Frequency of Dimethyl Fumarate-Induced Lymphopenia among Omani Patients with Multiple Sclerosis.

Objectives: Dimethyl fumarate (DMF) is known to cause lymphopenia when used to treat patients with multiple sclerosis (MS). However, research on DMF therapy in the Arab world, especially in Oman, is scarce. This study aimed to analyse the prevalence of lymphopenia among Omani patients with MS and their reasons for discontinuing DMF therapy. Methods: In this retrospective study, the medical records of Omani patients with MS who were treated using DMF at two tertiary hospitals in Muscat, Oman, from February 2017 to February 2023 were reviewed. Their demographic, clinical and laboratory data were retrieved and analysed. Absolute lymphocyte count values at baseline and at the last follow-up, as well as the reasons for discontinuing DMF therapy, were collected. Descriptive and inferential statistical techniques were used for data analysis. Binary-logistic regression analysis was used to identify the risk factors for DMF-induced lymphopenia. Results: A total of 64 Omani patients with MS were included in this study. The majority of the study participants (n = 40; 63%) were female. All included patients started DMF therapy at the mean age of 33 ± 7.7 years. After administration of DMF, 14 (21.9%) patients developed grades 1-3 of lymphopenia. The DMF therapy was discontinued for 23 (36.0%) patients, mainly in response to adverse events or confirmed pregnancy. Female gender was the only significant predictor of DMF-induced lymphopenia (P = 0.037). Conclusions: Most Omani patients with MS had mild lymphopenia (grades 1-2). Early adverse events and pregnancy were the main reasons provided for discontinuing DMF therapy.

An Evaluation of the Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the Management of Treatment-Resistant Depression with Somatic Attributes: A Hospital-Based Study in Oman.

Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, p < 0.0001, and 95% CI = 8.574-12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression.

Medical malpractice in Oman: A 12-year retrospective record review.

BACKGROUND: There is a paucity of studies documenting medical malpractice litigation in countries of the Arabian Gulf, such as Oman. OBJECTIVES: To describe the characteristics of malpractice claims, the outcomes decided by the medical liability committee, and predictors of medical errors. METHODS: This is a retrospective observational study that reviewed medical malpractice cases registered in Oman over a 12-year period (2010-2021) with the medical liability committee, known as the Higher Medical Committee (HMC). Descriptive and inferential statistical techniques, including multiple logistic regression techniques, were used for data analysis. RESULTS: Between 2010 and 2021, the HMC registered 1284 medical malpractice cases, out of which 1048 were fully investigated. The number of registered cases increased during this period. These cases included those raised by Omani nationals and expatriates, with a majority (86%) raised by Omani complainants. Two-thirds (67%) of the cases involved adult complainants aged 18-60 years. About 43% of the cases were from the urban Muscat region, and 68% were related to public hospitals. The most common specialties involved were obstetrics and gynecology (20.1%), internal medicine (19.7%), surgery (17.6%) and orthopedics (13.8%). Half (51%) of the appeals or grievances were dismissed because they were not preceded by medical negligence or malpractice. The average waiting time to initiate the investigation was 10 months. Errors were more common among non-Omani complainants and cases related to private hospitals. Significant predictors of errors included nationality (i.e. Omani vs. non-Omani), the referring institution, the medical specialty and the type of health institution involved, and the waiting time to initiate the investigation. CONCLUSION: To date, the number of cases of medical malpractice in Oman is lower compared to international trends, although there has been an upsurge in recent years. More research using a more robust methodology is warranted to contextualise the factors that contribute to this upward trend, as well as the preponderance in urban settings and among certain demographic populations.

Applying whole exome sequencing in a consanguineous population with autism spectrum disorder.

This study aimed to systematically assess the impact of clinical and demographic variables on the diagnostic yield of Whole Exome Sequencing (WES) when applied to children with Autism Spectrum Disorder (ASD) from a consanguineous population. Ninety-seven children were included in the analysis, 63% were male and 37% were females. 77.3% had a suspected syndromic aetiology of which 68% had co-existent central nervous system (CNS) clinical features, while 69% had other systems involved. The diagnostic yield of WES in our cohort with ASD was 34%. Children with seizures were more likely to have positive WES results (46% vs. 31%, p = 0.042). Probands with suspected syndromic ASD aetiology showed no significant differential impact on the diagnostic yield of WES.

Adverse childhood experiences and association with poorer health and health-harming behaviours in adulthood among the Americans.

