Epidemiology and antimicrobial resistance patterns of bacterial meningitis among hospitalized patients at a tertiary care hospital in Saudi Arabia: a six-year retrospective study.

INTRODUCTION: Bacterial meningitis poses significant medical challenges due to its acute inflammatory nature and potential for severe neurological complications, emphasizing the need for prompt diagnosis and treatment. Limited data exists on its epidemiology and antimicrobial resistance trends among hospitalized patients in Saudi Arabia. This study aimed to investigate these factors at a tertiary care hospital over six years. METHODS: A retrospective analysis was conducted on cerebrospinal fluid samples results from 222 bacterial meningitis cases among hospitalized patients between 2018 and 2023. Demographic, clinical, microbiological data, and antibiotic susceptibility patterns were collected and analyzed. RESULTS: Pseudomonas aeruginosa (43%) was the predominant pathogen isolated. Neonates (16%) and children (47%) were most affected population. Nosocomial meningitis accounted for 92% of cases, mainly in the intensive care settings (50.45%). Extended-spectrum beta-lactamase was the leading resistance pattern (12.2%). Seasonal variation was observed, with a peak incidence in October-November. CONCLUSION: The study highlights the substantial burden of bacterial meningitis among hospitalized patients, especially among high-risk groups. Emerging antimicrobial resistance emphasizes the need for optimized surveillance and stewardship. Future prospective research employing molecular techniques across multiple centers in the country is warranted to enhance understanding and guide public health strategies in Saudi Arabia.

COVID-19 and malaria co-infection: a systematic review of clinical outcomes in endemic areas.

Background: COVID-19 and malaria cause significant morbidity and mortality globally. Co-infection of these diseases can worsen their impact on public health. This review aims to synthesize literature on the clinical outcomes of COVID-19 and malaria co-infection to develop effective prevention and treatment strategies. Methods: A comprehensive literature search was conducted using MeSH terms and keywords from the start of the COVID-19 pandemic to January 2023. The review included original articles on COVID-19 and malaria co-infection, evaluating their methodological quality and certainty of evidence. It was registered in PROSPERO (CRD42023393562). Results: Out of 1,596 screened articles, 19 met the inclusion criteria. These studies involved 2,810 patients, 618 of whom had COVID-19 and malaria co-infection. Plasmodium falciparum and vivax were identified as causative organisms in six studies. Hospital admission ranged from three to 18 days. Nine studies associated co-infection with severe disease, ICU admission, assisted ventilation, and related complications. One study reported 6% ICU admission, and mortality rates of 3%, 9.4%, and 40.4% were observed in four studies. Estimated crude mortality rates were 10.71 and 5.87 per 1,000 person-days for patients with and without concurrent malaria, respectively. Common co-morbidities included Diabetes mellitus, hypertension, cardiovascular diseases, and respiratory disorders. Conclusion: Most patients with COVID-19 and malaria co-infection experienced short-term hospitalization and mild to moderate disease severity. However, at presentation, co-morbidities and severe malaria were significantly associated with higher mortality or worse clinical outcomes. These findings emphasize the importance of early detection, prompt treatment, and close monitoring of patients with COVID-19 and malaria co-infection.

Relationship Between Depression, Anxiety, Stress, and Weight Self-Stigma Among Youths in Saudi Arabia: A Nationwide Study.

