Acute Rheumatic Fever in Children: The Known and the Unknown Among Saudi Mothers in the Jazan Region.

Background Acute rheumatic fever (ARF) is a significant public health problem that causes morbidity and mortality in low and middle-income countries. Therefore, this study aims to assess mothers' knowledge of acute rheumatic fever and their attitudes in the Jazan region. Methods A cross-sectional study was conducted between the mothers using an online survey. The knowledge level was ranked as poor, fair, and good. In contrast, the attitudes were ranked as positive or negative. Association with sociodemographic variables was assessed, and statistical significance was set at p < 0.05. Results Four hundred thirty-six (436) mothers were included; 39.9% of them were aged 21-30 years, 68.8% were married, 57.3% were non-workers, and 72.2% were university-educated. Most of the mothers had a poor level of knowledge (53%); however, positive attitudes toward the disease were reported in 79.1% of mothers. The poor knowledge levels were related to age, marital status, occupation, and monthly income. Conclusion Despite having positive attitudes toward diagnosing and managing ARF, most of the mothers showed poor knowledge of acute rheumatic fever. This study highlights the situation in the Jazan region, which could be an essential basis for constructing an educational program to raise awareness and knowledge of acute rheumatic fever in the community.

COVID-19 and malaria co-infection: a systematic review of clinical outcomes in endemic areas.

Background: COVID-19 and malaria cause significant morbidity and mortality globally. Co-infection of these diseases can worsen their impact on public health. This review aims to synthesize literature on the clinical outcomes of COVID-19 and malaria co-infection to develop effective prevention and treatment strategies. Methods: A comprehensive literature search was conducted using MeSH terms and keywords from the start of the COVID-19 pandemic to January 2023. The review included original articles on COVID-19 and malaria co-infection, evaluating their methodological quality and certainty of evidence. It was registered in PROSPERO (CRD42023393562). Results: Out of 1,596 screened articles, 19 met the inclusion criteria. These studies involved 2,810 patients, 618 of whom had COVID-19 and malaria co-infection. Plasmodium falciparum and vivax were identified as causative organisms in six studies. Hospital admission ranged from three to 18 days. Nine studies associated co-infection with severe disease, ICU admission, assisted ventilation, and related complications. One study reported 6% ICU admission, and mortality rates of 3%, 9.4%, and 40.4% were observed in four studies. Estimated crude mortality rates were 10.71 and 5.87 per 1,000 person-days for patients with and without concurrent malaria, respectively. Common co-morbidities included Diabetes mellitus, hypertension, cardiovascular diseases, and respiratory disorders. Conclusion: Most patients with COVID-19 and malaria co-infection experienced short-term hospitalization and mild to moderate disease severity. However, at presentation, co-morbidities and severe malaria were significantly associated with higher mortality or worse clinical outcomes. These findings emphasize the importance of early detection, prompt treatment, and close monitoring of patients with COVID-19 and malaria co-infection.

Nursing Students' Knowledge and Attitudes toward Danger Signs in Neonatal Illnesses.

Background and Objectives: Neonates can show subtle signs of illness that could be overlooked by their mothers and caregivers. Therefore, basic knowledge regarding neonatal health and early detection of neonatal diseases can help improve survival. We assessed nursing students' knowledge and attitudes toward the danger signs of neonatal illnesses. Materials and Methods: We performed a descriptive cross-sectional study using a structured online questionnaire based on danger signs categorized by the World Health Organization to assess knowledge of neonatal illness danger signs among nursing students. Results: We assessed 342 students, of which 67.0% (95% CI: 61.8-71.7) had good knowledge regarding neonatal illness danger signs, and 71.6% received information about neonatal care. About 33% of the participants had a basic knowledge of neonatal care, such as breastfeeding, immunization, routine postnatal care, and eye care. Students who received information on neonatal care were three times (AOR = 2.95, 95% CI: 11.59-5.47, p = 0.001) more likely to have good knowledge than those who did not. The students also showed a positive attitude towards the importance of knowledge regarding neonatal illness danger signs, teaching this subject in their college, participating in studies involving the practice and knowledge of mothers regarding neonatal illness danger signs, and the importance of knowledge in reducing neonatal mortality in the region. Conclusions: More training programs on neonatal care should be implemented to enhance knowledge and raise nursing students' awareness of the dangerous signs of neonatal illnesses.

