The associations between cigarette smoking behavior and the use of heated tobacco products among Arab cigarette smokers: Findings from Saudi Arabia, Egypt, Kuwait, and Yemen.

As the availability of tobacco forms has evolved, emerging products known as heated tobacco products (HTPs) are increasingly being consumed worldwide and are claimed to be less harmful than tobacco cigarette smoking. To date, it is unknown whether Arab cigarette smokers are using or susceptible to HTPs. Therefore, this study aimed to assess the association between cigarette smoking behavior and the use of and susceptibility to HTPs in the Eastern Mediterranean region. Arab cigarette smokers (n = 628) from Saudi Arabia, Egypt, Kuwait, and Yemen were recruited using a convenience sampling technique. A cross-sectional survey comprised questions related to sociodemographic characteristics, cigarette smoking behavior characteristics (quitting attempts and desire to quit cigarette smoking, nicotine dependence, and consideration of switching to nicotine products with reduced health risks), and awareness of, use of, and susceptibility to use of HTPs. Descriptive and logistic regression models were used for analysis. The participants indicated a high frequency of past quitting attempts and a desire to quit smoking cigarettes. They were also considering switching to a nicotine product with reduced health risks. However, their awareness of HTPs was relatively low (24.2%), and the proportion of participants who had ever used HTPs or were currently using them was quite low as well (10.7% and 5.0%, respectively). A history of quit attempts was associated with more likely lifetime use of HTPs (adjusted odds ratio [AOR] = 2.63, 95% confidence interval [CI] [1.21-5.71]). Nicotine-dependent cigarette smokers were more likely to be susceptible to HTP use (AOR = 1.12, 95% CI [1.01-1.24]). Moreover, those who would consider switching to a product that provided nicotine and could reduce health risks by 99% were more likely to be susceptible to using HTPs (AOR = 2.17, 95% CI [1.05-4.51]). Awareness of HTPs is relatively low among Arab cigarette smokers. Attempts to quit cigarette smoking, nicotine dependence, and the consideration of switching to a product that delivers nicotine with reduced health risks were significantly associated with using HTPs. The findings of this study provide potential for evidence-based treatment for smokers and will help prevent the use of tobacco industry tactics in marketing HTPs.

Delphi consensus on research priorities in tobacco use and substance abuse in Saudi Arabia.

This is the first study to develop research priorities in tobacco use and substance abuse in Saudi Arabia. Health personnel and community volunteers participated in a national internet survey using the Delphi method. In Round 1, 75 experts identified 33 research priorities. In Round 2, 47 experts divided those research priorities into five primary research categories. The panelists then scored both the categories and priorities. Preventive services received the highest priority in research categories. Smoking relapse and its determinants were ranked the top research priorities. Future research should focus on cigarette smoking relapse and factors associated with long-term smoking cessation.

Is cesarean section delivery associated with autism spectrum disorder?

OBJECTIVE: To investigate a correlation between birth by caesarean section and autism spectrum disorder (ASD). METHODS: A case-control study with a case to control ratio of 1:2 was performed in Al-Madina Al-Munawarah city, Kingdom of Saudi Arabia during the year 2016. The cases were selected according to the eligibility criteria and children attending a well-baby clinic in the same hospital, were chosen as the control group subjects. Data was collected from the medical records and an interview-based questionnaire was administered to the mothers. The chi-square test was used for bivariate analysis and logistic regression to estimate the crude and adjusted odds ratios (ORs). RESULTS: Eighty-seven cases of ASD and 174 control group subjects were included in the current study. Approximately 39% (n=34) of the 87 children with ASD were delivered by cesarean section compared to 21% (n=36) of the 174 children in the control group. After adjusting for potentially confounding factors, the adjusted OR was 2.9 (95% confidence interval [CI]: 1.57-5.35). CONCLUSION: An association between delivery by cesarean section and ASD was found in this study, in support of the findings of other studies. It is recommended that preventive measures are adopted to avoid unnecessary cesarean sections.

Hepatitis C virus infection in Jeddah city, Saudi Arabia: Seroprevalence and knowledge.

