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1.
BMJ Open Qual ; 9(4)2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33199287

RESUMO

BACKGROUND: The COVID-19 pandemic represents an unprecedented challenge to healthcare systems and nations across the world. Particularly challenging are the lack of agreed-upon management guidelines and variations in practice. Our hospital is a large, secondary-care government hospital in Kuwait, which has increased its capacity by approximately 28% to manage the care of patients with COVID-19. The surge in capacity has necessitated the redeployment of staff who are not well-trained to manage such conditions. There was a great need to develop a tool to help redeployed staff in decision-making for patients with COVID-19, a tool which could also be used for training. METHODS: Based on the best available clinical knowledge and best practices, an eight member multidisciplinary group of clinical and quality experts undertook the development of a clinical algorithm-based toolkit to guide training and practice for the management of patients with COVID-19. The team followed Horabin and Lewis' seven-step approach in developing the algorithms and a five-step method in writing them. Moreover, we applied Rosenfeld et al's five points to each algorithm. RESULTS: A set of seven clinical algorithms and one illustrative layout diagram were developed. The algorithms were augmented with documentation forms, data-collection online forms and spreadsheets and an indicators' reference sheet to guide implementation and performance measurement. The final version underwent several revisions and amendments prior to approval. CONCLUSIONS: A large volume of published literature on the topic of COVID-19 pandemic was translated into a user-friendly, algorithm-based toolkit for the management of patients with COVID-19. This toolkit can be used for training and decision-making to improve the quality of care provided to patients with COVID-19.


Assuntos
Algoritmos , Infecções por Coronavirus/terapia , Assistência à Saúde/organização & administração , Implementação de Plano de Saúde/métodos , Pneumonia Viral/terapia , Betacoronavirus , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Pandemias
2.
PLoS One ; 15(11): e0242768, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33216801

RESUMO

This is a retrospective single-center study of 417 consecutive patients with coronavirus disease 2019 (COVID-19) admitted to Jaber Al-Ahmad Hospital in Kuwait between February 24, 2020 and May 24, 2020. In total, 39.3% of patients were asymptomatic, 41% were symptomatic with mild/moderate symptoms, 19.7% were admitted to the intensive care unit (ICU). Most common symptoms in cohort patients were fever (34.3%) and dry cough (32.6%) while shortness in breath was reported in (75.6%) of ICU admissions. Reported complications requiring ICU admission included Sepsis (68.3%), acute respiratory distress syndrome (95.1%) and heart failure (63.4%). ICU patients were more likely to have comorbidities, in comparison to non-ICU patients, including diabetes (35.4% vs 20.3%) and hypertension (40.2% vs 26.9%). Mortality rate of cohort was 14.4% and mean age of death was 54.20 years (± 11.09) and 90% of death cases were males. Chest high-resolution computed tomography for ICU cases reveled multifocal large patchy areas of ground glass opacification mixed with dense consolidation. Cases admitted to ICU showed abnormal levels of markers associated with infection, inflammation, abnormal blood clotting, heart problems and kidney problems. Mean hospital stay for asymptomatic cases was 20.69 days ±8.57 and for mild/moderate cases was 21.4 days ±8.28. Mean stay in ICU to outcome for survivors was 11.95 days ±8.96 and for death cases 13.15 days ±10.02. In this single-center case series of 417 hospitalized COVID-19 patients in Kuwait 39.3% were asymptomatic cases, 41% showed mild/moderate symptoms and 18.7% were admitted to ICU with a mortality rate of 14.4%.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas/epidemiologia , Betacoronavirus , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Adulto Jovem
3.
J Affect Disord ; 277: 977-985, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065842

RESUMO

BACKGROUND: In February 2020 the first cases of COVID-19 were identified in Kuwait. Inevitably as many countries worldwide, the general public were negatively affected by the pandemic. Unemployment, uncertainty, distress, increasing deaths, lockdown measures all of which are potential burdens on mental health. AIM: To assess the impact of COVID19 outbreak on mental health in Kuwait, and to explore the potential influencing risk factors. METHODS: We conducted an online questionnaire-based study in Kuwait between 25th May 2020 to 30th May 2020. Questions were based on demographics, lifestyle during outbreak, depression and anxiety assessment. Total PHQ9 and GAD7 scores were calculated for each responder. RESULTS: We had 4132 responders. Most were females (69.31%), married (59.37%), between the age of 21-30 (23.84%) and non-smokers (81.46%). Only (7.96%) had a positive past psychiatric history, (32.04%) had a past history of a chronic medical disease. During the outbreak most of the responders lost their jobs (39.21%) and only (12.83%) were attending work regularly, only (6.82%) worked in the healthcare sector. 59.27% report increased social media use compared to before the lockdown. When asked about their daily time spent following COVID19-related news, most (37.8%) spend more than 2 hours and (7.74%) spend more than 4 hours. The overall prevalence of depressive symptoms was (30.13%) and the prevalence of anxiety symptoms was (25.28%). LIMITATIONS: In the cross-sectional nature of the study. CONCLUSION: The COVID-19 pandemic caused a burden on mental health. Psychological support and mental health awareness should be implemented and made accessible to all individuals during pandemics.