The Efficacy of Educational Interventions in Improving School Teachers' Knowledge of Attention Deficit Hyperactivity Disorder.

BACKGROUND: Well-trained primary school teachers should be competent in recognizing attention deficit hyperactivity disorder (ADHD) in students and be able to assist in providing care and support. OBJECTIVES: This study intends to assess primary school teachers' knowledge of ADHD and evaluate the effectiveness of a short-term educational intervention.  Methods: A quasi-experimental quantitative study was conducted among primary school teachers in Jazan, Saudi Arabia. A two-hour educational intervention was designed and run in six schools using a specific knowledge rating scale before and after the application of the intervention.  Results: A total of 150 primary school teachers were included in this study, of which 64% were males, 51.3% were in the age group of 40-49 years, and 28% had teaching experience of more than 20 years. Regarding ADHD knowledge, the pre-intervention knowledge of the general criteria, symptoms and diagnosis, and treatment was considered adequate in 3.3%, 16.7%, and 2.7% of the participants, respectively, which improved post-intervention to 22%, 54.7%, and 19.3%, respectively. There was a significant association between the pre-intervention knowledge of the general criteria and the gender and between the knowledge of symptoms and diagnosis and the attendance of ADHD workshop by the participants. Also, there was a significant association between the participants' age, residence experience, attendance of ADHD workshops, and the general criteria and treatment domains. CONCLUSIONS:  Most primary school teachers in Jazan have insufficient knowledge of ADHD. Using a knowledge improvement intervention can substantially improve the teachers' knowledge. Therefore, it is necessary to incorporate thoughtful knowledge improvement programs into the educational curricula for teachers.

Multiple Cesarean Section Outcomes and Complications: A Retrospective Study in Jazan, Saudi Arabia.

BACKGROUND: Given the increase in the rate of cesarean sections (CSs) globally and in Saudi Arabia, this study was conducted to assess the maternal and perinatal complications after repeat cesarean sections in the studied population. METHODS: This retrospective study was conducted by reviewing the records of all women who underwent CSs between January and July 2023 in three hospitals in the Jazan region of Saudi Arabia. RESULTS: Of the 268 women studied, 195 (72.7%) had a CS for the first or second time and 73 (27.3%) had two, three, or four previous CSs (repeat CS). The most common maternal intra-operative complications reported by the repeat CS group were intra-peritoneal adhesions (7.5%) and fused abdominal layers (7.1%) while the most common postoperative complications were the need for blood transfusion (22%) and UTIs (3%). The most common neonatal complications were a low Apgar score (19%), needing neonatal resuscitation (2.6%), and intensive care admission. In addition, 3.7% of mothers failed to initiate breastfeeding in the first 24 h. CONCLUSIONS: The frequent complications were intra-peritoneal adhesions, fused abdominal wall layers, blood transfusion, and postoperative infections which were overcome by the optimal hospital care. However, the frequent neonatal complications were a low Apgar score, needing neonatal resuscitation, and intensive care admission.

Caffeine Consumption and Its Potential Health Effects on Saudi Adolescents in Jazan.

Background Caffeine is the most popular product consumed globally in different types and amounts by various age groups. This study aimed to identify caffeine consumption patterns among adolescents in Jazan and explore related health effects. Methodology A cross-sectional study was conducted in Jazan on adolescents between 12 and 18 years of age. The consumption of coffee and caffeinated products and their potential health effects were evaluated using a self-reported online questionnaire. The data were analyzed using software for descriptive and inferential statistics. Results A total of 718 participants were enrolled in this study, with the age group of 16-18 years constituting the highest percentage (48.9%). Nearly 94% of the participants consumed coffee or caffeinated products, with 57% consuming the products infrequently. About 6.6% consumed coffee or caffeinated products more than three times daily, and about half of the participants used medium-sized cups. The most consumed type of caffeinated beverage was Arabic coffee, followed by tea, soft drinks, and Nescafe. Education level and age group showed a significant correlation with consumption patterns. The most common health effects of caffeine consumption were headaches, irregular sleep, and nausea, which were statistically related to age group, gender, and comorbid conditions. Conclusions Consumption of coffee and caffeinated beverages was relatively high among adolescents in this study. Further research on the habits of Saudi adolescent consumers, particularly across different areas of the country, is required.

Sickle cell anemia in pregnant Saudi women and its impact on birth weight and gestational maturity.

