Public Health Ambassadors: A Novel Participatory Community Health Awareness Program in Abu Dhabi.

Community-based intervention (CBI) programs promote lifestyle changes, modify risk factors, and substantially improve public health. Social mobilization and community involvement improve health outcomes, reduce health disparities, and improve access to care and services. Health intervention program evaluations are essential to provide evidence-based strategies that can enhance the design and implementation of successful health promotion programs. Interventions that enable the United Arab Emirates (UAE) community to change and modify unhealthy behaviors were the priority of the last decade and are the health authorities' objectives. The Department of Health Abu Dhabi launched a wellness program to enable the community to adopt healthy behaviors. The Public Health Ambassadors program is a community-based health intervention program under the Abu Dhabi Public Health Centre, inaugurated in 2019. This paper describes the Public Health Ambassadors CBI conducted in Abu Dhabi. The implementation science framework was used to develop the intervention. The Public Health Ambassadors is one of the UAE's earliest and most successful CBIs. The program can be used as a model to encourage more health promotion interventions in the country and the region. The role of the program was highlighted during the COVID-19 pandemic. Voluntary community participation and social responsibilities are essential competencies promoted by this program.

Evaluating a novel method for vitamin A analysis in an observational study of the UAE's obese population.

Vitamin A plays a critical role in various biological functions, including vision, cellular differentiation, and immune regulation. However, accurately assessing its status, particularly in obese individuals, presents challenges due to potential alterations in metabolism and distribution. This study utilized Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) methodology to precisely measure serum vitamin A concentrations in population of UAE. The methodology's reliability and precision, as demonstrated through validation procedures, underscore its potential utility in clinical settings. Employing the Multiple Reaction Monitoring mode of positive ion electrospray ionization, the LC-MS/MS system achieves a limit of detection (LOD) of 0.48 ng/mL in serum, while adhering to FDA-US regulations for accuracy and compliance. A key aspect of this study was the application of LC-MS/MS to assess vitamin A status in an obese population within UAE. By employing a diverse cohort of 452 Emirati participants, including 277 individuals from a randomized controlled trial who were assessed at baseline and at 6th month, and 175 healthy individuals aged 18-82 assessed at baseline, this study explores the relationship between obesity and vitamin A levels, shedding light on potential implications for health and well-being. It was an observational study based on a new vitamin A method and participants were asked to eat vitamin A rich foods. The robust performance of the LC-MS/MS methodology positions it as a valuable tool for clinical research. By accurately quantifying vitamin A levels in human serum, this methodology opens avenues for advancing our understanding of vitamin A physiology and its implications for health, particularly in obese populations. In summary, this LC-MS/MS methodology presents a potent tool for clinical studies, providing reliable, specific, and robust detection of vitamin A in human serum, thus, opening a new frontier for advancing our understanding of vitamin A related physiology and health in the obese population.

Genetic diversity of Cryptosporidium species from diarrhoeic ungulates in the United Arab Emirates.

Cryptosporidiosis has previously been reported in animals, humans, and water sources in the United Arab Emirates (UAE). However, most reports were only to the genus level, or generically identified as cryptosporidiosis. We aimed to investigate the genetic diversity of Cryptosporidium species occurring in diarrhetic ungulates which were brought to the Central Veterinary Research Laboratory (CVRL) in Dubai. Using a combination of microscopic and molecular methods, we identified five species of Cryptosporidium occurring among ungulates in the UAE, namely C. parvum, C. hominis, C. xiaoi, C. meleagridis, and C. equi. Cryptosporidium parvum was the most prevalent species in our samples. Furthermore, we identified subtypes of C. parvum and C. hominis, which are involved in both human and animal cryptosporidiosis. This is also the first reported occurrence of Cryptosporidium spp. in the Arabian Tahr, to our knowledge. Since the animals examined were all in contact with humans, the possibility of zoonotic spread is possible. Our study correlates with previous reports in the region, building upon the identification of Cryptosporidium sp. However, there is a need to further investigate the endemic populations of Cryptosporidium, including more hosts, sampling asymptomatic animals, and location data.

The influence of social, demographic and economic factors on fertility trends in Gulf Cooperation Council countries: A longitudinal time trend analysis-1980-2021.

