Prevalence and factors associated with infectious intestinal diseases in Ras Al Khaimah, United Arab Emirates, 2017: A population-based cross-sectional study.

BACKGROUND: The United Arab Emirates (UAE) is a rapidly developing high-income country that has experienced significant population growth, urbanization, and improvements in the standard of living since its formation in 1971. Published estimates on the prevalence of infectious intestinal diseases (IID) in the UAE are scarce and exclusively based on hospital data. The aim of this study was to provide the first prevalence estimates of IID in the UAE. METHODS: A population-based cross-sectional study design using a telephone-based questionnaire was used to estimate the IID prevalence in the previous 4 weeks in a representative sample of the Ras Al Khaimah (RAK) population from January to September 2017. RESULTS: Data were collected from 1254 participants (57.3% male; 25.2% <18 years). The prevalence of IID was 4.2% in the 4 weeks prior to the interview. Multivariate logistic regression analysis identified that being female (odds ratio (OR) 2.4, 95% confidence interval (CI) 1.2-5.1) and having a middle-range monthly household income (approx. USD 4080-<6800: OR 5.42, 95% CI 1.15-25.48; approx. USD 6800-<9530: OR 7.13, 95% CI 1.47-34.57) were positively associated with IID. Age ≥6 years was negatively associated with IID (OR 0.95, 95% CI 0.90-0.99). Forty-nine percent of participants with an IID sought medical care and 20.8% took over-the-counter medication. CONCLUSIONS: This study provides the first population-based prevalence estimates of IID in the UAE, which are similar to those reported in China (4%), but lower than those reported in Canada (10%), the Netherlands (7%), and the USA (6%).

Provision of care for chronic kidney disease by non-nephrologists in a developing nation: a national survey.

OBJECTIVES: The prevalence of chronic kidney disease (CKD) in developing countries has increased dramatically. This study aimed to explore the practice patterns of non-dialysis-dependent CKD care in an affluent developing country. SETTINGS: Primary and specialised healthcare facilities of public and private sectors in the United Arab Emirates. PARTICIPANTS: 159 non-nephrologist physicians practising in the United Arab Emirates. INTERVENTIONS: A 28-item online self-administered questionnaire based on CKD clinical practice guidelines. PRIMARY AND SECONDARY OUTCOME MEASURES: The physicians' approach to identifying and managing patients with CKD. RESULTS: The survey was completed by 159 non-nephrologists, of whom 135 reported having treated patients with CKD. Almost all the respondents screen patients with hypertension and diabetes for CKD, but one-third of them do not screen patients with cardiovascular disease and elderly patients for CKD. The use of accurate CKD screening tests (estimated glomerular filtration rate and albumin/creatinine ratio) was suboptimal (77% and 59% of physicians used the procedures, respectively). One-third of the physicians do not offer treatment with inhibitors of the renin-angiotensin system to patients with CKD, and only 66% offer antilipid treatment. In general, the primary healthcare physicians are more familiar than secondary healthcare physicians with the diagnosis and management of patients with CKD. CONCLUSIONS: We identified substantial physician-declared deficiencies in the practice of identifying and managing early CKD. Integration of quality CKD care within the healthcare system is required to face the increasing burden of CKD in the United Arab Emirates and possibly in other developing nations.

Pattern of varicella and associated complications in children in Unite Arab Emirates: 5-year descriptive study.

The objective of this study was to characterize the epidemiology of varicella and varicella-associated complications in Al-Ain, United Arab Emirates (UAE) during 2000-04. The annual number of reported cases varied from 373 to 790 per 100 000 population. Most (89%) occurred in children < 15 years old. Of 187 children requiring hospital admission, 50.3% had febrile illness due to secondary bacterial infection and 17.6% had neurological complications. The overall mortality rate among hospitalized children was 1.1%, all due to invasive group A Streptococcus. Varicella and associated complications in previously healthy children is becoming an important clinical and public health problem in the UAE.

