Investigation of varicella outbreak among residents and healthcare workers in psychiatric hospital- Saudi Arabia.

BACKGROUND: Outbreak is an infection control challenge in health care setting especially when it occurs in a special setting as psychiatric hospitals. Objectives: Investigate and control an outbreak of varicella among patients and healthcare workers (HCWs) in a psychiatric hospital of Saudi Arabia. Methods: A multidisciplinary team of different specialties assigned to assess the situation, confirm the diagnosis, identify the causes and put an action plan to deal with such a situation. Results: The team investigated the varicella outbreak as per the Ministry of Health's (MOH) outbreak guidelines. Multiple risk factors contributed to this outbreak as the location of the outbreak in a psychiatric hospital, breaches in the hospital infection control program. Conclusion: Investigation of this outbreak was conducted as per MOH and CDC definitions and guidelines. Outbreak control plan was instituted and successfully implemented including enforcement of infection control program, the establishment of an employee health program, basic infection control orientation programs.

Toxocara Awareness Among Medical Practitioners in Saudi Arabia.

Human toxocariasis is a zoonotic infection with global and regional impacts. Worldwide it is underestimated and clinically overlooked. Medical practitioners are generally unaware of the extent of the resulting disease spectrum. The objective of the study was to assess knowledge and disease awareness among medical practitioners in Aseer, south-western Saudi Arabia. A questionnaire addressing knowledge about the parasite, its visceral larva migrans and the disease spectrum generated was used to interview participants. The study included 285 participants. In answer to the question what is toxocara, only 27%, answered correctly that it is a nematode, paediatricians being the majority. With regard to years of experience among participants, 56.8% of those who answered correctly had less than 5-year experience, as opposed to 35.4% for those with more than 10-year experience. The cumulative awareness about the disease manifestations and spectrum, i.e. those who knew, was less than 30% across specialties and years of experiences. Lack of awareness regarding Toxocara infection and the disease spectrum it can generate is evident. The consequence for such lack of knowledge within our practising medical community is simply unacceptable as it might translate into misdiagnosis and consequently misguided treatment.

Prevalence of latent TB among health care workers in four major tertiary care hospitals in Riyadh, Saudi Arabia.

BACKGROUND: Tuberculosis (TB) infection represents a global health problem and a great risk to Health Care Workers (HCWs). Identifying individuals, particularly HCWs with latent tuberculosis infection (LTBI) will support TB control through chemoprophylaxis and prevent cross-infection. OBJECTIVES: This study aimed to identify prevalence of Latent TB among a two-year new hires of HCWs in 4 major tertiary care hospitals in Riyadh, Saudi Arabia. MATERIAL AND METHODS: 2650 recently (2-years) hired HCWs were surveyed for latent TB using Tuberculin Skin Test (TST). Data was collected from January 2008 to December 2009. Induration due to TST equal to or more than 10 mm. within 48-72 hours was considered positive. The results of TST were correlated with other variables such as age group, gender, job category, country of origin. RESULTS: as an overall rate, 291(11%) out of 2650 were positive for TST, with the highest significant positive rates among physicians (14.9%) and nurses (12.9%) compared to students as a reference group. No statistically significant difference was detected between both sexes. The highest significant positive TST rates were found among HCWs in the age group of 50 years and older (32.6%) compared to 10-19 years age group as a reference group, and among HCWs coming from sub-Saharan countries (61.1%) compared to Saudi HCWs with the lowest positive rates (5%) as a reference group. CONCLUSION AND RECOMMENDATIONS: LTB is prevalent among newly hired HCWs in Riyadh tertiary hospitals. Standard programs for detection and treatment of LTB should be encouraged.

A prospective study of congenital malformations among live born neonates at a University Hospital in Western Saudi Arabia.

OBJECTIVE: To estimate the incidence of major and minor congenital malformations among liveborn infants at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Estimation of risk factors were also evaluated. METHODS: Between March 2004 and May 2005, a total of 5356 babies born at King Abdulaziz University Hospital, were enrolled in this study for malformations. Details of cases were recorded after parents' interviews, clinical, radiological, and laboratory evaluations. RESULTS: One hundred and forty-seven (27.06/1000 livebirth) and 13 (2.39/1000 birth) stillbirth had congenital anomalies. In all livebirth, incidences of major anomalies were 93.9% and minor were 6.1%. Mothers of 95.9% with congenital malformation were healthy, 3.4% were diabetic and 0.7% had cardiac malfomation. In 38.8% of cases parents were consanguineous. Among the liveborn births, the most common system involved was cardiovascular (7.1/1000), followed by musculoskeletal/limb (4.1/1000), external genitalia (2.8/1000), urinary (2.6/1000), multiple chromosomal (2.2/1000), orofacial (1.9/1000), central nervous system (1.9/1000), skin (1.7/1000), multiple single gene (1.3/1000), multiple sequence (0.75/1000), eyes (0.56/1000), unclassified (0.19/1000), musculoskeletal/abdominal (0.19/1000), endocrine (0.19/1000). CONCLUSION: High incidence of major malformation in Jeddah. Importance of Genetic Counseling is revealed in our study since more than three quarters of mothers were under 36 years, and may well plan future pregnancies.

Genotoxicity of air borne particulates assessed by comet and the Salmonella mutagenicity test in Jeddah, Saudi Arabia.

Fine airborne respirable particulates less than 10 micrometer (PM10) are considered one of the top environmental public health concerns, since they contain polycyclic aromatic hydrocarbons (PAHs) which are among the major carcinogenic compounds found in urban air. The objective of this study is to assess the genotoxicity of the ambient PM10 collected at 11 urban sites in Jeddah, Saudi Arabia. The PM10 extractable organic matter (EOM) was examined for its genotoxicity by the single cell gel electrophoresis (SCGE) comet assay and the Salmonella mutagenicity (Ames) test .Gas chromatography-mass spectrometry was used to quantify 16 PAH compounds in four sites. Samples from oil refinery and heavy diesel vehicles traffic sites showed significant DNA damage causing comet in 20-44% of the cells with tail moments ranging from 0.5-2.0 compared to samples from petrol driven cars and residential area, with comet in less than 2% of the cells and tail moments of < 0.02. In the Ames test, polluted sites showed indirect mutagenic response and caused 20-56 rev/ m3, mean while residential and reference sites caused 2-15 rev /m3. The genotoxicity of the EOM in both tests directly correlated with the amount of organic particulate and the PAHs concentrations in the air samples. The PAHs concentrations ranged between 0.83 ng/m3 in industrial and heavy diesel vehicles traffic sites to 0.18 ng /m3 in the residential area. Benzo(ghi)pyrene was the major PAH components and at one site it represented 65.4 % of the total PAHs. Samples of the oil refinery site were more genotoxic in the SCGE assay than samples from the heavy diesel vehicles traffic site, despite the fact that both sites contain almost similar amount of PAHs. The opposite was true for the mutagenicity in the Ames test. This could be due to the nature of the EOM in both sites. These findings confirm the genotoxic potency of the PM10 organic extracts to which urban populations are exposed.