Rift Valley fever among children and adolescents in Southwestern Saudi Arabia

Rift Valley fever [RVF] virus has expanded its geographical range, reaching Asia in 2000. This work investigated RVF seroprevalence among children born after the 2000-2001 outbreak in Saudi Arabia and compared it with the seroprevalence of adolescents born before the outbreak. In a seroepidemiological study in Southwestern Saudi Arabia [Jazan, Aseer, and Al-Qunfuda], a random sample of 389 children and adolescents was investigated. Data were collected regarding the subjects' sociodemographic status, housing conditions, and animal contact. Blood samples were collected and tested for RVF-specific IgG and IgM. None of the study samples were found to be seropositive for anti-RVF virus IgM. None of the study subjects aged 1-8 years [born after the outbreak] were positive for RVF-specific IgG. In contrast, 14 subjects [4.8%] aged 9-19 years [born before the outbreak] were positive for RVF-specific IgG. Among adolescents in our study, 4.9% were positive for anti-RVF IgG. This study showed that among adolescents, a history of contact with aborted animals [aOR = 13.361, 95% CI = 5.091-35.072] and transporting aborted animals [aOR = 18.861, 95% CI = 11.125-31.622] were significant risk factors. Despite the low virus activity recently reported among animals, neither clinically apparent RVF infections nor outbreaks among humans have been documented, indicating that the control measures taken by the Ministry of Agriculture and Ministry of Health are effective

Causes of hospitalization of pilgrims during the Hajj period of the islamic year 1423 [2003]

Approximately 2 to 3 million pilgrims perform Hajj every year. Planning for health care requires knowledge of the pattern of diseases, complications, and outcome of pilgrims who require hospitalization during the Hajj period. In a cross-sectional study we compiled data on all patients admitted to 1487 beds in four hospitals in Mena [793 beds] and three hospitals in Arafat [694 beds] from the seventh to the thirteenth day of the Hajj season of the Islamic year 1423, corresponding to 8 to 14 February 2003. Of 808 patients hospitalized, most [79%] were older than 40 years. There was no sex preponderance. A total of 575 [71.2%] patients were admitted to medical wards, 105 [13.0%] to surgical wards, and 76 [9.4%] to intensive care units. Most patients [84.8%] had one acute medical problem. Pneumonia [19.7%], ischemic heart disease [12.3%], and trauma [9.4%] were the most common admitting diagnoses. More than one third [39%] had co-morbid conditions. A total of 644 [79.7%] patients were discharged from the hospital in stable condition to continue therapy in their residential camps, 140 [17.3%] were transferred to other hospitals in Makkah for specialized services or further care, 19 [2.3%] were discharged against medical advice, and 5 [0.7%] patients died. This study provided information on the most common causes of hospitalization, pattern of diseases, and required medical services for pilgrims in Hajj. It is hoped that this data will be of help to health sector planners and officials to provide optimal and cost-effective health care services to pilgrims in Hajj

Significance of renal staging in lupus nephritis in relation to clinical manifestations, kidney function and serum autoantibodies profile

To assess the significance of renal staging in lupus nephritis in relation to clinical manifestation, kidney function and serum auto antibodies profile in patients with systemic lupus erythematosus [SLE] Thirty-eight patients with SLE nephritis subjected to renal biopsy were included in this study. The biopsies were classified according to WHO classification for renal staging. The activities of the disease were recorded using BILAG scoring for activity. Immunological profile include anti-dsDNA,ANA,C3,C4,Immunoglobulin G,M,A, were assessed and the kidney function includes serum creatinine,urea, 24 hours urinary protein as well as total serum protein and serum albumin were measured. There was significance increase in creatinine, 24-hour urinary protein excretion and anti-ds DNA in lupus nephritis patients than those with extra-renal lupus [controls]. In comparative study between different histological classes we found a significant elevation of serum creatinine in stage V glomerulonephritis [GN]. Significant increased urinary protein per 24 hours excretion in stage III and IV GN. Significant increase anti-dsDNA in stage IV GN Significant increase the incidence of renal insufficiency with stage V GN [p<0.05]. Significant positive correlation between the histological stages of lupus nephritis and renal insufficiency and serum creatinine level with insignificant positive correlation with activity score, anti-dsDNA, C3,C4, immunoglobulin level IgG,M,and A. Renal biopsy and histological staging has no significant relation to other parameters of clinical activity of systemic lupus erythematousus. Close monitoring of urine for protinurea, serum creatinine levels and anti-ds DNA especially in histological stages IV and V GN of renal biopsy may play a role in prediction of renal insufficiency in lupus nephritis