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Streptococcus agalactiae is known to cause invasive infections in risk groups such as pregnant women, newborns, and immunosuppressed patients but it is uncommon in older children. We describe a case of recurrent infective endocarditis due to S. agalactiae in an 11-year-old boy with Loeys-Dietz syndrome who was successfully treated with long-term antimicrobial therapy for one year.
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BACKGROUND: A strong understanding of infection prevention and control (IPC) procedures and comprehensive training among healthcare workers is essential for effective IPC programs. These elements play a crucial role in breaking the chain of nosocomial infections by preventing the transmission of resistant organisms to patients and staff members. This study mapped the components of IPC education and training across various member states of the World Health Organization (WHO) in the Eastern Mediterranean Region (EMR) at national, academic, and healthcare institutional levels. METHODS: A self-administered structured online questionnaire based on the WHO "Core Component 3" of IPC programs at the national and acute healthcare facility levels (IPC education and training) was given to national IPC focal persons in each of the WHO's EMR countries between February and March 2023. RESULTS: From 14 of the 22 countries,15 IPC persons participated in the survey. Most countries have scattered nonhomogeneous IPC education programs in human health undergraduate majors without considering it a standalone module. Academic institutions are rarely involved, and elaborate and predefined undergraduate IPC education programs provided by universities are present in 21.4% of the countries. In 71.4% of these countries, postgraduate training targeting IPC professionals is provided by national IPC teams, primarily based on national IPC guidelines developed with the aid of the WHO. Generally, healthcare worker training relies heavily on healthcare facilities in 92.9% of the countries, rather than on a national training program. In 42.9% of the countries, practicing IPC physicians are not necessarily specialists of infectious disease or medical microbiologists and IPC nurses are not required to specialize in IPC. However, nonspecialized IPC professionals are expected to undergo training upon employment and before beginning practice. Nongovernmental organizations such as the WHO play a significant role in IPC education and in supporting national IPC authorities in establishing national IPC guidelines, as it is the case in 78.6% of these countries. CONCLUSION: Clear disparities exist in IPC education and training across different countries in the WHO's EMR. Establishing a regional scientific network specializing in IPC would help bridge the existing gaps and standardize this education within individual countries and across countries in the region. This region needs to establish IPC certification standards and standardized education curricula.
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Currículo , Controle de Infecções , Humanos , Escolaridade , Organização Mundial da Saúde , Região do MediterrâneoRESUMO
Introduction: Severe acute respiratory illness (SARI) is a potentially lethal condition, necessitating thorough medical care. COVID-19 underscored the SARI threat, but other high-risk pathogens require monitoring alongside SARS-CoV-2. Oman instituted a comprehensive testing system to gauge the prevalence of these pathogens between 2017 and 2021, aiding resource allocation and public health responses to potential respiratory pathogen outbreaks. Methods: Samples from SARI cases admitted to ICU were tested for pathogens using the Fast-Track Diagnostic (FTD) molecular assay, a respiratory virus panel (RVP) that tests for 21 pathogens, including 20 viruses, by qPCR. Results: Between 2017 and 2022, ~30 000 samples were analysed using the RVP panel. Among SARI patients, 8%-42% tested positive for respiratory pathogens, with 4% showing multiple infectious agents, especially in children under 10. A drop in positivity during 2020-2021 can be attributed to SARS-CoV-2 control measures, followed by a rebound in infections in early 2022. Discussion: The COVID-19 pandemic heightened awareness of respiratory pathogens' spread without adequate control measures. Influenza A/B, human rhinoviruses and respiratory syncytial virus constituted over 50% of severe acute respiratory illness cases in Oman over the past 5 years. During the pandemic, the incidence of these infections significantly declined, demonstrating the efficacy of COVID-19 prevention measures in reducing spread of other pathogens.
