Cancer research in the Arab world - a review of publications from seven countries between 2000-2013

This review aimed to examine trends in cancer research in the Arab world and identify existing research gaps. A search of the MEDLINE[registered] database [National Library of Medicine, Bethesda, Maryland, USA] was undertaken for all cancer-related publications published between January 2000 and December 2013 from seven countries, including Bahrain, Kuwait, Iraq, Lebanon, Morocco, Palestine and Sudan. A total of 1,773 articles were identified, with a significant increase in yearly publications over time [P <0.005]. Only 30.6% of the publications included subjects over the age of 50 years old. There was a dearth of cross-sectional/correlational studies [8.8%], randomised controlled trials [2.4%] and systematic reviews/meta-analyses [1.3%]. Research exploring cancer associations mainly considered social and structural determinants of health [27.1%], followed by behavioural risk factors [14.1%], particularly tobacco use. Overall, more cancer research is needed in the Arab world, particularly analytical studies with high-quality evidence and those focusing on older age groups and associations with physical activity and diet

Outcomes of children with attention deficit/ hyperactivity disorder: global functioning and symptoms persistence

Many adolescents with ADHD show antisocial behaviour and low educational achievement. These issues have not been validated in the World Health Organization Eastern Mediterranean Region. The objective of this study was to assess the global functioning and behaviour of children with ADHD growing into adolescence 10 years after initial diagnosis. Parents were interviewed using a structured questionnaire, Conner's Short Version Test and the Children's Global Assessment Scale. Nearly half of our sample had low academic achievement and 36% had no friends. A quarter of the cases were smokers, one admitted abusing drugs and one had attempted suicide. One third of the sample continued to have ADHD symptoms. Adolescents with ADHD had similar school performance and peer relationships to those reported previously, but differences with regard to drug use, suicide and other impulsive behaviour. A follow-up study into adult life using a control group is recommended

Epidemiology of breast cancer among bahrain! women data from the bahrain cancer registry

The aim of this study was to describe the epidemiology of breast cancer among the Bahraini female population in the years 2000-2010 and examine its health policy implications. All breast cancer cases in the Bahrain Cancer Registry from 1[st] January 2000 to 31[st] December 2010 were included. There were 1,005 cases, 12.7% of which were detected by screening. The overall mean age at diagnosis was 50.9 years [95% confidence interval 50.1-51.6]. The age-standardised incidence rate declined from 58.2 per 100,000 in 2000 to 44.4 per 100,000 in 2010. The majority of cases were infiltrating ductal carcinoma [76.9%]. Of the registered cases, 44.1% and 48.1% had an unknown grade and stage, respectively. The five-year survival rate was 63 +/- 2%. The low percentage of cases detected by screening merits further evaluation of Bahrain's screening programme. More effort should be made to reduce the proportion of unknown stage and grade breast cancers. Future research has to be directed towards understanding the reasons for Bahrain having the highest incidence rate of breast cancer in the Gulf Cooperation Council countries

Air quality and seasonal variations in consultations for respiratory, allergic, dermatological and gastrointestinal diseases in Bahrain, 2007

Environmental health data in Bahrain are scarce. This study in 4 governorates of Bahrain aimed to establish baseline data on the seasonal prevalence of certain disease groups that are sensitive to climate [respiratory, allergic, dermatological and non-specific gastrointestinal diseases] over a 1-year period and to record local climate and air pollutant data for the same year. A 5% sample of medical records for those who attended primary health-care centres during 2007 was taken. Visit rates for all 4 diseases had peaks, in spring and in autumn, with the lowest rates in the summer season when the average temperatures were highest and average humidity was lower. Respiratory-related visits were highest when the air concentrations of SO[2] were highest. An ongoing surveillance system for climate-sensitive diseases should be initiated to monitor and relate health and environmental trends

Breast cancer risk assessment among Bahraini women

To estimate breast cancer risk among Bahraini women aged 35 years and older attending primary healthcare centers. Primary healthcare centers. Cross sectional descriptive study. One hundred seventy-two women aged 35 years and older were assessed for the risk of invasive breast cancer risk using the modified Gail model. The study was performed from 1 February to 31 May 2005. A questionnaire was used to collect information on five years and lifetime breast cancer risks. Four percent of the women had a high risk [