Background and objectives Many research studies show that self-stigma related to weight can exacerbate mental health issues. There is also evidence suggesting that depression, anxiety, and stress could be predictors of weight stigma. However, these connections have not been thoroughly investigated among young people in Saudi Arabia, where there is a high prevalence of obesity. This study aimed to explore the relationships between depression, anxiety, stress, and weight self-stigma in Saudi Arabian adolescents and young adults. Materials and methods This cross-sectional study was conducted between January and March 2022 and utilized online surveys, including the Weight Self-Stigma Questionnaire (WSSQ) and Depression, Anxiety, and Stress Scale 21 (DASS-21). We conducted descriptive analysis, independent samples t-tests, analysis of variance (ANOVA), and linear regression for the statistical analysis using SPSS version 25 (IBM Corp., Armonk, NY). Results A total of 1624 participants were enrolled in this survey. Most participants (889, 54.7%) were females. The mean age was 20.73 years (SD: 2.63). Males were more likely to report self-stigma compared to females (p = 0.018). Weight self-stigma demonstrated significant positive associations with body mass index (BMI) (p = 0.0001) and depression, anxiety, and stress (p = 0.0001) scores. Further analysis revealed weight self-stigma was positively correlated with psychological distress levels in the study population (p = 0.0001). The results demonstrated a statistically significant difference between different regions of Saudi Arabia with weight self-stigma being more prevalent in the Al-Baha region and least prevalent in the Al-Madinah region. Conclusions The results of this study indicate robust positive correlations between weight self-stigma scores and depression, anxiety, and stress scale scores among adolescents and young adults in Saudi Arabia. Further epidemiological and clinical studies on the national level are warranted.

Ocular Complications after COVID-19 Vaccination: A Systematic Review.

Background and Objectives: The COVID-19 pandemic affects various populations worldwide. The discovery of vaccinations was necessary for the prevention and elimination of the disease. Despite the high importance of these vaccinations, they may cause some complications, such as ocular complications. This study aims to draw attention to the possible complications of the vaccination and highlight its importance. Materials and Methods: Systematic review of the literature from January 2021 to January 2023. A total of 20 published articles were included and reported cases of ocular complications in patients who received COVID-19 vaccines. Results: A total of 243 patients with verified ocular complications following the COVID-19 vaccination were included, ranging in age from 18 to 84 years. The most common ocular complications reported in the current study were ocular inflammatory complications, which represented 47.3%, followed by optic neuritis (24.3%). Retinal artery occlusion, retinal vein occlusion, acute macular neuroretinopathy, and paracentral acute middle maculopathy represented 10.7%. Herpetic ocular infections and herpetic eye disease (14%). Nearly half (42%) of the patients with ocular problems received the Pfizer-BioNTech vaccination. Conclusions: Despite the high importance of the COVID-19 vaccination, it was found that it is associated with the occurrence of some ocular complications. Future projects should come with more extensive prospective studies to further elucidate the underlying mechanisms and risk factors associated with ocular complications following COVID-19 vaccination, thereby enhancing our understanding and guiding appropriate management strategies.

Case report of congenital neutropenia type 4 with glucose-6-phosphatase catalytic subunit 3 (G6PC3) deficiency.

Congenital neutropenia syndromes encompass a group of genetic disorders characterized by persistent neutropenia and recurrent infections inherited in an autosomal recessive, dominant, or X-linked manner. These syndromes arise from mutations in various genes, and one of the significant genes involved is glucose-6-phosphatase catalytic subunit 3 (G6PC3), giving rise to a condition known as Dursun syndrome. As per existing knowledge, a total of 92 cases of Dursun syndrome have been reported globally, including eight cases from Saudi Arabia. Our study identified two additional cases exhibiting neutropenia since the early postnatal period and recurrent admissions due to infections. Additionally, these patients presented with oral ulcers, chronic diarrhea, and anomalies affecting the cardiac and genitourinary systems. The rising incidence of congenital neutropenia on a global scale necessitates heightened vigilance among clinicians to ensure thorough follow-up of patients with neutropenia. This proactive approach can lead to early detection and appropriate management of associated complications, ultimately improving patient outcomes.

Adherence to Hydroxyurea and Patients' Perceptions of Sickle Cell Disease and Hydroxyurea: A Cross-Sectional Study.

