A Retrospective Study of Non-Communicable Diseases amongst Blue-Collar Migrant Workers in Qatar.

Background: South Asian workers have a greater predisposition to non-communicable diseases (NCDs) that is exacerbated by migration and length of residence in host countries. Aims: To examine the association between length of residence in Qatar with diagnosis of NCDs in male blue-collar workers. Methods: A retrospective investigation of the electronic health records (EHRs) of 119,581 clinical visits by 58,342 patients was conducted. Data included age, nationality and confirmed ICD-10 diagnosis. Based on duration of residence, the population was divided into groups: ≤6 months, 6-12 months, 1-≤2 years, 2-≤5 years, 5-≤6 years, >6 years. It was assumed that the group that had been resident in Qatar for ≤6 months represented diseases that had been acquired in their countries of origin. Results: South Asian (90%) patients presented with NCDs at a younger (mean ± SD age of 34.8 ± 9.0 years) age. Diabetes and hypertension were higher in those who had just arrived (<6 months' group), compared to the other durations of residence groups. Conversely, acute respiratory infections, as well as dermatitis and eczema, all increased, perhaps a consequence of shared living/working facilities. Only patients with diabetes and hypertension visited the clinic multiple times, and the cost of medication for these NCDs was affordable, relative to earnings. Discussion/Conclusions: Blue-collar workers were predominantly South Asian, from lower socioeconomic classes, with early onset chronic NCDs. Notably, residence in Qatar gave them better access to affordable, significantly subsidized healthcare, leading to effective management of these chronic conditions.

Arab female and male perceptions of factors facilitating and inhibiting their physical activity: Findings from a qualitative study in the Middle East.

OBJECTIVES: Physical inactivity is a leading global risk to health by contributing to obesity and other chronic diseases. Many chronic non-communicable diseases, such as cancer, diabetes, and cardiovascular diseases (CVDs), can be prevented and controlled by modifying lifestyle behaviors such as physical activity [PA]. However, prevalence of insufficient physical activity and obesity is high in the Middle East Region. In Qatar, the incidence rates of CVDs, diabetes, colon, and breast cancer have been rising rapidly. The purpose of this study was to explore facilitators and barriers influencing PA of adult Arab men and women living in Qatar and to understand what they think would be helpful to increase PA. The goal of the research is to identify culturally appropriate and effective interventions that improve the health of Arab population. DESIGN: Using the socioecological model as the theoretical framework, we conducted an exploratory qualitative study with 128 Arab adult men and women living in Qatar. We utilized focus group interviews to collect the data and performed thematic analysis to generate themes. RESULTS: At the individual level, perceived benefits of PA, presence of diseases, person's will, motivation and goals, and time to exercise influenced the individual's PA. At the sociocultural level, religious teachings of Islam, cultural, attitude, beliefs, and practices, and informal support influenced the participants' PA. At the organizational and political level, physical environment to exercise, accessibility of facilities, organizational support, and health information about PA influenced their PA. CONCLUSION: Arab men and women are aware of the importance and benefits of PA. They have the motivation to be physically active, but in the absence of supportive environment, their knowledge might not translate into action. Creating supportive environments at multiple levels that are conducive to PA is warranted.

Perceptions of Arab men regarding female breast cancer screening examinations-Findings from a Middle East study.

OBJECTIVES: In the Middle East, Qatar in particular, the incidence of breast cancer has substantially increased in recent years, and is expected to double by 2030. This diagnosis also occurs at a later stage in the disease. Early detection along with proper treatment reduces radical mastectomy and mortality rates, yet only one-third of Arab women in Qatar participate in breast cancer screening (BCS) activities of any sort. Many women in the conservative Qatari society rely on male family members for support and protection. This study investigates the attitudes and perceptions of Arab men in regards to breast cancer screening and what they see as both incentives and barriers to women's participation in BCS activities. DESIGN: A qualitative methodology using purposive sampling technique was chosen in order to explore participant's attitudes, beliefs and health-related actions. Individual in-depth interviews with open-ended questions were conducted with 50 Arab men during October 2011 to May 2012. Data collection, analysis, and interpretation occurred simultaneously. NVivo 9, a qualitative data analysis software program was used to organize themes and subthemes. RESULTS: It was found that most men understood the importance of regular BCS in early detection of breast cancer. They felt they had an important role in encouraging the women in their lives to participate in BCS activities, but were adamant that any examination must be done by a female health care professional. Few knew details about screening guidelines in Qatar, but most had a basic knowledge of some screening activities. Most indicated an interest in learning more about BC and screening activities in order to better help and inform their female family members. CONCLUSION: Because Arab men perceive that their opinions and support are a major factor influencing female family members' participation in breast cancer screening, it is important that any program instituted to increase such screening participation be aimed at both men and women. More information is needed by both sexes as to the need for and benefits of regular screening activities, the techniques used, and the newly revised guidelines in Qatar. Such a program needs to be introduced in the near future in order to avert, at least partially, the expected doubling in breast cancer cases by 2030 in the Middle East.