BACKGROUND: Adverse childhood experiences (ACEs) such as abuse and neglect have an immediate impact on children and are associated with poorer health and behavioural outcomes in adulthood. This study examined the prevalence of ACEs and their association with socio-demographic factors, physical and mental health, morbidity and health-harming behaviours in adulthood among Americans. METHOD: Data for the study come from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), covering a sample of 116 032 adult respondents from 22 states of the United States. Descriptive and inferential statistical techniques, including multiple logistic regression models, were employed to analyse the data. RESULTS: At least one kind of ACE was found to be quite common among American adults, as 60% of adults had at least one kind of ACE, 22.5% had one ACE and 17% had four or more ACEs during 0-17 years of life. Of the total ACEs, 42.2% were due to abuse (physical, emotional or sexual), and 46% were due to any kind of household dysfunction. There is an increasing trend in ACEs in the United States. Adults with low socio-economic status, female, living in urban areas, gay or bisexual orientation, minority other than White and unemployed had a significantly higher prevalence of ACEs than their counterparts. ACEs were found to be significantly associated with poor physical and mental health; health-harming behaviours such as binge drinking, heavy drinking and smoking; and chronic morbidities. CONCLUSION: Programmes aimed at reducing ACEs and mitigating the harms of ACEs among those who have already experienced them should be strengthened to improve public health and quality of life and reduce health-harming behaviours.

Intellectual Profile of Children with Autism Spectrum Disorder: Identification of verbal and nonverbal subscales predicting intelligence quotient.

OBJECTIVES: This study aimed to explore the intelligence quotient (IQ) profile among children with autism spectrum disorder (ASD) and identify the most important subscales that predict the IQ. The analysis of an intellectual profile with age and gender differentials and the identification of a battery of subscales of intelligence are important for clinical management of ASD among children and for facilitating placement for remedial and educational services. METHODS: Data were collected through an exploratory study of 100 children aged between three and 13 years, who were referred to the department of child health and development in Sultan Qaboos University Hospital, a tertiary hospital, in Oman between June 2016 and June 2019. RESULTS: Among the 100 participants of this study, 79% were male, resulting in a male-female ratio of 4:1. The mean of full-scale IQ was found to be 68.6 ± 18.1. Furthermore, the mean of nonverbal IQ (73.5 ± 17.5) was significantly higher than that of verbal IQ (65.5 ± 17.6). Finally, more than half (61%) of the children were observed to have had mild to moderate impairment in their IQ levels. CONCLUSIONS: Age and gender showed no significant association with IQ level. The regression analysis identified nonverbal fluid reasoning, nonverbal visual-spatial processing, nonverbal working memory and verbal knowledge as the significant predictors of total IQ. The crucial dimensions of verbal and nonverbal IQ identified in this study can be used to evaluate complicated cases.

Consanguineous marriage and its relevance to divorce, polygyny and survival of marriage: evidence from a population-based analysis in Jordan.

BACKGROUND: Consanguinity has been extensively studied in the context of its negative health outcomes for offspring and socio-demographic factors, but little evidence-based research has been done on its potential social benefits. AIM: To examine the association between consanguineous marriage and the risk of divorce or separation, polygyny, and survival of marriage in Jordan. SUBJECTS AND METHODS: Data were obtained from the 2018 Jordan Population and Family Health Survey, covering a nationally representative sample of ever-married women of reproductive age. Descriptive statistics, multiple logistic regression, and survival analysis techniques were used for data analysis. RESULTS: The prevalence of consanguineous marriage was found to be 27.5% in Jordan in 2018, while the prevalences of polygyny and divorced/separated rates were 4.4% and 4.7%, respectively. Both consanguineous and polygyny rates showed declining trends, but divorce/separation rate showed an increasing trend. Compared to non-consanguineous marriages, the risk of divorce/separation and polygyny were found to be lower among women with consanguineous marriage, while the survival of marriages was found to be higher for consanguineous marriages than for non-consanguineous marriages. CONCLUSIONS: Findings revealed that consanguinity has some social benefits as it plays protective roles against divorce or separation, polygyny and enhances the survival of marriages.

Prevalence and risk factors for low birth weight in Jordan and its association with under-five mortality: a population-based analysis.

