Assessment of hepatitis B immunization programme among school students in Qatar

Background: In 2010, Qatar adopted the target of reducing hepatitis B prevalence to < 1% in children by 2015. The World Health Organization Region for the Eastern Mediterranean is identified with intermediate hepatitis B virus [HBV] endemicity, ranging from 2% to 7%. It is estimated that 4.3 million individuals are living with HBV infection in the Region.

Aims: This study was conducted to assess hepatitis B seroprevalence in children, hepatitis B vaccination coverage, potential exposure to risk factors, and knowledge among parents/guardians about hepatitis B infection.

Methods: We carried out this cross-sectional study in Qatar during the academic year 2015/16. Multistage cluster sampling was used to select a nationally representative sample of 2735 grade 1 school students aged . 5 years. Blood was collected by finger prick and tested using the point-of-care test/rapid test. A self-administered, precoded questionnaire was used to assess parent/guardian knowledge about HBV and collect information on the childfs HBV vaccination coverage.

Results: All blood samples were HBsAg negative. Qataris had a vaccination card and were totally vaccinated but 17.7% of non-Qataris did not hold a vaccination card and most parents/guardians were not aware of the vaccination status of their children. Children were exposed to various hepatitis B risk practices. Knowledge about hepatitis B among parents/ guardians was low.

Conclusions: Qatar has averted the hepatitis B threat and maintained high vaccination coverage for children

Virological profiles of HBV and HCV in hepatocellular carcinoma in Egypt and Yemen

Background: Hepatocellular carcinoma [HCC] is one of the very frequent malignancies that has poor prognosis. Chronic hepatitis B is the most important risk factor in the world particularly in developping countries. In developed world, HCC occurs in the background of chronic infection with HCV or alcohol abuse. Several factors affects the development of HCC in chronic hepatitis patients including viral genotype

Objectives:The aim of this study was to determine HCV and HBV viral profile in Egyptian and Yemeni HCC patients. Additionally, HCV and HBV were genotyped to investigate any possible correlation with HCC development

Methodology:Thirty HCC Egyptian patients admitted to the Hepatology Unit, Medical Research Institute, Alexandria University and thirty HCC Yemeni patients attending the oncology center in Al-Gomhory hospital in Sanaahave been enrolled in this study.Hepatitis B surface Ag [HBs-Ag] was not detected in Egyptian HCC patients but in 36.7% of Yemeni HCC patients. On the other hand, anti-HCV antibodies were detected in 93.3% of the Egyptian HCC patients and in 16.7% only in Yemeni patients.HBV genotyping by direct sequencing of pol gene showed 11 cases of genotype D and 1 case of genotype E among HCC Yemeni patients. HCV genotyping by sequencing of NS5b and 5'UTR showed 21 cases of genotype 4 and 2 cases of genotype 1 and genotype 2 among Egyptian HCC patients

Conclusion:From the current study HCC appears to be significantly associated with HBV and HCV chronic infections in Yemen and Egypt respectively. In Egypt, occult HBV co-infection might escalate the danger of HCC development among HCV patients

Causes of death in the Eastern Mediterranean Region during the years 1998-2000

This paper aims to consider the available mortality data as an insight to epitomize the mortality pattern and the main leading causes of death specific to the Easter Mediterranean Region [EMR] in order to set priorities for future research in the region. Data was taken from the last 3 World Health Organization [WHO] mortality statistics. Crude mortality rates were compared between the 6 WHO regions for the years 1998, 1999 and 2000. Proportional mortality and standardized proportional mortality ratios were calculated for the causes of death and types of malignant neoplasm deaths and compared between the EMR and the other regions of the world. Spearman coefficient rank-order correlation was calculated to detect significant correlation between the ranking of the main causes of death in EMR and the 3 basic demographic, socio-economic and health care indicators in the 6 regions of the world. The results of this study showed that approximately 9 per 1,000 of the world's population die annually. Africa and Europe have the highest mortality rates. The main causes of death worldwide are cardiovascular diseases, infectious or parasitic diseases, malignant neoplasm, infectious respiratory diseases and other respiratory diseases. In EMR, approximately 8 per 1,000 die annually. The causes of death in EMR can be classified into 3 categories. 1] Non-prominent in EMR as compared to other regions of the world. 2] Prominent in EMR and significantly correlated to the basic indicators. 3] Prominent in EMR but not related to the basic indicators. These include deaths due to wars, congenital anomalies, perinatal conditions, genitourinary diseases, endocrine disorders, road traffic accidents, cancer bladder, lymphoma leukemia and cancers of the mouth or orpharynx, and ovaries. The results of this study emerged the need for extensive epidemiological studies to investigate thoroughly the main causes of death influencing mortality in EMR, specially that they coincide with the health consequences of depleted uranium. Also, most of these health conditions were previously described among the United States and European veterans who served in the Gulf War

