Prevalence of chronic venous insufficiency in the Saudi adult population.

OBJECTIVE: To estimate the prevalence of chronic venous insufficiency (CVI) in the Saudi adult population and to identify the association of CVI with possible risk factors. METHODS: Sixteen Primary Health Care (PHC) centers have been randomly selected in various districts of 3 major cities of Kingdom of Saudi Arabia, including Jeddah, Makkah and Dammam during the year 2001. Every Saudi patient, of both sexes and aged >18 years, visiting the selected PHC centres for any reason, was eligible. The study was conducted during 6 consecutive days. Patients' history, demographics and risk factors were recorded and clinical examination was performed in order to diagnose CVI according to the latest clinical severity, etiology or cause, anatomy, pathophysiology (CEAP) classification. RESULTS: A total of 2566 participants were recruited. Out of these, 2350 were included. Fifty-three percent of the included patients were females and 66% were from the Western region. The overall prevalence of CVI (from class 0 to 4) was 45.6% (95% confidence interval [CI] 43.6 - 47.6). Considering CVI with visible signs only (class 1 to 6), the prevalence was 38.3% (95% CI 36.6 - 40.2). It was found higher in female (49.6%) and in the Western region (43.0%). Chronic venous insufficiency was significantly associated with age, family history of CVI, prolonged standing occupation and the use of hormonal therapy. CONCLUSION: These data demonstrated a high prevalence of CVI in the Saudi population, which is higher than in Western countries, especially in the Western region. This is probably linked to the high frequency of risk factors in the Saudi population and to the current lifestyle.

Outbreak of W135 meningococcal disease in 2000: not emergence of a new W135 strain but clonal expansion within the electophoretic type-37 complex.

In 2000, >400 cases of disease caused by Neisseria meningitidis serogroup W135 (MenW135), the largest MenW135 outbreak reported to date, occurred worldwide among Hajj pilgrims and their contacts. To elucidate the origin of the outbreak strains and to investigate their relatedness to major clonal groups, genotypic and phenotypic subtyping was performed on 26 MenW135 outbreak-associated isolates and 50 MenW135 isolates collected worldwide from 1970 through 2000. All outbreak-associated isolates were members of a single clone of the hypervirulent electrophoretic type (ET)-37 complex, designated the "(W)ET-37 clone"; 19 additional MenW135 strains were also members of this clone, and the remaining 31 MenW135 strains were clearly distinct. The 2000 MenW135 outbreak was not caused by emergence of a new MenW135 strain but rather by expansion of the (W)ET-37 clone that has been in circulation at least since 1970; the strains most closely related to those causing the 2000 outbreak have been isolated in Algeria, Mali, and The Gambia in the 1990s.