Sking morbidity pattern among patients seen at a university primary care clinic in Riyadh, Saudi Arabia

Information on the morbidity pattern of patients seen at a primary care clinic is sparse or not readily available for most countries in the Middle East including Saudi Arabia. A prospective study of all new patients presenting with skin disorders at the Primary Care Clinic of King Khalid University Hospital, Riyadh, Saudi Arabia was, therefore, carried out over a period of one year [1993-94]. An analysis of the skin morbidities of 1183 new patients seen over this period is reported here. There is a male preponderance overall and more than 87% of the patients were below 40 years of age. Out of all patients with diseases of the skin, 77.5% were referred for specialist care. It is conceivable that the commonly observed pattern of dermatological diseases in this study may change over a period of time due to the interventions adopted by the primary care clinics, as part of social development, or as a cumulative effect of both. The primary care physician has to be aware of such changes by periodically analyzing the available morbidity pattern

Care of asthmatic patients in primary health care centers

This is a retrospective study of the medical records of asthmatics using a predesigned form. The purpose of the study is to define the number of patients registered as asthmatics at a random selection of primary health care centers [PHCCs] in Riyadh and to describe sociodemographic, clinical and management characteristics of this population of asthmatics with a view to recommending changes which might improve the care for asthma patients. Items of inquiry included demographic data, clinical features, management and health center profiles of the patients. Patients from 60 primary health care centers were studied. There were 2081 asthmatic patients found in the studied PHCCs [out of 255,145 surveryed], giving a rate of 0.8%. Out of all the patients, 32.8% were children 16 years of age or below and 24.7% were above 45 years of age. The male to female ratio was 1.2:1. The presenting symptoms were cough in 82.3% and shortness of breath in 64.8%. Atopic disorders such as eczema and allergic rhinitis were recorded in 27.7%. PHCCs diagnosed 61.9% depending on history and clinical examination. Out of all patients, 10.6% did not utilize a PHCC, 29.5% were referred to a specialist and 8.7% needed admission to the hospital one or more times. Oral salbutamol was used in more than 45.7% of the patients. The number of registered bronchial asthma patients at the PHCCs was very low. Even when registered, asthmatic patients are getting suboptimal care. The present study provides a basis for intervention and a baseline from which to measure the benefits of intervention. It also provides the strongest possible support for the Ministry of Health, who recently initiated a National Asthma Program

prevalence of obesity among Saudi males in the Riyadh region

Attendees of 15 health centers in urban and rural areas in the Riyadh region were screened for obesity during May and June 1994. Systemic selection yielded 1580 Saudi males for analysis. The mean age was 33.6 +/- 13.5 years and body mass index [BM1] was 26.9 +/- 5.7 kg/m 2. Only 36.6% of subjects were their ideal weight [BMI < 25 kg/m [2]], while 34.8% were overweight [BMI 25-29.9 kg/m [2]], 26.9% were moderately obese [BMI 30-40 kg/m [2]] and 1.7% were morbidly obese [BMI > 40 kg/m [2]]. Middle age, lower education and joblessness predicted a higher risk for obesity. Patients living in rural areas had greater BMIs than those living in urban areas [P < 0.01]. Forty percent of overweight participants did not think they were so. The high prevalence of obesity and the lack of awareness among those afflicted emphasizes the need for community-based programs for preventing and reducing obesity, since weight control is effective in ameliorating most of the disorders associated with obesity, such as Type II non-insulin-dependent diabetes mellitus, hypertension, stroke, heart disease, sleep apnea syndrome and osteoarthritis of the knees. Young parents who are at risk of developing obesity and who play a central role in perpetuating it in their offspring should be the target of obesity-prevention programs

prospective study of the morbidity pattern of patients seen at a university primary care clinic