Assuntos
Infecções por Coronavirus/psicologia , Efeitos Psicossociais da Doença , Pandemias , Pneumonia Viral/psicologia , Quarentena/psicologia , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Kuweit/epidemiologia , Estilo de Vida , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Mídias Sociais , Inquéritos e Questionários , Desemprego , Adulto Jovem
4.
Environ Health Prev Med ; 25(1): 61, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33045996

RESUMO

BACKGROUND: The coronavirus pandemic has transformed and continues to transform and affect the daily lives of communities worldwide, particularly due to the lockdown restrictions. Therefore, this study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak. METHODS: A cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults living in Kuwait (age range 18-73 years). RESULTS: The rate of skipping breakfast remained consistent, with a slight increase during the pandemic. Lunch remained the main reported meal before and during COVID-19. Compared to before COVID-19, people were much more likely have a late-night snack or meal during COVID-19 (OR = 3.57 (95% CI 1.79-7.26), p < 0.001). Moreover, there was a drastic decrease in the frequency of fast-food consumption during COVID-19, up to 82% reported not consuming fast food (p < 0.001). There was a significant increase in the percentage of participants who had their main meal freshly made (OR = 59.18 (95% CI 6.55-1400.76), p = 0.001). Regarding food group patterns, no significant differences were found before and during the pandemic in terms of the weekly frequency of consumption, except in the case of fish and seafood. There were no remarkable changes in beverage consumption habits among participants before and during the pandemic, except for Americano coffee and fresh juice. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants. CONCLUSION: In general, this study indicates some changes in daily life, including changes in some eating practices, physical activity and sleeping habits during the pandemic. It is important that the government considers the need for nutrition education programmes and campaigns, particularly during this critical period of the pandemic in Kuwait.


Assuntos
Infecções por Coronavirus/epidemiologia , Comportamento Alimentar , Estilo de Vida , Pneumonia Viral/epidemiologia , Adulto , Idoso , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Comportamentos de Risco à Saúde , Humanos , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tempo de Tela , Comportamento Sedentário , Sono , Inquéritos e Questionários , Adulto Jovem
5.
Soc Work Public Health ; 35(7): 546-556, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970542

RESUMO

With the COVID-19 pandemic threatening millions of lives around the world with no clear promises for treatment or vaccine yet, motivating the public to change their behaviors to prevent the spread of the disease becomes crucial and moral imperative. The current study investigated the associations between self-reported intentions to perform protective behaviors against COVID-19, the seven constructs of the Protection Motivation Theory PMT, trust in government, and sociodemographic factors within the general population in Kuwait. A cross-sectional design was adapted to explore the associations between study factors in a nonprobability voluntary response sample of 679 participants who completed an online public survey. Results indicate that the scores of trust in government and the severity, vulnerability, response efficacy, and self-efficacy subconstructs of the PMT were positively related to protective behavior intention, whereas intrinsic and extrinsic reward and response cost subconstructs were negatively associated with protective behavior intention. The results were discussed considering previous literature and future applications.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Comportamentos Relacionados com a Saúde , Motivação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Confiança , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Governo , Humanos , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
6.
BMC Public Health ; 20(1): 1384, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912230