The infection rate of the hepatitis C virus (HCV) in Saudi Arabia is among the lowest in the world. However, it is likely that poor knowledge and awareness of HCV infection could minimize the effectiveness of prevention and control programs in the kingdom. Thus, the study objective was to estimate the prevalence of HCV infection, and to assess current knowledge about it, in the targeted population. Data on 5482 Saudi people attending primary healthcare centers in Jeddah City in 2014/2015 were analyzed in this cross-sectional study. Questions that covered the natural history, risk behavior, and prevention, and treatment of HCV were collected using a predesigned questionnaire. HCV seroprevalence was assessed using an enzyme-linked immunosorbent assay. HCV prevalence of 0.38% (95% confidence interval: 0.22-0.54) was found. The level of knowledge of the natural history, risk behavior, and prevention and treatment of HCV was poor among the participants. The lowest level of knowledge for all participants pertained to its prevention and treatment. The prevalence of HCV was low in Saudi Arabia (0.38%). However, adequate knowledge of HCV was lacking. Thus, the need to increase knowledge and awareness of HCV in the Saudi population is warranted.

Breast Cancer Knowledge and Screening Practice and Barriers Among Women in Madinah, Saudi Arabia.

A breast screening program may help to reduce cancer mortality rates among women. However, the use of the screening program by women in Madinah city is low, and studies examining its practice and barriers of low uptake are sparse. To identify breast cancer knowledge, practice and screening barriers among women attending primary health centers (PHC) in Madinah, Saudi Arabia. A primary health center-based cross-sectional study was performed in Madinah city in 2015. A multistage stratified cluster sample was obtained and included 465 women (15 years and older) from five PHC. Data concerning socio-demographics, knowledge about breast cancer, and practice and barriers of mammography use were collected using a structured questionnaire. The mean age of the studied 465 women was 34.9 ± 12.2 years. Of these women, 27.7 and 38.5 % received mammography and performed breast self-examination, respectively. A high level of poor knowledge about breast cancer was detected in the overall studied women and those who never received a mammography, particularly knowledge related to the risk factors of breast cancer. The most important predictors of the barriers to mammography were incorrect beliefs about mammography and its procedures. A belief that mammography is painful was significantly associated with a 56 % reduction in its use (OR = 0.44; 95 % CI = 0.22-0.88). The high levels of poor knowledge about cancer breast observed in this study reflect the need for greater efforts to increase breast awareness education.

Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses.

Each year, 430,000 people are diagnosed with bladder cancer. Due to the high recurrence rate of the disease, primary prevention is paramount. Therefore, we reviewed all meta-analyses on modifiable risk factors of primary bladder cancer. PubMed, Embase and Cochrane database were systematically searched for meta-analyses on modifiable risk factors published between 1995 and 2015. When appropriate, meta-analyses (MA) were combined in meta-meta-analysis (MMA). If not, the most comprehensive MA was selected based on the number of primary studies included. Probability of causation was calculated for individual factors and a subset of lifestyle factors combined. Of 1496 articles identified, 5 were combined in MMA and 21 were most comprehensive on a single risk factor. Statistically significant associations were found for current (RR 3.14) or former (RR 1.83) cigarette smoking, pipe (RR 1.9) or cigar (RR 2.3) smoking, antioxidant supplementation (RR 1.52), obesity (RR 1.10), higher physical activity levels (RR 0.86), higher body levels of selenium (RR 0.61) and vitamin D (RR 0.75), and higher intakes of: processed meat (RR 1.22), vitamin A (RR 0.82), vitamin E (RR 0.82), folate (RR 0.84), fruit (RR 0.77), vegetables (RR 0.83), citrus fruit (RR 0.85), and cruciferous vegetables (RR 0.84). Finally, three occupations with the highest risk were tobacco workers (RR 1.72), dye workers (RR 1.58), and chimney sweeps (RR 1.53). The probability of causation for individual factors ranged from 4 to 68 %. The combined probability of causation was 81.8 %. Modification of lifestyle and occupational exposures can considerably reduce the bladder cancer burden. While smoking remains one of the key risk factors, also several diet-related and occupational factors are very relevant.

Public health education in Saudi Arabia: Needs and challenges.