Geographic epidemiology in a small area: cancer incidence in Baakline, Lebanon, 2000-2008

Aggregate data of the National Cancer Registry in Lebanon cannot discriminate cancer incidence in small areas. Trained community members surveyed the permanent population of the Baakline municipality using the verbal autopsy approach. We surveyed 1042 households with at least 1 member living permanently In Baakline during 2000-2008. Data covered 4330 persons yielding 34143 years of observation and 56 new cases of cancer were reported. Median age at diagnosis varied significantly between men [77 years] and women [56 years]. The most common types were lung cancer [20%] followed by colorectal [12.5%] and breast [9%]. Estimated crude cancer incidence rate was164 cases/100 000 persons/year, significantly higher in men [194] than women [130], and much lower overall than the national figure [218]. The permanent Baakline population Is older than that of Lebanon itself, yet the cancer Incidence rate is markedly lower than the national figure. This finding pleads for serious efforts to preserve the low environmental | contamination and the healthy lifestyles In food and tobacco abstinence that have protected the population so far

Fatalities from road traffic accidents among the young in Bahrain

In Bahrain and other Gulf countries, road traffic accidents [RTA] are recognized as a growing public health problem. This study described the trend of fatalities from RTA in Bahrain among those aged < 25 years from 2003-2010. The proportional mortality ratios of RTA deaths [up to 30 days from the accident] among the young were compared with those of all ages. The average proportion of young males killed by RTA in Bahrain during the 8-year period was 82.7%, with 2006 marking the lowest proportion among Bahraini nationals [72.2%] and the total population [79.2%]. RTA fatalities constituted 51.3% among the Bahrainis, 20.2% of non-Bahrainis and 39.0% of all fatalities in both sexes combined. The young in Bahrain were 3.5 times more likely to die from RTA than the general population. This paper calls on policy-makers to consolidate efforts to control this public health problem

Improving the accuracy of death certification among secondary care physicians

To assess the impact of an educational intervention on the accuracy of death certification of secondary healthcare physicians in Bahrain. Secondary Health Care, Ministry of Health. Interventional study. Twenty-seven secondary healthcare physicians were invited to attend an interactive workshop about death certificate completion. They were asked to complete a death certificate based on a Case-scenario at the start and after the end of the workshop. The errors made by the physicians were compared before and after the intervention. Five [18.5%] physicians had some type of training about death certificate completion and 3 [11.1%] were aware of the death certificate completion guidelines. A highly significant [p<0.001] reduction in errors prior to the intervention and after was revealed, 25 [92.6%] errors versus 11 [40.7%]. The most frequent error was listing the mechanism but it markedly dropped to one-third following the workshop. The number of errors has declined after attending the workshop. Training physicians in death certificate completion would improve the accuracy of mortality statistics

Use of electronic communication and entertainment devices: a survey of Arabian Gulf university medical students

To evaluate the use of electronic communication and entertainment devices by Arabian Gulf University [AGU] medical students. Arabian Gulf University, Kingdom of Bahrain. Cross sectional study. Years 1 to 4 medical students who were enrolled in the 2008-2009 academic year were included in the study. A self-administered anonymous questionnaire was used, which included enquiries on personal characteristics and the use of electronic communication and entertainment devices. Four hundred forty-three students responded. The study showed different habits according to gender and accommodation. Hundred and thirty [42%] female students used their mobile phones for more than 2 hours per day compared to 95 [31.3%] watched television [TV]/DVD and 203 [66.1%] used computers. The corresponding numbers and percentages for male students were 30 [24%], 49 [39.2%] and 79 [63.2%] respectively. The AGU medical students do not appear to adopt healthy habits for using electronic communication and entertainment devices. Moreover, these habits are seen among students based on gender and accommodation. Urgent interventions are needed at AGU on promoting the appropriate use of the devices among medical students

Breast cancer knowledge among Bahraini women attending primary health care centers