BACKGROUND: Low birth weight (< 2.5 kg) is an important indicator of health and development of infants throughout their life. AIMS: This study aimed to determine the prevalence and risk factors for low birth weight in Jordan and its association with under-5 mortality. METHODS: In this secondary analysis, data were extracted from the 2012 Jordan Population and Family Health Survey for 9734 live births born in the 5 years preceding the survey and for which birth weight was reported. Data were collected on child and maternal characteristics. Multivariable regression analysis was used to determine the significant risk factors for low birth weight and mortality. RESULTS: Of the 9734 births analysed, 13.8% were low birth weight and 1.3% were very low birth weight. Mother's age (< 30 and ≥ 35 years), education (less than higher education), birth interval (< 24 months and first birth), unplanned pregnancy, household wealth status (poorest and richest), consanguinity, residence (central and south regions of Jordan), female sex, birth order (1 and ≥ 6), twin birth and maternal smoking during pregnancy were significant risk factors for low birth weight. The risk of death under 5 years of age was 4.8 times higher in children with low birth weight than children with normal birth weight. CONCLUSIONS: The high rate of low birth weight and its increasing rate in Jordan is a challenge for public health. Preventing low birth weight neonates and increasing their survival need to be prioritized in the national health strategy. Special care needs to be taken for the high-risk groups identified in this study.

Twin births in Jordan: incidence, trends, risk factors and implications for under-five mortality: evidence from the 2012 Jordan Population and Family Health Survey.

Research on twinning in developed countries is well documented, but little is known about twinning in less-developed countries due to a lack of data or data limitations. This study examined the level of, trends in and determinants of twin births and their survival under age five in Jordan, using the 2012 Jordan Population and Family Health Survey (JPFHS) data. The birth history of 11,352 women included in the JPFHS provided information on 9859 live births that occurred within five years of the survey date, and these constituted the study subjects. Descriptive statistics, and bivariate and multivariate multilevel logistic regression models were used for data analysis. About 3.5% of the total live births were twins, which is one of the highest rates in developing countries. The twinning rate showed an increasing trend in Jordan, increasing by 45% from 2.4% in 1990 to 3.5% in 2012. Higher maternal age at child birth, higher parity, poor and richer economic status, contraceptive use status, secondary and above level of education of mothers and non-consanguinity were found to be associated with a higher rate of twin births in Jordan. Twins were observed to have a higher risk of low birth weight, being smaller in physical size at birth and at more than four times higher risk of neonatal death compared with singletons. To reduce the risk adverse outcomes of twin pregnancies and further improve maternal and child health, antenatal, delivery and postnatal care should be tailored towards the special needs of twin pregnancies and twin births in Jordan Twin pregnancies should be detected at the early stage of pregnancy so that perinatal outcomes can be improved by frequent prenatal visits, health education, counselling and proper management of peripartum complications.

Revisiting the Prevalence of Autism Spectrum Disorder among Omani Children: A multicentre study.

OBJECTIVES: This study aimed to provide an updated estimate of the prevalence of autism spectrum disorder (ASD) among Omani children. METHODS: This retrospective descriptive study was conducted from December 2011 to December 2018. Data were retrieved from the three main autism diagnostic centres in Oman: Sultan Qaboos University Hospital, Royal Hospital and Al-Massarah Hospital. The ASD diagnosis was made by experienced clinicians based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The overall population prevalence estimates per 10,000 children aged 0-14 years old in Oman were calculated using the denominator of the mid-period population data. RESULTS: A total of 1,705 ASD cases were identified with the majority of cases being male (78.1%). The overall prevalence rate of ASD was estimated at 20.35 per 10,000 children (95% confidence interval: 19.39-21.32) between 2012-2018. Boys were found to have a 3.4-fold higher prevalence of ASD than girls (31.23/10,000 versus 9.07/10,000). Regionally, the majority of cases were found in the capital, Muscat, where the highest prevalence was 36.51 cases per 10,000 children. CONCLUSION: The prevalence of ASD among Omani children is 15-fold higher than estimates from 2011. This increase can be attributed to improvements in diagnostic services, increased awareness of ASD, better screening programmes and changes in diagnostic criteria. In addition, this increase in prevalence suggests a need for a registry of developmental disabilities and more extensive diagnostic and rehabilitation services in Oman.

Determinants of frequency and contents of antenatal care visits in Bangladesh: Assessing the extent of compliance with the WHO recommendations.