In the last decade, public health (PH) has come to the frontlines in Saudi Arabia. The recent outbreak of a novel corona virus (MERS-CoV) highlighted the importance of PH services and the need for a competent PH workforce. The urgency and panic induced by infectious disease outbreaks explain the heightened interest. Decision makers' interest in public health was observed through a series of decisions, including creating a position for Deputy Minister for Public Health, changing the name of "Directorate of Primary Healthcare Centers" to "Directorate of Public Health" in all health regions and initiating a special scholarship program to prepare health administration professionals in collaboration with US-based universities. A distinguished group of PH leaders in Saudi Arabia was gathered in a structured workshop that was organized by the Al Imam Mohammad Ibn Saud Islamic University, college of medicine to discuss the current status and future needs of PH education in the Kingdom of Saudi Arabia. The workshop highlighted the need for PH education development and outlined the challenges ahead. The main challenges laid out by participants in the workshop were the development of an appropriate PH curriculum, appropriate training spots for practical placement, the development of research priorities for PH to satisfy the needs of PH programs and agencies, attracting the most qualified academic staff, the enrolment of highly motivated students and finally, the establishment of a quality assurance program to ensure the quality of PH education programs. The development of a framework for graduate competencies in PH was perceived to be a top priority. Moreover, setting a PH workforce surveillance system, building partnership between PH academic institutions and PH services providers, implementing national campaigns to explain what PH is about and illuminating the role of PH workers were also of utmost importance.

Perceptions of health warnings on cigarette sticks among the adult population in Al-Madinah, Saudi Arabia: A cross-sectional survey.

INTRODUCTION: Health warnings on cigarette sticks are emerging as a tool to control tobacco consumption; hence, understanding how they are perceived is valuable in determining their effectiveness. Our study aimed to evaluate the perception of health-related messages and warnings on individual cigarette sticks. It also aimed to evaluate the perceptions of the effectiveness of cigarette packaging warnings and the acceptance level for the inclusion of health warnings on cigarette sticks. METHODS: This cross-sectional survey was conducted on 285 individuals in Al-Madinah, Saudi Arabia. The survey was distributed online using a non-probability convenience sampling technique. The chi-squared test and logistic regression analysis were used to determine the association of sociodemographic characteristics and smoking-related variables with participants' perceptions of health warnings on cigarette sticks and packaging. The responses were also assessed qualitatively using conceptual content analysis. RESULTS: In all, 18.6% of participants perceived that the package warnings were either 'quite effective' or 'very effective' in prompting smokers to quit. For health warnings on cigarette sticks, 28.1% of participants perceived that the theme of statistics on mortality was either 'quite effective' or 'very effective' in prompting smokers to quit, compared to 35.0 % for the theme of social and financial consequences. Respondents who had secondary education and lower were almost two times more likely to support the inclusion of health warnings than those who had a university education and higher (OR=1.9; 95% CI: 1.02-3.7, p=0.042). Most of the comments were positive for the inclusion of health warnings on cigarette sticks. CONCLUSIONS: Most participants perceived that package warnings were ineffective, but warnings on cigarette sticks were effective methods of dissuasion of cigarette use. Smokers were almost twice as likely to perceive as effective supportive messages to quit than non-smokers. The majority of participants 'agreed' or 'strongly agreed' to the inclusion of health warnings on cigarette sticks.

The prevalence and sociodemographic determinants of tobacco and nicotine use among students in healthcare disciplines in Saudi Arabian universities: a cross-sectional survey.

Background: Tobacco smoking is one of the most significant health-related problems worldwide. However, the prevalence and sociodemographic determinants of tobacco and nicotine use among students on healthcare courses in Saudi Arabia are limited. Methods: This cross-sectional study used a questionnaire that was distributed via SurveyMonkey between November 2022 and June 2023 to all student universities offering healthcare courses. Data are presented as frequency and percentages. The associated sociodemographic factors with current tobacco and nicotine use were subjected to logistic regression. Results: Overall, 5,012, of whom 3,872 (77.25%) were males, responded to the online survey. The prevalence of current tobacco and nicotine use was 3,553 (71%). The majority of users used electronic nicotine delivery systems (1,622: 32.36%). The current use of cigarettes (AOR: 1.75 (1.42 to 2.15)), e-cigarettes (AOR: 1.17 (1.01 to 1.37)), and smokeless tobacco substances (AOR: 1.35 (1.02 to 1.90)) were more pronounced among males compared to female students. However, the current use of a hookah was less among males (AOR: 0.74 (95% CI: 61 to 0.91)). Smoking cigarettes was practiced less among students living in other regions compared to the Central Region. However, smokeless tobacco substances seem to be more prevalent in the Western, Southern, and Northern Regions, (AOR: 1.57 (95% CI: 1.09 to 2.26)), (AOR: 1.43 (95% CI: 1.04 to 1.95)), and (AOR: 1.57 (95% CI: 1.09 to 2.26)), respectively. Conclusion: Smoking is prevalent among students in the healthcare disciplines, with electronic nicotine delivery systems being the most used product. Several sociodemographic factors were associated with higher tobacco or nicotine use.