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COVID-19 , Influenza Humana , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Vírus , Criança , Humanos , COVID-19/epidemiologia , Pandemias , Omã/epidemiologia , Infecções Respiratórias/epidemiologia , SARS-CoV-2 , Vírus/genética , Influenza Humana/epidemiologiaRESUMO
BACKGROUND: HCV infection in hemodialysis units is a significant cause of morbidity and mortality. The risk of HCV infection among dialysis patients is higher compared to the general population due to high potential blood exposures in hemodialysis settings. This study aims to assess the national HCV seroprevalence in selected dialysis units and to determine the risk factors for acquiring HCV infection. METHODS: This cross-sectional study was conducted from 1 January to 31 March 2021. A total of 734 patients from 11 hemodialysis centers in Oman were included. Samples were tested simultaneously for HCV antibodies and HCV RNA. HCV genotyping was determined in all viremic patients. Demographic and hemodialysis center related data were gathered and their association with the positive HCV serology were explored using univariate and multivariate logistic regression analysis. RESULTS: Out of 800 patients selected from 11 dialysis units for the study, 734 patients (91.8%) were included. The overall seroprevalence of HCV infection among hemodialysis patients was 5.6%. (41/734). HCV RNA was detected in 31.7% (13/41) of seropositive hemodialysis patients. The most common genotype was subtype 1a, followed by subtype 3. Variables associated with high HCV prevalence were family history of HCV and duration of dialysis. CONCLUSION: The prevalence of infection within hemodialysis patients in Oman has significantly decreased but remained higher than the general population. Continuous monitoring and follow-up, including periodic serosurvey and linkage to care and treatment are recommended. Additionally, practice audits are recommended for identifying gaps and ensuring sustainability of best practices and further improvement.
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Hepacivirus , Hepatite C , Humanos , Hepacivirus/genética , Estudos Transversais , Estudos Soroepidemiológicos , Omã/epidemiologia , Hepatite C/epidemiologia , Diálise Renal , Fatores de Risco , Prevalência , RNARESUMO
We describe here the first confirmed case in Oman of chronic osteomyelitis due to Coxiella burnetii, in a previously healthy four-year-old Omani girl. After laboratory confirmation of C. burnetii infection using molecular and qualitative and quantitative serological assays, the case was successfully managed with a combination of oral ciprofloxacin and cotrimoxazole and thereafter followed up for a long period without remission.
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BACKGROUND: The World Health Organization (WHO)'s multimodal strategy for improving hand hygiene (HH) compliance was endorsed in 2009 and was implemented by every hospital in Oman. There was variation in adherence to the practice even within the same facility and in sustaining improvement after the intervention. OBJECTIVES: Evaluate the impact of national HH role model project on health care worker's immediate and long term compliance with HH practices. MATERIAL AND METHODS: A pretest-posttest quasi-experimental observational study was conducted in four hospitals, including 16 (medical/surgical/psychiatry) departments. The study consisted of four phases: Baseline assessment, intervention, three-month post-intervention assessment, and follow-up assessment after 15 months for sustainability. The intervention (role model in hand hygiene) consisted of four components: Leadership involvement as a role model for HH, posting HH messages with photos of role model leaders, a weekly selection of staff as HH role models, and conducting HH education and training from the focal point of each ward/department. RESULTS: There were 5796 observations recorded during the study for Moments 1 and 4 of HH. HCWs' overall compliance rate significantly increased from a baseline of 52.6% before the intervention to 74.1% after three months from the intervention, and 70.0% on follow-up after more than one year (p < 0.001). All the hospitals included, regardless of their baseline compliance, had a significant improvement in HH compliance post-intervention and were able to sustain compliance (> 60%) after 15 months from the start of the intervention. The likelihood of improvement in HH compliance with the intervention remained low for the moment before patient contact (AOR, 0.34; 95% CI = 0.27-0.44) during the weekend (AOR, 0.44; 95% CI = 0.32-0.59) in the psychiatry wards (AOR, 0.22; 95% CI = 0.15-0.34) and by the non-medical and nursing professions (AOR, 0.99; 95% CI = 0.61-1.66). CONCLUSIONS: Implementation of a role model as a behavioral intervention, in addition to the WHO's multimodal strategy, successfully improved and sustained HCWs' HH compliance rates. Understanding healthcare culture in the context of the driving factors of behavioral changes and regular follow-ups are essential to sustain adherence to safe HH practices.