Background and Objectives: Hydroxyurea is a crucial treatment for sickle cell disease (SCD), but some patients' adherence to it remains suboptimal. Understanding patients' perspectives on SCD and HU is essential for improving adherence. This study aimed to assess hydroxyurea adherence and patients' perceptions of SCD and hydroxyurea among SCD patients in the Jazan region of Saudi Arabia. Materials and Methods: This cross-sectional study collected data from 217 SCD patients using self-administered questionnaires from August 2022 to January 2023. The survey covered patient demographics, SCD consequences, and other clinical data. We used the Brief Illness Perception Questionnaire (B-IPQ) to measure patients' disease perception and the 8-item Morisky Medication Adherence Scale (MMAS-8) to evaluate patients' adherence to HU. Data were analysed using descriptive, t-test, and chi-square tests, and the p-value was set at <0.05 for significance. Results: More than half of the patients were male, with a mean age of 28.09 ± 8.40 years. About 57.6% of the patients were currently using HU. About 81.6% of HU users reported low adherence. The adherence was lower among individuals with infections/recurrent infections and in patients who received repeated blood transfusions. ICU admission, blood transfusion, and certain SCD complications were associated with HU use. Male patients had a higher perception of SCD consequences, concern, and understanding. ICU-admitted and recurrent hospitalized patients had a higher perception of the SCD-related consequences, symptoms, concerns, and emotional responses. Conclusions: HU seems a well-established and efficacious disease-modifying agent, but its underutilization for SCD patients remains challenging. To overcome the adherence challenges, healthcare providers must educate SCD patients about the role of hydroxyurea in lowering disease severity and addressing side effects to obtain maximum benefits. Healthcare providers may consider tailored educational interventions to improve adherence, particularly for patients with infections, recurrent hospitalizations, or repeated blood transfusions. Further research is needed to identify strategies for improving hydroxyurea adherence and patient education among SCD patients.

The Impact of Heart Attack and Sudden Cardiac Death Risk Perception on Lifestyle Modification Intention Among Adults in Jazan Province.

Purpose: This study aimed to assess the perception of sudden cardiac death (SCD) and heart attack risk and its influence on the intention to adopt healthy lifestyle behaviors among the general population in Jazan province, Saudi Arabia. SCD refers to an abrupt and unexpected loss of heart function resulting in death, and its incidence has been alarmingly increasing worldwide. Several factors, including smoking, hypertension, diabetes, obesity, and specific medications, have been associated with an elevated risk of SCD. Methods: A descriptive cross-sectional study was conducted using a pretested questionnaire distributed among the general population in Jazan province. Descriptive statistics, chi-square, and t-tests were employed for data analysis. Results: The study included 974 participants with a mean age of 27.90 ± 9.32 years, of whom 56% were female. More than half of the participants perceived themselves as highly susceptible to SCD, and all participants demonstrated a moderate willingness and readiness to modify their unhealthy lifestyle behaviors. Age, gender, marital status, body mass index (BMI), history of hypertension, dyslipidemia, medication use, physical exercise, and family history of chronic diseases and SCD were statistically associated with the perception of SCD. Conclusion: The study revealed a high-risk perception and a moderate readiness to adopt lifestyle modifications. These findings can inform the development of effective strategies and support programs aimed at reducing the burden of SCD.

Effectiveness of Blood Glucose Time in Range to Reduce Risk of Blood Glucose Extrusion and Improve Blood Glucose Metrics in Type 1 Diabetic Patients.

BACKGROUND: With evolving diabetes technology, continuous glucose monitoring (CGM) and time in range have been advanced as critical measurements to assess complications. They have shown improvement in A1C levels and decreased episodes of blood glucose extrusion. AIMS: This study aimed to assess the awareness and utilization of blood glucose time in range and its effectiveness in reducing the risk of blood glucose extrusion and improving blood glucose metrics among patients with type 1 diabetes mellitus. METHODS: A retrospective study included 342 patients who met the inclusion criteria and were using the CGM, aiming for a TIR of 70% daily. Glycemic control was followed using TIR data, blood glucose extrusion frequency (including hyperglycemia and hypoglycemia events), active sensor time, average blood glucose, and glucose management indicator (GMI) levels. RESULTS: A total of 342 individuals participated in this study, the majority of whom were below 18 years of age (62.3%). The hypoglycemic frequency was significantly increased compared to the baseline, and most participants experienced hypoglycemia events (p = 0.0001). The incidences increased over time, with 90.9% and 93% having hypoglycemia at 60 and 90 days (p = 0.0001), respectively. The active scan and sensor time were not followed, which led to the blood glucose target not being achieved, with no improvement throughout the study. Consequently, no improvement occurred in glycemic control. CONCLUSION: CGM technology has been promising and proven effective in improving glycemic. However, our study did not show these benefits as expected, which could be explained by the underutilization and improper use of the CGM.