OBJECTIVES: To analyze the fertility rate trends in the GCC countries and their association with socioeconomic factors so that policymakers may use the study findings for future healthcare plans. METHODS: Total population, crude death rate, life expectancy, literacy rate, human development index (HDI), female employment, unemployment rate, urbanisation, gross domestic product (GDP) per capita and inflation were chosen as possible predictors of TFR trends. The data were collected for the Global Burden of Disease 2021 study and other official databases such as the World Bank, the United Nations Development Program and Our World in Data for the 6 Gulf Cooperation Council (GCC) countries. Mean with standard deviation and percentage change was calculated to assess trends of TFR and all other variables from 1980-2021. RESULTS: The fertility rate declined in all 6 countries in 2021 compared to 1980. The highest decline was found in the United Arab Emirates (75.5%), while the lowest was in Kuwait (60.9%). From 1980-2021, total population, life expectancy, HDI, literacy rate, GDP, urbanisation, and female labor force increased in all GCC countries. The total population, life expectancy, urbanisation, female labor force, GDP and HDI were negatively and significantly correlated with TFR (p<0.01). The literacy rate showed a negative and significant correlation with TFR in Bahrain, Kuwait, Saudi Arabia, and Qatar. CONCLUSION: The TFR is declining in GCC countries. The plausible causes include the inclination towards postponement of marriages and excessive costs of living. These trends and associations need to be evaluated by policymakers so that they identify priority areas for interventions, allocate resources and formulate developmental plans accordingly to ensure strategic progress of the region.

Exploring pharmacists' attitude, willingness and barriers to provide extended community pharmacy services: Implications for improved pharmacy services.

OBJECTIVE: This study aimed to evaluate pharmacists' attitude and willingness to provide extended community pharmacy services (ECPS), the barriers to ECPS, and the factors associated with attitude and willingness to implement ECPS. METHODS: In this cross-sectional study, a validated, self-administered questionnaire was distributed online to community pharmacists across the United Arab Emirates between September and November 2023. In addition to sociodemographic data, the questionnaire evaluated attitudes toward ECPS, willingness to provide ECPS, and barriers to its implementation. Binary logistic regression was conducted to explore the factors associated with attitude and willingness to implement ECPS. RESULTS: The study included 409 pharmacists. Over half of the participants reported below the median attitude (58.7%) and willingness (59.4%) scores. Female pharmacists had a lower attitude towards ECPS (OR = 0.425, 95%CI: 0.242-0.747). Higher number of daily prescriptions (OR = 1.066, 95%CI: 1.029-1.105) and being a Pharm D graduate (OR = 2.664, 95%CI: 1.439-4.932) were associated with higher willingness to provide ECPS, while an increased number of employed pharmacists (OR = 0.518, 95%CI: 0.397-0.676) was associated with a lower willingness (OR = 0.049, 95%CI: 0.004-0.660). Patients' preoccupation (76.5%), lack of specific training (76.3%), lack of clinical problem-solving skills (74.6%) and lack of a private consultation room (74.6%) were the most commonly reported barriers to ECPS. CONCLUSIONS: Community pharmacists demonstrated unsatisfactory levels of attitude and willingness towards ECPS provision. Therefore, providing training and education programs that enhance pharmacists' perception and willingness to implement ECPS and emphasize improving clinical problem-solving skills, as well as setting up specific private consultation rooms, is deemed necessary. Female pharmacy graduates, pharmacists dispensing fewer daily prescriptions, and those working with a higher number of employed pharmacists should be specifically targeted when implementing these strategies.

The long shadow of accumulating adverse childhood experiences on mental health in the United Arab Emirates: implications for policy and practice.

Introduction: This study investigates the cumulative effects of adverse childhood experiences (ACEs) on adult depression, anxiety, and stress in Abu Dhabi, controlling for demographic factors, lifestyle, and known health and mental health diagnoses. Methods: Utilizing a cross-sectional design and self-report measures, the research aims to fill a critical gap in understanding the specific impacts of ACEs in the UAE. Based on a multi-site, cross-sectional community sample of 697 residents of Abu Dhabi. Results: The findings reveal significant variances in current screening values for depression, anxiety, and stress attributable to ACEs after controlling for demographic factors, lifestyle risk factors, and adult diagnoses of health and mental health conditions. Discussion: The results underline the lifelong impact of ACEs and reinforce the importance of early identification and intervention. In particular, the implications for policy and practice in understanding and mitigating ACEs long-term effects on mental health are considered.

