Epidemiology of communicable diseases in Jazan region: Situational assessment, risk characterization, and evaluation of prevention and control programs outcomes.

The incidence of communicable diseases has witnessed a reduction in Saudi Arabia during the last 4 decades. Nonetheless, the Jazan region has been indicated as one of the main regions affected by various communicable conditions. The geographical, socioeconomic, and climate characteristics of Jazan have made it vulnerable to communicable and vector-borne diseases. This review aims to provide a comprehensive overview of the epidemiology of communicable diseases in Jazan, Saudi Arabia. This review also gives a historical description of infectious diseases in the region and the relevant prevention and control measures. Prevention and control efforts in the Jazan region successfully eliminated Rift Valley fever and reduced the number of locally acquired malaria and chickenpox cases. Hepatitis B, dengue fever, and pulmonary tuberculosis have exhibited an increased incidence in recent years, suggesting a need for further epidemiological investigations and the application of relevant prevention and control measures.

Assessment of School Contributions to Healthy Eating, Physical Activity Education, and Support for Weight-Loss Attempts among Adolescents from Jazan, Saudi Arabia.

This study evaluates the contribution of schools in Saudi Arabia towards the provision of education and support concerning weight management among adolescents. It also identifies adolescents who have attempted to lose weight and examines their preferred weight-loss methods and their sources of weight-loss support. This study is a cross-sectional investigation that targets adolescents in intermediate and secondary schools in Jazan, Saudi Arabia. Data was collected via a self-administered questionnaire that looked at the involvement of the school in the provision of education pertaining to weight control and the weight-loss experiences of students who had attempted to lose weight. The study involved 501 adolescents, 45% of whom had attempted to lose weight, where the most common methods for weight loss being reducing food consumption (77%), exercising (75%), and fasting (49%). The assessment of the schools' contributions indicated its suboptimal role in the provision of education concerning physical activity compared to education about eating habits. The most commonly reported sources of weight-loss support were the students' families (54%), followed by community facilities (44%). The least common sources were the students' schools (24%). These findings indicate that schools need to enhance their contribution to encouraging adolescents to adopt a healthy lifestyle, while also ensuring multi-sectorial collaboration with families and community members.

Assessment of Influenza Vaccine Uptake According to the Presence of a Chronic Disease.

Patients diagnosed with a chronic disease are at higher risk of influenza complications. This investigation aimed to estimate influenza vaccine uptake rates among healthy subjects and patients with chronic diseases, and to identify barriers to and facilitators of its uptake. This study was a cross-sectional investigation that targeted the general population in the Jazan region of Saudi Arabia. Data were collected via online platforms between October and November 2022. Data were collected via a self-administered questionnaire that assessed the demographics, influenza vaccine uptake, and factors associated with the uptake. A chi-squared test was used to investigate factors associated with the uptake of the influenza vaccine. A total of 825 adult subjects participated in the current investigation. The proportion of male participants was higher (61%) compared to females (38%). The mean age of the participants was 36, with a standard deviation of 10.5. Nearly 30% of the sample reported being diagnosed with a chronic disease. Among the recruited sample, 576 (69.8%) reported having ever received the influenza vaccine, and only 222 participants (27%) indicated that they receive the influenza vaccination annually. Only history of being diagnosed with a chronic disease was statistically associated with the history of ever receiving the influenza vaccine (p < 0.001). Among the 249 participants with a chronic disease, only 103 (41.4%) ever received the influenza vaccine and only 43 (17.3%) of them received the vaccine annually. The main barrier to the uptake was fear of side effects due to the vaccination. A minority of the participants indicated that they were motivated by a healthcare worker to have the vaccine. This suggests an area for further investigation to assess the involvement of healthcare workers in motivating their patients with chronic diseases to have the vaccine.

Assessment of the Association Between Use of WhatsApp for Work-Related Purposes and Levels of Depression, Anxiety, and Stress Among Healthcare Workers from Jazan, Saudi Arabia.