Comparison between body mass index, triceps skin fold thickness and mid - arm muscle circumference in Saudi adolescents

Adolescence is an important period in an individual's life. Overweight and obesity are fraught with several health problems even later in life. The objective of this study was to estimate the overweight, obesity, body fat and muscle content of Saudi adolescents as compared to a recognized reference population. Subjects and Data were collected from a sample of Saudi adolescents in Jeddah from 42 boys' and 42 girls' schools during the month of April 2000. Data collection was done by personal interviews to collect sociodemographic factors and by direct measurement of weight, height, triceps skin fold thickness [TSF] and mid-arm circumference [MAC]. The 50th, 85th, and 95th percentiles [P50, P85 and P95] for body mass index [BMI] and triceps skin fold thickness [TSF] were taken, then the 50th, 90th, and 95th percentiles [P50, P90 and P95] for the mid-arm muscle circumference [MAMC] were calculated. These measurements were compared with corresponding values of the National Health and Nutrition Examination Survey I [NHANES I]. The P85 and P95 for BMI and TSF were higher for Saudi adolescents than the NHANES I and the difference was wider for P95. Conversely, there was a lower MAMC at P90 and P95 than the NHANES I reference population curves. The lower MAMC curves were less marked in girls than in boys. On the other hand, Saudi boys and girls showed on average similar body mass index indicated by BMI at P50, which was misleading, since those adolescents showing similar body mass index had more fatness than the average reference population indicated by TSF at P50, and less muscularity on average than reference population indicated by MAMC at P50. Overweight and obesity with increased body fat content and decreased body muscle content appear to be widespread among Saudi adolescents even among those adolescents showing average body mass index. Public health interventions are required to improve quality of food, encourage physical activity and exercise, as well as correct the perception of appropriate body stature

Perception of body weight among Saudi school children

The objectives of this study were to explore the perception of body weight among students in schools in Jeddah City and identify the main determinants of self-perceived obesity, weight management goals and practices. Material and Data were collected from a sample of Saudi school children of 42 boys' and 42 girls' schools in Jeddah city during the month of April 2000, Personal interviews were conducted to collect data on socio-demographic factors, food choices, perception of body weight, weight management goals and weight management practices, as well as the actual measurement of weight and height Students were asked about their perception of their body weight[responses included: very underweight [thin], slightly underweight, about right weight, slightly overweight and grossly overweight [obese]]. Proportion, prevalence and 95% confidence intervals were calculated. Multiple logistic regression models were fitted to calculate the adjusted odds ratio [OR] for an attempt to lose weight and weight management practices. The distribution of self-perception of body size was nearly similar to the measured body moss index [BMI] classification except for the overweight students, where 21.3% perceived themselves, as slightly overweight and 5.5% as very overweight although 13.4% were actually overweight and 13.5% were obese by BMI standards. Approximately half the students look at least 3 pieces of fruit or fruit juice servings, and a third ate at least 4 vegetable servings per day. A third of the students managed to lose weight. This coincides with the proportion of those actually overweight and obese. Around 28.0% of the students ate less food, fat or calories, 31.0% took exercise and 17.6% were engaged in vigorous exercise to lose weight or prevent weight gain. Staving for at least 24 hours without food which is a potentially harmful means of weight control was practiced by 10.0% of students. Females were less likely than males to be overweight and obese but more likely to perceive themselves as grossly overweight and more likely to try to lose weight. Factors associated with efforts to lose weigh: by eating less fat or fewer calories were older age, high social class, being actually obese and perceiving oneself as being obese. Staying for at least 24 hours without eating was mainly practiced by females, older age groups, and the actually obese. Exercise was done mainly by the older age groups, those with educated and highly educated mothers, obese and perceiving oneself as being obese. Vigorous exercise was mainly performed by males, younger age groups, taking < 3 pieces of fruit or fruit juice servings per day, eating < 4 vegetable servings per day, and those perceiving themselves as obese. Overweight and obesity are prevalent among our youth and not all obese have a correct image of their body size. Highly recommended are intervention programs of education on nutrition starting in childhood through school age to promote and ensure healthy food choices improve student's awareness of ideal body size and clinical obesity, encourage physical exercise but discourage potentially harmful weight control measures