RESUMO

BACKGROUND: In light of the COVID-19 pandemic, many have flagged racial and ethnic differences in health outcomes in western countries as an urgent global public health priority. Kuwait has a unique demographic profile with two-thirds of the population consisting of non-nationals, most of which are migrant workers. We aimed to explore whether there is a significant difference in health outcomes between non-Kuwaiti and Kuwaiti patients diagnosed with COVID-19. METHODS: We used a prospective COVID-19 registry of all patients (symptomatic and asymptomatic) in Kuwait who tested positive from February 24th to April 20th, 2020, collected from Jaber Al-Ahmad Al-Sabah Hospital, the officially-designated COVID-19 healthcare facility in the country. We ran separate logistic regression models comparing non-Kuwaitis to Kuwaitis for death, intensive care unit (ICU) admission, acute respiratory distress syndrome (ARDS) and pneumonia. RESULTS: The first 1123 COVID-19 positive patients in Kuwait were all recruited in the study. About 26% were Kuwaitis and 73% were non-Kuwaiti. With adjustments made to age, gender, smoking and selected co-morbidities, non-Kuwaitis had two-fold increase in the odds of death or being admitted to the intensive care unit compared to Kuwaitis (OR: 2.14, 95% CI 1.12-4.32). Non-Kuwaitis had also higher odds of ARDS (OR:2.44, 95% CI 1.23-5.09) and pneumonia (OR: 2.24, 95% CI 1.27-4.12). CONCLUSION: This is the first study to report on COVID-19 outcomes between Kuwaiti and non-Kuwaiti patients. The current pandemic may have amplified the differences of health outcomes among marginalized subpopulations. A number of socioeconomic and environmental factors could explain this health disparity. More research is needed to advance the understanding of policymakers in Kuwait in order to make urgent public health interventions.


Assuntos
Infecções por Coronavirus/etnologia , Infecções por Coronavirus/terapia , Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Pneumonia Viral/etnologia , Pneumonia Viral/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Sistema de Registros , Resultado do Tratamento , Adulto Jovem
7.
J Headache Pain ; 21(1): 115, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32972360

RESUMO

BACKGROUND: Since the declaration COVID-19 as a pandemic, healthcare systems around the world have faced a huge challenge in managing patients with chronic diseases. Patients with migraine were specifically vulnerable to inadequate medical care. We aimed to investigate the "real-world" impact of COVID-19 pandemic on migraine patients, and to identify risk factors for poor outcome. METHODS: We administered an online, self-reported survey that included demographic, migraine-related, COVID-19-specific and overall psychosocial variables between July 15 and July 30, 2020. We recruited a sample of patients with migraine from headache clinic registry and via social media to complete an anonymous survey. Outcomes included demographic variables, change in migraine frequency and severity during the lockdown period, communication with treating physician, compliance to migraine treatment, difficulty in getting medications, medication overuse, symptoms of anxiety and/or depression, sleep and eating habits disturbance, screen time exposure, work during pandemic, use of traditional medicine, effect of Botox injection cancellation, and overall worries and concerns during pandemic. RESULTS: A total of 1018 patients completed the survey. Of the respondents, 859 (84.3%) were females; 733 (71.9%) were aged 20 to 40 years, 630 (61.8%) were married, and 466 (45.7%) reported working during the pandemic. In comparison to pre-pandemic period, 607 respondents (59.6%) reported increase in migraine frequency, 163 (16%) reported decrease in frequency, and 105 (10.3%) transformed to chronic migraine. Severity was reported to increase by 653 (64.1%) respondents. The majority of respondents; 626 (61.5%) did not communicate with their neurologists, 477 (46.9%) reported compliance to treatment, and 597 (58.7%) reported overuse of analgesics. Botox injections cancellation had a negative impact on 150 respondents (66.1%) from those receiving it. Forty-one respondents (4%) were infected with COVID-19; 26 (63.4%) reported worsening of their headaches amid infection period. Sleep disturbance was reported by 794 (78.1%) of respondents, and 809 (79.5%) reported having symptoms of anxiety and/or depression. CONCLUSIONS AND RELEVANCE: COVID-19 pandemic had an overall negative impact on patients with migraine. Several risk factors for poor outcome were identified. Long-term strategies should be validated and implemented to deliver quality care for patients with migraine, with emphasis on psychosocial well-being.