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Infecção Hospitalar , Higiene das Mãos , Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes , Desinfecção das Mãos , Pessoal de Saúde/educação , Hospitais , Humanos , Controle de InfecçõesRESUMO
BACKGROUND: Candida auris (C. auris) is an emerging healthcare-associated pathogen resulting in significant morbidity and mortality. The aim of this study is to report data from the national C. auris surveillance system for 2019 and conduct a survival analysis of the reported cohort. METHODS: a retrospective analysis was conducted for all C. auris cases reported nationally to the Oman Antimicrobial Surveillance System (OMASS) in 2019, and isolates were sent to the Central Public Health Laboratories (CPHL). Clinical and demographic data were obtained through the E-Surveillance reporting system and the Electronic System (NEHR Al-Shifa) at CPHL. Statistical analysis was done using Kaplan-Meier analysis and Cox proportional hazard models. RESULTS: One hundred and twenty-nine isolates of C. auris were grown from 108 inpatients; 87% were isolated from clinical samples, of which blood was the most common (38.9%). Forty (37%) were ≥65 years of age, 72 (66.7%) were males, and 85 (78.7%) were Omani nationals. Of the total isolates, 43.5% were considered as colonization; 56.5% were considered infection, of which 61.8% of them were candidemia. At least one risk factor was present in 98.1% of patients. The mean time from admission to infection was 1.7 months (SD = 2.8), and the mean length of hospital stay was 3.5 months (SD = 4). Totals of 94.8% and 96.1% of the isolates were non-susceptible to fluconazole and amphotericin, respectively. The variables found to be significantly associated with longer survival post C. auris diagnosis (p < 0.05) were age < 65 years, absence of comorbidities, length of stay < 3 months, colonization, and absence of candidemia. The infection fatality rate was 52.5%. CONCLUSION: Including C. auris in an ongoing antimicrobial surveillance program provides important data for the comprehensive management of this growing public health threat. The current study shows health care outbreaks of C. auris are ongoing, with 52.5% infection fatality, although our isolates remained sensitive to Echinocandins in vitro.
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BACKGROUND: Mortality surveillance provides a crucial method for monitoring disease activity. Coronavirus disease 2019 (COVID-19) can cause excess mortality both directly and indirectly by increasing deaths from other diseases. The aim of this study was to investigate the effects of COVID-19 on mortality in Oman. METHODS: A cross-sectional retrospective analysis of mortality data from 1 January 2015 to 16 August 2020 was undertaken. Baseline mortality estimated using the Farrington flexible model and excess mortality were calculated for the pandemic period (16 March-16 August 2020) according to cause of death, place of death and age group. RESULTS: During the pandemic period, there was a 15% [95% confidence interval (CI) 14-17] increase in all-cause mortality from baseline. When classifying by cause, there was a 9% (95% CI 5-12) increase in deaths due to respiratory diseases, a 2% (95% CI 1-4) increase in deaths due to infectious diseases and a 9% (95% CI 8-11) increase in unclassified deaths. In terms of place of death, 12% (95% CI 11-14) of excess mortality occurred in hospitals and 7% (95% CI 5-8) occurred in homes during the pandemic period. Patients aged >60 years recorded a 15% (95% CI 13-16) increase in all-cause mortality during this period. CONCLUSION: The COVID-19 pandemic has resulted in a 15% increase in all-cause mortality in Oman, mainly as a result of deaths from COVID-19. However, unclassified deaths, deaths due to respiratory diseases and deaths due to infectious diseases have also increased, enforcing the need for a holistic approach and appropriate coordination of health services during such health crises.
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COVID-19/mortalidade , Pandemias , SARS-CoV-2/fisiologia , Adulto , Idoso , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/virologia , Estudos Transversais , Monitoramento Epidemiológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Omã/epidemiologia , Estudos RetrospectivosRESUMO
Clostridioides difficile infection is an increasing presence worldwide. Prevention is multipronged, reflecting a complex and evolving epidemiology. Multiple guidelines exist regarding the prevention of C. difficile infection in healthcare settings; however, existing guidelines do not address C. difficile in low- and middle-income countries (LMIC). Nevertheless, the prevalence of C. difficile in LMIC likely parallels, if not exceeds, that of high-income countries, and LMIC may experience additional challenges in C. difficile diagnosis and control. A panel of experts was convened by the International Society for Infectious Diseases (ISID) to review the current state of C. difficile infections globally and make evidence-based recommendations for infection prevention that are broadly applicable.
