Changing prevalence of asthma and allergic diseases among Kuwaiti children: an ISAAC study [phaseIII]

To estimate the prevalence of asthma and allergic diseases in 13- and 14-year-old schoolchildren and to compare it with previous phase I data. A survey of 2,922 third and fourth grade students from randomly selected intermediate level schools across Kuwait was conducted. Supervised, self-administered, written and video questionnaires of the International Study of Asthma and Allergies in Childhood [ISAAC] was used. Of the 2,922 students, 2,882 [96.3%] completed the questionnaires. The prevalence [95% CI] in the written questionnaire for wheeze ever, current wheeze [within the last 12 months] and physician diagnosis of asthma were 13.4, 7.6 and 15.6%, respectively. The prevalence [95% CI] for symptoms of allergic rhinitis [AR] ever, current symptoms of AR, and diagnosis of AR was 41.4, 27.6 and 22.2%, respectively. The prevalence [95% CI] for itchy rash ever, current itchy rash, and diagnosis of eczema was 10.6, 8.3 and 12.8%, respectively. Comparing to ISAAC phase I data [1995-1996], the prevalence of current wheeze has decreased from 16.1 to 7.6% [p<0.001]. Current symptoms of AR decreased from 30.7 to 27.6 [p = 0.008] and current itchy rash decreased from 17.5 to 10.6% [p<0.001]. However, physician diagnoses of asthma and eczema remained the same as in the previous study, but physician diagnosis of AR increased from 17.1 to 22.2% [p<0.001]. The findings show that there is a decrease in the self-reported symptoms of allergic diseases over a 5-year period while physician diagnoses of these diseases remained the same over the same period

Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait

The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia [CAP] in Kuwait. The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team [PORT] severity index. The microbial etiology was determined using st and ard methods for bacteria and serological tests for atypical and viral pathogens. The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 +/- 18 years. The severity class distribution was: class 131%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identified from 44 patients [35%], with one pathogen in 31 [25%], two in 9 [7%], and three or more in 4 [3%]. The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients [11%], Legionella pneumophila in 10 [8%], Chlamydia pneumoniae in 8 [6%], influenza B virus in 8 [6%], influenza A virus in 5 [4%], Haemophilus influenzae in 4 [3%], Streptococcus pneumoniae in 3 [2%], Staphylococcusaureus in 3 [2%], gram-negative enterobacteria in 5 [4%], Moraxella catarrhalis in 2 [2%], and viruses in 4 [3%]. The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait, Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides

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

Clinical patterns of diffuse parenchymal lung disease in Kuwait: aprospective study

To report our experience of the clinicopathological patterns of diffuse parenchymal lung disease [DPLD]. Subjects and Over a 4-year period, 75 patients [41 males, 34 females], aged 13-76 years, who were referred to Mubarak Al-Kabeer and the Chest Diseases Hospitals, Kuwait with a diagnosis of diffuse lung disease, were included in the study. After a comprehensive history and physical examination, further investigations were done, including hematological and immunological profiles, sputum and bronchoalveolar lavage fluid examination, chest radiograph, high resolution computed tomography [HRCT], pulmonary function test and lung biopsy. Of the 75 patients 60 [80%] were over 40 years of age. The duration of symptoms in 34 patients [45%] was less than 6 months and longer than 1 year in 28 [37.7%] patients. Twenty-five of the patients were cigarette smokers. The mean forced lung capacity [FVC], total lung capacity and diffusing capacity for carbon monoxide were less than 60% of the predicted values in most patients. There was a significant difference in mean FVC value between smokers and nonsmokers [p < 0.05]. The HRCT findings were at an advanced stage in 65 patients, with additional honeycombing in 21 of the 65 patients. Idiopathic pulmonary fibrosis was the most common cause of DPLD, occurring in 52 patients, followed by sarcoidosis and collagen vascular diseases. DPLD was observed predominantly in middle aged and elderly patients, due probably to increasing industrialization in the country. The role of cigarette smoking as a contributory factor remains unclear