Assuntos
Infecções por Coronavirus/epidemiologia , Transtornos de Enxaqueca/fisiopatologia , Pneumonia Viral/epidemiologia , Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos , Adulto , Analgésicos/uso terapêutico , Ansiedade/psicologia , Betacoronavirus , Toxinas Botulínicas Tipo A/uso terapêutico , Comunicação , Depressão/psicologia , Feminino , Acesso aos Serviços de Saúde , Humanos , Internet , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/prevenção & controle , Transtornos de Enxaqueca/psicologia , Fármacos Neuromusculares/uso terapêutico , Pandemias , Relações Médico-Paciente , Fatores de Risco , Sono , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Inquéritos e Questionários , Adulto Jovem
8.
Eur Rev Med Pharmacol Sci ; 24(15): 8232-8238, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767355

RESUMO

OBJECTIVE: The COVID-19 pandemic has caused a global public health crisis with social, psychological and long-lasting economical damages. Weather-related dynamics have an impact on the pattern of human health and disease. The present study aimed to investigate the impact of heat and humidity on daily basis incidence and mortality due to COVID-19 pandemic in ten of the world's hottest countries compared to ten of the coldest ones. MATERIALS AND METHODS: Worldwide, we selected 20 countries; 10 hottest countries with the highest temperatures and 10 coldest countries with the lowest temperature. The selection of the countries was based on the daily basis mean temperature from the date of appearance of the initial cases of COVID-19, Dec 29, 2019 to May 12, 2020. In the world's 10 hottest countries, the mean temperature was (26.31±1.51) and humidity (44.67±4.97). However, in the world's 10 coldest countries the mean temperature was (6.19±1.61) and humidity (57.26±2.35). The data on the global outbreak of COVID-19, daily new cases and deaths were recorded from World Health Organization, and daily information on temperature and humidity was obtained from metrological web "Time and Date". RESULTS: In countries with high temperatures and low humidity, the mean daily cases incidence were (407.12±24.33); cumulative cases (9094.34±708.29); and cumulative deaths (452.84±43.30) were significantly low compared to countries with low temperatures and high humidity: daily cases (1876.72±207.37); cumulative cases (44232.38±5875.11); and cumulative deaths (2008.29±310.13). Moreover, COVID-19 cases and deaths per million population were significantly low in countries with high temperatures (cases 711.23, and deaths 16.27) compared to countries with low temperatures (cases 1685.99; and deaths 86.40). Furthermore, in hottest countries, a 1% increase in humidity reduced number of cases and deaths by (ß = -5.40, p<0.001) and (ß = -0.187, p=0.004) respectively. A similar trend was seen with a 1°C increase in temperature, reducing the number of deaths by (ß = -1.35. p<0.001). CONCLUSIONS: The results revealed a significant decrease in incidence of daily cases and deaths in countries with high temperatures and low humidity (warmest countries), compared to those countries with low temperatures and high humidity (coldest countries). The findings could be of interest to the policymakers and the health officials on the epidemiological trends of COVID-19 pandemic and weather changes.


Assuntos
Clima , Infecções por Coronavirus/epidemiologia , Temperatura Alta , Umidade , Pneumonia Viral/epidemiologia , Argélia/epidemiologia , Áustria/epidemiologia , Betacoronavirus , Canadá/epidemiologia , Infecções por Coronavirus/mortalidade , Estônia/epidemiologia , Finlândia/epidemiologia , Gana/epidemiologia , Humanos , Incidência , Índia/epidemiologia , Irã (Geográfico)/epidemiologia , Cazaquistão/epidemiologia , Kuweit/epidemiologia , México/epidemiologia , Mortalidade , Noruega/epidemiologia , Omã/epidemiologia , Paquistão/epidemiologia , Pandemias , Pneumonia Viral/mortalidade , Análise de Regressão , República de Belarus/epidemiologia , Federação Russa/epidemiologia , Arábia Saudita/epidemiologia , Suécia/epidemiologia , Emirados Árabes Unidos/epidemiologia , Estados Unidos/epidemiologia
9.
BMJ Glob Health ; 5(7)2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32641292

RESUMO

As a marginalised subpopulation, migrant workers often fall short from protection by public policies, they take precarious jobs with unsafe working and living conditions and they grapple with cultural and linguistic barriers. In light of the current COVID-19 pandemic, migrant workers are now exposed to additional stressors of the virus and related responses. We applied a comprehensive qualitative cumulative risk assessment framework for migrant workers living in Kuwait. This pandemic could be one of the few examples where the stressors overlap all domains of migrant workers' lives. No single intervention can solve all the problems; there must be a set of interventions to address all domains. Local authorities and employers must act quickly to stop the spread, ensure easy access to testing and treatment, provide adequate housing and clear communication, encourage wide social support, safeguard financial protection and mental well-being and continuously re-evaluate the situation as more data are collected.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Medição de Risco , Migrantes , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Kuweit/epidemiologia , Masculino , Saúde do Trabalhador , Ocupações , Pesquisa Qualitativa , Fatores de Risco
10.
Int J Infect Dis ; 98: 153-160, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32619761

