Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia.

OBJECTIVES: To report the experience with Middle East respiratory syndrome coronavirus (MERS-CoV) infection at a single center in Saudi Arabia. METHODS: Cases of laboratory-confirmed MERS-CoV occurring from October 1, 2012 to May 31, 2014 were reviewed retrospectively. Information sources included medical files, infection control outbreak investigations, and the preventive medicine database of MERS-CoV-infected patients. Data were collected on clinical and epidemiological aspects and outcomes. RESULTS: Seventy consecutive patients were included. Patients were mostly of older age (median 62 years), male (46, 65.7%), and had healthcare acquisition of infection (39, 55.7%). Fever (43, 61.4%), dyspnea (42, 60%), and cough (38, 54.3%) were the most common symptoms. The majority developed pneumonia (63, 90%) and required intensive care (49, 70%). Infection commonly occurred in clusters. Independent risk factors for severe infection requiring intensive care included concomitant infections (odds ratio (OR) 14.13, 95% confidence interval (CI) 1.58-126.09; p=0.018) and low albumin (OR 6.31, 95% CI 1.24-31.90; p=0.026). Mortality was high (42, 60%), and age ≥65 years was associated with increased mortality (OR 4.39, 95% CI 2.13-9.05; p<0.001). CONCLUSIONS: MERS-CoV can cause severe infection requiring intensive care and has a high mortality. Concomitant infections and low albumin were found to be predictors of severe infection, while age ≥65 years was the only predictor of increased mortality.

Prevalence of obesity among military personnel in Saudi Arabia and associated risk factors.

OBJECTIVE: To measure the prevalence of obesity among military personnel in the Kingdom of Saudi Arabia (KSA), and to identify its risk factors. METHODS: This nationwide cross-sectional study covered all 5 military regions of KSA. It included a multistage stratified random sample of 10,500 active military personnel. The World Health Organization STEP wise approach to chronic disease risk factor surveillance (STEPS) was used in the design of the data collection tool. The project lasted from January 2009 to February 2011. RESULTS: The response rate was 97.4%; 40.9% of the participants were overweight, 29% obese, and 42.4% had central obesity. Multivariate analysis revealed age, education years, and family history of diabetes or hypertension as statistically significant positive predictors of body mass index, while higher military rank, smoking, eating fruits more than twice per week, and heavy physical activities were negative predictors. CONCLUSION: Obesity is a major health problem among military personnel in this survey especially among soldiers, and is associated with unhealthy dietary and physical activity habits. Prompt action must be taken by the military medical services department in terms of intervention programs primarily directed to soldiers and overweight personnel to control obesity and mitigate its consequences. Review of the anthropometric standards for recruitment, continuation, and promotion in military service is recommended.

Meningitis and seasonal influenza vaccination coverage among military personnel in central Saudi Arabia.

OBJECTIVE: To determine the meningitis and influenza vaccination coverage rates among Saudi military personnel in Riyadh (Central Military Region [CMR]), Kingdom of Saudi Arabia, (KSA) and the socio-demographic factors that influence vaccination. METHODS: This cross-sectional descriptive study was carried out on a sample of 2286 military personnel from different army forces and different military ranks in CMR in KSA selected by a 2-stage stratified random sampling technique. A self-administered questionnaire designed for the National Military Health Survey was used with a section added for assessment of vaccination status. Data collection was carried out from May to August 2009. RESULTS: The response rate was 97.6%. The vaccination coverage was higher for meningitis (51.7%) compared with influenza (17.8%). A high percentage lacked awareness of their vaccination status. Vaccination rates were higher in the Land Forces, and increased with more years of education, and lower crowding index. CONCLUSION: The proportion of vaccination coverage among military personnel in CMR of KSA is low, especially for influenza, along with their awareness of their vaccination status. A vaccination program that includes awareness promotion of vaccine-preventable diseases is recommended, with changes in the policies to mandate vaccination against meningitis and influenza.

Home caregivers' satisfaction with the services provided by Riyadh Military Hospital's home support program.