The association between food preferences, eating behavior, and body weight among female university students in the United Arab Emirates.

Introduction: This cross-sectional study investigated the associations between lifestyle, eating habits, food preferences, consumption patterns, and obesity among female university students in the United Arab Emirates (UAE). Methods: Approximately 4,728 participants, including both Emirati and Non-Emirati students (International Students). Data collection involved face-to-face interviews and anthropometric measurements, showing an interrelated relationship between food preferences and obesity among female university students. Results: While sociodemographic factors and lifestyle habits contribute to obesity, this study uniquely focuses on the role of food preferences and food consumption patterns in body weight status. The findings reveal a significant correlation between the intake of high-sugar beverages-such as milk, juices, soft drinks, and energy drinks-and an increased risk of overweight and obesity among both Emirati and Non-Emirati populations. Notably, milk consumption was particularly associated with obesity in non-Emirati populations (F = 88.1, p < 0.001) and with overweight status in Non-Emiratis (F = 7.73, p < 0.05). The consumption of juices and soft drinks was linked to obesity. Additionally, a significant preference for fruits and vegetables among overweight and obese students was observed, indicating a trend toward healthier food choices. However, there was also a clear preference for high-calorie, low-nutrient foods such as processed meats, sweets, and salty snacks. Fast food items like burgers, fried chicken, fries, pizza, shawarma, chips, and noodles were significantly correlated with increased body weight status, especially shawarma, which showed a notably high correlation with both obesity and overweight statuses (F-values of 38.3 and 91.11, respectively). Conclusion: The study indicated that food choices shape weight-related outcomes is important for designing effective strategies to promote healthier dietary patterns.

United Arab Emirates Consensus Recommendations for Management of Acne Vulgaris.

Acne in the United Arab Emirates is a common disease that causes burden to patients, has psychosocial impacts, and is associated with physical sequelae such as dyspigmentation and scarring. This guideline, which was developed from an evaluation of existing international and national evidence-based acne guidelines along with live meetings of United Arab Emirates acne experts, is designed to facilitate the management of acne in the UAE health care system. It discusses the evaluation of acne severity, evidence-based guidance on acne treatment, and strategies for the management of this chronic disease. Effective treatment of active lesions and prevention of sequela is likely to improve the health of many United Arab Emirates patients with acne. J Drugs Dermatol. 2024;23(8):653-660.  doi:10.36849/JDD.7748R1.

Assessment of the medical school learning environment at United Arab Emirates University.

BACKGROUND: The purpose of the article was to assess students' perception of the learning environment at the College of Medicine and Health Sciences, United Arab Emirates University using the 'Medical School Learning Environment Survey' (MSLES). Evaluating the learning environment and working towards its improvement is crucial for the physical and mental well-being of medical students, as it contributes to fostering an optimal learning environment. METHODS: Students participated in four groups: Year-1 (pre-medical), Year-2 (pre-medical), Year-3/Year-4 (pre-clinical), and Year-5/Year-6 (clinical). MSLES data was collected from each group using an online survey tool (Qualtrics XM). Latent factor structures in the learning environment constructs were assessed using 'exploratory factor analysis'; and reliability was measured by Cronbach's alpha. Differences among groups were assessed by 'single factor ANOVA'. RESULTS: Three hundred seventy-seven (65%) of the 584 eligible students completed the survey. Exploratory factor analysis revealed four factors: (Genn J. AMEE Medical Education Guide 23 (Part 1): Curriculum, environment, climate, quality and change in medical education-a unifying perspective. Med Teach. 2001;23(4):337-44.) Learning experience (∝=0.71), (Maudsley RF. Role models and the learning environment: essential elements in effective medical education. Acad Med. 2001;76(5):432-4.) Student-student interaction (∝=0.69), (Gruppen LD, Irby DM, Durning SJ, Maggio LA. Conceptualizing learning environments in the health professions. Acad Med. 2019;94(7):969-74.) Student-faculty interaction (∝=0.62), and (Soemantri D, Herrera C, Riquelme A. Measuring the educational environment in health professions studies: A systematic review. Med Teach. 2010;32(12):947-52.) Academic support (∝=0.62). Students in Y3-Y6 rated the learning environment statistically significantly lower than that in Y1-Y2. Student-student interaction in Y2 was significantly lower than that in other years. Student-faculty interaction in Y1 was significantly higher than that in Y2. Academic support was significantly higher in Y1 than that in Y2-Y6. CONCLUSION: The MSLES revealed variabilities in learning domains across the years. Improvement efforts should foster student-student collaboration in Y2 and improve academic support approaches for Y2-6. These findings provide valuable insights for medical educators to enhance the medical school learning environment and foster an optimal learning environment in lifelong medical education.