Reassessment of the undergraduate educational environment in College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi Arabia.

BACKGROUND: We reassessed the perception of all undergraduate students in Taibah medical college regarding the educational environment during the academic year 2010-2011 and compared it with the assessment carried out three years earlier in order to identify the change over time from previous assessment. METHOD: In the present prospective study, the validated 50-item Dundee Ready Education Environment Measure (DREEM) inventory was collected from medical students of basic phase (n = 302) and clinical phase (n = 222) and compared the scores of students' responses with those of previous assessment 3 years earlier. RESULTS: In the year 2007/2008 DREEM inventory scored 109.1/200 and scored 120.70/200 (p ≤ 0.0001) in the year 2010/2011. There was an interesting inclination of female students towards a more positively perceived learning environment as compared to male students (26/48 versus 24/48, p < 0.03). There were statistically significant differences in all domain components of DREEM between the academic years 2007/2008 and 2010/2011. CONCLUSIONS: DREEM helped pinpoint areas of change in students' perception regarding many aspects of the educational environment. It also helped to identify areas that are still in need of improvement by the college's administration and staff. DREEM inventory can be used to monitor change over time in the educational environment.

Academic and socio-demographic factors influencing students' performance in a new Saudi medical school.

OBJECTIVE: The objective of this study is to examine factors such as the students' demographic data, motivation, educational factors and socio-cultural factors, and identify whether these factors affect the academic performance of undergraduate medical students. METHODS: A cross-sectional study design utilising grade point averages (GPAs) of two cohorts of students in both levels of the pre-clinical phase. In addition, self-administered questionnaire was used to evaluate the effect of these factors on students with poor and good cumulative GPA. RESULTS: Academic performance was significantly affected with factors such as gender, marital status, interest and motivation, and the transportation used to reach the faculty. Students with a cumulative GPA of 3.0 or greater significantly differed than those with a GPA of less than 3.0 being higher in female students, in married students, students have interest to study medicine and type of transportation used to reach the college. Factors including age, motivation, learning resources, study time and type of transportation used have shown to create a significant difference in GPA between male and females. CONCLUSION: Factors such as age, gender, marital status, interest and motivation to enter medical school, learning resources, study time and the transportation used have been shown to significantly affect medical student's cumulative GPA as a whole batch as well as when they are tested for gender.

Silver Spike Point Therapy in smoking cessation: What is it and does it work?

Smoking is a global health challenge that causes a myriad of diseases. Smoking cessation services are part of the armamentarium to combat smoking epidemic. In addition to the approved treatments, alternative therapies, including electrical stimulation, have been proposed. The aim of this study is to review and summarize the evidence for the efficacy of electrical stimulation, including Silver Spike Point therapy, in smoking cessation. A historical background and descriptive summary of various acupuncture and related therapies is provided. Systematic reviews and original studies were reviewed, and their results were summarized. In conclusion, the current best available evidence does not support the use of electrical stimulation, including Silver Spike Point therapy, in smoking cessation. Policy makers and healthcare providers should aim to utilize the available resources to provide evidence-based treatment options for patients seeking to quit tobacco use.

The association between cultural and social occasions and smoking cessation: The case of Saudi Arabia.