BACKGROUND AND OBJECTIVES: The satisfaction of the family is essential to the success of home care support services. This study aimed to assess home caregivers' satisfaction with support services and to identify potential factors affecting their satisfaction. DESIGN AND SETTINGS: The study was conducted in the Family and Community Medicine Department at Riyadh Military Hospital using cross-sectional design over a period of six months. PATIENTS AND METHODS: Two hundred forty participants were recruited by systematic random sampling from the division registry. Data were collected through telephone calls using a designed structured interview form. All research ethics principles were followed. RESULTS: The response rate was 76.25%. Most caregivers were patients' sons or daughters. The duration of patients' disabling illnesses varied from less than 1 year to up to 40 years. The majority of caregivers agreed that a home care services team provided the proper healthcare-related support to the patients and improved caregivers' self-confidence in caring for their patients. Overall, on a scale of 100%, the median level of satisfaction was 90%, and 73.2% of caregivers had a satisfaction score of 75% or higher. Increased age, female gender, and more frequent home visits were positive independent factors associated with caregivers' satisfaction scores. CONCLUSION: Although most caregivers are satisfied with the services provided by a home care support program, there are still areas of deficiency, particularly in physiotherapy, vocational therapy, and social services. The implications are that caregivers need to be educated and trained in caring for their patients and need to gain self-confidence in their skills. The program's administration should improve physiotherapy, vocational therapy, social services, and procedures for hospital referral.

Perceptions of secondary technical schools students in Assiut, upper Egypt, about AIDS: Effect of an educational intervention.

BACKGROUND AND PURPOSE: Acquired Immunodeficiency Syndrome (AIDS) is a great threat to the youth. The aim is to assess the knowledge of secondary technical schools students on AIDS, identify related misconceptions, and measure the effect of a short health education program on their level of knowledge. MATERIALS AND METHODS: This quasi-experimental study was done on 575 secondary technical schools students in Assiut City, recruited through a two-stage stratified cluster sampling. A self-administered anonymous questionnaire was used to collect data. A health education program was implemented, and its effect assessed through pre-post testing. RESULTS: The age range of the students was 16 to 20 years, with more girls (57.0%). Only 30.8% had satisfactory knowledge about AIDS in the pretest. Statistically significant improvements in knowledge were revealed after program implementation (P<0.001). Students who were Muslim, of urban residence, and had mobile phones had significantly higher scores (P=0.037, 0.004, 0.038 respectively). The most common misconceptions were the definition of AIDS according to transmission, and phobias related to transmission, which decreased after the intervention. Multivariate analysis showed that the statistically significant independent predictors of the change in knowledge score after the intervention were age, religion and the health education program. CONCLUSION: Secondary technical schools students in Assiut city have a major deficiency in knowledge and many misconceptions regarding AIDS. The educational intervention had a positive impact on their knowledge, but a less marked effect on misconceptions. Knowledge was affected by age and religious belief. It is recommended that more health educational efforts tailored to needs and with approaches suitable to community cultures and values be introduced.

Pancreatic cancer mortality in Egypt: comparison to the United States pancreatic cancer mortality rates.

OBJECTIVES: Little is known about the descriptive epidemiology of pancreatic cancer in many developing countries, such as Egypt. It is believed to be rare in developing countries, but this may reflect lack of systematic cancer registration. Mortality may serve as a surrogate for incidence, since the disease is lethal. Because of availability of reliable mortality registration in Egypt, we used the national mortality data to estimate pancreatic cancer mortality in 2765 deaths from 2000 to 2004, and to gain insights into the disease incidence. METHODS: Mortality data in Egypt was obtained from the electronic national mortality records of the Ministry of Health. We calculated population-based age-specific and age-standardized pancreatic cancer mortality rates for Egypt, and compared them with the Surveillance, Epidemiology, and End Results (SEER) mortality data of the United States. RESULTS: Comparisons of age-specific mortality demonstrated higher rates in Egypt compared to the United States for subjects under age 20 years (relative risks (RR) of 7.7 and 4.2, for the age groups 0-15 and 15-20, respectively), and significantly higher rates in the United States compared to Egypt for subjects 40 years and older (RR 1.8-80.5 for the age groups of 40-45 to 75+). For the majority of age groups in Egypt and the United States, mortality in males was higher than in females. Analysis of regional distribution of pancreatic cancer mortality in Egypt showed significant variations in rates among provinces (p<0.0001) with Northern provinces having average rate that is 2.85 times the rate of Southern provinces. The highest mortality rates were observed in the Nile Delta compared to southern Egypt and the oasis. CONCLUSIONS: The findings of this study demonstrate both international and regional variation in pancreatic cancer mortality, and highlight the importance of further investigation to explore the possible factors that may contribute to the observed epidemiological patterns.