BACKGROUND: It is well documented that sickle cell anemia (SCA) in pregnancy increases the risk of problems that can influence the growth and maturation of the newborn. To assess the gestational maturity and birth weight of babies born to Saudi mothers with SCA in the Jazan region. METHODS: A case-control study was conducted in three hospitals in the Jazan region. An interview with a semi-structured questionnaire was used to collect data from the participants' women, and then the birth weight was taken. RESULTS: Of 187 delivered women, 20.3% had SCA (13% had sickle cell disease, and the remaining had sickle cell trait). Among the 38 affected mothers, 15.7% were considered to have an additional risk (7.9% had diabetes mellitus, 5.3% had hypertension, and 2.6% were smokers). The mean birth weight was 2.95 ± 0.40 kg and 2.99 ± 0.55 kg in the case and control groups, respectively. However, the low birth weight babies constitute 31% of the delivered babies in the SCA group with a weight of 2.33 ± 0.16 kg and 15% of the control group with a mean weight of 2.16 ± 0.30 kg. The gestational age was 39.36 ± 1.02 weeks in the SCA group compared to 39.5 ± 1.17 weeks in the control group. Maternal age and hypertension significantly influence the birth weight in the SCA group compared to the influence of diabetes mellitus on the birth weight in the control group. CONCLUSION: This study indicates that SCA in pregnant mothers influences birth weight, which is more impacted by maternal age and co-morbidities. Therefore, a multidisciplinary approach must monitor these risky pregnancies well to avoid undesirable neonatal outcomes.

Prevalence and Pattern of Birth Defects in Saudi Arabia: A Systematic Review of Observational Studies.

INTRODUCTION: Birth defects are a significant concern since they can lead to permanent disability and death. This study comprehensively reviews the prevalence and patterns of birth defects in Saudi Arabia. METHODS: A systematic analysis of the literature retrieved from three databases (Pub Med, Science Direct, and the Saudi digital library) published between 1989 and 2022 was performed. Observational studies that addressed the prevalence and patterns of birth defects in Saudi Arabia were chosen based on the eligibility criteria, while systematic reviews, review articles, non-relevant articles, and studies that did not fulfill the eligibility criteria were excluded. Quality and risk of bias were evaluated based on the JBI and GRADE tools, respectively. RESULTS: We identified 26 eligible publications of 1277 records that included 297,668 patients from different regions of Saudi Arabia. The highest overall prevalence of birth defects was 46.5 per 1000 live births compared to a lowest rate of 8.6 per 1000 in one study. Several studies have reported positive associations of consanguinity, maternal folic acid supplementation, family history of birth defects or genetic abnormalities, and maternal co-morbidities. The most frequent birth defects include cardiac, genitourinary, craniofacial, and nervous system defects. CONCLUSION: Robust findings have improved our understanding of the prevalence and pattern of birth defects in Saudi Arabia. Importantly, future studies will likely require multicenter collaboration to arrive at appropriate sample sizes in the context of the effects of risk factors on elevated prevalence. Furthermore, quantitative data require careful evaluation in more complex statistical models.

Prevalence and related risks of cyberbullying and its effects on adolescent.

BACKGROUND: Cyberbullying is becoming common in inflicting harm on others, especially among adolescents. This study aims to assess the prevalence of cyberbullying, determine the risk factors, and assess the association between cyberbullying and the psychological status of adolescents facing this problem in the Jazan region, Saudi Arabia. METHODS: A cross-sectional study was conducted on 355 students, aged between 12-18 years, through a validated online questionnaire to investigate the prevalence and risk factors of cyberbullying and assess psychological effects based on cyberbullying questionnaire and Mental Health Inventory-5 (MHI-5) questions. RESULTS: The participants in this study numbered 355; 68% of participants were females compared to 32% were males. Approximately 20% of the participants spend more than 12 h daily on the Internet, and the estimated overall prevalence of cyberbullying was 42.8%, with the male prevalence slightly higher than females. In addition, 26.3% of the participants were significantly affected in their academic Performance due to cyberbullying. Approximately 20% of all participants considered leaving their schools, 19.7% considered ceasing their Internet use, and 21.1% considered harming themselves due to the consequences of cyberbullying. There are essential links between the frequency of harassment, the effect on academic Performance, and being a cyber victim. CONCLUSIONS: Cyberbullying showed a high prevalence among adolescents in the Jazan region with significant associated psychological effects. There is an urgency for collaboration between the authorities and the community to protect adolescents from this harmful occurrence.