The Child Abuse Potential Inventory: Development of an Arabic version.

The Child Abuse Potential Inventory (CAPI) is a well-validated screening tool for assessing potential for child physical abuse, and has been translated into many different languages. To date the CAPI has not been translated into Arabic or used in any studies in Arabic-speaking populations. This study reports on the process of adapting the CAPI into Arabic Language which was undertaken following the International Society of Pharma-economics and Outcomes Research (ISPOR) guidelines. The translation/adaptation process was multi-stage, and involved the use of a Delphi process, cognitive debriefing, back translation, and a pilot testing of the Arabic CAPI at two primary health care centers with a population of pregnant women (n=60). Following "literal translation" 73 out of the 160 items needed re-phrasing to adapt the items to the Oman context. No differences were found when comparing results of the translated or back-translated versions to source; however, eight items needed further amendment following translated to back-translated comparison and feedback from the pilot. Iterations were resolved following in-depth interviews. Discrepancies were due to differences in culture, parenting practices, and religion. Piloting of the tool indicated mean score value of 155.8 (SD=59.4) and eleven women (18%) scored above the cut off value of 215. This Arabic translation of the CAPI was undertaken using rigorous methodology and sets the scene for further research on the Arabic CAPI within Arabic-speaking populations.

Factors influencing sputum smear conversion at one and two months of tuberculosis treatment.

BACKGROUND: In the era of Direct Observation Treatment (DOT) for tuberculosis, clinicians need to focus on high-risk groups. We present sputum conversion rate at one and two months following DOT and its predictors in Oman. STUDY DESIGN: Hospital-based clinical intervention type of case series. METHODS: Chest physicians in a referral hospital examined sputum-positive cases of tuberculosis between 2001 and 2006. Patients with HIV infection and treated in the past were excluded. History of smoking, diabetes and duration of symptoms were noted. Sputum was tested for bacillus density. Blood was tested for platelet count and blood sugar levels. One and two months following treatment, the sputum was retested to determine sputum conversion. Regression analysis was done to identify the predictor of late conversion. RESULTS: Of the 112 sputum-positive TB cases, 39 (34.8%) and 49 (43.7%) cases were sputum negative one and two months respectively after DOT. Lower platelet count was significantly associated with early sputum conversion. (Diff of mean = 38.3 cells x 9/L (95% CI 36.9 - 39.7). On univariate analysis, duration of symptoms, history of diabetes, smoking and ESR were not associated with the early sputum conversion. Knowledge of platelet count seems to assist the clinician to predict the early sputum conversion following DOT for pulmonary TB. CONCLUSIONS: Sputum conversion rate among tuberculosis patients treated with DOT for one and two months in Oman was 34.8% and 78.6% respectively. Platelet count could assist in predicting early sputum conversion.

Human immunodeficiency virus type 1 infection in Oman: antiretroviral therapy and frequencies of drug resistance mutations.

Highly active antiretroviral therapy (HAART), consisting mainly of two nucleoside reverse transcriptase inhibitors (NRTIs) and one protease inhibitor (PI), is offered to < 10% of HIV-infected subjects in Oman. The aims of the present study were to determine the frequency of resistance-associated mutations in these patients, and to assess the contribution of drug resistance to treatment outcome. Among 29 patients on HAART for > or =6 months, virological, failure was observed in 27 (93%). Genotypic analysis indicated that in five of these 27 patients, there were no mutations that confer resistance to reverse transcriptase inhibitors (RTIs). The genotypes of 17 other patients carried one or two RTI mutations, mainly the lamivudine-associated resistance mutation M184V. Three or more RTI mutations were found in only five (14.7%) patients with virological failure, including three patients on the nonnucleoside RTI efavirenz. Major PI mutations were infrequent, and were detected in seven (26%) of 27 patients failing HAART, mainly as single mutation at codons 82 or 90. In contrast, accessory mutations in the protease gene were present in all patients. However, there were significant differences in the prevalence of accessory mutations at codons 36 and 77 among clade B and non-B viruses. When genotypic data of this study were used to change therapy of seven patients whose isolates had multiple resistance mutations, adequate viral suppression was observed in five. Our results indicate that the high rate of treatment failure among patients in Oman is mainly due to factors other than resistance to antiretroviral drugs. These factors, which may include nonadherence to therapy and treatment interruptions, need to be investigated.