass Index (BMI) and number of NCDs were found to be significant independent parameters associated with polypharmacy. CONCLUSIONS: The prevalence of polypharmacy among Qatari elderly attending PHC Centers is very high. Our findings confirm the strong relationship between polypharmacy and BMI, and certain NCDs. Healthcare professionals should be educated about the magnitude of polypharmacy, its negative effects, and its associated factors. Best practice guidelines should be developed for improved medical practice in the prescription of medications for such a vulnerable population.

Epidemiology of herpes zoster in the State of Qatar, 2012-2017.

Purpose: This study aimed to determine the epidemiological features of herpes zoster (HZ) in Qatar. Methods: This study was a retrospective review of all reported HZ cases received by the surveillance unit at the Ministry of Public Health, between January 2012 and December 2017. Results: A total of 2815 cases were reported during the study period. The mean incidence of HZ was estimated to be 19/100,000 population, which increased from 9.8/100,000 in 2012 to 36.2/100,000 in 2017. The ratio of male/female was about 4:1. HZ incidence overall was found to be highest in those aged ≥ 50 years. According to nationality, the mean incidence of HZ was estimated to be 79/100,000 among Qataris and 101/100,000 among expatriates. Additionally, more HZ cases were notified during the hot months. Conclusion: Such epidemiological data will contribute to the baseline information, which is necessary for effective preventive and control measures to be implemented in the country.

Epidemiological characteristics of a salmonella outbreak among infants in Qatar, 2017.

Purpose: This study was conducted to investigate the epidemiology behind the increased incidence of infant salmonella cases in Qatar during 2017 and identify the possible risk factors. Methods: This was a cross-sectional study using the notification reports of laboratory-confirmed infant salmonella cases received by the Ministry of Public Health during the year 2017. Furthermore, complementary phone interviews with the infants' mothers using a validated questionnaire were conducted. Results: The infant salmonella attack rate was calculated at approximately 3.23 cases per 1000 infants. Among the 89 confirmed infant salmonella cases, there were more girls (53%) than boys (47%) with a median age of 8 months. The most common type of salmonella species isolated was group B (50.5%). Among the 59 infant cases whose mothers were interviewed, the majority (94.9%) were symptomatic and diarrhea was the main reported symptom (90%), particularly bloody diarrhoea (62%). Regarding their dietary consumption, the majority (69.5%) of the infected infants were formula-fed. Moreover, the majority reported having no pets at home (91.6%) and were not enrolled in a day care center (93.3%). Conclusion: This study revealed a high incidence of salmonella infection among infants in the State of Qatar, which poses a public health concern. Therefore, targeted interventions and health awareness programs are required for outbreak prevention, detection and control.