RESUMO

OBJECTIVES: Prompt understanding of the temporal and spatial patterns of the COVID-19 pandemic on a national level is a critical step for the timely allocation of surveillance resources. Therefore, this study explored the temporal and spatiotemporal dynamics of the COVID-19 pandemic in Kuwait using daily confirmed case data collected between the 23 February and 07 May 2020. METHODS: The pandemic progression was quantified using the time-dependent reproductive number (R(t)). The spatiotemporal scan statistic model was used to identify local clustering events. Variability in transmission dynamics was accounted for within and between two socioeconomic classes: citizens-residents and migrant workers. RESULTS: The pandemic size in Kuwait continues to grow (R(t)s ≥2), indicating significant ongoing spread. Significant spreading and clustering events were detected among migrant workers, due to their densely populated areas and poor living conditions. However, the government's aggressive intervention measures have substantially lowered pandemic growth in migrant worker areas. However, at a later stage of the study period, active spreading and clustering events among both socioeconomic classes were found. CONCLUSIONS: This study provided deeper insights into the epidemiology of COVID-19 in Kuwait and provided an important platform for rapid guidance of decisions related to intervention activities.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Modelos Estatísticos , Pandemias , Migrantes
11.
Eur Rev Med Pharmacol Sci ; 24(13): 7524-7533, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32706095

RESUMO

OBJECTIVE: Weather-related dynamics have an impact on the pattern of health and disease. The present study aimed to investigate the effect of temperature and humidity on the daily new cases and daily new deaths due to COVID-19 in Gulf Cooperation Council (GCC) countries in the Middle East. MATERIALS AND METHODS: We selected all the six GCC countries, including Saudi Arabia, United Arab Emirates, Bahrain, Kuwait, Qatar and Oman. This region has a relatively high temperature and humidity, and has homogenous Arab ethnicity with a similar socioeconomic culture. The data on the global outbreak of COVID-19, including daily new cases and deaths were recorded from World Health Organization. The information on daily temperature and humidity was obtained from world climate web "Time and Date". The daily basis, mean temperature and humidity were recorded from the date of appearance of first case of COVID-19 in the region, Jan 29, 2020 to May 15, 2020. We also evaluated the growth factor, "a ratio by which a quantity multiplies itself over time; it equals daily cases divided by cases on the previous day". RESULTS: In GCC countries, the daily basis mean temperature from Jan 29, 2020 to May 15, 2020 was 29.20±0.30°C and humidity was 37.95±4.40%. The results revealed that there was a negative correlation and decrease in the number of daily cases and deaths from COVID-19 with increase in humidity in Oman, Kuwait, Qatar, Bahrain, United Arab Emirates and Saudi Arabia. The correlation coefficient between temperature with daily cases shows that an increase in temperature was associated with an increase in daily cases and deaths due to COVID-19, however, the temperature is still gradually rising in the region. The growth factor result for daily cases was 1.09±0.00 and daily deaths was 1.07±0.03 for COVID-19, and shows declining trends in GCC region. CONCLUSIONS: An increase in relative humidity was associated with a decrease in the number of daily cases and deaths due to COVID-19 in GCC countries. The daily growth factor for patients and deaths shows a declining trend. However, the climate is swiftly changing in the region; further studies may be conducted during the peak of summer season. The findings have outcomes for policymakers and health officials about the impact of temperature and humidity on epidemiological trends of daily new cases and deaths due to COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Surtos de Doenças , Umidade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Temperatura , Barein/epidemiologia , Humanos , Kuweit/epidemiologia , Oriente Médio/epidemiologia , Omã/epidemiologia , Pandemias , Catar/epidemiologia , Arábia Saudita/epidemiologia , Emirados Árabes Unidos/epidemiologia
12.
Medicine (Baltimore) ; 99(23): e20520, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32502002

