Institutional review boards in Saudi Arabia: the first survey-based report on their functions and operations.

BACKGROUND: Institutional review boards (IRBs) are formally designated to review, approve, and monitor biomedical research. They are responsible for ensuring that researchers comply with the ethical guidelines concerning human research participants. Given that IRBs might face different obstacles that cause delays in their processes or conflicts with investigators, this study aims to report the functions, roles, resources, and review process of IRBs in Saudi Arabia. METHOD: This was a cross-sectional self-reported survey conducted from March 2021 to March 2022. The survey was sent to 53 IRB chairpersons and the administration directors (or secretary) across the country through email after receiving verbal consent. The validated survey consisted of eight aspects: (a) organizational aspects, (b) membership and educational training, (c) submission arrangements and materials, (d) minutes, (e) review procedures, (f) communicating a decision, (g) continuing review, and (h) research ethics committee (REC) resources. A total of 200 points indicated optimal IRB functions. RESULTS: Twenty-six IRBs across Saudi Arabia responded to the survey. Overall, the IRBs in this study scored a total of 150/200 of the points on the self-assessment tool. Relatively newer IRBs (established less than ten years ago) conducted meetings at least once in a month, had annual funding, had more balanced gender representation, tended to score higher than older IRBs. The organizational aspect score was the lowest among all items in the survey (14.3 score difference, p-value < 0.01). The average turnaround time for expedited research from proposal submission to final decision was 7 days, while it was 20.5 days for the full committee review. CONCLUSION: Saudi IRBs performed generally well. However, there is room for focused improvement with respect to extra resources and organizational issues that require closer evaluation and guidance from the regulatory bodies.

Marital status among patients with epilepsy in Saudi Arabia.

There are no adequate studies on Saudi Arabia regarding the effect of the social environment on marriage among people with epilepsy (PWE). To fill this gap in the literature, we investigated the marital status of PWE to determine the factors affecting their marital prospects. The subjects of the study included PWE aged 18 years or above, recruited between 1998 and 2019 from the Epilepsy Registry of King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We collected a wide range of socio-demographic data on age, gender, location, education level, employment status, and marital status. In total, 1857 PWE, comprising 1086 men (58.48%) and 771 women (41.52%), were enrolled in the study. The data analysis showed that those 'married' and those who 'had been married' comprised 46.96% of the sample, while those 'never married' comprised 53.04%; 65.37% of the sample held a 'high school diploma or less' or had 'no education', 26.85% reported ongoing university education or had already obtained a bachelor's or higher degree; 50.08% of the respondents were employed, while 47.98% were not. Of the sample, 40.28% resided in Riyadh, whereas 13.14% were from the Asir region. We found that socio-demographic factors, especially employment status, had a major influence on the marital prospects of PWE.

The prevalence and correlates of bulimia nervosa, binge-eating disorder, and anorexia nervosa: The Saudi National Mental Health Survey.

OBJECTIVE: Limited studies have been conducted in the Kingdom of Saudi Arabia on eating disorders (EDs). This study presents national epidemiological survey data on the prevalence and correlates of anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) and their association with other mental health disorders, impairment in role functioning, and individual help-seeking behaviors in the Saudi National Mental Health Survey (SNMHS). METHOD: A face-to-face survey was conducted in a nationally representative household sample of Saudi citizens aged 15-65 (n = 4004). The Composite International Diagnostic Interview (CIDI 3.0) was used to produce estimates of lifetime and 12-month prevalence and treatment of common DSM-IV mental disorders. RESULTS: Twelve-month prevalence of any of the three EDs was 3.2%; the overall lifetime prevalence was 6.1%. Education and marital status were significantly associated with both 12-month and lifetime EDs prevalence. Significant mental health comorbidities associated with 12-month EDs were anxiety, mood, and impulse-control disorders, while lifetime EDs were significantly related to all disorders. A similar percentage of respondents that reported having ED-related treatment at some point in their lifetime utilized healthcare and nonhealthcare sector. There was a significant relationship between body mass index category, and lifetime BED and BN. DISCUSSION: The 12-month prevalence of EDs in the Saudi population was higher than the EDs rates reported worldwide. These findings can help healthcare experts, and policymakers in the implementation of initiatives for raising awareness of EDs among the Saudi population, and the development of a country-wide plan for the prevention of EDs. PUBLIC SIGNIFICANCE STATEMENT: The study presents data on the prevalence, correlates, and help-seeking behaviors of AN, BN, and BED, in the Saudi National Mental Health Survey (SNMHS). Obtaining information on this underrepresented region is essential due to the large differences in cross-national data in addition to cultural beliefs about mental illness and treatment seeking to exert an important influence on eating disorders. Such knowledge could provide a better understand of mechanisms underlying the development of eating disorders and thereby improve prediction, prevention, and treatment.

