Surveillance of adverse events following immunization: 10 years' experience in Oman.

A descriptive record-based review of adverse events following immunization (AEFI) was carried out in Oman using the national database for the period 1996-2005. A total of 790 adverse event reports were received with an annual rate during the review period of 33.7 per 100 000 population or 10.8 per 100 000 doses administered. There were no reported deaths. The most frequently reported AEFI were BCG adenitis (69.7 per 100 000 doses) and local reactions (3.6 per 100 000 doses respectively). The statistically significant higher rates among males, in children aged > 2 years and in some sparsely populated regions of Oman need further research. AEFI rates in Oman were similar or below the international averages

Absence of lymphatic filariasis infection among secondary-school children in Oman.

The endemicity status of lymphatic filariasis in Oman is uncertain, with only sporadic cases reported, mostly imported. Immunochromatographic card test surveys were carried out to assess the presence of circulating Wuchereria bancrofti antigenaemia as a marker for active infection in children from suspected high-risk areas of Oman (South Batinah and Dhofar). Lot quality assurance sampling surveys were carried out on a minimum of 250 secondary-school children aged 17-18 years in each of 8 districts from February 2004 to March 2004. All tested students were negative for circulating W. bancrofti antigen. Based on these findings as well as previous data, Oman may possibly be classified as a nonendemic country, with no evidence of indigenous lymphatic filariasis transmission.

Considerations for introduction of a rotavirus vaccine in Oman: rotavirus disease and economic burden.

Rotavirus is the most common cause of fatal childhood diarrhea worldwide. We provide the first estimates of the health care and economic burden of severe rotavirus disease in Oman. We conducted active, hospital-based surveillance of rotavirus disease at 11 regional public hospitals in Oman, using the guidelines suggested by the generic World Health Organization protocol. From July 2006 through June 2008, all children aged <5 years who were hospitalized for acute gastroenteritis were enrolled in the surveillance program, and their stool samples were tested for rotavirus using a commercially available enzyme immunoassay (ID EIA Rotavirus Test; Dako Diagnostics). Rotavirus was detected in samples from 1712 (49%) of 3470 children. These children were hospitalized for a median of 3 days for severe diarrhea. A marked seasonal peak was evident with a majority of the cases occurring from December through May. Of the rotavirus cases, 69% occurred in children aged 6-17 months. We identified a diverse strain pattern in Oman, with G2 (37%), G1 (38%), and G9 (11%) accounting for most of typeable strains. By our burden estimates, the Omani government spends an estimated US$791,817 and US$1.8 million annually to treat rotavirus-associated diarrhea in the outpatient and hospital settings, respectively. A rotavirus vaccination program might substantially reduce the burden of severe diarrhea among children in Oman.

Measles epidemiology and its implications for a vaccination programme in Oman.

To describe the epidemiology of measles in Oman and the implications for a vaccination programme, we conducted a retrospective record-based study from 1 January 2000 to 31 December 2003 using data from the national epidemiological surveillance system. All cases notified as suspected measles during the study period were included. Of the 185 notified cases, 19.4% were confirmed measles positive. Blood samples for measles IgM were collected in 97.3% of cases. The mean age of measles cases was 8.0 (SD 10.7) years. The estimated overall incidence rate of measles for the study period was 0.53 per 100,000 person-years. Regression analysis indicated measles was significantly commoner among non-Omanis and children who had not been vaccinated.

Safe injection practices in a primary health care setting in Oman.

We conducted a national survey of injection practices in 78 government health facilities in Oman in 2001. Data were obtained by interview and observation. The overall standards were good and the stock of disposable equipment was adequate. Recapping of needles was only observed in 1 facility but in 28%, waste disposal boxes contained recapped needles and 17.9% reported needle-stick injuries in the past year. In 9% of the institutions, sharps were observed around the facility, in 12.8% unsupervised disposal containers were seen and in 11.5% unsafe storage of full boxes was observed. While disposal of the used waste was done away from the health facility, only 33.3% disposed of it by correct incineration.