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Clostridioides difficile , Infecções por Clostridium/prevenção & controle , Infecção Hospitalar/prevenção & controle , Animais , Infecções por Clostridium/epidemiologia , Infecções por Clostridium/transmissão , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , HumanosRESUMO
OBJECTIVES: The aim of the current study was to describe COVID-19's epidemiological characteristics in Oman during the initial stages of the outbreak and compare findings with other countries' reports. METHODS: Data were drawn from a descriptive, records-based review of reported cases of COVID-19 collected through the national COVID-19 Surveillance System from February to April 2020. RESULTS: A total of 2,443 confirmed cases were reported during the study period. The overall first-time testing rate for this period was 851.7 per 100,000, the positivity rate was 53.1 (confidence intervals [CI]: 51.0-55.2) and the death rate was 0.32 (CI: 0.20-0.54) per 100,000 population, respectively. The overall national positive ratio was 5.7% and ranged from 2.2-7.1% across various governorates. Muscat Governorate had the highest positive ratio (12.5%). People in the 51-60 year old age group (RR = 1.97), males (RR = 1.24), non-Omanis (RR = 2.33) and those living in Muscat (RR = 2.14) emerged as categories with significant demographic risk for COVID-19 cases when compared to the national average. The mean age was 35.6 ± 13.4. Asymptomatic cases accounted for nearly 16%. CONCLUSION: The overall rate of COVID-19 cases and deaths were low in Oman compared to the rest of the world during the study period.
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COVID-19/epidemiologia , Pandemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Tosse/epidemiologia , Feminino , Febre/epidemiologia , Febre/etiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Omã/epidemiologia , SARS-CoV-2 , Adulto JovemRESUMO
In this paper, we present a multicentre record-based descriptive study used to estimate the incidence and characterize the spectrum of confirmed bacille Calmette-Guérin (BCG) vaccine-related disease among children in Oman. This study included all children (age ≤ 14 years) who had culture and/or polymerase chain reaction (PCR)-confirmed BCG disease from January 2006 to December 2018, as identified from Central Public Health Laboratory data and International Classification of Diseases coding of an electronic patient information system. In total, 88 children confirmed to have BCG disease were included in the study, making an average incidence of 9.2 cases per 100,000 vaccinated neonates. The males comprised 65.9%, Omanis 93.2%, and the median age of presentation was 4 months in children with BCG disease. The most common type of disease was BCG abscesses (72.4%). Children with immunodeficiency and those presenting within 6 months were found to have a more severe and disseminated disease. In total, 28 children had immunodeficiency. The age of presentation and type of BCG disease was significantly associated with immunodeficiency status. The majority of cases required therapy (both medical and surgical) and recovered well. The incidence of laboratory-confirmed BCG vaccine-related disease was low in Oman supporting continuing the use of the BCG vaccination practice at birth.
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BACKGROUND: In January 2016, the National AIDS Programme (NAP) in Oman introduced a package of interventions, including capacity building for service providers, to improve the quality of HIV services. AIMS: To report the impact of these interventions on the rate of vertical HIV transmission in the period from January 2016 to December 2019. We also describe the virological and obstetric outcomes for HIV-infected pregnant women. METHODS: This was a medical record review of 94 HIV-positive pregnant women (median age 32 years; interquartile range 25-34 years) reported to NAP in 2016-2019. RESULTS: There were 110 pregnancies in 94 women. The majority (75.3%, 61/81) of women were diagnosed with HIV infection from routine antenatal screening, with 60% (66/110) of pregnancies occurring in women who knew their HIV status at conception. Caesarean section was the most common (50%) mode of delivery. The preterm labour and low birth weight rates were 21.2% and 15.9%, respectively. The antiretroviral coverage during pregnancy was 95.5%, with most (87.8%) women reporting excellent or good adherence. The majority (81.6%) of women achieved HIV viral load of < 400 copies/ml at or near delivery. Almost all infants (99%) were given prophylactic antiretrovirals. The rate of mother-to-child transmission of HIV was 1%. CONCLUSION: The obstetric and virological outcomes for HIV-infected pregnant women delivered in 2016-2019 were favourable, with a low rate of mother-to-child transmission of HIV. Oman is now in the process of finalizing application of World Health Organization validation of elimination of mother-to-child transmission of HIV.