INTRODUCTION: Tobacco use remains high in Saudi Arabia, necessitating an understanding of the influence of cultural and social events on smoking cessation. This study examined whether cultural and social events like Ramadan, Eids, and birthdays, motivate Saudi adults to quit smoking. METHODS: Convenience sampling of 742 Saudi tobacco users was conducted between July 2021 and May 2022. A cross-sectional survey was used to assess self-reported desire to quit (1 = 'least desire' to 10 = 'highest desire') and behaviors in relation to special occasions. Multiple linear regression was performed to examine the association between cultural and social occasions and the desire to quit, while logistic regression was used to assess the relationship between cultural and social occasions and historical quit attempts, medicinal nicotine product use, visiting smoking cessation clinics, and calling the national Quitline. Demographic variables and tobacco types were controlled for in the analyses. RESULTS: Considering quitting during Ramadan, Eids, and birthdays was associated with a higher desire to quit (Ramadan: B=2.99; 95% CI: 2.51-3.47, Eids: B=2.83; 95% CI: 2.12-3.54, and birthdays: B=2.76; 95% CI: 1.93-3.60, p<0.01) and a greater likelihood of past quit attempts (Ramadan: AOR=8.2; 95% CI: 5.5-12.1, Eids: AOR=5.8; 95% CI: 3.2-10.5, and birthdays: AOR=4.8; 95% CI: 2.4-9.4). Only considering quitting during Ramadan was associated with calling the national Quitline (AOR=2.9; 95% CI: 1.8-4.9). CONCLUSIONS: Cultural and social events like Ramadan and Eids motivate adults in Saudi Arabia to attempt tobacco cessation. Targeting interventions around meaningful cultural occasions may promote successful quitting. These findings highlight the importance of understanding cultural and religious influences on cessation behaviors in Saudi Arabia and in other countries.

Awareness and utilization of smoking cessation clinics in Saudi Arabia, findings from the 2019 Global Adult Tobacco Survey.

BACKGROUND: Tobacco use remains a leading cause of premature death. To combat tobacco use, the Ministry of Health (MOH) improved access to smoking cessation clinics (SCCs) by developing fixed SCCs and mobile SCCs, which move based on demand across locations. The goal of this study was to investigate awareness and utilization of SCCs among tobacco users in Saudi Arabia and the factors that influence their awareness and utilization. METHOD: This cross-sectional study used the 2019 Global Adult Tobacco Survey. Three outcome variables were employed, including tobacco users' awareness of fixed SCCs, mobile SCCs, and utilization of fixed SCCs. Several independent variables were examined, including sociodemographic characteristics and tobacco use. Multivariable logistic regression analyses were performed. RESULTS: One thousand six hundred sixty-seven tobacco users were included in this study. There were 60%, 26%, and 9% of tobacco users who were aware of fixed SCCs, aware of mobile SCCs, and visited fixed SCCs, respectively. The likelihood of being aware of SCCs increased among users residing in urban areas (fixed SCCs: OR = 1.88; 95% CI = 1.31-2.68; mobile SCCs: OR = 2.09; CI = 1.37-3.17) while it decreased among those reported self-employed (fixed SCCs: OR = 0.31; CI = 0.17-0.56; mobile SCCs: OR = 0.42; CI = 0.20-0.89). The likelihood of visiting fixed SCCs increased among educated tobacco users aged 25-34 (OR = 5.61; CI = 1.73-18.21) and 35-44 (OR = 4.22; CI = 1.07-16.64) while the odds of visiting SCCs decreased among those who were working in the private sector (OR = 0.26; CI = 0.09-0.73). CONCLUSION: The decision to quit smoking must be supported by an effective healthcare system that provides accessible and affordable smoking cessation services. Knowing the factors that influence the awareness and utilization of SCCs would help policymakers dedicate efforts targeting those who desire to quit smoking yet face limitations in using SCCs.

The associations between the credibility of the tobacco control regulatory body and smoking behavior change among Saudi smokers.

INTRODUCTION: Recently, Saudi Arabia has extensively reformed its tobacco control policies and extended its smoking cessation services. A public outrage on social media among smokers was witnessed, especially after the implementation of plain cigarette packaging, which might have discredited the significant efforts of tobacco treatment services and tobacco control policies. However, it is not known how the credibility of the tobacco control regulatory body among Saudi smokers might affect their smoking behavior. METHODS: Saudi tobacco smokers (n=511) were recruited using a convenience sampling technique. A cross-sectional survey was conducted comprising questions related to the credibility of the tobacco control regulatory body (modified Food and Drug Administration Tobacco Credibility Scale), quit attempts, use of nicotine replacement therapy (NRT), and motivation to change smoking behavior in the future. Logistic and linear regression models were used for the analysis. RESULTS: The public interest subscale of the credibility of the tobacco control regulatory body, was positively associated with confidence in changing smoking behavior (ß=0.204; 95% CI: 0.078-0.713; t=2.449, p=0.015) and readiness to change smoking behavior (ß=0.237; 95% CI: 0.127-0.727; t=2.802, p=0.005). Moreover, the subscale of expertise was positively associated with confidence in changing smoking behavior (ß=0.190; 95% CI: 0.006-0.697; t=1.999, p=0.046) and readiness to change smoking behavior (ß=0.225; 95% CI: 0.063-0.710; t=2.352, p=0.019). However, public interest in the credibility of the tobacco control regulatory body was negatively associated with NRT use among smokers who tried to quit (adjusted odds ratio, AOR=0.691; 95% CI: 0.526-0.909). The credibility of the tobacco control regulatory body, however, was not associated with the last month's or ever quit attempts. CONCLUSIONS: The credibility of the tobacco control regulatory body was positively associated with motivation to change smoking behavior but negatively associated with NRT use. Optimizing communication tools with the public is a potential avenue for improving smoking treatment and prevention in Saudi Arabia.