Purpose: This study aims to investigate the potential association between use of WhatsApp in healthcare settings for work-related purposes and depression, stress, and anxiety levels among a sample of healthcare workers in Saudi Arabia. Methods: This was a cross-sectional study of healthcare employees working in different hospitals in Jazan. The data was collected via a semi-structured, self-administered questionnaire with three components that measured the demographics of the sample; the presence of depression, anxiety, and stress; and their use of WhatsApp in the work environment. A multivariate regression analysis was carried out to estimate the statistical likelihood of depression, anxiety, and stress as a result of using WhatsApp and how these factors affected occupational and social relationships. Results: A total of 294 healthcare workers participated in the current study. The median age of the participants was 32 years, and the gender distribution was almost even. Over 90% of the participants stated that they were members of work-related WhatsApp groups, and nearly 70% agreed that use of WhatsApp in work-related settings could be stressful. Among the recruited sample, 48.6% exhibited abnormal levels of depression, 55.8% had abnormal levels of anxiety, and 63% showed abnormal levels of stress. The findings of the regression analysis (P values <0.05) indicated that the likelihood of these participants suffering with depression, anxiety, and stress was high, with the participants themselves agreeing that using WhatsApp in work settings could be stressful and affect their relationships with colleagues, friends, and family members. Conclusion: The findings suggests the presence of a potential association between use of WhatsApp for work-related purposes and levels of depression, anxiety, and stress, especially among those who perceive its use as a stressor and influencer on occupational and social relationships.

Assessment of COVID-19 Symptoms Distribution According to Tobacco Products Consumption and Khat Chewing: A Potential Antinociceptive Role of Nicotine Among COVID-19 Patients.

Purpose: To assess the distribution of COVID-19 symptoms according to the consumption of tobacco products and khat chewing among samples of Saudi Arabian individuals. Methods: This retrospective cohort study was conducted in the Jazan region of Saudi Arabia. Data was collected online via a self-administered questionnaire. The questionnaire measured demographic variables, COVID-19 symptoms and vaccination, comorbidities history, tobacco product consumption, and khat chewing. In addition, logistic regression was performed to assess the association between the clinical presentation of COVID-19 with tobacco product consumption and khat chewing. Results: A total of 1026 subjects were recruited. The mean age of the participants was 31 years, and more than half were male (53%). Among the reported tobacco product consumption, hookah smoking was more frequently reported as a currently consumed tobacco product (14.3%), followed by cigarette smoking (11.5%) and chewing tobacco (3.8%). Thirteen percent (134) were khat chewers at the time of recruitment. The odds of reporting five symptoms or more were higher among patients who have never been tobacco product consumers (OR: 1.6, 95% CI: 1.15-2.35) while accounting for khat chewing, age, vaccination status, and history of comorbidities. Nonetheless, the difference in symptom distribution with khat chewing status was not statistically significant. Conclusion: The findings of the current investigation suggest the presence of a potential impact of nicotine toxicity in masking pain among the subjects infected with COVID-19. Therefore, it is possible to hypothesize that, with the potential masking effect of nicotine, infected smokers may be less likely to suffer from the symptoms and seek official healthcare services, including diagnostic services.

An Assessment of the Knowledge and Practices of Adults in Jazan, Saudi Arabia, Concerning Routine Medical Checkups.