Nutritional Rickets Among Children: A Retrospective Study from Saudi Arabia.

Background: Nutritional rickets remains a significant concern in certain countries, with increasing prevalence attributed to factors such as limited sunlight exposure and undernourishment. This study aimed to identify the factors associated with rickets due to nutritional deficiency in children from Jazan Province, southwestern Saudi Arabia. Methods: A retrospective cross-sectional study was conducted using descriptive data from medical records at a tertiary hospital in Jazan Province. Records of patients diagnosed with rickets between January 2010 and December 2020 were analyzed. Symptomatic rickets cases from pediatric clinics were included, and diagnoses were based on biochemical and clinical tests. Risk factors were assessed using patient medical records. Data were analyzed using percentages, mean, and standard deviation. Results: The study included 84 patients with rickets (53 females and 31 males), primarily between 11-18 years old. The mean body mass index (BMI) of the participants was 21.21. The most common risk factor was nutritional deficiencies, including vitamin D deficiency or calcium deficiency, with 75 patients reporting a family history of vitamin D deficiency. The children had limited sunlight exposure and low levels of calcium and vitamin D. Malnutrition was identified as the highest risk factor for rickets in the study population. Conclusion: Nutritional rickets appears to be prevalent in the Jazan Province, emphasizing the need for government organizations to address this preventable disease. Adequate sun exposure and recommended dietary vitamin D intake are crucial to prevent rickets, as this study detected inadequate levels of calcium and vitamin D in children. National studies are required to further identify risk factors and develop appropriate strategies.

Frequency of Knee Pain and Risk Factors and Its Impact on Functional Impairment: A Cross-Sectional Study from Saudi Arabia.

BACKGROUND: Adolescents frequently self-report pain, according to epidemiological research. The knee is one of the sites wherein pain is most commonly reported. Musculoskeletal disorders play a significant role in the prolonged disability experienced by individuals, leading to substantial global personal, societal, and economic burdens. Patellofemoral pain (PFP) is a clinical knee pain commonly affecting adolescents. This study aimed to estimate the frequency of knee pain in Saudi adolescents. METHODS: This cross-sectional survey was conducted from June to November 2022 and included 676 adolescents aged 10 to 18 years. The participants were questioned regarding their demographics, school habits, and the impact of these factors on back pain, musculoskeletal pain in the past 12 months, as well as quality-of-life scale and knee pain symptoms. The data were analyzed using descriptive statistics, with frequencies and percentages presented for categorical variables. Analysis of variance (ANOVA) was performed to compare means between groups, while the chi-squared test was used to compare categorical variables. Statistical significance was set at p < 0.05. RESULTS: A total of 676 adolescents participated in the study, with 57.5% females and 42.5% males. Among the participants, 68.8% were aged between 15 and 18 years. The prevalence of knee pain was notably higher among females (26%) compared to males (19.2%). Age and BMI were identified as significant predictors of knee pain. A significant association was also found between BMI classification and knee stiffness (p-value = 0.008). Furthermore, a significant difference was observed between adolescents who engaged in physical activities during leisure time and those who experienced difficulty bending (p-value = 0.03). CONCLUSIONS: Our study highlights a high prevalence of knee pain among Saudi adolescents, emphasizing the need for increased awareness about its risk factors. Preventive measures, including conservative approaches and lifestyle/activity modifications, can effectively mitigate adolescent knee pain.