Effect of maternal education on the rate of childhood handicap

The objectives of this study were to determine the relation between maternal education and various maternal risk factors, identify the impact of maternal education on the risk of childhood handicap and estimate the proportion of childhood handicap that can be prevented by maternal education. Data was collected from all married women attending the two major maternity and child hospitals in Jeddah during April 1999. Women with at least one living child were interviewed for sociodemographic factors and having at least one handicapped child. The risk of having a handicapped child and the population attributable risk% were calculated. Some potential risk factors are dominant in our society as approximately 30% of women did not attend school and 84% did not work. Consanguineous marriages accounted for about 43%. Pre-marriage counseling was limited as only 10% of women counseled before marriage. The proportion of unemployment and consanguineous marriages decreased significantly by increase in maternal education level. Conversely, the proportion of women reporting pre-marriage counseling increased significantly by increase in maternal education level. Approximately, 7% of women reported having at least one handicapped child. The risk of having a handicapped child showed a significant sharp decline with increase in maternal education level. At least 25% of childhood handicap can be prevented by achieving female primary education and up to half of cases can be prevented if mothers finish their intermediate education. Female education plays a major role in child health. The results of this study suggest investment in female education, which would have substantial positive effects in reducing incidence of childhood handicap in Jeddah

Going beyond the curriculum to promote medical education and practice in Saudi Arabia

The foundation of health starts as early as undergraduate medical education. Medical education in the Kingdom has always been successful in promoting the medical profession and population health. The current issue in the Kingdom is quality assurance in all organizations including the health field. Thus emerges the value of evaluating the efficiency and effectiveness of the current system in meeting health needs and expectations. The aim of this paper was to analyze the current situation in order to design a frame for the direction of promotion of medical education and practice that best meets health needs and expectations. In fact, medical practice is a multidisciplinary process that is showing continuously changing theories. It has a broad scope of serving the whole community and improving the quality of life of all population categories. The huge quantity of information, needed to be retained by medical professionals, necessitates the move away from traditional methods of education to more practical and comprehensive programs of study. Most of the recent reform in medical education, in the Kingdom, has focused on curriculum and disregarded the education process. The requisite for the education process is a complete model of community-based health care, education and research. This study proposes a design aiming to enhance medical education and promote the medical profession, through developing the quality of medical professionals, that will foster growth of their activity and productivity, moving them into the community where clinical practice and experience are more relevant to the true health situation

Hepatitis C infection among drug addicts

To assess the prevalence of Hepatitis C Virus infection among drug abusers, identify the possible associated risk factors and recognize the characteristics of Hepatitis C Virus positive drug addicts in order to conclude possible health strategies for this category of patients. Drug addicts are prone to develop Hepatitis C Virus infection that can spread concealed to the population. Structured questionnaires were copied from the files of patients hospitalized in Jeddah Al-Amal Hospital during March/April 1998. Striking high prevalence of Hepatitis C Virus infection was seen among drug addicts and accounted for 63.9%. Intravenous route users were at triple risk to develop Hepatitis C Virus infection [P<0.05]. Heroin addicts were also at triple risk to develop Hepatitis C Virus infection but results were just at level of significance. Alcohol consumers and jobless drug addicts were at higher risk of Hepatitis C Virus infection but results did not reach statistical significance. Hepatitis C Virus infected drug addicts showed a significantly higher mean ALT and mean number of relapses than Hepatitis C Virus negative addicts. Drug addicts are at tremendous risk of Hepatitis C Virus infection. National health educational programs, directed to the population, are mandatory. Hepatitis C Virus screening should be routinely done to all drug addicts. Assessment of liver functions for all Hepatitis C Virus positive drug abusers are crucial and the liver condition of the patients should be taken in consideration during the detoxification therapy