To evaluate breast cancer knowledge among Bahraini women aged 20 years and more attending primary health care centers. Primary health care. Cross sectional descriptive study. Three hundred Bahraini women attending the primary health care clinics were interviewed from 1st February to 31st May 2005. A multistage sample was selected with a cluster sampling technique for the selection of one health center from each region; five health centers were selected. The sample was stratified according to the percentage of females residing in each region. A semi-structured questionnaire was used for interviewing the study participants. Seventeen [5.6%] women knew more than half of the correct answers, and the mean "Percent Knowledge Index" was 32.1% +/- 12.7%. Newspapers, television, radio, were identified as the main source of knowledge of breast cancer. Highly educated women were more knowledgeable about breast cancer [p=0.002], diagnostic modalities [p=0.008], and risk factors [p<0.0001]. Women with positive family history of breast cancer knew more about treatment modalities than those without a history [p=0.017]. Moreover, no significant differences were found between the general knowledge and its subtypes among women with positive or negative personal history of breast complaints. Breast cancer knowledge was deficient among Bahraini women. Efforts to improve women's education should be encouraged. Breast cancer should be included as a subject in the high school curricula, with emphasis on modifiable risk factors. The maximum use of media should be encouraged in breast cancer campaigns

study of ill-defined causes of death in Bahrain. determinants and health policy issues

To find the actual cause of death in death certificates that had "ill-defined" causes in 2006, evaluate the correctness of the completion of those certificates, and recommend ways to decrease the proportion of "ill-defined" causes of death in Bahrain. This was a retrospective review of all death certificates that had "ill-defined" as a cause of death [International Classification of Diseases-10 codes R0-R99] from January through December 2006 in Bahrain. Of the decedents with "ill-defined causes" of death in 2006, 76.7% were Bahraini, 70.6% males, 37% older than 70 years, and 62.7% died in their homes. The underlying causes of death of 92% were recorded as "brought dead" and "cardiopulmonary failure." Of those whose place of death was recorded as "brought dead", 86% had died in their homes. Sixty percent of the death certificates were signed by Salmaniya Medical Complex [SMC] physicians and the remaining by forensic doctors and over half by senior residents. Of the death certificates retrieved at SMC, 60% were corrected, 47.4% of which were certified by doctors from the accident and emergency department, 31.5% from medical, and 21.1% from surgical departments. Death certification in Bahrain should be reevaluated by all stakeholders to improve the quality of mortality data. The revised policy should stress upon increasing the awareness of the physicians on the implications of inaccurate death certification

Knowledge of and attitudes towards tobacco control among smoking and non-smoking physicians in 2 gulf arab states

The global health professional survey is a project organized by the World Health Organization, to determine the smoking habits, knowledge and attitude towards tobacco control of health professionals in several countries around the world. This paper presents data from Kuwait and Bahrain. The survey period was between May 2000 and March 2001. A questionnaire was distributed to all physicians in Bahrain and to a r and om sample from Kuwait. The responses to knowledge and attitude questions were on a scale of 1-5, [1 strongly agree, 2 agree, 3 unsure, 4 disagree and 5 strongly disagree]. Four hundred and seventy physicians from Bahrain and 1095 from Kuwait completed the questionnaire. The prevalence of cigarette smoking in Kuwait was: current smokers 18.4%, previous smokers 15.8%, Bahrain 14.6% and 14.3%. The prevalence of shisha smoking was 12% and 6.4% for Kuwait and Bahrain, [p=0.004]. The mean scores of agreement with the association between passive smoking and lung diseases, lower respiratory tract infections in children were 1.6, 1.7 and 1.8, 1.9 for non smoking physicians and smoking physicians [P<0.01]. The mean scores of agreement with the following policies: large health warning on cigarette packages, complete ban on tobacco advertisement and an increase in the price of cigarette were 1.3, 1.4, 1.7 and 1.7, 1.7, 2.5 for smoking and non-smoking physicians [p<0.01]. Smoking physicians have less knowledge and less favorable attitude towards tobacco control compared to non-smokers. There was no difference in the prevalence of cigarette smoking between Kuwait and Bahrain, but the prevalence of shisha smoking was higher in Kuwait

Risk factors of major noncommunicable diseases in Bahrain. the need for a serveillance system

