HIV / AIDS epidemic features and trends in Sudi Arabia

More than 60 million persons have been infected since AIDS was described in 1981. By the end of 2003, an estimated 40 million individuals were living with HIV globally. The surveillance of HIV/AIDS still faces challenges in Saudi Arabia. This study describes the pattern and characteristics of HIV/AIDS cases in Saudi Arabia. This descriptive analytic study describes the reported HIV/AIDS data for all notifiable cases during the period 1984 to 2003 in the Kingdom of Saudi Arabia. Case definitions based on ELISA and Western Blot tests were used. Age, sex and regional distribution were studied in addition to survival rates. As of 2003, 1743 Saudi nationals and 6064 non-Saudi HIV cases were reported. Among Saudis, 872 were AIDS cases. Males accounted for 1329 HIV infections, comprising 77%, with a male-to-female ratio of about 3:1. Adults 15-49 years constituted 78% of cases, including 46% of cases infected through sexual activity, while 33% of reported HIV seropositive cases had already died. Most cases [67%] were registered in Jeddah, Riyadh and Dammam. Infection through blood transfusion declined with no reported cases since 2001. The number of reported HIV infections in KSA has increased in the last few years. Using the coverage rate estimating method, the number of Saudi HIV infections since the emergence of the epidemic was estimated to be 2640 cases as of the beginning of the year 2004. The estimated number of HIV infections is almost one and one-half times the reported number, indicating that a problem of underreporting of HIV/AIDS cases still exists

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

Disease burden and case management of bacterial meningitis among children under 5 years of age in Saudi Arabia

This study was designed to explore the case management and disease burden of bacterial meningitis among children below the age of 5 years in the Kingdom of Saudi Arabia. A prospective descriptive study was conducted during June 1999 through to May 2001 in 8 hospitals from 5 cities in different areas of the country. Those were, King Fahad Specialist Hospital and Maternity and Children Hospital, Buraidah, Belgorashi General Hospital and King Fahad Specialist Hospital, Al-Baha, Maternity and Children Hospital and Ohud Hospital, Al-Madina, Al-Qatif General Hospital in the Eastern Region and Prince Abdulrahman Bin Ahmed Alsudairy Central Hospital, Sakaka. The study population was 171,818 children under the age of 5 years. During the study period 208 cases of bacterial meningitis were identified, 141 [67.8%] with a definite causative organism: Hemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae and other bacterial species. The remaining 67 cases [32%] were labeled as aseptic meningitis. A considerable proportion of cases was found to have received an antibiotic prior to presentation. While symptoms such as fever or poor feeding were common among cases, meningeal signs were less prominent. A lumbar puncture was carried out on all cases to reach diagnosis by gram stain, latex agglutination test and cerebrospinal fluid [CSF] and blood cultures following standard procedures. The immediate burden of meningitis cases was found to be the lengthy stay of patients in the hospital wards and intensive care units. Some of the main causative agents were resistant to the conventional antimicrobial therapy, but susceptible to newer antibiotics. The study being based on a population based surveillance gave a better overview on causative organisms of meningitis emphasizing that Gram stain, serology of CSF and culture [of CSF and blood] should be used. A high index of suspicion is needed to diagnose meningitis in children. Lumbar tap should be encouraged and supported in terms of training and more authorization to apply in diagnostic tests of such conditions. Audiometric measurement is a crucial need in the assessment of meningitis cases and in the process of their follow up. This type of service is clearly missing in our system. Influential steps are to be planned to avail this service

Disease burden and case management of bacterial meningitis among children under 5 years of age in Saudi Arabia

This study was designed to explore the case management and disease burden of bacterial meningitis among children below the age of 5 years in the Kingdom of Saudi Arabia. A prospective descriptive study was conducted during June 1999 through to May 2001 in 8 hospitals from 5 cities in different areas of the country. Those were, King Fahad Specialist Hospital and Maternity and Children Hospital, Buraidah, Belgorashi General Hospital and King Fahad Specialist Hospital, Al-Baha, Maternity and Children Hospital and Ohud Hospital, Al-Madina, Al-Qatif General Hospital in the Eastern Region and Prince Abdulrahman Bin Ahmed Alsudairy Central Hospital, Sakaka. The study population was 171,818 children under the age of 5 years. During the study period 208 cases of bacterial meningitis were identified, 141 [67.8%] with a definite causative organism: Hemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae and other bacterial species. The remaining 67 cases [32%] were labeled as aseptic meningitis. A considerable proportion of cases was found to have received an antibiotic prior to presentation. While symptoms such as fever or poor feeding were common among cases, meningeal signs were less prominent. A lumbar puncture was carried out on all cases to reach diagnosis by gram stain, latex agglutination test and cerebrospinal fluid [CSF] and blood cultures following standard procedures. The immediate burden of meningitis cases was found to be the lengthy stay of patients in the hospital wards and intensive care units. Some of the main causative agents were resistant to the conventional antimicrobial therapy, but susceptible to newer antibiotics. The study being based on a population based surveillance gave a better overview on causative organisms of meningitis emphasizing that Gram stain, serology of CSF and culture [of CSF and blood] should be used. A high index of suspicion is needed to diagnose meningitis in children. Lumbar tap should be encouraged and supported in terms of training and more authorization to apply in diagnostic tests of such conditions. Audiometric measurement is a crucial need in the assessment of meningitis cases and in the process of their follow up. This type of service is clearly missing in our system. Influential steps are to be planned to avail this service