Community-based projects in rural internships: an alternative approach.

Supervision of medical interns posted to various primary health centres and rural health training centres by specialists in preventive and social medicine and other clinical disciplines is becoming less and less effective for a number of unavoidable reasons. Because of lack of proper and timely guidance, interns feel that during the 6-month rural internship they do not get enough experience of rural life. In order to provide them with learning experiences in community medicine and orient them in the social dynamics of the community, a new approach involving interns in small community-based projects, probably for the first time, was tried on a pilot basis at the Rural Health Training Centre (RHTC), Sirur, a field practice area of B.J. Medical College, Pune, Maharashtra, India. Interns working at RHTC Sirur completed these community-based projects successfully. Identification of problems, study design analysis and drawing conclusions, based on observation, were all undertaken by the interns under the guidance of the staff of the Department of Preventive and Social Medicine, B.J. Medical College. The opinion poll at the end of the rural internship revealed that 76% of interns considered this experience valuable for improving their knowledge and skills, and 56% though that interaction during these projects was beneficial to the community as well. This experience with community-based projects for interns during their rural posting provides them with an opportunity for interaction with the community.

Surveillance of adverse events following immunization: 10 years' experience in Oman

A descriptive record-based review of adverse events following immunization [AEFI] was carried out in Oman using the national database for the period 1996-2005. A total of 790 adverse event reports were received with an annual rate during the review period of 33.7 per 100000 population or 10.8 per 100000 doses administered. There were no reported deaths. The most frequently reported AEFI were BCG adenitis [69.7 per 100000 doses] and local reactions [3.6 per 100000 doses respectively]. The statistically significant higher rates among males, in children aged > 2 years and in some sparsely populated regions of Oman need further research. AEFI rates in Oman were similar or below the international averages

Absence of lymphatic filariasis infection among secondary-school children in Oman

The endemicity status of lymphatic filariasis in Oman is uncertain, with only sporadic cases reported, mostly imported. Immunochromatographic card test surveys were carried out to assess the presence of circulating Wuchereria bancrofti antigenaemia as a marker for active infection in children from suspected high-risk areas of Oman [South Batinah and Dhofar]. Lot quality assurance sampling surveys were carried out on a minimum of 250 secondary-school children aged 17-18 years in each of 8 districts from February 2004 to March 2004. All tested students were negative for circulating W. bancrofti antigen. Based on these findings as well as previous data, Oman may possibly be classified as a nonendemic country, with no evidence of indigenous lymphatic filariasis transmission

Measles epidemiology and its implications for a vaccination programme in Oman

To describe the epidemiology of measles in Oman and the implications for a vaccination programme, we conducted a retrospective record-based study from 1 January 2000 to 31 December 2003 using data from the national epidemiological surveillance system. All cases notified as suspected measles during the study period were included. Of the 185 notified cases, 19.4% were confirmed measles positive. Blood samples for measles IgM were collected in 97.3% of cases. The mean age of measles cases was 8.0 [SD 10.7] years. The estimated overall incidence rate of measles for the study period was 0.53 per 100 000 person-years. Regression analysis indicated measles was significantly commoner among non-Omanis and children who had not been vaccinated

Safe injection practices in a primary health care setting in Oman

We conducted a national survey of injection practices in 78 government health facilities in Oman in 2001. Data were obtained by interview and observation. The overall standards were good and the stock of disposable equipment was adequate. Recapping of needles was only observed in 1 facility but in 28%, waste disposal boxes contained recapped needles and 17.9% reported needle-stick injuries in the past year. In 9% of the institutions, sharps were observed around the facility, in 12.8% unsupervised disposal containers were seen and in 11.5% unsafe storage of full boxes was observed. While disposal of the used waste was done away from the health facility, only 33.3% disposed of it by correct incineration