High-fidelity simulation versus case-based tutorial sessions for teaching pharmacology: Convergent mixed methods research investigating undergraduate medical students' performance and perception.

INTRODUCTION: Medical educators strive to improve their curricula to enhance the student learning experience. The use of high-fidelity simulation within basic and clinical medical science subjects has been one of these initiatives. However, there is paucity of evidence on using simulation for teaching pharmacology, especially in the Middle East and North Africa region, and the effectiveness of this teaching modality, relative to more traditional ones, have not been sufficiently investigated. Accordingly, this study compares the effects of high-fidelity simulation, which is designed in alignment with adult and experiential learning theories, and traditional case-based tutorial sessions on the performance and perception of undergraduate Year 2 medical students in pharmacology in Dubai, United Arab Emirates. METHODS: This study employed a convergent mixed methods approach. Forty-nine medical students were randomly assigned to one of two groups during the 16-week pharmacology course. Each group underwent one session delivered via high-fidelity simulation and another via a case-based tutorial. A short multiple-choice question quiz was administered twice (immediately upon completion of the respective sessions and 5 weeks afterwards) to assess knowledge retention. Furthermore, to explore the students' perceptions regarding the two modes of learning delivery (independently and in relation to each other), an evaluation survey was administered following the delivery of each session. Thereafter, the iterative joint display analysis was used to develop a holistic understanding of the effect of high-fidelity simulation in comparison to traditional case-based tutorial sessions on pharmacology learning in the context of the study. RESULTS: There was no statistically significant difference in students' knowledge retention between high-fidelity simulation and case-based tutorial sessions. Yet, students expressed a greater preference for high-fidelity simulation, describing the corresponding sessions as more varied, better at reinforcing learning, and closer to reality. As such, the meta-inferences led to expansion of the overall understanding around students' satisfaction, to both confirmation and expansion of the systemic viewpoint around students' preferences, and lastly to refinement in relation to the perspective around retained knowledge. CONCLUSION: High-fidelity simulation was found to be as effective as case-based tutorial sessions in terms of students' retention of knowledge. Nonetheless, students demonstrated a greater preference for high-fidelity simulation. The study advocates caution in adapting high-fidelity simulation, where careful appraisal can lend itself to identifying contexts where it is most effective.

Concurrent validity between self-reported International Physical Activity Questionnaire Short Form and Fibion accelerometer data among young adults in the UAE.