Purpose: This study aims to measure the knowledge and practices of adults in the Jazan region of Saudi Arabia concerning routine medical checkups. Methods: This study used a cross-sectional design that targeted adults in the Jazan region of Saudi Arabia. The data was collected via self-administered questionnaires, with participants being approached in online settings. The questionnaires measured participant demographics, knowledge, and practice of routine medical checkups as well as their response to the Know Your Numbers campaign services initiative from the Saudi Ministry of Health. A chi-square test was used to detect statistically significant differences between the levels of knowledge and practice according to the measured demographic characteristics. Results: A total of 516 persons participated in this study. The mean age of the participants was 25 years; 54.7% were female. The median level of knowledge was 3 (out of 9), varying between 0 and 9. The recruited sample exhibited average knowledge of parameters used to classify levels of blood glucose, blood pressure, body mass index, and blood lipids, but low knowledge regarding the recommended age to begin screening for several chronic diseases. Factors associated with levels of knowledge were gender, age, education level, and employment (p value < 0.05). However, a history of chronic disease was the only factor associated with the practice of routine medical checkups (p value 0.023). Finally, less than 5% of this sample reported their participation in the Know Your Numbers campaign. Conclusion: Attending routine medical checkups is uncommon and only motivated by the existence of a diagnosed medical condition. Furthermore, this study found low utilization of the Know Your Numbers campaign services. This suggests a need for greater emphasis on increasing awareness of routine medical checkups among adults in the Jazan region.

Assessment of the risk of obstructive sleep apnoea among patients with type 2 diabetes and its associated factors using the STOP-BANG questionnaire: A cross-sectional study.

Objective: To assess the risk of obstructive sleep apnoea (OSA) and its associated risk factors among patients with type 2 diabetes in southern KSA. Methods: This was a cross-sectional study conducted at the Armed Forces Hospital in Jazan. The prevalence of OSA was assessed using a validated Arabic translation of the STOP-BANG screening questionnaire. The odds of a higher OSA risk were calculated via regression analysis, according to the measured clinical and demographic variables. Results: The total number of participants was 306, of which 213 (69.6%) were over the age of 50, 247 (80.7%) were married, and 161 (52.6%) were female. The overall median score of the OSA risk level assessed by the STOP-BANG items was three on a scale of 0-8, of which 193 (63.1%) of the participants in the sample were classified as being at high risk of developing OSA. Several statistically significant associations were identified, where odds ratios (ORs) with a higher OSA risk level were detected according to age, sex, marital status, waist and neck circumference, haemoglobin A1c (HbA1c) and body mass index levels, duration of diabetes, and comorbidity with hypertension (p < 0.05). Conclusion: The higher risk of OSA identified in our sample of diabetic patients can be related to a high prevalence of obesity, larger neck circumferences, hypertension, and other factors linked to the duration and treatment of diabetes. Additionally, the association between waist circumference, HbA1c, and duration since the diagnosis of diabetes suggests an interaction effect that requires further investigation.

Assessment of caffeine consumption behavior among Jazan University students in the south of Saudi Arabia: A cross-sectional study.

Caffeine is a central nervous system stimulant. High consumption levels of caffeine can lead to intoxication and serious side effects. Saudi Arabia is witnessing a rise in the commercialization and consumption of caffeine. Young adults such as university students may exhibit high levels of caffeine consumption. This investigation aims to assess caffeine consumption habits among a sample of Jazan University students in the south of Saudi Arabia. This study was a cross-sectional investigation that utilized multistage sampling to recruit the students. Data was collected via a self-administered questionnaire that measured student demographics, their frequency of consuming caffeine-containing food, portion sizes, and patterns of consumption during different times of the day. Caffeine consumption levels were estimated based on a cutoff point of 400 mg per day. A chi-squared test was used to investigate the association between levels of caffeine consumption and measured study characteristics. A sample of 964 students was recruited with a mean age of 21.8 years. The most frequently consumed product among the recruited students was coffee (32%), followed by chocolate bars (16%) and soft drinks (12%). The median total consumed caffeine amount was 185 mg per day. 194 (20%) students of the sample exceeded the recommended level of daily caffeine consumption (>400 mg/day). Among the measured demographics, only the year of study was associated with caffeine consumption (P value of .003), suggesting that students in their earlier years of university are likely to exceed the recommended daily consumption of caffeine in comparison with those who are in their later years of study. Our investigation identified high levels of caffeine consumption among some students. The findings imply the need to enhance the awareness of students who exceed the recommended daily intake of caffeine regarding the harmful impacts of caffeine toxicity.

Assessment of factors influencing the contribution of primary healthcare physicians in prevention of type 2 diabetes in South of Saudi Arabia.