RESUMO

The objective of this study is to describe the epidemiology and causes of traumatic cardiac arrest (TCA) in Kuwait aiming to provide a preliminary background to update the current guidelines and improve patients' management.This is a retrospective analysis of TCA cases retrieved from emergency medical services archived data between 1 January and 31 December 2017. The TCA cases were sub-grouped based on mechanism of injury then compared in terms of patient demographics, vital signs, patterns of injuries, resuscitation practices, and outcomes.Outcomes; On scene mortality rate and pre-hospital return of spontaneous circulation.Among the 204 TCA patients, 140 patients met the inclusion criteria. This whole group was then divided in to 4 subgroups: road traffic accident (RTA) 76% (n=106), fall from height (FFH) 13% (n = 18), slip/fall 4% (n = 6), and assaults 7% (n = 10). There was significant difference between the four mechanisms in: mean age (P =  < .001), type of injury (P = .005), head injury (P = .005), chest injury (P = .003), GCS score < 9 (P = .004) and initial hypertension (P =  < .001). Initial hypertension and GCS score < 9 were only documented in head injuries of RTA and slip/fall groups. Significant difference was also seen in cardiopulmonary resuscitation (P = .006), airway management (P = .035) and on scene mortality rate (P = .003). All patients who had isolated head injury in FFH were pronounced dead on scene, 60%.Not all TCA incidents are the same, there are different pattern of injuries in each TCA mechanism. Head injuries are predominantly seen in RTA, FFH, slip /falls and chest injuries are seen in assaults. This can influence emergency medical services personals resuscitation plan. Further research is required to address the resuscitation of TCA of different mechanisms.


Assuntos
Parada Cardíaca/etiologia , Traumatismos Torácicos/complicações , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Distribuição de Qui-Quadrado , Feminino , Parada Cardíaca/epidemiologia , Parada Cardíaca/mortalidade , Humanos , Escala de Gravidade do Ferimento , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Traumatismos Torácicos/epidemiologia
13.
J Med Microbiol ; 69(7): 1005-1012, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32579103

RESUMO

Introduction. Globally, human bocavirus (HBoV) has been detected in respiratory samples from patients suffering from upper and lower respiratory diseases. In Kuwait, little is known about the epidemiological and clinical characterization of the virus and genetic characterization of the virus as a respiratory pathogen is unknown.Aim. This study aims to explore the molecular epidemiology and clinical features of HBoV isolates in patients with respiratory diseases.Methodology. Retrospectively, between 2018 and 2020, 5941 respiratory samples from patients with respiratory diseases were screened for respiratory viruses using multiplex real-time PCR. Samples that were positive for HBoV were then subjected to NP1 and VP1/PV2 phylogenetic analysis.Results. HBoV was detected in 1.9 % of the patients, with a peak incidence of infection among children <1 year old. Co-infection with other respiratory viruses was observed in 56.8 % of HBoV-positive patients. Fever, cough and respiratory distress were the most common clinical features of HBoV infection. Phylogenetic analysis of the Kuwaiti HBoV isolates revealed that all the isolates were of the HBoV-1 genotype, with slight sequence variations among the isolates.Conclusion. This study illustrated the predominance of the HBoV-1 genotype in patients with respiratory diseases in Kuwait with minimal genetic variability. It also highlighted the clinical features of HBoV-1 infection, verifying its role in respiratory diseases.


Assuntos
Infecções por Parvoviridae/epidemiologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Coinfecção/epidemiologia , DNA Viral/genética , Feminino , Genótipo , Bocavirus Humano/genética , Bocavirus Humano/patogenicidade , Humanos , Incidência , Lactente , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular/métodos , Nasofaringe/virologia , Filogenia , Infecções Respiratórias/genética , Estudos Retrospectivos , Análise de Sequência de DNA
15.
Sci Rep ; 10(1): 5857, 2020 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-32246050

RESUMO

We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p < 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p < 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement.


Assuntos
Anemia/epidemiologia , Adolescente , Fatores Etários , Anemia/etiologia , Criança , Estudos Transversais , Feminino , Ferritinas/sangue , Ácido Fólico/sangue , Hemoglobinas/análise , Humanos , Ferro/sangue , Kuweit/epidemiologia , Modelos Logísticos , Masculino , Fatores de Risco , Fatores Sexuais , Vitamina B 12/sangue
16.
BMC Neurol ; 20(1): 64, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32085743

