Serosurvey of hepatitis B surface antigen in pregnant Saudi women.

In 1990, Saudi Arabia began vaccinating all children at school entry against hepatitis B. We evaluated hepatitis B surface antigen (HBsAg) prevalence rate among pregnant Saudi women 12 years later in 5 regions of the country. Using multistage sampling, 2664 pregnant Saudi women were recruited. Blood samples were tested for HBsAg; positive samples were also tested for hepatitis Be antigen (HBeAg). In all 2.44% were positive for HBsAg and 4 (0.15%) were also positive for HBeAg. HBsAg prevalence was highest in Gizan (4.2%) and lowest in Tabuk (1.4%). Positivity for women < or = 20 years of age was 0.5% compared with 2.6% for older women (P = 0.049). The overall HBsAg prevalence rate was lower than previously reported.

Serosurvey of hepatitis B surface antigen in pregnant Saudi women

In 1990, Saudi Arabia began vaccinating all children at school entry against hepatitis B. We evaluated hepatitis B surface antigen [HBsAg] prevalence rate among pregnant Saudi women 12 years later in 5 regions of the country. Using multistage sampling, 2664 pregnant Saudi women were recruited. Blood samples were tested for HBsAg; positive samples were also tested for hepatitis Be antigen [HBeAg]. In all 2.44% were positive for HBsAg and 4 [0.15%] were also positive for HBeAg. HBsAg prevalence was highest in Gizan [4.2%] and lowest in Tabuk [1.4%]. Positivity for women < or = 20 years of age was 0.5% compared with 2.6% for older women [P = 0.049]. The overall HBsAg prevalence rate was lower than previously reported

Effect of gender on reporting of MMR adverse events in Saudi Arabia.

We evaluated the safety of a measles-mumps-rubella (MMR) immunization campaign for Saudi children (age range: 6-13 years) and gender differences in reporting post-MMR adverse events. After vaccinations were administered, we monitored 160 schools for 14 days and 19 hospitals in the 8 cities under study for 10 weeks. Incidence rates were: all MMR adverse events, 26.5/10,000 MMR vaccines (significantly higher in females than males); Urabe strain aseptic meningitis, 1.0/295,000; fever, 40.2/10,000 (females) and 0.9/10,000 (males); and parotitis, 5.4/10,000 (females) and 0.9/10,000 (males). Combined MMR vaccine containing the Urabe mumps strain was safe for children aged 6-13 years. Gender differences regarding reactogenicity were evident and should be considered when designing future studies.

Effect of gender on reporting of MMR adverse events in Saudi Arabia

We evaluated the safety of a measles-mumps-rubella [MMR] immunization campaign for Saudi children [age range: 6-13 years] and gender differences in reporting post-MMR adverse events. After vaccinations were administered, we monitored 160 schools for 14 days and 19 hospitals in the 8 cities under study for 10 weeks. Incidence rates were: all MMR adverse events, 26.5/10,000 MMR vaccines [significantly higher in females than males]; Urabe strain aseptic meningitis, 1.0/295,000; fever, 40.2/10,000 [females] and 0.9/10,000 [males]; and parotitis, 5.4/10,000 [females] and 0.9/10,000 [males]. Combined MMR vaccine containing the Urabe mumps strain was safe for children aged 6-13 years. Gender differences regarding reactogenicity were evident and should be considered when designing future studies

Organization of the Saudi health system.

Using existing data, we reviewed the organizational structure of the Saudi Arabian health system: its demography and history, principal health indicators, organization and management, type and distribution of facilities, financial base, and the impact on it of the Haj. We noted duplication of services, inadequate coordination between some health industry sectors, and the need for a more extensive and rational health centre network with improved information systems and data collection. We also noted scope for a greater role for the private health sector and increased cooperation between it and the public sector to improve health service delivery and population health.