Addressing Factors Associated with Arab Women's Socioeconomic Status May Reduce Breast Cancer Mortality: Report from a Well Resourced Middle Eastern Country.

Differences in socioeconomic status (SES) such as income levels may partly explain why breast cancer screening (BCS) disparities exist in countries where health care services are free or heavily subsidized. However, factors that contribute to such differences in SES among women living in well resourced Middle East countries are not fully understood. This quantitative study investigated factors that influence SES and BCS of Arab women. Understanding of such factors can be useful for the development of effective intervention strategies that aim to increase BCS uptake among Arab women. Using data from a cross-sectional survey among 1,063 Arabic-speaking women in Qatar, age 35+, additional data analysis was performed to determine the relationship between socioeconomic indicators such as income and other factors in relation to BCS activities. This study found that income is determined and influenced by education level, occupation, nationality, years of residence in the country, level of social activity, self-perceived health status, and living area. Financial stress, unemployment, and unfavorable social conditions may impede women's participation in BCS activities in well resourced Middle East countries.

Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?

OBJECTIVES: Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. SETTING: A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ(2) tests and multivariate logistic regression analyses. RESULTS: Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. CONCLUSIONS: Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. RECOMMENDATIONS: Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women.

Beliefs and attitudes about breast cancer and screening practices among Arab women living in Qatar: a cross-sectional study.

BACKGROUND: Despite rising breast cancer incidence and mortality rates, breast cancer screening (BCS) rates among women in Qatar remain low. Previous studies indicate the need to better understand the many complex beliefs, values, and attitudes that influence Arab women's health seeking behavior for the development of culturally appropriate and effective intervention strategies to address breast cancer in the Middle East. This study investigates beliefs, attitudes, and BCS practices of Arabic-speaking women in Qatar. METHODS: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) Arabic-speaking female Qatari citizens and non-Qatari residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Associations between beliefs and BCS practice were estimated using chi-square tests and multivariate logistic regression analyses. Participants who adhered to BCS guidelines (BCS practice = Yes) were compared to those who did not (BCS practice = No). RESULTS: In addition to low levels of awareness and low participation rates in BCS, one quarter of the participants stated their doctors talked to them about breast cancer, and less than half of the women interviewed believed breast cancer can be prevented. Women who engaged in BCS practice were more likely to have a doctor who talked to them about breast cancer, to believe they were in good-excellent health, that cancer can be prevented, or that cancer might be hereditary. The majority wanted to know if they had cancer and felt their health care needs were being met. The main reasons given for not planning BCS were lack of a doctor's recommendation, fear, and embarrassment. CONCLUSIONS: These findings indicate that a variety of channels (health care providers, media, breast cancer survivors, community leaders) should be utilized to create culturally appropriate breast cancer intervention programs and increased awareness of breast cancer, BCS, and the benefits of early detection of breast cancer. Employment of these measures will reduce breast cancer mortality rates among Arabic-speaking women living in the State of Qatar.

Extraskeletal neuroectodermal tumour of the vagina: a single case report and review.

UNLABELLED: A case report and review of an extraskeletal neuroectodermal tumour of the vagina. BACKGROUND: Ewing's sarcoma (ES) and primitive neuroectodermal tumours (PNETs) account for approximately 6-10% of primary malignant bone tumours and, following osteosarcoma, are the second most common group of bone sarcomas in children. Ewing's sarcoma rarely affects the genitourinary tract. We report a rare case of extraskeletal Ewing's sarcoma diagnosed in a 47-year-old Indian woman presenting with a simple cystic lesion in the posterior wall of the vagina. The histopathology revealed a rare presentation of a primitive malignant extraskeletal neuroectodermal tumour. CONCLUSION: As our PubMed review found only six previously reported cases of vaginal extraskeletal Ewing's sarcoma. Presentation as vaginal masses helped in early disease detection.