BACKGROUND: In addition to the number of antenatal care (ANC) visits, the items of ANC services covered by ANC visits greatly influence the effectiveness of the ANC services. Recently the World Health Organization (WHO) recommended not only to achieve a minimum of eight ANC visits, but also to use a core set of items of ANC services for safe motherhood. This study examined the levels and determinants of frequency and contents of ANC visits in Bangladesh and thus assessed the level of compliance with the WHO recommended number and the content of ANC services during pregnancy in Bangladesh. METHODS: The data for the study come from the 2014 Bangladesh Demographic and Health Survey (BDHS), which covereda nationally representative sample of 17,863 ever-married women aged 15-49 years. Data derived from 4,627 mothers who gave birth in the three years preceding the survey constituted the study subjects. Descriptive, inferential and multivariate statistical techniques were used for data analysis. RESULTS: On average, mothers received less than three (2.7 visits) ANC visits and only 6% receive the recommended eight or more ANC visits. About 22% of the mothers received all the prescribed basic items of ANC services. About one-fifth (21%) of the mothers never received ANC visits and thus no items of ANC services. Measurement of blood pressure was the most common item received during ANC visit as reported by 69% mothers. Blood test was the least received item (43%). Significant positive association was found between frequency of ANC visits and receiving the increased number of items of ANC services. High socio-economic status, low parity, living in urban areas and certain administrative regions, planned pregnancies, having media exposure, visiting skilled providers for ANC services and visit to public or NGO health facilities are associated with frequent ANC visits and receiving higher number of items of ANC contents. CONCLUSION: An unsatisfactory level of coverage of and content of ANC visits have been observed in Bangladesh. Further investigation is needed to identify the causes of under-utilization of ANC services in Bangladesh. A greater understanding of the identified risk factors and incorporating them into short and long term strategies would help improve the coverage and contents and thus quality of ANC services in Bangladesh.

Health care seeking behaviour during pregnancy, delivery and the postnatal period in Bangladesh: Assessing the compliance with WHO recommendations.

BACKGROUND: The World Health Organization (WHO) recommends four antenatal care (ANC) visits, delivery in a health facility and three postnatal care (PNC) visits for women to optimize the maternal health outcomes. OBJECTIVES: To examine the level and determinants of maternal health care seeking behaviour during pregnancy, delivery and the postnatal period, and assess the compliance with the WHO recommended levels of care in Bangladesh. DESIGN/SETTING: The study is based on secondary analysis of the data obtained from the 2014 Bangladesh Demographic and Health Survey (BDHS). The 2014 BDHS was a cross-sectional survey of a nationally representative sample of 17,863 ever-married women aged 15-49 years. The sample was selected following a two-stage stratified cluster sampling design. PARTICIPANTS: The dataset from a subsample of 4.627 ever-married women who had delivered their last birth within three years before the survey were included in the analysis to meet the objectives of the study. ANALYSIS: Descriptive statistics and multinomial logistic regression model were used for data analysis. FINDINGS: It has been observed that only 31% mothers had recommended four or more ANC visits, 37% births were delivered at health facilities, and 65% mothers received at least one PNC visit. Only 18.0% mothers received the WHO recommended optimal level of four or more ANC visits, births in a health facility and at least one PNC visit. Mothers aged less than 20 years, living in rural area, having no education and media exposure, multiparous, poor wealth status, husband with no education and husband's employment status appeared as significant predictors of optimal level maternal health care after adjusting for other factors. Mothers living in Sylhet, Chittagong and Barisal regions were less likely to receive the optimum level health care. KEY CONCLUSION: Utilization of maternal health care during pregnancy, delivery and the postnatal period among Bangladeshi women does not reflect the complete compliance with the WHO recommendations. Further studies are needed to identify the reasons for underutilization of optimum level maternal care practice in Bangladesh. IMPLICATION FOR PRACTICE: The findings underscore the need for targeted intervention for those groups of mothers who were identified as having lowest level of maternal care across the continuum of care.

The changing pattern and determinants of declining consanguinity in Jordan during 1990-2012.