Self-reported physical activity questionnaires (e.g., International Physical Activity Questionnaire, IPAQ) are a cost-effective, time-saving, and accessible method to assess sedentary behaviour and physical activity. There are conflicting findings regarding the validity of self-reported questionnaires in comparison to accelerometer-measured data in a free-living environment. This study aimed to investigate the concurrent validity between self-reported Arabic-English IPAQ short form (IPAQ-SF) and Fibion (Fibion Inc., Jyväskylä, Finland) accelerometer-measured sedentary and physical activity time among young adults. One hundred and one young healthy adults (mean age 20.8 ± 2.4 years) filled in the IPAQ short form (IPAQ-SF) and wore the Fibion device on the anterior thigh for ≥ 600 min per day for 4-7 days. Concurrent validity between the IPAQ-SF and Fibion accelerometer for sitting, walking, moderate activity, and vigorous activity time was assessed using the Spearman correlation coefficient ( ρ ) and Bland-Altman plots. Significant weak associations between IPAQ-SF and Fibion measurements were found for total activity time ( ρ = 0.4; P < 0.001) and for the duration of walking ( ρ = 0.3; P = 0.01), moderate ( ρ = 0.2; P = 0.02), and vigorous-intensity activities ( ρ = 0.4; P < 0.001). However, ρ was not significant ( ρ = - 0.2; P = 0.09) for sitting time. In addition, all the plots of the measured variables showed a proportional bias. A low association and agreement were found between self-reported IPAQ-SF scores and Fibion accelerometer measurements among young adults in the UAE. Adult sedentary and physical activity measurements should be obtained objectively with accelerometers rather than being limited to self-reported measures.

Parents' satisfaction with physiotherapy services for neuropediatric outpatients in government and private hospitals in the United Arab Emirates: a cross-sectional study.

Background: Healthcare, like other industries, emphasizes performance, quality, and consumer experience while also attempting to reduce costs. However, high-quality healthcare remains paramount for vulnerable and ill patients. This study aimed to investigate parents' and caregivers' level of satisfaction with physiotherapy services provided to neuropediatric outpatients on the United Arab Emirates (UAE). Methods: This descriptive cross-sectional study included 103 parents/caregivers of children with neurological disabilities that were randomly selected from different Emirates Health Services Hospitals in the UAE. Data was collected using the long-form Patient Satisfaction Questionnaire (PSQ-III). Results: The overall mean satisfaction was 159±7.73 (out of 250 points). Communication (20.36/25), interpersonal factors (20.17/35), and doctor-patient time (20.17/35) had the highest mean satisfaction scores (8.06/10). The lowest mean satisfaction scores were for access/availability/convenience (34.60/60), technical quality (33.17/50), and economic elements (23.83/40). Conclusion: Despite participants' overall satisfaction scores being positive, some service domains require improvement to improve satisfaction, specifically the access/availability/convenience, technical quality, and economic elements. These areas should be prioritized by service providers and managers to improve patients' experiences and clinical outcomes.

Vaccine practices, literacy, and hesitancy among parents in the United Arab Emirates.

BACKGROUND: Immunisation is one of public health's greatest success stories, yet, annually, 20 million children miss out entirely or partially on routine immunisation. National immunisation estimates have the United Arab Emirates (UAE) lagging behind with 4% of children under the age of 1 not having received any vaccines. Vaccine hesitancy is considered one of the biggest barriers to vaccination. This study aims to evaluate the UAE's parents' vaccination attitudes and practices as well as estimate vaccine hesitancy's prevalence and determinants. METHODOLOGY: This cross-sectional, descriptive study collected data from parents across the UAE during the months of March and April 2024. The 60-item questionnaire included the Parental Attitudes towards Childhood Vaccines scale (PACV), the Vaccine Hesitancy Scale, and the Digital Vaccine Literacy (DVL) scale. Univariate, bivariate (chi-squared test), and multivariate (logistic regression) analyses were conducted. RESULTS: A total of 550 responses were retained. 84.55% of participants were female (n = 465/550), half were middle-aged (31-45 years old), and 21.09% (n = 116/550) were healthcare workers. 94.36% (n = 519/550) had their child/children receive all mandated vaccines. Only 39.82% (n = 219/550) found their level of knowledge about childhood vaccinations to be good/excellent. 70.11% (n = 386/550) of participants had high digital vaccine literacy. More than 95% had positive attitudes towards measles, meningitis, and pertussis vaccines. 14.00% (n = 77/550) were identified as vaccine-hesitant according to the PACV. Overall, using general practitioner/ paediatrician as a knowledge source, digital vaccine literacy, perceived children's vaccine knowledge, and nationality were associated with lower vaccine hesitancy status. CONCLUSION: Vaccine hesitancy exists and is prevalent in the UAE; however, the majority of participants reported high trust in vaccines, the local healthcare systems and physicians. Vaccine hesitancy can be tackled but will require tailored solutions and proactive healthcare workers.