Factors Affecting Awareness of Pregnancy Screening for Group B Streptococcus Infection Among Women of Reproductive Age in Jazan Province, Saudi Arabia.

Background: Group B streptococcus (GBS) infection is one of the leading causes of neonatal sepsis and meningitis. GBS screening and intrapartum antibiotic prophylaxis can effectively prevent early-onset GBS disease. This study aimed to assess the awareness of the risks of GBS infection and screening in Jazan Province, Saudi Arabia. Methodology: A cross-sectional study was conducted using a survey of 995 women aged 18-45 in Jazan, Saudi Arabia. Data were collected between January to April 2023 and included information on sociodemographic characteristics, awareness of GBS infection, and perspectives on GBS screening. Results: The response rate was 97.45%, and the mean age of the participants was 31.50 ± 9.80 years. Most were married (60.2%), had a university education (81.11%), and 59% were pregnant or had a pregnancy history. Only 23% had heard of GBS, associated with age, marital status, job, pregnancy status, awareness of GBS risk factors, and pregnancy follow-up (p < 0.05). Women most aware were students (55.9%), married (55.46%), pregnant or had a pregnancy history (51.09%), knew risk factors of GBS (38.86%), and were followed by a specialist (88.14%). Regarding GBS screening preferences, 40% preferred universal screening without consent, 31% with consent, 16% for high-risk pregnancies with consent, and 13% for high-risk pregnancies without consent. Conclusion: The study found low awareness of GBS among women residing in Jazan, Saudi Arabia. Factors related to demographic details and obstetric follow-up were associated with better understanding. Most women preferred universal screening for GBS, with or without consent. Effective health education is needed to raise women's awareness of screening benefits and risks. This education can help women make informed decisions and improve prevention and care. Future studies may evaluate healthcare providers' awareness of GBS.

The Impact of Artificial Intelligence on the Preference of Radiology as a Future Specialty Among Medical Students at Jazan University, Saudi Arabia: A Cross-Sectional Study.

Background The use of artificial intelligence (AI) in healthcare continues to spark interest and has been the subject of extensive discussion in recent years as well as its potential effects on future medical specialties, including radiology. In this study, we aimed to study the impact of AI on the preference of medical students at Jazan University in choosing radiology as a future specialty. Methodology An observational cross-sectional study was conducted using a pre-tested self-administered online questionnaire among medical students at Jazan University. Data were cleaned, coded, entered, and analyzed using SPSS (SPSS Inc., USA) version 25. Statistical significance was defined as a P-value of less than 0.05. We examined the respondents' preference for radiology rankings with the presence and absence of AI. Radiology's ranking as a preferred specialty with or without AI integration was statistically analyzed for associations with baseline characteristics, personal opinions, and previous exposures among those who had radiology as one of their top three options. Results Approximately 27.4% of males and 28.3% of females ranked radiology among their top three preferred choices. Almost 65.2% were exposed to radiology topics through pre-clinical lectures. The main sources of information about AI for the studied group were medical students (41%) and the Internet (27.5%). The preference of students for radiology was significantly affected when it is assessed by AI (P < 0.05). Around (16.1%) of those who chose radiology as one of their top three choices strongly agree that AI will decrease the job opportunities for radiologists. Logistic regression analysis showed that being a female is significantly associated with an increased chance to replace radiology with other specialty when it is integrated with AI (Crude odds ratio (COR) = 1.91). Conclusion Our results demonstrated that the students' choices were significantly affected by the presence of AI. Thereover, to raise medical students' knowledge and awareness of the potential positive effects of AI, it is necessary to organize an educational campaign, webinars, and conferences.

Bacterial Contamination of Mobile Phones Used by Healthcare Workers in Critical Care Units: A Cross-Sectional Study from Saudi Arabia.

BACKGROUND: Healthcare-associated infections (HAIs) present a formidable challenge for healthcare institutions, resulting in heightened mortality, morbidity, and economic burden. Within healthcare settings, various equipment and materials, including mobile phones, can potentially act as sources of infection. This study sought to examine the occurrence of bacterial contamination on mobile phones utilized by healthcare workers (HCWs) in intensive care units (ICUs), pediatric intensive care units (PICUs), neonatal intensive care units (NICUs), and cardiac care units (CCUs) within a central hospital (CH) and two peripheral hospitals (PHs) situated in the southwestern province of Saudi Arabia. MATERIALS AND METHODS: We collected a total of 157 samples from mobile phones utilized by HCWs across all ICUs in the CH and PHs. These samples underwent bacteriological analysis to evaluate the degree of bacterial contamination. RESULTS: We found that 45 out of 55 samples from physicians (81.81%) and 58 out of 77 samples from nurses (75.32%) showed bacterial contamination. Contamination rates on HCWs' mobile phones in the ICU, PICU, and NICU departments of the CH were observed at 69.56%, 80.95%, and 70.27%, respectively. Furthermore, the overall contamination rates in the ICUs, NICUs, and CCUs of the PHs were 78.26%, 88.88%, and 66.66%, respectively. The overall contamination rates of mobile phones in the CH and PHs were 72.11% and 81.13%, respectively. CONCLUSION: These findings underscore the necessity of routinely disinfecting the mobile phones of HCWs to mitigate the risk of cross-contamination. Implementing robust disinfection protocols can significantly contribute to curtailing the propagation of bacterial pathogens and reducing the incidence of HAIs in healthcare settings.

Epidemiology and Antimicrobial Resistance Patterns of Urinary Tract Infections: A Cross-Sectional Study from Southwestern Saudi Arabia.

Background: Urinary tract infections (UTIs) are a prevalent form of urinary tract diseases affecting individuals of all ages and genders. In the Kingdom of Saudi Arabia (KSA), UTIs are a significant burden on the healthcare system, comprising 10% of all infections and ranking as the second leading cause of emergency department admissions. Despite this, limited research has been conducted in Saudi Arabia, particularly in Jazan Province, located in the southwestern region. Methods: This retrospective, cross-sectional study encompassed individuals with positive urine cultures who sought care at a tertiary hospital in Jazan between January 2022 and March 2023. A standardized data collection form was utilized to retrieve relevant information from microbiology lab test results and patients' electronic medical records. Variables such as sex, urine sample collection date, bacterial isolates, antibiotic sensitivity, and resistance were collected using the data collection form. Data were analyzed using SPSS software, version 23.0 (IBM Corp., Armonk, NY, USA). Results: A total of 1082 urinary bacterial samples were isolated and identified. Females accounted for more bacterial infections (62.66%) than males (37.34%). Gram-negative bacteria represented 94% of all isolated strains. The most prevalent pathogens associated with UTIs were Escherichia coli (47.97%), Klebsiella pneumoniae (24.58%), and Pseudomonas aeruginosa (11.55%). Antimicrobial resistance patterns indicated the presence of extended-spectrum beta-lactamase (ESBL) (30.13%), carbapenemase-resistant Enterobacter (CRE) (1.94%), methicillin-resistant Staphylococcus aureus (MRSA) (0.74%), and vancomycin-resistant Enterococci (VRE) (0.18%). UTI incidence demonstrated a higher prevalence in September (13%) compared to other months in 2022. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the predominant Gram-negative multidrug-resistant organisms (MDRO), accounting for 34.42%, 13.95%, and 1.63% of the population. Conclusions: The prevalence of UTIs caused by antibiotic-resistant microbes is notable in Jazan. Consistent with findings from other regions, Escherichia coli remains the most common causative pathogen of UTIs, displaying a seasonal pattern that warrants attention. Approximately 35% of reported cases involve MDRO, with ESBLs accounting for 30%. These results should raise concerns among healthcare officials, highlighting the necessity for further investigations into factors contributing to the circulation of MDRO in Jazan.

Pediatric Gastrointestinal Basidiobolomycosis: A Retrospective Study from Jazan Province, Saudi Arabia.

Introduction: Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum, and its incidence is poorly understood due to its rarity. Gastrointestinal Basidiobolomycosis (GIB) is an uncommon presentation with limited reports in Saudi Arabia. This retrospective study aims to describe risk factors, clinical findings, diagnosis, and management of GIB in the pediatric population. Methods: We conducted a retrospective analysis of all pediatric patients diagnosed with GIB at a tertiary hospital between 2010 and 2022. Patients were identified based on their diagnosis of GIB. A self-administered questionnaire was distributed to assess risk factors associated with GIB. Results: We analyzed 25 cases of pediatric GIB, with approximately half of the cases (56%) occurring during the COVID-19 pandemic. The mean age of affected patients was 6.6 years, with a male predominance (60%, n=15). About 100% of parents acknowledged gecko existence in their residence, and their children were exposed to insect bites. Poor appetite was reported in all patients, and high counts of eosinophils and erythrocyte sedimentation rate were observed. Thrombocytosis was present in approximately 90% of patients, and 87% had anemia. Abdominal computerized tomography scans and ultrasound-guided biopsies were the most used diagnostic tools, with cases being diagnosed based on histopathological findings and confirmed via fungal culture. Conclusion: Our study provides valuable information on the potential risk factors, clinical features, diagnosis, and management of pediatric GIB in the Jazan region. The observed increase in cases during the COVID-19 pandemic highlights the need for continued surveillance and research to understand better the epidemiology and associated risk factors with this rare fungal infection. These findings emphasize the need for heightened awareness, early detection, and effective prevention strategies to mitigate the impact of pediatric GIB.

Health Workers' Knowledge and Attitude towards Monkeypox in Southwestern Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Monkeypox outbreaks in non-endemic countries emphasize the importance of being prepared to prevent its progression to a pandemic. To effectively control monkeypox, healthcare providers must have sufficient knowledge and good attitudes and practices to limit its spread. We initiated this project to assess the factors associated with health workers' knowledge and attitude toward monkeypox in southwestern Saudi Arabia. METHODS: We included 398 eligible health workers working at various health facilities. Data was collected using an online survey, and participants had an opportunity to consent. We conducted descriptive statistics for all variables and used chi-square statistics, t-test, and multivariate analysis to establish the association between health workers' demographic characteristics and knowledge of monkeypox disease. RESULTS: The mean age was 30.93 ± 8.25 years for the included participants, and most of them were between 22 and 29 years, male, single, nurses, working in government hospitals, and had worked for at least five years. The chi-square and t-test showed that the participants' knowledge level was significantly related to age, marital status, job title, and medical practice. Most of the participants had low knowledge and good attitudes toward monkeypox prevention measures. Multivariate analysis showed that higher knowledge was associated with younger age after controlling all other significant bivariate relationships between knowledge and demographics. CONCLUSIONS: This study found low knowledge levels and high good attitude levels of monkeypox among the participants. As such, there is a need to support health workers in understanding monkeypox epidemiology, prevention, and treatment. Therefore, Saudi Arabia will be making significant strides to being well prepared and ready to handle future monkeypox outbreaks.

Factors Associated with Anxiety During COVID-19 Pandemic and Its Association with Hypertension in Saudi Arabia.

Objective: Patients with chronic diseases such as hypertension (HTN) are considered a vulnerable group, and they are prone to anxiety and other psychological conditions during pandemics. Very few reports discussed factors related to anxiety and how it is associated with HTN during COVID-19 pandemic. In this project, we aimed to identify the prevalence of anxiety among hypertensive patients in Saudi Arabia during the COVID-19 pandemic. Methods: A cross-sectional study was conducted, and data were collected using an electronic self-administered pretested questionnaire distributed via trained data collectors. Data were analyzed using t-test and chi-test. Results: A total of 2135 participants were enrolled in this study. Anxiety was reported in 5% of all participants and 8% of the hypertensive participants. Older age, marital status, higher body mass index (BMI), smoking, and Khat chewing were strongly associated with anxiety among the general population. In addition, less adherence to medication made participants with HTN significantly more anxious. Conclusion: The prevalence of anxiety among hypertensive individuals is higher compared to the general population. Moreover, anxiety is significantly associated with some sociodemographic in the general population, and with less adherence to medications in hypertensive patients. Further studies with data from medical record including more variables are needed to highlight this association.

Corrigendum: Effectiveness and determinants of smoking cessation in the Saudi Arabian Region of Jazan: A cross-sectional study.

[This corrects the article DOI: 10.18332/tid/156842.].

Adverse Childhood Experience as a Risk Factor for Developing Type 2 Diabetes among the Jazan Population: A Cross-Sectional Study.

BACKGROUND: Adverse Childhood Experiences (ACEs), such as childhood abuse, neglect, and family dysfunction, prevent appropriate emotional, behavioral, and physical development. They are also a major public health issue, and have been debatably linked to chronic diseases, including type 2 diabetes mellitus (T2DM). T2DM is highly prevalent in Saudi Arabia, and various theories have been raised to explain the epidemiology of diabetes. However, few studies have discussed the relationship between ACEs and T2DM. Thus, we aimed to evaluate the association between ACEs and T2DM in Jazan Province, Saudi Arabia. METHODS: This observational, cross-sectional study was conducted using a validated questionnaire distributed among patients with T2DM in a diabetes center. The t-test and Chi-Square test were used for comparison, and the p-value was set at <0.05 for significance. RESULTS: A total of 579 participants were involved in this study, and 303 (52.33%) were female. Among the included participants, 45.25% were diagnosed with T2DM. About 28.71% of participants with diabetes experienced verbal abuse, 16.09% experienced physical abuse, and 30.91% reported that parents beat them. Additionally, 1.58% of participants with diabetes reported living with a family member who abused substances, 8.83% believed that no one would take them to the doctor even if essential, 12.62% of participants with diabetes felt that no one would protect them, and 23.03% reported that they felt no one in their family loved them. All reported ACEs were significantly associated with a high risk of T2DM (p < 0.05), and the more frequent the ACEs, the more the risk of T2DM (p = 0.0001). CONCLUSIONS: This study indicated that ACEs are significantly associated with the development of T2DM, and the risk increases with the frequency of ACEs, which aligns with other studies. Further national studies are required to understand how ACEs could contribute to T2DM, and preventive interventions in childhood must be considered to reduce the burden of T2DM.

Effectiveness and determinants of smoking cessation in the Saudi Arabian Region of Jazan: A cross-sectional study.

INTRODUCTION: Smoking cessation has significant health benefits. The purpose of this study is to assess the efficacy and related factors of smoking cessation therapies in the Jazan Region of Saudi Arabia. METHODS: This is a cross-sectional study that took place at smoking cessation clinics in primary healthcare centers between January 2019 and January 2020. RESULTS: This study enrolled a total of 103 people. The success rate for quitting smoking was 36% at three months, with a 13% relapse rate at six months. Age (p=0.017), occupation (p=0.046), daily cigarette intake (p=0.015), and number of visits (p=0.001) were all found to be significant determinants of smoking cessation. In the multivariate analysis, only the number of visits increased the likelihood to quit smoking (AOR=0.31; 95% CI: 0.15-0.63). Self-efficacy was cited as the primary reason for quitting smoking by 71% of the participants, whereas family support, smoking cessation therapies, and friends' support were cited as predictive variables by 18%, 10%, and 1% of the participants, respectively. CONCLUSIONS: Smokers who received the smoking cessation intervention package were three times more likely to succeed in giving up smoking when compared to those who received the routine service. Regular follow-up during smoking cessation interventions significantly enhanced the quit rate. It is recommended that pharmacotherapy strategies and intense therapy performed face-to-face with a cessation counselor be combined to improve the quit rate.