BACKGROUND: This study was aiming to assess factors influencing the contribution of primary healthcare physicians concerning prevention of type 2 diabetes in the Jazan region, south of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was conducted to assess physicians' knowledge about evidence-based guidelines concerning diabetes prevention, their attitude towards lifestyle interventions and their practice concerning screening and provision of lifestyle interventions in their clinics. Interviews were conducted to complete a semi-structured questionnaire. Data analysis involved reviewing open-ended responses of physicians followed by quantitative analysis to assess level of knowledge, attitudes, and practice adherence. RESULTS: A total of 234 physicians from 127 primary healthcare centres (PHCs) in the region were recruited. Knowledge of evidence-based clinical indicators for the prevention of diabetes was limited (mean level of knowledge 3.14/8 [SD: 1.2)]. Recruited physicians did have a positive overall attitude to the influence of lifestyle/behavioural therapy on the prevention of type 2 diabetes. The physicians narrated a variety of factors that might influence the effectiveness of this approach, which were related to the community, the patients and the physicians themselves. Only the association between gender of physicians and their levels of knowledge was statistically significant where odds of greater knowledge were higher among female physicians in comparison to males (odds ratio : 1.8, P value = 0.025). CONCLUSION: Most of the physicians in our sample were misinformed about the components of lifestyle/behavioural interventions for diabetes prevention, which mandates designing and implementing lifestyle medicine programmes for the PHC physicians in Jazan region.

Lifestyle Counseling for Patients with Type 2 Diabetes in the Southwest of Saudi Arabia: An Example of Healthcare Delivery Inequality Between Different Healthcare Settings.

PURPOSE: Adherence to a healthy lifestyle can have a positive impact on the course of diabetes management. This investigation aims to study lifestyle counseling provision among patients with type 2 diabetes in Saudi Arabia and the delivery of lifestyle counseling within different healthcare settings. METHODS: This cross-sectional investigation was conducted in the Jazan region in Saudi Arabia. Data were collected using a semi-structured questionnaire during phone interviews. The questionnaire measured items related to the demographics of the patients, diabetes diagnoses, and follow-up locations. The items pertaining to lifestyle counseling were related to whether the patients were given an assessment of dietary and physical activity levels, receipt of a personalized lifestyle change plan, and smoking cessation therapy among smokers. Odds ratios (ORs) were calculated to estimate the probability of receiving the lifestyle counseling items in primary healthcare centers (PHCs) compared to other healthcare facilities. RESULTS: A total of 461 patients diagnosed with diabetes were identified. The development of symptoms or complications related to diabetes was the main cause of diagnosis (63%). Sixty-six patients reported not attending a follow-up at any healthcare facility. The ORs of receiving a lifestyle plan and having daily caloric needs calculated were higher among patients who followed up at hospitals, diabetes centers or within the private sector compared to those who went to PHCs (ORs: 1.8 [1.1-2.8] and 2.7 [1.2-5.9] respectively). In all the identified healthcare settings, health education was mostly provided by the treating physicians, indicating the limited role of nutritionists or health educationists. CONCLUSION: This study suggests a limited receipt of lifestyle counseling services for patients with type 2 diabetes in PHCs compared to other healthcare facilities. The majority of counseling services were provided by physicians, which indicates the limited inter-disciplinary involvement of other health professionals, such as nutritionists and health educationists.

Assessment of Factors Associated with the Effectiveness of Premarital Screening for Hemoglobinopathies in the South of Saudi Arabia.