BACKGROUND: Consanguinity is a deep rooted cultural trait in Jordan. AIM: To examine the patterns and determinants of declining rates of consanguineous marriage in Jordan during 1990-2012 in the context of the changing pattern of socio-economic and demographic conditions. MATERIALS AND METHODS: The data come from the 1990 and 2012 Jordan Population and Family Health Surveys (JPFHSs). A total of 6461 women in 1990 and 11,352 women in 2012 were successfully interviewed. Descriptive and multivariate statistical techniques were used for data analysis. RESULTS: Consanguinity was found to be widely practiced (35% in 2012) until recent times in Jordan. However, there has been a secular declining trend over the last few decades as the practice of consanguinity has declined from 56% in 1990 to 35% in 2012. Increasing age at marriage and female education, higher level of education of husbands, declining family size, increasing rate of urbanisation and female employment, exposure to mass media and higher economic status appeared as significant predictors of declining consanguinity in Jordan. CONCLUSIONS: The findings of this study support Goode's hypothesis of a decrease of consanguinity with modernisation. Although consanguinity is a deeply rooted cultural trend in Jordan, it is gradually losing ground due to modernisation and socio-demographic transition of the country.

CONSANGUINEOUS MARRIAGE IN JORDAN: AN UPDATE.

This study examined the recent level, trends and determinants of consanguineous marriage in Jordan using time-series data from the Jordan Population and Family Health Surveys (JPFHSs). According to the 2012 JPFHS, 35% of all marriages were consanguineous in Jordan in 2012. There has been a declining trend in consanguinity in the country, with the rate decreasing from a level of 57% in 1990. Most consanguineous marriage in 2012 were first cousin marriages, constituting 23% of all marriages and 66% of all consanguineous marriages. The data show that women with a lower age at marriage, older marriage cohort, larger family size, less than secondary level of education, rural place of residence, no employment, no exposure to mass media, a monogamous marriage, a husband with less than higher level of education and lower economic status, and those from the Badia region, were more likely to have a consanguineous marriage. Increasing age at marriage, level of education, urbanization and knowledge about the health consequences of consanguinity, and the ongoing socioeconomic and demographic transition in the country, will be the driving forces for further decline in consanguinity in Jordan.

The Effects of Low Birth Weight on School Performance and Behavioral Outcomes of Elementary School Children in Oman.

OBJECTIVES: Our study aimed to examine the effects of low birth weight (LBW) on the school performance and behavior of elementary school children in Oman. . METHODS: Data were gathered through a cross-sectional survey of nine elementary schools from the Muscat and A'Dhahirah regions. The study utilized a unique database created by linking information from the children's health cards and current academic and behavioral performance records. Information on children's performance in various areas such as language, mathematics, science, information technology, sports, and behavior were obtained from the school registers. Birth weight (BW) and selected sociodemographic data were obtained from the copy of their health cards kept by each school. A total of 542 elementary school children aged 7-11 years, who had completed grades 2-4, were surveyed. . RESULTS: Data from the school register revealed a very high rate (17.7%) of LBW and, overall, 12% of the children exhibited below average performance on selected outcome measures. The below average school performance varied from 5-17% across the six selected areas of school performance. The highest rate of below average performance was observed in science (17%), followed by arithmetic and language (16% each). BW showed significant differential effects on school performance and behavioral outcomes, which remained significant after controlling for the effect of potential confounders. It was found that LBW children were 2-6 times more likely to have poorer school performance in all areas than their normal BW peers. . CONCLUSION: Early intervention programs or special care for LBW children in school could be an effective means of improving educational outcomes and the behavior of these children. Attempts should be made to reduce or prevent poor pregnancy outcomes, which, in turn, would reduce the cost of the health, education, and social services systems.

Increasing Incidence of Infants with Low Birth Weight in Oman.

This review article provides an overview of the levels, trends and some possible explanations for the increasing rate of low birth weight (LBW) infants in Oman. LBW data from national health surveys in Oman, and published reports from Oman's Ministry of Health and the World Health Organization were collected and assessed between January and August 2014. Oman's LBW rate has been increasing since the 1980s. It was approximately 4% in 1980 and had nearly doubled (8.1%) by 2000. Since then, it has shown a slow but steady rise, reaching 10% in recent times. High rates of consanguinity, premature births, number of increased pregnancies at an older maternal age and changing lifestyles are some important factors related to the increasing rate of LBW in Oman. The underlying causes of this increase need to be understood and addressed in obstetric policies and practices in order to reduce the rate of LBW in Oman.

Advanced Maternal Age and Risks for Adverse Pregnancy Outcomes: A Population-Based Study in Oman.

