Health innovations in response to the COVID-19 pandemic: perspectives from the Eastern Mediterranean Region.

BACKGROUND: This paper aims to document the numerous health innovations developed in response to the COVID-19 crisis in the Eastern Mediterranean Region (EMR) using a scoping review approach. METHODS: A literature search was conducted using PubMed, the Eastern Mediterranean Health Journal, the Index Medicus for EMR to identify peer-reviewed articles between December 2019 and November 2020 and WHO and ministries of health websites for grey literature. Following an initial review, full-text screening identified studies reporting on health innovations in response to the COVID-19 pandemic in the region. RESULTS: This review describes 82 health innovations reported from 20 countries across the region: 80% (n = 66) were digital and technology-based products and services including health care delivery (n = 25), public health informatics (n = 24) and prevention (n = 17); 20% (n = 16) were innovative processes including health care delivery (n = 8), educational programmes (n = 6) and community engagement (n = 2). CONCLUSION: The speed with which these technologies were deployed in different contexts demonstrates their ease of adoption and manageability and thus can be considered as the most scalable. Strengthened frameworks to protect users' privacy, documentation and evaluation of impact of innovations, and training of health care professionals are fundamental for promoting health innovations in the EMR.

Epidemiological profile of malaria in a university hospital in the eastern region of Saudi Arabia.

OBJECTIVE: To study the epidemiological, clinical and hematological profile of laboratory-diagnosed malaria cases at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, during the period from January 1990 to December 1999, and to provide suitable recommendations accordingly. METHODS: This was a clinical case series study of confirmed cases presenting to King Fahd Hospital of the University during the period from January 1990 to December 1999. A specially designed form was used for data collection and 602, laboratory-confirmed cases of malaria were retrospectively analyzed. RESULTS: There were 602 cases with a mean age of 25.8 + 14.3 and a male to female ratio of 2.9:1. Less than half the cases were Saudis (42%), most of whom (93%) reported a history of travel to the Southwestern part of the Kingdom. The highest frequency of cases was observed in the years 1992, 1994 and 1998 and 40% of the cases were diagnosed during the months of February, March and September. Plasmodium falciparum was the most common species among Saudi (83%), Sudanese (72%) and Yemeni (64%) patients, while Plasmodium vivax was predominant among others. Most of these cases (75%) had a history of travel to their home countries (endemic areas). The most common clinical presentation was fever (97%), while the most common clinical signs were splenomegaly (9%) and jaundice (8%). Anemia (60%) and thrombocytopenia (53%) were the most common hematological findings. CONCLUSION: Although it appears that the Eastern Province is still free of indigenous malaria transmission, this could not be confirmed by the data. Imported cases, however represent a continuous threat due to the existence of such vectors as Anopheles stephensi, Anopheles fluviatilis, Anopheles sergentii and Anopheles superpictus and a large number of non-immune persons. It is recommended that malaria be always considered in the differential diagnosis of all acute fevers, especially among those with a history of travel to an endemic area. Prompt diagnosis and treatment is necessary. Chemoprophylaxis, when traveling to endemic areas is mandatory, as well as the use of other primary preventive measures to protect against mosquito bites.

Predictive models for mortality and length of hospital stay in an Egyptian burns centre.

Our aim was to obtain a statistical profile of survivors and deaths among burn victims and to develop predictive models for mortality and length of hospital stay. All patients admitted to the Burns Unit of Alexandria Main University Hospital over a 1-year period were included. Of 533 cases, mean length of hospital stay was 15.5 +/- 21.6 days and the mortality rate was 33%. Total surface area burnt, inhalation burns, age, sex, depth and degree of burn wounds were the significant independent predictors of mortality in multiple logistic regression analysis. The significant independent predictors of the length of hospital stay were clothing ignition, total surface area burnt, sex, degree and depth of burn and inhalation burns.

Knowledge, attitude and smoking patterns among nursing and laboratory technology students, dammam, saudi arabia.