PURPOSE: Southern region of Saudi Arabia has one of the highest prevalence of sickle cell disease and thalassemia in the kingdom. This study aims to assess the factors associated with the rejection of premarital clinical counselling in the Jazan region. METHODS: This is a cross-sectional investigation conducted in the Jazan region of Saudi Arabia. The investigation targeted subjects who performed premarital screening and, with their screened partners, were identified as high-risk couples and proceeded with their marriage. Data were collected via a web-based self-administered questionnaire. A section of the questionnaire targeted those who attended the premarital counselling clinic in the Jazan region and assessed the factors that led to the rejection of premarital counselling advice. RESULTS: A total of 413 participants were recruited. The mean age of the respondents was 33 years, and the majority of the respondents were female (62.5%). The majority of the respondents were related to their partners (66.8%) and were carriers of sickle cell disease (67.8%). Among the respondents, only 192 had attended premarital counselling clinics in the Jazan region. More than half of the attendees rejected the premarital counseling advice because they believed that their marriage was their unavoidable destiny. About 30% of the attendees reported that disease complications were not well explained during the counselling. Thirty-five attendees (18.2%) proceeded with the marriage because they thought the risk of transmitting the disease to their children was small and 10 attendees (5.2%) proceeded with their marriage because they believed their children's lives would not be affected by the disease. CONCLUSION: The findings explain the limited influence of the premarital counselling advice in raising the awareness of the attendees about inherited blood disorders. The findings indicate a strong cultural influence leading to the reduced effectiveness of premarital counselling in the Jazan region.

An assessment of cerebral venous thrombosis risk factors and associated clinical outcomes in Jazan region, Saudi Arabia.

OBJECTIVES: To assess cerebral venous thrombosis risk factors, and associated clinical outcomes in Jazan region, Kingdom of Saudi Arabia. METHODS: This study is a retrospective review of the medical records of patients diagnosed with cerebral venous thrombosis and admitted to King Fahad Central Hospital in Jazan between 2010 and 2019. Data concerning socio-demographics, clinical features, risk factors, laboratory, and imaging investigations were retrieved. Furthermore, data about cases management, and outcomes, including death, were collected and analysed. RESULTS: A total of 51 medical records were identified. The majority of the patients were females (68.6%), and the mean age of the patients was 33.3 years, of which three patients were under 18 years old. The most frequently recorded symptom was headache (76.5%), followed by seizure (45.1%). The most commonly recorded risk factor was protein S deficiency (57%), followed by anaemia (51%). Venous infarction and haemorrhage were the most common acute complications (13.7%). The majority of the patients had a favourable prognosis where only 27.5% recovered with disability and only one patient died due to the disease. CONCLUSION: Clinical presentation of cerebral venous thrombosis in Jazan region is similar to other local and international studies. However, anaemia was recorded as a main risk factor for the disease, which might require further investigation to assess the possible association between prevalence of anaemia in Jazan region and the incidence of cerebral venous thrombosis.

Community-based observational assessment of compliance by the public with COVID19 preventive measures in the south of Saudi Arabia.

BACKGROUND: At the end of August 2020, a surge in the number of cases in the Jazan region has been observed. The number of reported cases by 19th of August in the Jazan region was more than 300, which exceeded the number of reported cases in larger regions such as Riyadh, and Makkah. This study aims to measure compliance by the public with COVID-19 preventive measures. METHODS: This study was a cross-sectional, field-based observational assessment of compliance by individuals in public settings with COVID-19 preventive measures in the Jazan region of Saudi Arabia. The assessment was performed in the last week of July 2020. The assessment was based on observing the actual compliance of individuals and different establishments in the Jazan region with COVID-19 preventive measures. To perform the field observations, a standardised check-list was adopted from COVID-19 preventive measures in the community, which was developed by the Saudi Centre for Disease Prevention and Control (CDC). RESULTS: A total of 1096 individuals were observed in 69 different locations in the Jazan region. Compliance by the observed individuals was variable depending on the age group, the setting and the recommended preventive practice. The findings indicate very low compliance of specific precautionary measures within public parks in comparison to other measured settings. Proportions of individuals not compliant with mask-wearing instructions varied according to settings and age group from 5% in malls and shopping areas to nearly 83% in public parks. Additionally, Proportions of children not compliant with mask-wearing instructions was higher in comparison to adults in all observed settings. CONCLUSIONS: The findings of this study identified variability in the levels of compliance with specific preventive measures against COVID-19. Further assessment is needed to explore factors associated with the limited observed compliance, in particular with regard to limited compliance to precautionary measures applied in specific settings and compliance of children to mask-wearing instructions.

