ABSTRACT
To evaluate the role of the rapid influenza diagnostic test [RIDT] and clinical decision in the diagnosis of H1N1. In November 2009, 290 suspected influenza patients were examined for H1N1 during an outbreak in Riyadh, Saudi Arabia. Nasopharyngeal swabs were analyzed using Directigen EZ Flu A+B kit. Monoclonal anti-human influenza A/B and reverse transcription- polymerase chain reaction [RT-PCR] were used. Positive and negative controls were used in each run of specimens. Validity indices were calculated for RIDT and clinical diagnostic criteria. The sensitivity and specificity of RIDT were 40.5% [95% confidence interval [CI]: 33.0-48.5], and 94.5% [95% CI: 88.6-97.6]. The sensitivity of clinical decision was 66.3% [95% CI: 58.4-73.4], and the specificity was 65.4% [95% CI: 56.3-73.4]. The sensitivity of clinical decision was higher in early presenters [79.2%; 95% CI: 57.3-92.1]. The RIDT sensitivity was higher in younger patients [48.4%; 95% CI: 35.7-61.3]. The positive predictive value [PPV] was 90.4% [95% CI: 80.7-95.7] for RIDT, and 71.1% [95% CI: 63.1-78.0] for clinical decision. The PPV for RIDT was greater for older [94.7%; 95% CI: 80.9-99.1] and late [90.7%; 95% CI: 76.9-97.0] presenters. The adjusted odds ratio for clinical decision was significant for cough, headache, and fatigue. The RIDT can be useful in epidemics and high prevalence areas, whereas clinical decision, and RT-PCR complement the diagnosis of H1N1 in any setting
ABSTRACT
The occurrence and progress of chronic non-communicable diseases [NCDs] is associated with unhealthy lifestyles and behaviors. Modification of barriers to healthy lifestyle can produce great benefits. The objective of this study was to identify barriers to physical activity and healthy eating among patients attending primary health care clinics in Riyadh city. A cross-sectional study was conducted at King Khalid University Hospital [KKUH] in Riyadh city. Four hundred and fifty participants attending primary health care clinics [PHCC] from 1 March to 30 April 2007 were randomly selected. A questionnaire about barriers to physical activity and healthy eating was adapted from the CDC web site. The prevalence of physical inactivity among the Saudi population in the study was 82.4% [371/450]. Females were more physically inactive [87.6%, 268/306] compared to males [71.5%, 103/144] [P < .001]. The most common barrier to physical activity was lack of resources [80.5%, 326/405], which was significantly higher among females than males and among the lower income versus the higher income group. The most common barrier to healthy diet was lack of willpower. More than four-fifths [80.3%, 354/441] of the study group stated that they did not have enough will to stick to a diet. Lack of resources was the most important barrier for physical activity, while lack of willpower and social support were both barriers for adherence to physical activity and a healthy diet