Monitoring COVID-19 Vaccine Acceptance in Kuwait During the Pandemic: Results from a National Serial Study.

BACKGROUND: With COVD-19 cases on the rise globally and two approved vaccines, determining vaccine acceptance is imperative to avoid low inoculation rates. The aim of this study was to evaluate the changes and determinants of vaccine acceptance among citizens and non-citizens, over time during the pandemic in Kuwait. METHODS: Data were obtained from the COVID-19 Snapshot Monitoring (COSMO Kuwait) study that was implemented according to the WHO tool for behavioral insights on COVID-19. Data was collected online, every two weeks throughout the pandemic. Individuals living in Kuwait during the pandemic were surveyed, representing an independent sample of the population during each data collection wave. RESULTS: A total of 7241 adults living in Kuwait participated. Sixty-seven percent of those participating agreed to take a vaccine if it was available and recommended. However, the proportion of vaccine acceptance drastically dropped overtime as COVID-19 related restrictions were eased, among citizens (73 to 47%) and noncitizens (80 to 60%). Some factors associated with increased odds of agreeing to take the COVID-19 vaccine, among citizens and non-citizens, included increased frequency of informing oneself about the virus (OR, 1.34-1.83; 95% confidence interval 1.16-2.55), having high versus low confidence in doctors (OR, 1.79-2.11; CI 1.17-3.80), increased agreement with containment policies (OR, 1.11-1.27; CI 1.05-1.41), expressing more fears and worries (OR, 1.05-1.12; 1.01-1.24), and the increased perceived likelihood of getting infected with influenza (OR, 1.3-1.4; CI 1.03-1.84). Decreased odds of agreement were associated with increased age (OR, 0.37-0.61; CI 0.26-0.95), being female (OR, 0.56-0.62; CI 0.43-0.73), and not taking the influenza vaccine in 2019 (OR, 0.61; CI 0.43-0.87). CONCLUSION: Vaccine acceptance was multifactorial, heterogenous among citizens and non-citizens, and changed over time. While acceptance was relatively high, it decreased throughout the pandemic and as restrictions in the country loosened. This increase in vaccine hesitancy reveals a challenge in achieving high inoculation levels, and the need for effective vaccine-promotion campaigns and increased health education in the country.

Trends in Thyroid Cancer Incidence in the Gulf Cooperation Council States: a 15-Year Analysis.

INTRODUCTION: Thyroid cancer is a predominant malignancy in the Gulf Cooperation Council (GCC) states. Explicit regional assessments of incidence are crucial among countries that share similar demographic, cultural, and economic characteristics. This study provides an assessment of trends in thyroid cancer in the GCC over fifteen years. METHODS: Data included cases in the GCC, reported to the Gulf Center for Cancer Registration during 1998-2012 (N=10,417). Age-specific rates, age-standardized rates (ASR), and stage at diagnosis are compared between the GCC states during 1998-2002, 2003-2007, and 2008-2012. Standardization of rates was performed using the World Standard Population. RESULTS: Between 1998-2002 and 2008-2012, the frequency of thyroid cancer in the GCC was approximately fourfold higher in females than males. The average ASR increased from 1.8 to 2.4/100,000 for males and 5.7 to 8.4/100,000 for females. Age-specific incidence showed a shift towards a younger age for women and an older age for males. During 1998-2012, the proportion of localized stage at diagnosis ranged from 18% in Oman to 57% in the UAE. The proportion of unknown stage varied considerably among states, ranging from 13% to 64%. Over the study period, the proportion of unknown stage increased in all but two states (Bahrain and Saudi Arabia). CONCLUSION: The incidence of thyroid cancer in the GCC has generally increased. This could reflect improved testing, leading to enhanced detection and diagnosis of thyroid cancers, as well as a possible increase in exposure to risk factors. Improved ascertainment of stage data is essential to reflect changes in early diagnosis activities.

A Novel Approach to Obtain Follow-up Data on the Vital Status of Registered Cancer Patients: The Kuwait Cancer Registry Experience.

OBJECTIVE: We present an approach to obtain accurate and complete data on the last known vital status, and the date of last known vital status of all Kuwaiti cancer patients. These data are essential for robust estimation of population-based cancer survival. METHODS: Government-issued Civil ID numbers (IDs) of patients registered during 2000-2013 were obtained from the Kuwait Cancer Registry. Missing IDs were traced using the Ministry of Health's Information System or the patient's medical records. IDs were manually entered in the Public Authority of Civil Information (PACI) database to ascertain vital status for patients whose vital status was not known in the registry. To obtain the date of death for deceased patients, IDs were then manually entered and searched in the electronic archive of "Death Announcements" at the Ministry of Health's Central Records Department of Births and Deaths. Patients not found in the "Death Announcements" archive were considered alive as on 31 December 2015. RESULTS: The traditional method to obtain data on cancer patients' vital status, restricted to patients whose death was certified as due to cancer, had captured only 62% of all patients' deaths. This new approach resolved the vital status for 98.3% of patients for whom it was previously unknown. The impact was substantial: the proportion of patients known to be dead rose from 27.9% to 45.0%, while the proportion presumed alive dropped from 72.1% to 53.7%. Only 1.3% of the patients remained lost to follow-up. CONCLUSION: This approach substantially improved the quality and completeness of follow-up data for all Kuwaiti cancer patients. We recommend that this approach should be performed routinely in Kuwait to enable accurate estimation and monitoring of population-based survival trends.

Cancer survival trends in Kuwait, 2000-2013: A population-based study.

OBJECTIVE: To examine population-based cancer survival trends in Kuwait; to facilitate public assessment of cancer control. METHODS: Data were obtained from the Kuwait Cancer Registry for Kuwaiti adults (15-99 years) and children (0-14 years) diagnosed with one of 18 common cancers during 2000-2013 and followed up to 31 December 2014. Net survival was estimated at 1, 3, and 5 years by sex. To control for background mortality, life tables of all-cause mortality in the general population were constructed by single year of age, sex, and calendar year of death ("complete" life tables). Net survival estimates were age-standardised using the International Cancer Survival Standard weights. RESULTS: Cancers with the highest net survival throughout the 14-year period were prostate, breast (women) and rectum in adults, and lymphoma in children. Survival was lowest for liver, pancreas and lung cancer in adults, and brain tumours in children. During 2010-2013, one year survival was over 80% for cancers of the prostate, breast, rectum, cervix and colon. Five-year survival was above 80% only for prostate cancer. For children, one and five-year survival was above 80% only for acute lymphoblastic leukaemia (ALL) and lymphoma. Survival was generally higher for women than men, and declined faster in women than men between 1 and 3 years after diagnosis. Differences between boys and girls were small. CONCLUSION: Cancer survival improved for most Kuwaiti adults and children over the 14-year period, with women generally having a more favourable prognosis than men. Continuous surveillance is required to monitor cancers for which survival did not improve, and to dissect the underlying causes for the differences in survival between Kuwait and other countries.