Factors Associated with Mothers' Care of Their Newborns in Saudi Arabia.

BACKGROUND: Infant mortality rates are highest in the southern regions of Saudi Arabia, compared to other regions in the kingdom. OBJECTIVE: To measure demographic factors associated with mothers' levels of knowledge and practice of care for their newborns in Jazan region, south of Saudi Arabia. METHODS: This is a cross-sectional study conducted between November and December 2018 in Jazan region, Saudi Arabia, on the northern borders of Yemen. A questionnaire was utilised to measure mothers' level of knowledge and practice of newborn care. Data was collected via interviews, and a scoring system was developed to classify knowledge level and practice adequacy. Logistic regression was used to assess the presence of statistically significant associations between demographic factors and level of knowledge and practice adequacy. FINDINGS: A total of 450 mothers participated in the current investigation. A majority of participating mothers were able to give correct answers, where the mean level of knowledge was 11.85/16 [SD: 2.6]. Additionally, the mean score for practice adequacy was 7.11/10 [SD: 1.45]. However, 122 mothers (27%) reported using alternative treatments to treat their newborns instead of seeking professional health care from available health services. Additionally, 42 mothers (9.3%) reported not attending any antenatal visits during their pregnancy. Factors which were found to be statistically associated with knowledge were education level, employment status, and adherence to antenatal visits during pregnancy (p < 0.05). Age and employment status appeared to be associated with practice where older and employed mothers had higher odds of competency (p < 0.05). CONCLUSIONS: The proportions of correct answers measuring knowledge and practice adequacy concerning newborn care varied between 40% to 93%. Knowledge and practice appeared to be associated with demographic factors, such as level of education, age, and attending antenatal care visits.

Do healthier foods cost more in Saudi Arabia than less healthier options?

OBJECTIVES: To investigate whether healthy foods in Saudi Arabia cost more compared with less healthy options. METHOD: This is a cross-sectional study conducted in Riyadh, Saudi Arabia during June and July 2015. The study targeted well-known market chains in the city of Riyadh. The selection of food items was purposive to include healthy and less healthy food items in each category. Price, caloric value, salt, fat, sugar, and fiber contents for each food item were collected. To test for the correlation between nutritional contents and average price, Spearman's correlation coefficients were calculated. The Mann-Whitney U test was used to test for the presence of average price difference between healthy and less healthy food items. RESULTS: A total of 162 food items were collected. Sixty-six food items were classified as healthy compared with 96 less healthier options. The calculated correlation coefficients indicate an association between increased cost of food with increased caloric values (0.649 p=0.0000001), increased fat content (0.610 p=0.0000003), and increased salt contents (0.273 p=0.001). Prices of food items with higher fiber contents showed a weaker association (0.191 p=0.015). The overall average cost of healthy food was approximately 10 Saudi riyals cheaper than less healthy food (p=0.000001).  CONCLUSION: The findings of the study suggest that the cost of healthy food is lower than that of less healthy items in the Saudi market.

Assessment of the environmental and genetic factors influencing prevalence of metabolic syndrome in Saudi Arabia.

 Metabolic syndrome (MS) is a combination of factors that increases the risk of cardiovascular atherosclerotic diseases including diabetes, obesity, dyslipidemia, and high blood pressure. Cardiovascular diseases are one of the leading causes of death in the adult Saudi population where the increase in cardiovascular-related mortality is augmented by the rise in the prevalence of MS. Metabolic syndrome is a multi-factorial disorder influenced by interactions between genetic and environmental components. This review aims to provide a comprehensive assessment of studied environmental and genetic factors explaining the prevalence of MS in the Kingdom of Saudi Arabia. Additionally, this review aims to illustrate factors related to the population genetics of Saudi Arabia, which might explain a proportion of the prevalence of MS.