COVID-19-We urgently need to start developing an exit strategy.

AIM: The purpose of this perspective is to review the options countries have to exit the draconian "lockdowns" in a carefully staged manner. METHODS: Experts from different countries experiencing Corona Virus Infectious Disease 2019 (COVID-19) reviewed evidence and country-specific approaches and the results of their interventions. RESULTS: Three factors are essential: 1. Reintroduction from countries with ongoing community transmission; 2. The need for extensive testing capacity and widespread community testing, and 3. An adequate supply of personal protective equipment, PPE, to protect health care workers. Discussed at length are lifting physical distancing, how to open manufacturing and construction, logistics, and the opening of higher educational institutions and schools. The use of electronic surveillance is considered. CONCLUSION: Each country should decide on the best path forward. However, we can learn from each other, and the approaches are, in reality, very similar.

Cost-effectiveness of IGRA/QFT-Plus for TB screening of migrants in Oman.

OBJECTIVE: To estimate the cost of a screening program for identifying latent tuberculosis (TB) infections in migrants to Oman. METHODS: A Markov model was used to estimate the cost of screening using an interferon-gamma release assay (IGRA) applied to all migrants from high TB endemic countries, followed by preventive TB treatment. RESULTS: The model compared seven different scenarios, with a comparison of the direct cost and the quality-adjusted life-years (QALYs) saved. CONCLUSIONS: IGRA testing followed by 3 months of preventive treatment with rifapentine/isoniazid (3HP) was the most cost-effective intervention.

Knowledge, attitude and practice of travel medicine among primary care physicians in Oman: the need for intervention.

BACKGROUND: Oman is witnessing an increase in outbound and inbound travelers. AIMS: This study was undertaken to assess the current knowledge, attitude, and practice of travel medicine among primary care physicians (PCPs) working in the Muscat Governorate. METHODS: We conducted a cross-sectional survey of 108 primary healthcare physicians in primary healthcare institutions in the Muscat Governorate in December 2014 using a self-administered questionnaire. RESULTS: We had a response rate of 81%, 78% (n = 84) were females, 56.5% (n= 61) were Omani nationals. More than 50% (n= 54) of study participants had been in practice for more than 8 years. Sixty-eight (58.3%) reported having pre-travel consultations during the previous 1-month period and 86 (79.6%) had post-travel consultations. Most of the PCPs were aware of the issues that needed to be addressed in pre-travel consultation. CONCLUSIONS: This study showed that travel health is in an early stage of development in Oman and supports the need for the establishment of travel medicine services.

Epidemiology of Meningitis in Oman-Implications for Future Surveillance.

OBJECTIVES: This study aimed to understand the epidemiology of meningitis cases admitted to hospitals in Oman and to identify any changing microbial patterns from the introduction of the new vaccines. METHODS: A retrospective analysis of all cases of meningitis reported through a national surveillance system. Meningitis is a notifiable disease. RESULTS: Of a total of 581 cases of meningitis from the period between January 1, 2005 and December 31, 2013, 15% (88) were confirmed to be bacterial in origin and 7.2% (42/581) viral. In 50.9% (296) of patients with suspected pyogenic meningitis, no specific bacterial pathogen were identified, and in 26% of cases (151) a cerebrospinal fluid study could not be undertaken. Among 88 cases with confirmed bacterial pathogens the organisms identified were Streptococcus pneumoniae (65.9%), Neisseria meningitides (18.2%), Haemophilus influenzae (6.8%), and other organisms (9.1%). The peak incidence was in children <2 years of age (39.4%). It showed notable decline in H. influenzae cases as well as pneumococcal meningitis cases, possibly indicative of the successful immunization program. CONCLUSION: A drop in H. Influenzae and pneumococcal meningitis cases was possibly the effect of the introduction of vaccines. It shows the need for improving diagnostic accuracy, laboratory capacities, and quality of surveillance reporting.

Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice.