Super-spreading social events for COVID-19 transmission: evidence from the investigation of six early clusters in Bahrain.

Introduction: This study aimed to characterize six early clusters of COVID-19 and derive key transmission parameters from confirmed cases that were traced between April and June 2020 in Bahrain. Methods: Pairs of "infector-infectee" allowed us to map the clusters and estimate the incubation period serial interval as the secondary attack rate. The chi-squared test, with a p-value computed using the Monte Carlo test, measured associations between categorical variables. Statistical analysis was performed using R software and the "data.tree, tidyverse" libraries. Results: From 9 April to 27 June 2020, we investigated 596 individuals suspected of COVID-19, of whom 127 positive cases were confirmed by PCR and linked in six clusters. The mean age was 30.34 years (S.D. = 17.84 years). The male-to-female ratio was 0.87 (276/318), and most of the contacts were of Bahraini citizenship (511/591 = 86.5%). Exposure occurred within the family in 74.3% (411/553), and 18.9% of clusters' cases were symptomatic (23/122 = 18.9%). Mapped clusters and generations increased after 24 May 2020, corresponding to "Aid El-Fitr." The mean incubation period was 4 days, and the mean serial interval ranged from 3 to 3.31 days. The secondary attack rate was 0.21 (95% C.I.) = [0.17-0.24]. Conclusion: COVID-19 transmission was amplified due to the high number of families mixing during "Aid El Fitr" and "Ramadhan," generating important clusters. Estimated serial intervals and incubation periods support asymptomatic transmission.

Knowledge, awareness, and attitudes towards epilepsy among elementary schoolteachers in the Kingdom of Bahrain.

BACKGROUND: Teachers' awareness of epilepsy and attitudes toward students with epilepsy (SWE) largely affect their health, behavior, and academic performance. This study aimed to assess elementary schoolteachers' background knowledge and attitudes toward epilepsy in the Kingdom of Bahrain. METHODS: A 23-item online questionnaire was distributed to elementary school teachers in all public schools in Bahrain between September 2022 and February 2023. The questionnaire included three sets of questions about teachers'1) demographics and teaching experience, 2) knowledge and experience with epilepsy, and 3) attitude towards SWE. RESULTS: Three hundred and sixty-seven teachers responded to the questionnaire. Only 82 participants (22.3%) thought they had enough information about epilepsy. Approximately 25% had previously taught SWE. Even though 9.3% have witnessed a seizure before, only 2.2% received seizure first aid training courses. Most respondents (68.7%) knew that epilepsy is caused by abnormal brain electrical activity and is not contagious (95.1%). Regarding seizure types, 76.6% were aware of uncontrollable jerky movements, while staring spells were recognized by 45%. Most first-aid responses were inappropriate, as 59.7% would open the patient's mouth. Only 39.5% agreed on patient transfer to the hospital if the seizure lasted ≥5 min. Epilepsy was thought to cause mental retardation by 32.4%. Also, the belief that SWE were more prone to bullying was reported by 57.2%. CONCLUSION: The knowledge and attitudes of schoolteachers in Bahrain towards epilepsy are relatively good but with remaining improvement potential. They do not fully grasp all seizure types nor adequate first-aid measures promoting future epilepsy educational programs.

Nomophobia among university students in five Arab countries in the Middle East: prevalence and risk factors.

BACKGROUND: Excessive use of mobile phones leading to development of symptoms suggestive of dependence syndrome with teenagers are far more likely to become dependent on mobile phones as compared to adults. COVID-19 pandemic has had an impact on the mental health of several groups in society, especially university students. This study aimed to explore the prevalence of mobile phone dependence among university students and its associated factors. METHODS: Between September 2021 and January 2022, a cross-sectional study was conducted at universities in Jordan, Lebanon, Egypt, Bahrain, and Saudi Arabia utilizing an online and paper-based self-administered questionnaire. We employed a previously developed questionnaire by Aggarwal et al. RESULTS: A total of 5,720 university students were involved in this study (Egypt = 2813, Saudi Arabia = 1509, Jordan = 766, Lebanon = 432, and Bahrain = 200). The mean estimated daily time spent on using mobile phone was 186.4 (94.4) minutes. The highest mobile dependence score was observed for the university students from Egypt and the lowest mobile dependence score was observed for the university students from Lebanon. The most common dependence criteria across the study sample was impaired control (55.6%) and the least common one was harmful use (25.1%). Females and those reported having anxiety problem or using a treatment for anxiety were at higher risk of developing mobile phone dependence by 15% and 75%, respectively. CONCLUSION: Mobile phone dependence is common among university students in Arab countries in the Middle East region. Future studies exploring useful interventions to decrease mobile phone dependence are warranted.

An experimental vignette study to assess stigmatized attitudes towards tobacco smokers in Kuwait.

INTRODUCTION: Smoking is the most common method to consume tobacco. Although the prevalence of smoking is on the increase among females, it is still shown to be lower when compared with males, as there is a buildup of stigma towards tobacco smokers, with structural discrimination beginning to emerge. This study explored the effect of gender on stigmatizing attitude and behavior towards tobacco smokers. METHODS: An experimental vignette study design was used to explore the effect of gender on stigmatizing attitudes towards tobacco smokers of 151 students of both genders from Kuwait University. Students were divided into control and experimental groups and were provided with describing vignettes of male (control) and female (experimental) tobacco smokers along with the standard stigmatization questionnaire 1 (SSQ1). Data were analyzed using independent samples t-test, a p-value <0.05 was considered as statistically significant. RESULTS: Female smokers were more stigmatized than male smokers (p=0.007). In social self-interest, more students think that it is socially acceptable for men to smoke than it is for women (p<0.001). In evolutionary self-interest, there was a significant difference between the participants in accepting to marry or to have a relative who is a smoker (p<0.001), indicating disapproval for female smokers. In psychological self-interest, female tobacco smokers were not considered as good parents compared to male tobacco smokers (p=0.003). CONCLUSIONS: The findings of the study indicate the presence of stigmatizing attitudes towards female tobacco smokers in contrast to male tobacco smokers.