Ranking of Modifiable Lifestyle Risk Factors for Breast Cancer in Saudi Women: Population Attributable Risk and Nomogram.

Purpose: Breast cancer is the most common cancer among women in the Saudi Arabia, and over 50% of the cases are detected at a late stage. This study aimed to estimate population attributable risk percentage (PAR%) of modifiable lifestyle risk factors for breast cancer in Saudi Arabia. Patients and Methods: A secondary analysis of previously published papers was performed . Relative risks (RR) and odds ratios (OR) were obtained from published international epidemiological studies, and the prevalence of each risk factor in Saudi Arabia was obtained from various sources (eg, national surveys and published literature) to calculate PAR%. A nomogram was used to visually translate the RRs/ORs and their prevalence into PAR% using a practical tool. Results: Seven modifiable lifestyle risk factors for breast cancer were identified in Saudi Arabia. The identified risk factors included lack of physical activity (sedentary lifestyle), oral contraception (current use), obesity (postmenopausal), hormone replacement therapy (current use), passive smoking, age at first birth (≥ 35 years), and tobacco smoking (current or daily smoking). The PAR% for these risk factors ranged from 0.5% for tobacco smoking to 23.1% for a lack of physical activity. Few modifiable lifestyle risk factors were excluded from this study, due to limited nor unavailable data in Saudi Arabia (eg, alcohol consumption, breastfeeding patterns and childbearing patterns, obesity according to menopausal status, and night-shift work). Conclusion: Physical inactivity has the most significant modifiable health impact and is a major risk factor for breast cancer. Removing this risk factor would reduce the prevalence of breast cancer in the Saudi population by 23%. There is an immense need to prioritize cancer control strategies based on local needs, current data on cancer risk factors, and the disease burden.

Psychological distress reported by healthcare workers in Saudi Arabia during the COVID-19 pandemic: A cross-sectional study.

INTRODUCTION: Few studies have considered the impact of COVID-19 on the mental health of healthcare workers (HCWs) in the Kingdom of Saudi Arabia (KSA). We estimated the prevalence and severity of psychological distress and characterized predisposing risk factors among HCWs in KSA during the COVID-19 pandemic. METHODS: We conducted a cross-sectional online survey of 1,985 HCWs from 6 hospitals across the country designated with caring for COVID-19 patients between April 16 and June 21, 2020. Our data analysis was performed using logistic regressions. Ordered logistic regressions were also performed using forward stepwise model selection to explore the effects of risk factors on psychological distress. RESULTS: The prevalence of psychological distress reported by HCWs in KSA was high, ranging from mild-moderate to severe in severity. Younger HCWs, women, those in contact with COVID-19 patients, and those who either had loved ones affected or who were themselves affected by COVID-19 were the most at-risk of psychological distress. Risk factors such as insomnia, loneliness, fear of transmission, and separation from loved ones most significantly predicted elevated levels of distress among HCWs. CONCLUSIONS: Increasing psychological distress was commonly reported by HCWs during the early months of COVID-19 pandemic in KSA. Public health policy makers and mental health professionals must give special attention to risk factors that predispose HCWs in KSA to psychological distress.

Ten public health strategies to control the Covid-19 pandemic: the Saudi Experience.

Saudi Arabia plays an important strategic role within the Middle East and afar because of its geographical location, and being the host of one of the largest annual religious mass gatherings in the world "The Hajj". During the recent coronavirus pandemic, the Kingdom of Saudi Arabia (KSA) developed a multisectoral plan that adopted multiple measures to limit the spread of Covid-19 transmission both domestically and internationally. In this article, we review all public health related policy decisions from the Saudi Ministry of Health, other government departments, and the private sector that contributed to limiting the severe consequences from Covid-19. Ten effective strategies are outlined and the challenges related to their implementation are explored. The strategies include: 1. Quarantine and travel restriction, 2. Expansion of serological screening, 3. Mask wearing (covering the face and nose) and social distancing, 4. Preparation of hospitals to deal with the influx of coronavirus cases, 5. Use of artificial intelligence, 6.Public assurance, 7.Removal of slum areas and re housing of its inhabitants, 8. Cancellation of the Hajj season, 9. Economic stimulus packages to safeguard the economy, and 10. fair and priority driven vaccine distribution. Conclusion: The government of Saudi Arabia demonstrated responsibility at the highest level to prioritize the safety and well-being of its citizens and residents. Rapid early response to the pandemic warnings, extensive experience in previous epidemics and in mass gathering medicine, wise management of healthcare resources, and unprecedented harmonization of governmental and private sectors were significant factors for this success.