Evolving radiology continuing medical education: Tapping into the power of online learning.

INTRODUCTION: Global education, particularly Continuing Medical Education (CME) for healthcare professionals, is quickly shifting online. This study assesses the opportunities and challenges of adopting online learning in radiology CME. It explores how radiologists and radiographers have adapted to this digital shift and the changing landscape of radiology education. The study also seeks to envision an innovative future for radiology education. METHODS: A descriptive cross-sectional survey was conducted among radiologists and radiographers working in radiology departments in the United Arab Emirates (UAE). The survey collected data on participant demographics, experiences with CME, sources of CME, and perceptions of online learning. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software. RESULTS: The survey involved 65 radiologists and 215 radiographers. Findings indicated a significant shift from face-to-face to online CME activities, with 76.9% of radiologists and 70.7% of radiographers utilizing online resources for CME. Concerns about time management, technical issues, and expenses have emerged as challenges for online CME. Participants also highlighted the importance of free-of-charge CME and the value of active participation and anonymity in online discussions. CONCLUSION: Radiology professionals have rapidly adapted to the changing landscape of CME by embracing online learning. While this shift offers greater flexibility and accessibility, technology-related challenges and concerns over time management persist. The study suggests that the future of radiology CME may involve personalized, adaptive, and interactive learning experiences, emphasizing mental well-being and resilience. IMPLICATIONS FOR PRACTICE: Radiology professionals must embrace online CME for continuous skill enhancement, addressing technical challenges, fostering interactive learning environments, and ensuring accessibility to maintain high standards in patient care and medical advancements.

The impact of gender, psychology, and cultural dimensions on leadership development in distance education.

The research purpose is to evaluate the effectiveness of leadership in the process of distance learning from the perspective of the psychological theories of leadership, gender, and cross-cultural issues. The present research is based on such methods as surveys, testing, quantitative and qualitative analysis, and statistical data processing. The subjective (the experience of the respondents) and objective (machine calculation of clusters) assessments allowed the scholars to generate more arguments on leadership in the learning process. The sample consisted of 600 female and male students (300 from each sex, respectively) aged 18-20 years from Abu Dhabi University, American University in The Emirates, and the United Arab Emirates University. The research stated that the majority of students, regardless of gender, suppose that both sexes can develop similar leadership traits (80%). The research claims that female leaders have to be more dynamic and demonstrate higher intelligence (26% vs. 20%) and confidence (20% vs. 15%) than male leaders. Cultural and socio-demographic characteristics do not play a significant role in leadership development (10%). The main cause for the choice of a leader is behavioural and communication characteristics (50%) as well as personal qualities (35%). These results can be used for the online design of distance learning courses in universities (both group and individual), as well as for psychologists to study the aspect of individuals' predisposition to leadership. It makes sense for further research to explore the issue of differences in the perception of educational leadership in Asian and Western European countries based on the cross-cultural aspect, that is, the influence of national culture on the choice of leader in the educational environment.

Enhancing radiation safety awareness and practices among female radiographers: a comprehensive approach.

OBJECTIVE: This study evaluates the level of radiation safety awareness and adherence to protective practices among pregnant female radiographers in the United Arab Emirates, aiming to identify gaps and develop targeted interventions for enhancing occupational safety. METHODS: Employing a cross-sectional design, the study surveyed 133 female radiographers using a self-developed questionnaire covering demographics, awareness and knowledge, workplace practices, communication, and satisfaction. RESULTS: The survey showed high awareness among radiographers, with 97% acknowledging radiation risks during pregnancy, although 42.9% had not received formal training. Concerns over long-term health effects were significant, with 66.2% of participants worried about potential impacts. Despite these concerns, 83.5% had been informed about radiation risks and protective measures, indicating active information provision in many workplaces. However, inconsistencies in information dissemination across different work settings were noted. CONCLUSIONS: The findings highlight the need for standardized radiation safety protocols for pregnant radiographers. The variability in safety training and information dissemination suggests the importance of establishing uniform safety practices. Recommendations include developing comprehensive education and training programs for pregnant radiographers, ensuring open communication for radiation safety and pregnancy-related concerns, and enforcing clear guidelines for workplace accommodations.