Noncommunicable diseases NCDs are the major cause of morbidity and mortality in Bahrain. The review examines the prevalence of risk factors of major NCDs from the available literature and determines the impact of the rapid socio economic changes on their burden. It further recommends ways of improving their reporting and monitoring. Smoking, obesity, diabetes, hypertension, hyperlipidemia, physical activity and nutrition are considered. The review points out that data on some of the factors is available but deficient for others. The call for the establishment of an integrated surveillance system using the World Health Organization STEPwise approach is stressed

Smoking among secondary-school boys in Bahrain: prevalence and risk factors

To determine the prevalence of smoking among male secondary school students in Bahrain and to identify their risk factors for smoking, we surveyed a random sample of students by questionnaire. The prevalence of smoking was 26.6%, 25.5% and 25.4% among first-year, second-year and third-year students respectively. Cigarettes [21.0%], water-pipes [13.0%] and cigars [1.6%] were popular. Smokers and non-smokers had similar socioeconomic profiles, but differed in degree of disapproval of smoking shown by close contacts and whether close contacts were smokers. The prevalence of smoking among male secondary-school students in Bahrain did not decline despite intense anti-smoking efforts in the last decade, perhaps indicating the effectiveness of tobacco advertising and promotions that target youth

Bahraini women's health: a background paper

This study assessed the trends in the health status of Bahraini women from the early 1980s to the mid 1990s through review of census data and health data. Sociodemographic characteristics, reproductive health, mortality, morbidity and lifestyle patterns were studied. The implications of the data and measures needed to be taken to further improve the health and health care services of women are discussed

Noncommunicable diseases among the Bahraini population: a review

The review investigates changes in the morbidity and mortality due to noncommunicable diseases in the Bahraini population and looks at the conditions which may have contributed to them in the 1980s and 1990s. Data were extracted from the Ministry of Health annual health reports and the 1981 and 1991 censuses and other relevant published papers. Government strategies for the control of noncommunicable diseases and the promotion of healthy lifestyles are outlined

Smoking in the Gulf cooperation council [GCC] countries

Review of available documents on smoking shows variation in the number and nature of studies in the Gulf Cooperation Council [GCC] countries. The majority of the studies done were smoking prevalence studies while few were on tobacco consumption, smoking related diseases, and mortality attributed to smoking. The prevalence of smoking among males in the Arabian Gulf is higher than that of their female counterparts. The prevalence of smoking among males is higher in Kuwait and Saudi Arabia than Bahrain and Oman while that of females is highest in Kuwait. Smoking among physicians is high in the GCC countries compared to Western countries. Comparing smoking among physicians in GCC countries, Kuwait and UAE are on the top for male physicians, and Saudi Arabia and Kuwait for female physicians. However, there are differences in the type of physicians sampled. The prevalence of smoking among male and female medical and non-medical university students as well as male secondary school students is high in the region. The prevalence data however lack uniformity in definition of a smoker and do not separate the data by nationals and expatriates. The adult cigarette per capita consumption has generally declined in the early 90s compared to that of the late 80s. All the GCC countries seem to have similar health warnings and statements of content and control of tar and nicotine. The recent decrees on smoking control in Bahrain and Kuwait have put these countries ahead in other aspects of control

Smoking habits in Bahrain, 1981-1991

The purpose of the study was to utilize the available data on smoking in 1981 and 1991 to examine if the increase in efforts to control tobacco smoking in the decade has resulted in a decline in the prevalence of smoking in Bahrain. The 1981 prevalence data on smoking were based on a national morbidity survey [NMS] of 4.5% of the households in Bahrain while the data for 1991 were based on the 1991 census. There was almost no change in the prevalence of regular smoking among males for cigarettes, other tobacco and all types of smoking as well as light and heavy cigarette smoking. In contrast, females showed a significant increase in regular smoking of all types and in particular, cigarette smoking. An increase in light cigarette smoking among them was also noted. The increase in the prevalence of daily smoking among females in Bahrain and no change in that of the males imply that the public education and control measures that have been implemented during the 80's were not sufficient in reducing regular smoking and would require the implementation of the legislative action that was stated in the amiri decree. However, it cannot be concluded whether occasional smoking has changed during this decade