Tea consumption and risk of bladder cancer in the Bladder Cancer Epidemiology and Nutritional Determinants (BLEND) Study: Pooled analysis of 12 international cohort studies.

BACKGROUND & AIMS: Tea has been shown to be associated with reduced risk of several diseases including cardiovascular diseases, stroke, metabolic syndrome, and obesity. However, the results on the relationship between tea consumption and bladder cancer are conflicting. This research aimed to assess the association between tea consumption and risk of bladder cancer using a pooled analysis of prospective cohort data. METHODS: Individual data from 532,949 participants in 12 cohort studies, were pooled for analyses. Cox regression models stratified by study centre was used to estimate hazard ratios (HR) and corresponding 95% CIs. Fractional polynomial regression models were used to examine the dose-response relationship. RESULTS: A higher level of tea consumption was associated with lower risk of bladder cancer incidence (compared with no tea consumption: HR = 0.87, 95% C.I. = 0.77-0.98 for low consumption; HR = 0.86, 95% C.I. = 0.77-0.96 for moderate consumption; HR = 0.84, 95% C.I. = 0.75-0.95 for high consumption). When stratified by sex and smoking status, this reduced risk was statistically significant among men and current and former smokers. In addition, dose-response analyses showed a lower bladder cancer risk with increment of 100 ml of tea consumption per day (HR-increment = 0.97; 95% CI = 0.96-0.98). A similar inverse association was found among males, current and former smokers while never smokers and females showed non-significant results, suggesting potential sex-dependent effect. CONCLUSIONS: Higher consumption of tea is associated with reduced risk of bladder cancer with potential interaction with sex and smoking status. Further studies are needed to clarify the mechanisms for a protective effect of tea (e.g. inhibition of the survival and proliferation of cancer cells and anti-inflammatory mechanisms) and its interaction with smoking and sex.

The seroprevalence of SARS-CoV-2 IgG antibodies among asymptomatic blood donors in Saudi Arabia.

BACKGROUND: In late 2019, cases of severe pneumonia with unidentified etiology began to emerge in Wuhan, China, before progressively spreading first nationally and then globally.The current study sought to investigate the seroprevalence of immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blood donors in Al-Madinah, Saudi Arabia. To our knowledge, this is the first study in Saudi Arabia to screen blood donors who were not known to be previously infected with SARS-CoV-2. METHODS: This study was a cross-sectional study to assess individuals who donated blood to the central blood bank in Al-Madinah between mid-May and mid-July 2020. An enzyme-linked immunosorbent assay (ELISA) was designed and established to detect antibodies directed against the SARS-CoV-2 spike protein in serum samples. A total of 1,212 healthy blood donors participated in this study. The donors were males and met the requirements for blood donation during the COVID-19 pandemic period in Saudi Arabia. RESULTS: The SARS-CoV-2 seroprevalence among blood donors in Al-Madinah was 19.31% (n = 234/1212; 95% confidence interval: 17.12%-21.64%). No statistically significant difference was identified in seropositivity according to age. However, significant differences (p < 0.001) were identified according to ABO blood groups, with those with type A blood presenting the highest rate of seropositivity (29.18%) compared with the other blood groups (12.65% for type B, 16.36% for type AB, and 15.11% for type O). CONCLUSION: A high prevalence of SARS-CoV-2 antibodies was detected among blood donors in Al-Madinah, which indicated a high level of exposure to the virus within the population. This further suggested that as high as one-fifth of the population may have acquired innate immunity against the virus.

Association of Viral Load in SARS-CoV-2 Patients With Age and Gender.