Pattern of varicella and associated complications in children in United Arab Emirates: 5-year descriptive study

The objective of this study was to characterize the epidemiology of varicella and varicella associated complications in Al-Ain, United Arab Emirates [UAE] during 2000-04. The annual number of reported cases varied from 373 to 790 per 100 000 population. Most [89%] occurred in children < 15 years old. Of 187 children requiring hospital admission, 50.3% had febrile illness due to secondary bacterial infection and 17.6% had neurological complications. The overall mortality rate among hospitalized children was 1.1%, all due to invasive group A Streptococcus. Varicella and associated complications in previously healthy children is becoming an important clinical and public health problem in the UAE

Pattern of meningitis in Al-Ain medical district, United Arab Emirates--a decadal experience (1990-99).

OBJECTIVES: Haemophilus influenzae vaccine was introduced in the United Arab Emirates in 1999. Our objective was to describe the pattern of meningitis in a health district in the decade before the introduction of the vaccine and compare it with the data from elsewhere. METHODS: For this retrospective study we included 128 meningitis cases reported from 1990 to 1999. Information on the cases was abstracted from the case notification forms and clinical and laboratory data from the hospital case notes. RESULTS: H. influenzae was the most common cause of bacterial meningitis (n=59, 46.1%) followed by Streptococcus pneumoniae (n=20, 15.6%). Meningitis was a disease primarily of infants and children and the median age was 15 months. One fifth of the patients (n=27) had neurological sequelae of which 33.3% had seizures and 25.9% developed deafness. 18.9% (10 out of 53) of H. influenzae isolates were resistant to ampicillin compared with 5.9% (3 out of 51) to chloramphenicol. 78.9% (15 out of 19) of S. pneumoniae isolates were susceptible to penicillin. CONCLUSIONS: The epidemiology of meningitis in our health district is similar to the epidemiology of meningitis during the pre-vaccine era in other countries.

Mycobacterium tuberculosis in the United Arab Emirates: evidence of local transmission with unique strains.

A retrospective epidemiological analysis was performed of Mycobacterium tuberculosis infections in the Al Ain Medical District, Al Ain, United Arab Emirates (U.A.E.) during the period 1995-2000. The mean incidence for the study period was 7.1%, more than 3 times that reported for the period 1983-1992 (2.1%). For the years 1997 through 2000, the highest incidences (approximately 5-7% of tested) were from health care facilities that cater exclusively for citizens and long-term residents of the U.A.E. Corresponding rates for the immigrant visa applicants (non-citizens) were lower and showed a dramatic decrease from approximately 18% in 1995 to approximately 2% in 2000. Most importantly, the number of multidrug-resistant cases showed an increase from 1.4% during the period August 1997-December 1998 to 8.5% during the period January 1999-July 2000. Analysis of 7 different isolates by restriction fragment length polymorphism (RFLP) showed RFLP patterns that did not match > 4000 individual patterns from 32 countries, suggesting the possible presence of M. tuberculosis strains unique to the U.A.E. Our data demonstrate local transmission of M. tuberculosis in the Al Ain Medical Region of the U.A.E.

Use of existing data for public health planning: a study of the prevalence of hepatitis B surface antigen and core antibody in Al Ain Medical District, United Arab Emirates.

INTRODUCTION: Hepatitis B is of major public health importance. Accurate information on its occurrence, with particular reference to the prevalence of immunity and chronic infection (marked by the presence of hepatitis B core antibody and surface antigen, respectively, in serum), is essential for planning public health programmes for the control of the disease. The generation of marker prevalence data through serological surveys is costly and time-consuming. The present study in Al Ain Medical District, United Arab Emirates, investigated the possibility of obtaining sufficiently accurate marker prevalence estimates from existing data to plan public health programmes. METHODS: Two antenatal screening databases, one student serological survey database, one immunization programme database and one pre-marriage screening database containing information on marker prevalence were identified. Epidemiological data were abstracted from these databases and analysed. RESULTS: The data showed that the prevalence of hepatitis B surface antigen and the prevalence of core antibody in young citizens in 1998 were approximately 2% and 14% respectively, that any immunization campaign aimed at citizens of the United Arab Emirates should target teenagers as they had the highest risk of acquiring the disease, and that pre-immunization screening of young adults would be wasteful. However, the data did not yield information on the prevalence of hepatitis B surface antigen and core antibody in other population subgroups of public health significance. DISCUSSION: While data generated by the study are sufficient to support a hepatitis B immunization programme targeted at teenaged citizens, more accurate data, generated by a well-designed serological survey, would be essential for optimal public health planning.