OBJECTIVE: To study the reported practices of knowledge about and attitude towards smoking among nursing and medical laboratory technology (MLT) students, College of Medicine, King Faisal University at Dammam and Al-Khobar. SETTING: College of Medicine, Dammam and King Fahd Hospital of the University, Al-Khobar, Saudi Arabia METHODS: A cross-sectional approach involving a sample of 266 students and interns (152 nursing and 114 MLT), which included all enrolled students in the academic year (1998/1999). A self-administered questionnaire was used to collect data covering knowledge, practice and attitude to smoking. SPSS was used for statistical analysis. RESULTS: The overall smoking prevalence was low (5.6%), slightly higher among nursing (6.6%) versus MLT (4.4%) students. Knowledge of and attitude towards smoking was generally satisfactory in both groups, although deficient in some key areas, such as the addictive nature of smoking, some of its consequences on health, and difficulty of quitting. CONCLUSION AND RECOMMENDATIONS: The prevalence of smoking among nursing and MLT students is generally low but their knowledge and attitude need improvement. Health education on facts, dangers and consequences of smoking should start as early as the primary school, and should continue throughout the education of future health professionals (role models for the community).

Audit of diabetic care in a saudi primary care setting.

OBJECTIVE: To audit the care offered to diabetic patients attending the Family and Community Medicine Clinic (FAMCO), King Faisal University, Kingdom of Saudi Arabia (KSA). DESIGN: A cross-sectional study of medical records of 45 diabetic patients who regularly visited the clinic during a one-year period from June 1997 to May 1998. SUBJECTS: Patients who presented at the clinic because of non-insulin-dependent diabetes mellitus (type II). RESULTS AND CONCLUSIONS: The level of care for diabetic patients was relatively inappropriate, and some important parameters were under-recorded. Specific measures to improve and promote diabetic care in FAMCO clinics need to be undertaken. These include formulating and using protocols for diabetes management and better training of health-care providers.

Prevalence of rheumatic heart disease among school children in Alexandria, Egypt: a prospective epidemiological study.

The aim of this work was to study the epidemiologic features of Rheumatic Heart Disease (RHD) among basic education students in Alexandria, including the demographic and clinical profiles as well as risk factors for RHD development. A stratified random sampling technique was used to allocate 5465 school children in the six educational zones of Alexandria. Clinical RHD cases were confirmed by using chest X-ray, ECG and echocardiography. Factors related to occurrence of RHD were studied using a case control design. Thirty four RHD cases (with an estimated prevalence of 6.2/1000 students) were diagnosed. Low socioeconomic status, chronic tonsillitis, positive family history of acute rheumatic fever/RHD and paternal consanguinity were significantly associated with the occurrence of RHD. Almost all previously diagnosed cases were enrolled in a prophylaxis program, with a defaulter rate of 31%. More than half of the identified cases had moderately severe valvular lesions. We recommend the implementation of an educational program targeted to both parents and teachers; the training of upgrading of school health physicians, and the standardization of secondary prophylaxis programs nationwide, with emphasis on assurance of compliance.

Epidemiological aspects and cost of managing hypertension in Saudi Arabian primary health care centres

The main epidemiological features and the direct cost of management of hypertension for a sample of registered patients in primary health care centres in Al-Khobar, Saudi Arabia were examined. Epidemiological features were gathered through patient interviews and from medical records, while direct cost of management was obtained using a standard formula. Consultation accounted for the highest direct cost of disease management [67%]; investigations and drugs were responsible for 16% and 17%, respectively. Number of visits, frequency of follow-up and use of additional drugs were significantly associated with higher total direct cost and higher cost of consultation. Medical education for physicians regarding cost containment and the complete documentation of medical treatment is advised

Prescribing patterns at primary health care level in the Asir region, Saudi Arabia: an epidemiologic study.

Out of 208 primary health care centres (PHCCs) in the Asir region, southwestern Saudi Arabia, a stratified random sample of 23 PHCCs was randomly chosen. Data regarding all the medical consultations (66,438) provided by all PHCCs physicians (49) and their prescriptions were collected to study prescribing patterns. The data were collected from the health information system of the PHCCs without the physicians' knowledge. The study showed that more than two-thirds of medical consultations (71.5%, 47,494) ended by prescribing medications. The average number of drug items prescribed for the individual patient was 1.44. The leading missing items in the studied prescriptions were, for how long should medication be taken (32.9%), the patient's name (15.8%) and the family health record number (6.5%). Prescribing drugs by generic name is very minimal among physicians (2.9%). The groups of drugs commonly prescribed were analgesics-antipyretics (61.9%), antibiotics (56.2%), cough medications (26.6%) and vitamins (22.7%). The observed defects identify fields to be addressed in continuing medical education programmes aimed at encouraging more rational prescribing among PHC physicians.