To test the hypothesis that advanced maternal age (AMA) of 35 years and above is associated with increased risk of adverse pregnancy outcomes, we performed a population-based retrospective study using data from the 2000 National Health Survey in Oman. The last pregnancy outcomes of mothers aged ≥35 years were compared with adult mothers aged 20-34 years using bivariate and multivariate statistical techniques. Significantly increased risks of spontaneous abortion, gestational diabetes, preeclampsia, prolonged labor, and cesarean section delivery have been observed for advanced maternal age. Our findings may contribute to cross-cultural understanding of the risks associated with AMA and will facilitate evidence-based counseling of older expectant mothers.

Consanguinity, endogamy and inborn errors of metabolism in Oman: a cross-sectional study.

The Sultanate of Oman, like many other Arab countries, has relatively high rates of consanguinity. Reports suggest that the incidence of inborn errors of metabolism (IEM) is also high in Oman. This retrospective cross-sectional study was designed to evaluate the number of patients with IEM being followed at the only two tertiary centers in Oman treating such patients, and to calculate the consanguinity rates among these families. The electronic medical records of all patients were reviewed for demographic and clinical characteristics. A total of 285 patients with IEM were being followed at the 2 centers involved; 162 (56.8%) were male and 123 (43.2%) were female. The history of consanguinity was documented or available for 241 patients: 229 patients (95%) were born to consanguineous parents related as second cousins or closer. First-cousin marriages were reported in 191 families (79.3%), while 31 patients (12.9%) were born to second cousins. The parents of 5 patients (2%) were related as double first cousins, and 2 patients (1%) were born to first cousins once removed. The average coefficient of inbreeding (F) in our study was 0.081. Seventeen patients (6%) had associated comorbid conditions other than IEM. Our study highlights the clinical burden of IEM in Oman and emphasizes the high consanguinity rates among the parents of affected patients.

Can maternal recalled birth size be used as a proxy measure of birth weight? An evaluation based on a population health survey in Oman.

To evaluate the utility of maternal recalled birth size (BS) as a proxy measure for actual birth weight (BW) when BW data are missing. Data for the study come from the 2000 National Health Survey of Oman. Frequency distribution, sensitivity and specificity analysis, bivariate, and multivariate statistical techniques were used for data analysis. The BW data exhibited a moderate level of heaping on measurements ending in 0 or 5, suggesting that health personnel often round when recording. About 31% of actual BW data were missing due to non-availability of health cards. Maternal assessment of BS was found to be closely linked to BW on an aggregate level. However, on an individual level, there was misclassification of birth weights across all categories of BS. The overall agreement between recalled BS and recorded BW was moderate (κ = 0.44). Infants with missing BW records were more likely to be low birth weight (LBW). Maternal recalled BS appeared to be a poor proxy for BW. Estimates of LBW based on maternal assessments of BS as small should be considered as an underestimate of its actual prevalence. As infants with missing BW data have different characteristics from those with recorded BW, estimates of LBW depending solely on available BW records will produce a biased prevalence. Health personnel should record actual BW without rounding. They should inform mothers of the birth weight and advise them to retain health cards for future reference.

The pattern of female nuptiality in oman.

OBJECTIVES: The purpose of this study was to examine Omani patterns of female nuptiality, including the timing of marriage and determinants of age at a woman's first marriage. METHODS: The study utilised data from the 2000 Oman National Health Survey. Univariate, bivariate, and multivariate statistical methods, including logistic regression analysis, were used for data analysis. RESULTS: One of the most important aspects of the marriage pattern in Oman is the high prevalence of consanguineous marriages, as more than half (52%) of the total marriages in Oman are consanguineous. First cousin unions are the most common type of consanguineous unions, constituting 39% of all marriages and 75% of all consanguineous marriages. About 11% of the marriages are polygynous. Early and universal marriage is still highly prevalent in Oman. Three-quarters (75%) of married women respondents aged 20-44 years were married by age 20, with their median age at their first wedding being 16 years. However, women's average age upon marriage is gradually increasing. The change is especially apparent in more recent marriages or among younger cohorts of women, and for certain socio-cultural groups. Multivariate analysis identified female education, age cohort, residential status, region of residence, types of marriage, and employment as strong predictors of Omani women's age at marriage. CONCLUSION: The growing number of young adults, accompanied by their tendency to delay marriage, may have serious demographic, social, economic, and political ramifications for Oman, highlighting the need to understand the new situation of youth, their unique characteristics, and their interests and demands. Culturally appropriate policies need to be implemented to address the issues and challenges of unmarried young adults.