RESUMO

BACKGROUND: Genetic and environmental factors seem to have etiologic roles in multiple sclerosis (MS). Kuwait is regarded as medium to high risk country for MS. However, there is a paucity of published data on the risk factors for MS in Kuwait. Therefore, this matched case-control study examined the association between various factors including family history, stressful life events, exposure to tobacco smoke, vaccination history, comorbidities and MS risk in Kuwait. METHODS: Confirmed 110 MS cases and age (± 5 years), gender and nationality matched controls (1:1) were enrolled. A pre-tested structured questionnaire was used to collect the data through face-to-face interviews both from cases and controls. Conditional logistic regression was used to analyze the data. RESULTS: Among both cases and controls, majority were Kuwaiti (82.7%), and female (76.4%). Multivariable model showed that cases compared to controls were significantly more likely to have had a family history of MS (adjusted matched odds ratio (mORadj) = 5.1; 95% CI: 2.1-12.4; p < 0.001) or less likely to have been vaccinated against influenza A and B viruses before MS onset (mORadj = 0.4; 95% CI: 0.2-0.8; p = 0.010). None of the other variables considered were significantly related to MS status in this study. CONCLUSIONS: Family history of MS had significantly direct, whereas, vaccination against influenza A and B viruses had inverse associations with MS status. Future studies may contemplate to verify the observed results.


Assuntos
Esclerose Múltipla/epidemiologia , Adolescente , Adulto , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
17.
Cancer Causes Control ; 31(3): 231-240, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31960178

RESUMO

BACKGROUND: This retrospective cohort study examines the trends in childhood leukaemia age-standardized incidence rates (ASIRs) (per million person-years) using cases which were diagnosed at age 0-19 years from 1980 to 2014 and recorded in the Kuwait Cancer Control Center (KCCC) registry. METHODS: Childhood leukaemia age-specific incidence rates overall and by sub-cohorts defined by age (0-4, 5-9, 10-14, and 15-19 years), sex (male, female) and nationality (Kuwaiti, non-Kuwaiti) were computed and age-standardized. Joinpoint regression models were used to evaluate trends in childhood leukaemia ASIRs. Average annual percent change (AAPC) and its 95% confidence interval (CI) were used to interpret the observed trends. RESULTS: During the study period, 1077 childhood leukaemia cases of 32.3 million person-years were diagnosed. From 1980 to 2014, the average annual childhood leukaemia ASIR was 53.1 (95% CI 20.9, 85.2). Overall childhood leukaemia ASIRs significantly decreased on average by 6.8% per year (AAPC = -6.8; 95% CI -12.1, -1.1; p = 0.02) from 1980 to 1993, but a marginally significant increase in ASIRs from 1993 to 2014 was recorded (AAPC = 2.5; 95% CI -0.5, 5.5; p = 0.10). During the entire period, childhood leukaemia ASIRs trends significantly (p < 0.05) increased among 6 of 16 sub-cohorts, which was more pronounced among females and 10-14-year-old children. CONCLUSIONS: Overall, ASIRs significantly increased from 1993 to 2014, which specifically seems to be driven by an increase in ASIRs among females and 10-14 -year-old children. These increasing trends underscore the potential involvement of a range of exposures. Future studies on unravelling such factors may help develop preventive measures to minimize childhood leukaemia risk in this and similar settings in the region.


Assuntos
Leucemia/epidemiologia , Sistema de Registros , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Kuweit/epidemiologia , Masculino , Estudos Retrospectivos , Adulto Jovem
18.
Sci Rep ; 10(1): 152, 2020 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-31932636

RESUMO

Consanguineous populations of the Arabian Peninsula, which has seen an uncontrolled rise in type 2 diabetes incidence, are underrepresented in global studies on diabetes genetics. We performed a genome-wide association study on the quantitative trait of fasting plasma glucose (FPG) in unrelated Arab individuals from Kuwait (discovery-cohort:n = 1,353; replication-cohort:n = 1,196). Genome-wide genotyping in discovery phase was performed for 632,375 markers from Illumina HumanOmniExpress Beadchip; and top-associating markers were replicated using candidate genotyping. Genetic models based on additive and recessive transmission modes were used in statistical tests for associations in discovery phase, replication phase, and meta-analysis that combines data from both the phases. A genome-wide significant association with high FPG was found at rs1002487 (RPS6KA1) (p-discovery = 1.64E-08, p-replication = 3.71E-04, p-combined = 5.72E-11; ß-discovery = 8.315; ß-replication = 3.442; ß-combined = 6.551). Further, three suggestive associations (p-values < 8.2E-06) with high FPG were observed at rs487321 (CADPS), rs707927 (VARS and 2Kb upstream of VWA7), and rs12600570 (DHX58); the first two markers reached genome-wide significance in the combined analysis (p-combined = 1.83E-12 and 3.07E-09, respectively). Significant interactions of diabetes traits (serum triglycerides, FPG, and glycated hemoglobin) with homeostatic model assessment of insulin resistance were identified for genotypes heterozygous or homozygous for the risk allele. Literature reports support the involvement of these gene loci in type 2 diabetes etiology.