Background: The coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global public health emergency. Age and sex are two important factors associated with risks and outcomes of various diseases. COVID-19 morbidity also seems to be affected by patient age and sex. It has been found that older age groups have more severe COVID-19 symptoms and higher fatality rates while children tend to have lower prevalence and milder symptoms than adults. Methods: The study reviewed electronic medical records of COVID-19 patients from Madinah city, Saudi Arabia. The study included all cases who tested positive (n = 3,006) between March 20 and May 22, 2020. Data were obtained from the Health Electronic Surveillance Network (HESN) database. Results: Approximately 80% of the study sample were males and half were in the 30-40-year-old age group. The Ct value of the whole sample ranged from 15.08 to 35, with a mean of 27.44 (SD: 5.23; 95% C.I. = 27.25-27.66). The means of Ct values varied between age groups from 27.05 to 27.82. Analysis of the mean differences between age groups using one-way ANOVA indicated no statistically significant difference among the groups (F6,2999 = 1.63; p-value = 0.135). A comparison of mean Ct values of males (n = 2,422) and females (n = 584) revealed that males had a statistically significant higher mean Ct value (27.61 ± 5.20) than females (26.72 ± 5.31). The difference between the means of the two groups was -0.89 (95% C.I. = -1.36 to -0.42; t-test -3.71; df = 3,004; p-value < 0.001). Conclusion: The study found no statistically significant difference in viral loads between age groups. It showed that females had a higher SARS-CoV-2 viral load compared to males. The findings have implications for preventive strategies. Further studies are needed to correlate viral load with clinical symptoms and outcomes.

Cancer incidence attributable to tobacco smoking in GCC countries in 2018.

INTRODUCTION: The Gulf Cooperation Council (GCC) member countries include Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates. The current study aims to provide an estimate of the population fractions of cancer cases attributable to tobacco smoking in the GCC countries. METHODS: Population attributable fraction (PAF) was calculated for cancers that were listed by the International Agency for Research on Cancer (IARC) to have sufficient evidence of causal association. The estimated number of incident cancer cases in GCC countries were retrieved from the IARC GLOBOCAN database. The prevalence estimates of current tobacco smoking among persons aged ≥15 years were obtained from the World Health Organization report on prevalence of tobacco smoking. Relative risk estimates for various cancers were obtained from published meta-analyses. Summary PAFs and cancer cases attributable to tobacco smoking are reported by country, sex, and cancer type. RESULTS: Tobacco smoking was responsible for 2536 (16.3%) of cancer cases in GCC countries in 2018. It accounted for 22.8% (n=2396) and 2.8% (n=140) of cancer cases among males and females, respectively. Among males, the highest number of cancer incident cases attributable to smoking was lung cancer (807) followed by urinary bladder (328), and colorectal cancer (305). Among females, the highest number of cancer cases attributable to smoking was lung cancer (62) followed by lip and oral cavity (13), and cervical cancer (13). CONCLUSIONS: Tobacco smoking accounted for a large portion of cancer cases attributable to preventable risk factors in GCC countries. Preventive efforts focusing on reducing tobacco smoking should be a high priority in GCC countries.

Asthma control and its association with knowledge of caregivers among children with asthma. A cross-sectional study.

OBJECTIVES: To investigate the level of asthma control among children and to investigate the association between asthma control and the knowledge of caregivers. METHODS: A cross-sectional study was conducted from January 2018 to July 2018 among 278 children with asthma aged 1-12 with their caregivers attending the primary health care centers in Al Madinah Al Munawarah, Saudi Arabia. An asthma knowledge questionnaire was used to measure the parents' knowledge. The Test for Respiratory and Asthma Control in Kids (TRACK) and the Childhood Asthma Control Test (C-ACT) were used to evaluate asthma control among the children. Univariate and multivariate analyses were used to compare the knowledge level between the controlled and uncontrolled asthma groups. RESULTS: Approximately 62.6% of children had uncontrolled asthma and 37.4% were controlled. The knowledge scores of the caregivers ranged from 43 to 64, with a mean score of 52.55. The mean knowledge score was higher in the controlled group (55.57) than in the uncontrolled group (50.76). There was a statistically significant difference in the knowledge scores between the participant groups (t=9.892, p less than 0.001). CONCLUSION: There is a high percentage of children with uncontrolled asthma and 3 is a high knowledge deficit among the caregivers of children with asthma. An educational program targeting the general population and the caregivers should be implemented to correct any false beliefs regarding asthma and asthma medications.