ABSTRACT
Human brucellosis is an important zoonotic disease and is especially concerning in the Kingdom of Saudi Arabia [KSA], where livestock importation is significant. We analyzed reported human brucellosis disease trends in KSA over time to help policymakers understand the magnitude of the disease and guide the design of prevention and control measures. By using data from the national registry from 2004 to 2012, we calculated the cumulative numbers by age group and months. Trends of incidence rates [IRs] by gender, nationality, and region were also calculated. We found that there was a greater number of cases [19,130] in the 15-44 years age group than in any other age group. The IRs significantly decreased from 22.9 in 2004 [95% confidence interval [CI] = 22.3, 23.5] to 12.5 in 2012 [95% CI = 12.1, 13]. Males had a significantly greater IR than females. Most cases were reported during spring and summer seasons. The IR of Saudi citizens was significantly greater than that of non-Saudis, but this difference reduced over time. The IRs of Al-Qassim, Aseer, and Hail were in the highest 25th percentile. Young, male Saudi citizens living in highly endemic areas were at greatest risk of acquiring brucellosis. We recommend vaccinating susceptible animals against brucellosis and increasing the public's awareness of preventive measures
ABSTRACT
This was an evaluation of home respiratory therapy [HRT] services administered through the Madinah Home Medical Program [MHMP] Center of the Ministry of Health [MoH], Kingdom of Saudi Arabia [KSA]. Using a retrospective design and descriptive analyses, we analyzed 83 patient records for the clinical care received, outcomes, and patient satisfaction. We also assessed a subset from an economic perspective. Demographically, 72% were >60 years of age, 80% were female, and 90% were Saudi. Asthma accounted for 34% of the diagnosed respiratory diseases, followed by chronic obstructive pulmonary disease [11%]. Most patients [71%] required two or three respiratory modalities: 94% used oxygen therapy and 14% were on mechanical ventilation. A full 90% of HMP patients expressed a high level of satisfaction with the HMP overall care, and 43% saw an improvement in their condition. The MHMP lowered healthcare costs for HRT-receiving patients by decreasing the frequency of emergency room [ER] and outpatient visits by 50.8% from 59 to 30 visits. HRT administered through the MHMP Center improved clinical outcomes and increased patient satisfaction while reducing hospital utilization and associated costs. A prospective study is recommended to assess HMP services in comparison with hospitalization
ABSTRACT
The objective of the study is to evaluate the quality of the data, the sensitivity of the surveillance, and the completeness of identification and investigation of tuberculosis [TB] patient's contacts. The study covered the TB surveillance program in Al-Madinah province in 2011. First, we reviewed all the notifications, treatment cards, and register books, as well as monthly and quarterly reports, for completeness and accuracy of data. Then, we searched for the missed cases that were not reported. Finally, we reviewed all the patients' household contacts' reports to assess the degree of completion of identification and investigation. There were 444 cases detected during the study period; only 200 cases were reported. The sensitivity of the TB surveillance system was 45%. Among the 200 reported cases, the results revealed high completeness rates for demographic and disease data and low completeness rates for the test result fields. The contact identification and investigation showed that 34.4% of smear-positive cases' contacts were not identified. Only 67% of identified contacts were investigated. The review of hospital records and lab registers showed that 244 cases were not reported. In conclusion, the TB surveillance system has several areas that need improvement