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Fármacos Anti-HIV , Infecções por HIV , Complicações Infecciosas na Gravidez , Adulto , Fármacos Anti-HIV/uso terapêutico , Cesárea , Criança , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Oriente Médio , Omã/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controleRESUMO
Oman is globally acknowledged for its well-structured immunization program with high vaccination coverage. The massive spread of misinformation brought on by the COVID-19 pandemic, as well as the easy access to various media channels, may affect acceptance of a vaccine, despite the inherent trust in the local system. This cross-sectional study evaluated the knowledge, attitudes, and practice (KAP) in Oman toward COVID-19 vaccines. It included 3000 randomly selected adults answering a structured questionnaire via telephone. Participants were 66.7% Omani, 76% male, and 83.7% without comorbidities. Their mean age was 38.27 years (SD ± 10.45). Knowledge of COVID-19's symptoms, mode of transmission, and attitudes toward the disease was adequate; 88.4% had heard of the vaccine, 59.3% would advise others to take it, 56.8% would take it themselves, and 47.5% would take a second dose. Males (CI = 2.37, OR = (2.00-2.81)) and Omani (CI = 1.956, OR = (4.595-2.397)) were more willing to be vaccinated. The history of chronic disease, source of vaccine knowledge, and education level were factors that affected the willingness to accept the vaccine. The Omani community's willingness to take the COVID-19 vaccine can be enhanced by utilizing social media and community influencers to spread awareness about the vaccine's safety and efficacy.
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OBJECTIVE: To determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare workers (HCWs) based on risk of exposure to COVID-19 patients. METHOD: This was a SARS-CoV-2 seroprevalence cross-sectional study in risk-stratified HCWs randomly selected from three main district hospitals in Oman. RESULTS: 1078 HCWs were included, with an overall SARS-CoV-2 seroprevalence of 21%. The seropositivity rates in low-, variable-, and high-risk groups were 29%, 18%, and 17%, respectively (p-value < 0.001). The study found higher positivity in males (crude odds ratio [COR] 1.71, 95% confidence interval [CI] 1.28-2.3), and workers residing in high-prevalence areas (COR 2.09, 95% CI 1.42-3.07). Compared with doctors, workers from supporting services, administration staff, and nurses were more likely to test positive for SARS-CoV-2 antibodies (COR 9.81, 95% CI 5.26-18.27; 2.37, 95% CI 1.23-4.58; 2.08 95% CI 1.14-3.81). The overall rate of previously undetected infection was 12%, with higher values in low-risk HCWs. High district prevalence was a driving factor for seropositivity in the low-risk group (adjusted odds ratio [AOR] 2.36, 95% CI 1.0-5.59). CONCLUSION: Low-risk supporting services workers can drive SARS-CoV-2 transmission in hospitals. More attention and innovation within this area will enhance the safety of health care during epidemics/pandemics.
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COVID-19/transmissão , Pessoal de Saúde , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos SoroepidemiológicosRESUMO
Cryptosporidium is a rare but important pathogen, especially in children with immunodeficiency. Intestinal cryptosporidiosis is well described in immunocompetent and immunocompromised children, but respiratory and disseminated cryptosporidiosis in immunodeficient children is not often reported. We describe an Omani infant with disseminated cryptosporidiosis and failing pharmacological therapy in the context of severe combined immunodeficiency. Chronic diarrhea can be an initial symptom of immunodeficiency in the pediatric population. Awareness of cryptosporidiosis is critical to early detection and management for such patients. As antiparasitic agents are often ineffective, amelioration of immunosuppression in immunodeficient children should be a priority.
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BACKGROUND: In Oman, many extended families tend to live in one household. Some families can include 20-30 individuals with the majority of them being children. This study investigates the role of children in spreading SARS-CoV-2 causing COVID-19 within family clusters in Oman. METHODS: This retrospective study includes data of 1026 SARS-CoV-2 positive children (≤18 years) collected from the national surveillance database for COVID-19 between 1 February 2020 and 30 May 2020. RESULTS: We included 1026 patients. Most, 842 were Omani (82%), 52% male, and 28.5% asymptomatic. Close to the half of symptomatic 419 (40%), patients presented with fever associated with other respiratory symptoms. Fifty pediatric patients were index cases who transmitted the virus to 107 patients in total (86 adults and 21 children) with a mode of 1. There is no statistical significance of all studied risk factors in the transmission of the SARS-CoV-2 virus including age, gender, and cycle threshold (CT) value. CONCLUSIONS: According to this study, children are not to be considered a significant driver of transmission of SARS-CoV-2 in Oman.