Assuntos
Árabes/genética , Biomarcadores/análise , Glicemia/análise , Diabetes Mellitus Tipo 2/genética , Regulação da Expressão Gênica , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Proteínas de Ligação ao Cálcio/genética , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/patologia , Jejum , Feminino , Perfilação da Expressão Gênica , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Resistência à Insulina , Kuweit/epidemiologia , Masculino , Fenótipo , Prognóstico , RNA Helicases/genética , Proteínas Quinases S6 Ribossômicas 90-kDa/genética , Valina-tRNA Ligase/genética , Proteínas de Transporte Vesicular/genética
19.
PLoS One ; 15(1): e0227606, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31935243

RESUMO

Cardiovascular disease (CVD) risks persist in patients despite treatment. CVD susceptibility also varies with sex and ethnicity and is not entirely explained by conventional CVD risk factors. The aim of the present study was to identify novel CVD candidate markers in circulating Peripheral blood mononuclear cells (PBMCs) and plasma from Arab obese subjects with and without CVD using proteomic approaches. Human adults with confirmed CVD (n = 208) and matched non-CVD controls (n = 152) living in Kuwait were examined in the present cross-sectional study. Anthropometric and classical biochemical parameters were determined. We employed a shotgun proteomic profiling approach on PBMCs isolated from a subset of the groups (n = 4, each), and differentially expressed proteins selected between the two groups were validated at the mRNA level using RT-PCR (n = 6, each). Plasma levels of selected proteins from the proteomics profiling: Proteinase-3 (PR3), Annexin-A3 (ANX3), Defensin (DEFA1), and Matrix Metalloproteinase-9 (MMP9), were measured in the entire cohort using human enzyme-linked immunosorbent assay kits and were subsequently correlated with various clinical parameters. Out of the 1407 we identified and quantified from the proteomics profiling, 47 proteins were dysregulated with at least twofold change between the two subject groups. Among the differentially expressed proteins, 11 were confirmed at the mRNA levels. CVD influenced the levels of the shortlisted proteins (MMP9, PR3, ANX3, and DEFA1) in the PBMCs and plasma differentially. Despite the decreased levels of both protein and mRNA in PBMCs, PR3 circulating levels increased significantly in patients with CVD and were influenced by neither diabetes nor statin treatment. No significant changes were; however, observed in the DEFA1, MMP9, and ANX3 levels in plasma. Multivariate logistic regression analysis revealed that only PR3 was independently associated with CVD. Our results suggest that the dysregulation of PR3 levels in plasma and PBMCs reflects underlying residual CVD risks even in the treated population. More prospective and larger studies are required to establish the role of PR3 in CVD progression.


Assuntos
Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/metabolismo , Mieloblastina/metabolismo , Adulto , Anexina A3/análise , Anexina A3/sangue , Anexina A3/metabolismo , Árabes , Estudos Transversais , Defensinas/análise , Defensinas/sangue , Defensinas/metabolismo , Feminino , Perfilação da Expressão Gênica , Humanos , Kuweit/epidemiologia , Leucócitos/metabolismo , Leucócitos Mononucleares/metabolismo , Masculino , Metaloproteinase 9 da Matriz/análise , Metaloproteinase 9 da Matriz/sangue , Metaloproteinase 9 da Matriz/metabolismo , Pessoa de Meia-Idade , Mieloblastina/análise , Mieloblastina/sangue , Plasma/metabolismo , Estudos Prospectivos , Proteômica , RNA Mensageiro/genética
20.
J Autism Dev Disord ; 50(4): 1198-1209, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31897855

RESUMO

There is a lack of information on early childhood inclusive education and the parental perspectives towards the inclusion of autistic children in Kuwait. The aim of this study was to explore the perspectives and experiences amongst mothers of young autistic children regarding the inclusion of their children in general education kindergarten settings. Focus group and individual semi-structured interviews were conducted with (n = 34) Kuwaiti mothers of children with (ASD). The study participants were of the opinion that the behaviours unique to (ASD) can only be managed in highly structured special education settings. The themes that emerged from the interviews demonstrate that the general view amongst the study participants is that the inclusive educational model will not meet the autistic children's needs.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Educação Especial/métodos , Mães/psicologia , Pesquisa Qualitativa , Atitude , Criança , Pré-Escolar , Educação Especial/tendências , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Pais/psicologia , Instituições Acadêmicas/tendências
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