Information on the morbidity pattern of patients seen at a primary care clinic is sparse or not available for most countries in the Middle East including Saudi Arabia. A prospective study of all new patients at the primary care clinic of King Khalid University Hospital [KKUH], Riyadh, Saudi Arabia was therefore carried out over a period of one year [1991G to 1992G]. An analysis of the morbidity pattern of 9,441 new patients seen over this period is hereby reported. There is a male preponderance overall and more than 70% of the patients were below 40 years of age. Ill-defined illnesses, diseases of the skin, genitourinary, digestive, musculoskeletal and respiratory diseases accounted for more than 70% of the patients. About one-third of the patients, mainly those with diseases of the skin and genitourinary systems, were referred for specialist care. It is conceivable that the commonly observed pattern of diseases in this study may change over a period of time either due to the interventions adopted by the primary care clinics or as part of social development or as a cumulative effect of both. The primary physician has to be aware of such a change by periodically analyzing the available morbidity pattern

Low back pain and obesity in primary health care, Riyadh, Saudi Arabia

To assess the prevalence of obesity and its association with low back pain in patients attending health care centres. A case-control study of 2460 Arab patients attending urban and rural health centres in Riyadh region was conducted during Jan-Feb 1993. Twelve health centres participated in the study. All patients attending the health centres with low back pain [cases] were compared with patients free from back pain [non-cases]. The mean ages were 34 years for males and 32 years for females. Only 17.6% cases can be considered as non-obese compared with 42.6% non-obese among non-cases. The mean body mass index [BMI] of cases was 30.6 +/- 6.1 kg/m[2] compared with 26.7 +/- 5.8 kg/m[2] of non-cases [p<0.01]. Body mass indices were higher among females, those of low education, housewives, non-Saudis and the divorced or widowed than other groups [p<0.01]. Patients living in rural areas had higher BMI than those residing in urban areas [P< 0.01]. Low back pain is associated with obesity. The prevalence of obesity is higher in females, housewives, non-Saudis, the divorced, the widowed, and among those living in rural areas

Public attitude towards acceptability, availability and accessibility of immunization services in Riyadh

A study of accessibility, availability, and acceptability of immunization was carried out by interviewing 1422 parents selected randomly from the catchment areas of 15 health care centers in Riyadh. The parents were included if they had children who were under two years or who had not completed the essential immunizations necessary for issuing birth certificates. The demographic data of parents and children were also obtained. The majority, 1270 [89.3%] parents said they would immunize their children to protect them against diseases while only 25 [1.8%] of the parents said they immunized their children to obtain the birth certificate. Of all parents, 87.3% strictly followed the immunization schedule. Mothers in the younger age group, with higher education and whose husbands are in the higher occupational category had higher compliance rates than others. Various reasons were given for this failure. Parents [21.4%] attributed failure to attend the scheduled immunizations to inaccessibility to the service, for example the distance which needed transport, or non-availability of father to accompany the family to the health center. Other reasons for failure were due to false perception of the necessity, the indications and the contraindications of immunization. It was found that parents who failed to comply with the immunization schedule were more likely to have more than the average number of children

case study of doctor-patient encounter in Riyadh primary health care centers, Saudi Arabia

1222 consultations [doctor-patient encounters] were selected randomly from 10 primary health care centers which represented 17% of all health centers in urban Riyadh. Tow health centers were selected randomly from each of the five sections of Riyadh [North, South, Centre, East, West]. 32 doctors participated in the study and 9 of them were females. The quality of consultation as reflected by the duration and content of doctor-patient encounter was studied. The data we re collected using a structured questionnaire/interview form. The study was conducted over a period of two weeks during the two main seasons, winter and summer, making a total of four weeks. Every tenth consultation was included. The mean consultation time was 5.69 minutes + SD 4.27 [The mode was 3 minutes]. The following factors were found to increase the mean consultation time: male sex, non-Saudi nationals, the high level of education, professional and married status. The doctor's interest in paediatrics was associated with an in crease in mean consultation time. Elderly patients took more time than the younger ones. The elder doctors spent less time with their patients. Other factors which increased or decreased mean consultation time were discussed. Due to pressure of time and more patients waiting to be seen, primary health ca re doctors resorted to issuing prescriptions more than spending time with the patient Doctors tended to manage the presenting problem e.g. Upper respiratory tract infection but forgot or neglected involving the patient in a discussion a med at modifying the help-seeking behavior of the patient or the preventive and health promotive activities. 75% of the consultations ended in prescriptions. The referral rate was 4% and the investigation rate was 13.6% Recommendations for improving the quality of consultation in primary health care settings we resuggested