Voluntary and non-voluntary blood donations among doctors.

BACKGROUND: Physicians may be an important source of blood donations as they are more likely to be familiar with the importance of donating and the donation process. The aim of this study is to report physicians' knowledge, attitudes, and practices towards voluntary and non-voluntary blood donations. STUDY DESIGN AND METHODS: This was a cross-sectional study conducted at King Faisal Specialist Hospital and Research Centre (KFSH&RC), Saudi Arabia. One-hundred-and-sixteen physicians and dentists responded to an online structured questionnaire sent to their institutional emails. RESULTS: Sixty-eight percent of participants (79% of males and 43% of females) reported previously having donated blood. Eighty-six percent of donors had previously donated on a voluntary basis, whereas 31% of donors had previously donated for a specific person. A recent donation within 5 years was associated with the younger age group and knowledge of the minimum interval between donations. Fifty-six percent of participants agreed with using replacement donations. Compared to participants in the youngest age group (25-35 years), older participants in the age groups (46-55 years) and (>55 years) were less likely to express intention to donate in the next 6 months (OR 0.289, P = .022 and OR 0.083, P = .004, respectively). Participants reporting poor nutritional status or other medical reasons as a barrier to donating blood were less likely to intend to donate (OR 0.146, P < .001). Among previous donors, intention to donate was associated with a recent donation within 1 year (OR 27.13, P = .002) and having had a pleasant donation experience (OR 14.98, P < .001). CONCLUSION: Blood donation practices are strongly tied to physicians' gender and age and their knowledge of the donation process. The most significant barrier to blood donation was found to be nutritional and medical status.

Coping with the COVID-19 Pandemic's Unique Challenges Associated with Medical Research: A Saudi Institution Approach.

The spread of COVID-19 has become a significant threat to economic activity throughout the world, and it has made life particularly difficult for research institutions. According to a report published by Spain's largest public research body, Cybermetrics Labs, King Faisal Specialist Hospital and Research Centre (KFSH&RC) is ranked first among the leading hospitals in the Arab world, and it has instituted a wide range of policy changes to accommodate researchers by providing them with additional flexibility. The aim of this project was to highlight the most prevalent COVID-related global challenges facing research institutions and describe how research protocol at KFSH&RC has been adjusted to minimize the disruption experienced by its researchers.

Lifetime treatment of DSM-IV mental disorders in the Saudi National Mental Health Survey.

OBJECTIVES: To estimate lifetime treatment rates of mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS: The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens ages 15-65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to produce estimates of lifetime prevalence and treatment of common DSM-IV mental disorders. RESULTS: Lifetime treatment ranged from 52.2% for generalized anxiety disorder to 20.3% for attention deficit/hyperactivity disorder, had a median (interquartile range) of 35.5% (30.6-39.5%) across disorders, and was 28.3% for people with any lifetime DSM-IV/CIDI disorder. Half (49.0%) of patients received treatment in the mental health specialty sector, 35.9% in the general medical sector, 35.2% in the human services sector, and 15.7% in the complementary-alternative medical sector. Median (interquartile range) delays in help-seeking after disorder onset among respondents who already sought treatment were 8 (3-15) years. Odds of seeking treatment are positively related to age-of-onset and comorbidity. CONCLUSIONS: Unmet need for treatment of lifetime mental disorders is a major problem in KSA. Interventions to ensure prompt help-seeking are needed to reduce the burdens and hazards of untreated mental disorders.

Twelve-month treatment of mental disorders in the Saudi National Mental Health Survey.

OBJECTIVES: To estimate treatment rates of 12-month mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS: The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens ages 15-65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization Composite International Diagnostic Interview (CIDI) was used to produce estimates of 12-month prevalence and treatment of common DSM-IV mental disorders. RESULTS: About one eighth (13.7%) of respondents with a 12-month DSM-IV/CIDI disorder received 12-month treatment. The highest proportion of treatment occurred in the general medical sector (53.0%). Close to half (45.2%) of patients received treatment rated at least minimally adequate using standard treatment guidelines. Although serious disorders were significantly more likely to be treated (20.2%) than mild or moderate disorders (8.5-10.7%), no association was found between disorder severity and probability of receiving adequate treatment. Sociodemographic correlates were for the most part nonsignificant. CONCLUSIONS: A high level of unmet need for treatment of mental disorders exists in KSA. Further analyses of the SNMHS data might provide insights into modifiable barriers to treatment and policy options to address the problem of unmet need for treatment.