Public awareness and practices towards health impacts of PM2.5 in the Kingdom of Bahrain: identifying areas for intervention.

Air quality has critical public health impacts as several diseases have been attributed to exposure to high PM2.5 concentrations. In the Kingdom of Bahrain context, while the sources of PM2.5 and prevailing trends have been studied, its social and health dimensions remain a gap in the literature. This study explores public perceptions of PM2.5 in the Kingdom of Bahrain, focusing especially on public awareness of PM2.5, its sources, and its health impacts. It further highlights actions taken by individuals to mitigate associated health impacts. This cross sectional study was based on the Driver-Pressure-State-Impact-Response framework. A self-administered questionnaire was distributed to the public, a total sample size of 263 responses. Descriptive statistics, including frequencies and percentages of participants' responses, were calculated. The Independent Samples t-test and a one-way analysis of variance (ANOVA) were applied along with the Chi-Square test to identify factors associated with the public's knowledge and practices relating to PM2.5 in Bahrain. A p-value of less than 0.05 was considered as statistically significant. A significant proportion of the participants were unaware of PM2.5, its concentration in Bahrain, and whether it is being measured. However, the majority of respondents had respiratory problems and took self-protective measures when the air quality was bad. There were statistically significant differences in the adoption of precautionary measures, which was prevalent among participants suffering from respiratory problems. Around 32% of the respondents were willing to pay monthly contributions to improve air quality and indicated their interest in receiving information on Bahrain's air quality via social and mass media. The findings suggest that there is a need to raise public awareness towards air pollution and its health effects. Moreover, epidemiological studies should be conducted to advance understanding on how air pollution is linked to morbidity and mortality in Bahrain.

Innovations in Medical Education During the COVID-19 Era and Beyond: Medical Students' Perspectives on the Transformation of Real Public Health Visits Into Virtual Format.

Background: At the College of Medicine and Medical Sciences (CMMS), Arabian Gulf University (AGU), Bahrain, the Public Health Program comprises two core components, namely, lectures and field visits (consumer products safety, communicable diseases control, and food safety). Digital transformation has innovated the medical educational activities during the COVID-19 pandemic where the real public health field visits were transformed into a virtual format. This study is aimed to examine the potential effect of converting the real public health field visit programs into a virtual format during the COVID-19 pandemic. Methods: All medical students who have submitted online feedback evaluation forms upon completing the Public Health Program in the academic years 2019-2020 (180 students; before the COVID-19 pandemic) and 2020-2021 (167 students; during the COVID-19 pandemic) were included in the study, a total sample size of 347 responses. Independent samples t-test was employed to compare students' feedback on Public Health Program before and during the COVID-19 pandemic while the Pearson chi-square test was used for categorical data. A p-value of <0.05 was considered statistically significant. Results: The mean score of students' satisfaction from the virtual program during the COVID-19 pandemic toward the consumer products safety and food safety field visits was significantly higher than that for students before the COVID-19 pandemic (the real field visits). However, there was no observed statistically significant difference for the Communicable Diseases Control visit. In addition, no significant differences were detected between the mean responses of male and female students toward all field visits, whether the feedback was provided before or during the COVID-19 pandemic. Conclusion: Transformation of real public health field visits into virtual format is acceptable and applicable during the COVID-19 era and maybe beyond.

Diverging levels of COVID-19 governmental response satisfaction across middle eastern Arab countries: a multinational study.

BACKGROUND: Public acceptance of governmental measures are key to controlling the spread of infectious diseases. The COVID-19 pandemic has placed a significant burden on healthcare systems for high-income countries as well as low- and middle-income countries (LMICs). The ability of LMICs to respond to the challenge of the COVID-19 pandemic has been limited and may have affected the impact of governmental strategies to control the spread of COVID-19. This study aimed to evaluate and compare public opinion on the governmental COVID-19 response of high and LMICs in the Middle East and benchmark it to international countries. METHODS: An online, self-administered questionnaire was distributed among different Middle Eastern Arab countries. Participants' demographics and level of satisfaction with governmental responses to COVID-19 were analyzed and reported. Scores were benchmarked against 19 international values. RESULTS: A total of 7395 responses were included. Bahrain scored highest for satisfaction with the governmental response with 38.29 ± 2.93 on a scale of 40, followed by the Kingdom of Saudi Arabia (37.13 ± 3.27), United Arab Emirates (36.56 ± 3.44), Kuwait (35.74 ± 4.85), Jordan (23.08 ± 6.41), and Lebanon (15.39 ± 5.28). Participants' country of residence was a significant predictor of the satisfaction score (P < 0.001), and participants who suffered income reduction due to the pandemic, had a history of SARS-CoV-2 infection, and held higher educational degrees had significantly lower satisfaction scores (P < 0.001). When benchmarked with other international publics, countries from the Gulf Cooperation Council had the highest satisfaction level, Jordan had an average score, and Lebanon had one of the lowest satisfaction scores. CONCLUSION: The political crisis in Lebanon merged with the existing corruption were associated with the lowest public satisfaction score whereas the economical instability of Jordan placed the country just before the lowest position. On the other hand, the solid economy plus good planning and public trust in the government placed the other countries of the Gulf Cooperation Council on top of the scale. Further investigation is necessary to find out how the governments of other low-income countries may have handled the situation wisely and gained the trust of their publics. This may help convey a clearer picture to Arab governments that have suffered during the pandemic.