Prevalence of smoking among national military service recruits in UAE.

Background: According to the various screening programs conducted, the prevalence of tobacco use among UAE Nationals is high. A considerable increase is also seen in various forms of smoking is seen among young military men during deployment which results in loss of physical health, less productivity, readiness and increased health care utilization. Also smokers are more likely to develop other addictions and chronic medical conditions. Aim: To estimate the prevalence of smoking among national military service recruits in the United Arab Emirates and to find its relation with various factors: socio-demographics, lifestyle, comorbidities, and military environment. Methods: A cross sectional study was conducted amongst national service recruits selected by random stratification through a self-administered anonymized questionnaire which was distributed to a final sample of 369 patients. Data was analyzed using SPSS version 16. Chi square, percentage and frequencies were used to present the data where applicable. A p < 0.05 was considered to be significant. Results: The prevalence of smoking among national military service recruits was 41.6%. As the level of education increased the prevalence of smoking decreased. Smokers with insufficient income, divorced or widowed recruits tend to smoke more as against single and married recruits. Smoking rates were decreased in those who exercise regularly. There was a significant relationship between smoking status and chronic diseases. Smoker gatherings inside military campus encouraged initiation of smoking or its continuity. About half of the smokers were not satisfied with environment at military facilities. Conclusion: Smoking has high prevalence among national service military recruits. For this reason, a goal directed future plan toward screening of smokers among recruits and assigning them to smoking cessation clinics and educational seminars prior to joining the national service is the need of the hour.

Epidemiology and antimicrobial resistance of Mycobacterium spp. in the United Arab Emirates: a retrospective analysis of 12 years of national antimicrobial resistance surveillance data.

Introduction: The Eastern Mediterranean Regional Office (EMRO) region accounts for almost 8% of all global Mycobacterium tuberculosis (TB) cases, with TB incidence rates ranging from 1 per 100,000 per year in the United Arab Emirates (UAE) to 204 per 100,000 in Djibouti. The national surveillance data from the Middle East and North Africa (MENA) region on the epidemiology and antimicrobial resistance trends of TB, including MDR-TB remains scarce. Methods: A retrospective 12-year analysis of N = 8,086 non-duplicate diagnostic Mycobacterium tuberculosis complex (MTB complex) isolates from the UAE was conducted. Data were generated through routine patient care during the 2010-2021 years, collected by trained personnel and reported by participating surveillance sites to the UAE National Antimicrobial Resistance (AMR) Surveillance program. Data analysis was conducted with WHONET, a windows-based microbiology laboratory database management software developed by the World Health Organization Collaborating Center for Surveillance of Antimicrobial Resistance, Boston, United States (https://whonet.org/). Results: A total of 8,086 MTB-complex isolates were analyzed. MTB-complex was primarily isolated from respiratory samples (sputum 80.1%, broncho-alveolar lavage 4.6%, pleural fluid 4.1%). Inpatients accounted for 63.2%, including 1.3% from ICU. Nationality was known for 84.3% of patients, including 3.8% Emiratis. Of UAE non-nationals, 80.5% were from 110 countries, most of which were Asian countries. India accounted for 20.8%, Pakistan 13.6%, Philippines 12.7%, and Bangladesh 7.8%. Rifampicin-resistant MTB-complex isolates (RR-TB) were found in 2.8% of the isolates, resistance to isoniazid, streptomycin, pyrazinamide, and ethambutol, was 8.9, 6.9, 3.4 and 0.4%, respectively. A slightly increasing trend of resistance among MTB-complex was observed for rifampicin from 2.5% (2010) to 2.8% (2021). Conclusion: Infections due to MTB-complex are relatively uncommon in the United Arab Emirates compared to other countries in the MENA region. Most TB patients in the UAE are of Asian origin, mainly from countries with a high prevalence of TB. Resistance to first line anti-tuberculous drugs is generally low, however increasing trends for MDR-TB mainly rifampicin linked resistance is a major concern. MDR-TB was not associated with a higher mortality, admission to ICU, or increased length of hospitalization as compared to non-MDR-TB.