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COVID-19 , SARS-CoV-2 , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Omã/epidemiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
Despite the apparent challenges inflicted by COVID-19 globally, the pandemic provided an opportunity to utilize and expand existing public health capacities for a more adaptive and resilient system during and after each wave of the disease. This paper provides a narrative review of Oman's public health response to the COVID-19 pandemic from January 2020 to July 2021, and the challenges it faced for a more rapid and efficient response. The review demonstrates that the three main pillars influencing the direction of the pandemic and aiding the control are Oman's unified governmental leadership, the move to expand the capacity of the health care system at all levels, and community partnership in all stages of the response including the COVID-19 vaccination campaign. The opportunities identified during response stages in the harmonization of the multisectoral response, streamlining communication channels, addressing vulnerable communities (dormitories, residences at border regions), and providing professional technical leadership provide an excellent precursor for expediting the transformation of Oman's health care system to one with a multisectoral holistic approach. Some of the major challenges faced are the shortage of the public health cadre, lack of a fully integrated digital platform for surveillance, and the scarcity of experts in risk communication and community engagement. A future health system where the center for diseases surveillance and control acts as a nucleus for multisectoral expertise and leadership, which includes community representatives, is crucial to attain optimum health. The destruction inflicted by this prolong COVID-19 pandemic at all levels of human life had valued the importance of investing on preventive and preparedness strategies.
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COVID-19 , Pandemias , Vacinas contra COVID-19 , Serviços de Saúde , Humanos , Omã/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
BACKGROUND: Non-pharmaceutical interventions (NPIs), particularly mobility restrictions, are mainstay measures for the COVID-19 pandemic worldwide. We evaluated the effects of Oman's mobility restriction strategies to highlight their efficacy in controlling the pandemic. METHODS: Accessible national data of daily admissions and deaths were collected from 1 April 2020 to 22 May 2021. Google Community Mobility Report (CMR) data were downloaded for the same period. Among six CMR categories, three were used and reduced to one index-the community mobility index (CMI). We used a generalised linear model with a negative binomial distribution combined with a non-linear distributed lag model to investigate the short-term effects of CMI on the number of admitted PCR-confirmed COVID-19 cases and deaths, controlling for public holidays, day of the week, and Eid/Ramadan days. RESULTS: We demonstrated the feasibility of using CMRs in the evaluation and monitoring of different NPIs, particularly those related to movement restriction. The best movement restriction strategy was a curfew from 7 p.m. to 5 a.m. (level 3 of CMI = 8), which had a total reduction of 35% (95% confidence interval (CI); 25-44%) in new COVID-19 admissions in the following two weeks, and a fatality reduction in the following four weeks by 52% (95% CI; 11-75%). CONCLUSION: Evening lockdown significantly affected the course of the pandemic in Oman which lines up with similar studies throughout the world.
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COVID-19 , Pandemias , Controle de Doenças Transmissíveis , Hospitalização , Humanos , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
OBJECTIVES: To describe the epidemiology, clinical and laboratory features, and outcome of children hospitalized with coronavirus disease 2019 (COVID-19) in the Middle East. METHODS: A multicenter retrospective study of children hospitalized with COVID-19 in 7 centers across Oman between February and July 2020. RESULTS: In total, 56 children <14 years old required hospitalization in 7 Omani centers over 5 months (February - July 2020). Thirty-seven (68%) children were admitted with uncomplicated COVID-19, 13 (23%) with pneumonia and 5 (9%) with multisystem inflammatory syndrome in children. Infants constituted 41% of cases (23/56), approximately half of whom (12/23, 52%) were <2-months old. Fever was the most common symptom (46, 82%), followed by respiratory symptoms (33, 59%), and gastrointestinal symptoms (31, 55%). Twenty-two (39%) children had underlying medical conditions: sickle cell disease (7, 13%), chronic respiratory disease (4, 7%) and severe neurological impairment (4, 7%). Leukocytosis, elevated inflammatory markers and anemia were independently associated with intensive care admission. There were no mortalities related to admission with COVID-19 in this cohort. CONCLUSION: Most of the children hospitalized with COVID-19 had a mild course and a satisfactory outcome. Sickle cell disease is the most common comorbidity associated with pediatric admission of COVID-19 in Oman.