Serosurvey of measles, mumps and rubella antibodies in Saudi children

A serosurvey study to evaluate the proportion of children with antibodies against diseases targeted by the Expanded Program of Immunization in the Kingdom of Saudi Arabia. Using multistage sampling techniques, we collected samples and sent them for laboratory assay from the following age groups; 100 samples at 6 months, 12 months, 18 months, 6 years, 13 years, and 17 years. We conducted the study from September 2001 to February 2002. We assayed sera for measles, rubella, and mumps antibodies in the measles-mumps-rubella reference laboratory in Germany, using enzyme immunoassay and plaque neutralization [PN] as a backup test for equivocal and negative samples. We only carried out a backup test for measles samples. The age group of 6 months had the highest proportion with negative measles antibodies. After adding the backup test [PN], the proportions of children with protective measles antibody were; 64% at 6 months, 87% at 12 months, 91% at 18 months, 75% at 6 years, 96% at 13 years, and 98% at 17 years. Rubella antibody positivity rates [>7 IU] were 28% at 6 months, 49% at 12 months, 97% at 18 months, 98% at 6 years, and 100% at 13 years. While positivity rates in mumps were 14% at 6 months, 29% at 12 months, 59% at 18 months, 64% at 6 years, and 75% at 13 years. The unexpected low proportion of children with protective level at 6 years, despite being vaccinated with 2 measle doses is an important phenomenon. This reflects the interference between the first and the second measles dose. The Ministry of Health decided to conduct a catch up campaign targeting 1st through 3rd grade primary schools, who did not catch the mass campaign conducted in 2000. Also, this supports the decision taken by the ministry to change the measles immunization schedule to MMR at 12 months and a second dose at 6 years of age

Screening of pregnant Saudi women for hepatitis B surface antigen

The high prevalence of hepatitis B surface antigen [HBsAg] and hepatitis B e antigen [HBeAg] in pregnant women is considered the most important factor contributing to the higher carrier rate of HBsAg in some populations, including Saudi Arabia. Universal hepatitis B vaccination in infancy was implemented in Saudi Arabia in 1990 to avoid early acquisition of infection. At the same time, another program was launched to vaccinate all school children at school entry as a second target group. The aim of this study was to evaluate the HBsAg prevalence rate in Saudi pregnant women 12 years after launching the program and to assess regional variation, if any. In a cross-sectional study, 2664 pregnant Saudi women were recruited from the five main regions in Saudi Arabia. Blood samples were tested for HBsAg. Positive samples were tested also for HBeAg. Of 2664 pregnant Saudi women, 65 were positive for HBsAg [2.46%, 95% CI=2.11%- 2.69%]. Four were positive for HBeAg [0.15%]. The HBsAg prevalence rate was higher in Gizan [4.2%] and lower in Tabuk [1.4%] [P=0.035]. Only one case was positive for HBsAg in women under the age of 20 years [1/186], a 0.5% positivity rate in this age group compared with 2.6% in the older age group [P=0.049 for the one-sided test]. A history of surgical procedures was associated with a higher [3%], but not significantly higher rate of HBsAg positivity. No significant association was found between HBsAg positivity and a history of dental procedures or blood transfusion.Although the HBsAg prevalence rate among Saudi pregnant women was lower than previously published data, the full impact of the hepatitis B vaccination program in infancy and childhood will take more years to decrease the prevalence rate in pregnant women. The MOH should continue to give the first dose of hepatitis B vaccine at birth to prevent early acquisition, but in the meantime a regional policy can be adopted to deal with the high prevalence rate of HBsAg among pregnant Saudi women

Evaluation of continuing medical education in Al-Qasim, Saudi Arabia

To evaluate CME activities in All Qassim region in the Kingdom of Saudi Arabia A study using a pre-structured questionnaire was conducted in AL- Qassim, targeting physicians working in he hospitals. The survey was conducted in two phases. The first phase has conducted at the inception of the department of professional education and the second one year later. Questionnaires were given to a sample of physicians working in the hospitals. Mean CME hours in the region increased from 5.5 [ +/- 5.9] to 14. 2 [ +/- 19.7], p = 0.0001. 50% said that the CME should be presented differently. There was need for regular courses [61%] departmental and bedside activities [52%] and visiting speakers [45%]. Only 47% of the physicians were using the Internet. There is a need to shift from credit counting to a process that can yield professional development through practical courses and departmental activities. The use of the Internet in CME activities should be encouraged

use of FDA oral polio formula in vaccinating Saudi children

To evaluate the immunogenicity of USA [FDA] Oral polio vaccine versus WHO Oral polio vaccine. Open randomized trial where 210 children were randomized into three groups. First group received Hemophilus influenza type b [Hib] vaccine plus WHO DTP and OPV. The second group received Hib plus FDA DTP and OPV. The third group received WHO DTP and OPV without Hib vaccine. 3 doses were given at 6 weeks, 3 months and 5 months. Blood samples were collected at 6 months of age. Bar coded sera were used to assess for polio antibody for the three poliovirus types using microneutralization assay. The result of polio assay will be presented in this paper. Proportion of children with detectable antibody [titre =/> 1/8] polioviruses were higher in the group vaccinated with the FDA OPV formula but no significant difference was found for our sample size. FDA oral polio is not superior to WHO OPV at our sample size and there is an improvement in the seroresponse to WHO OPV compared to previous survey