Organization of the Saudi health system

Using existing data, we reviewed the organizational structure of the Saudi Arabian health system: its demography and history, principal health indicators, organization and management, type and distribution of facilities, financial base, and the impact on it of the Haj. We noted duplication of services, inadequate coordination between some health industry sectors, and the need for a more extensive and rational health centre network with improved information systems and data collection. We also noted scope for a greater role for the private health sector and increased cooperation between it and the public sector to improve health service delivery and population health

Measles immunization in Saudi Arabia: the need for change.

This paper describes the measles immunization programme in Saudi Arabia and the change from the single-dose schedule with the Schwartz vaccine to the double-dose schedule with the Edmonston-Zagreb vaccine. The recent measles-mumps-rubella school campaign is also described.

Measles immunization in Saudi Arabia: the need for change

This paper describes the measles immunization programme in Saudi Arabia and the change from the single-dose schedule with the Schwartz vaccine to the double-dose schedule with the Edmonston-Zagreb vaccine. The recent measles-mumps-rubella school campaign is also described

Vaccines: World Health Organization versus Federal Drug Administration recommended formula.

Vaccines produced in accordance with WHO formulas, differ in concentration from those used in United States according to FDA formulas. We aimed to compare the immunogenicity of both formulas. Infants who were 6 weeks old were randomly put into 3 groups to receive 3 doses of vaccines at 6 weeks, 3 months and 5 months of age. The vaccines consisted of Haemophilus influenzae type b vaccine, diphtheria-tetanus-pertussis and oral polio vaccine. Antibody levels for polyribosylribitol phosphate (PRP), tetanus, diphtheria and poliovirus were measured 1 month after the third dose of vaccines. Although diphtheria and tetanus antigens in the FDA formula are half the concentration of the WHO formula, anti-tetanus and anti-diphtheria antibodies were significantly higher. No difference was found between groups regarding oral poliovirus vaccine.

Integrating maternal and child health with primary health care in Saudi Arabia.

Integration is an important tool for successful implementation of components of a comprehensive health programme. We describe strategies adopted to integrate the Saudi maternal and child health (MCH) activities with other primary health care (PHC) components in order to achieve optimal quality care. Achieving such integration was one of the specific objectives of the MCH programme. Besides training MCH workers, other important tools of MCH/PHC integration included: organization, supervision, continuing education, data management and health systems research. The strengths and weaknesses of integration are discussed while the opportunities, limitations and implications are reviewed.

Integrating maternal and child health with primary health care in Saudi Arabia

Integration is an important tool for successful implementation of components of a comprehensive health programme. We describe strategies adopted to integrate the Saudi maternal and child health [MCH] activities with other primary health care [PHC] components in order to achieve optimal quality care. Achieving such integration was one of the specific objectives of the MCH programme. Besides training MCH workers, other important tools of MCH/PHC integration included: organization, supervision, continuing education, data management and health systems research. The strengths and weaknesses of integration are discussed while the opportunities, limitations and implications are reviewed

Vaccines: World Health Organization versus Federal Drug Administration recommended formula

Vaccines produced in accordance with WHO formulas, differ in concentration from those used in United States according to FDA formulas. We aimed to compare the immunogenicity of both formulas. Infants who were 6 weeks old were randomly put into 3 groups to receive 3 doses of vaccines at 6 weeks, 3 months and 5 months of age. The vaccines consisted of Haemophilus influenzae type b vaccine, diphtheria-tetanus-pertussis and oral polio vaccine. Antibody levels for polyribosylribitol phosphate [PRP], tetanus, diphtheria and poliovirus were measured 1 month after the third dose of vaccines. Although diphtheria and tetanus antigens in the FDA formula are half the concentration of the WHO formula, anti-tetanus and anti-diphtheria antibodies were significantly higher. No difference was found between groups regarding oral poliovirus vaccine

Measles immunization: early two-doses policy experience.

Before the implementation of the two-dose measles immunization policy in Saudi Arabia, 50 per cent of measles cases in children below the age of one year were reported for the age group 6-8 months. In 1991 two doses of measles vaccine, at 6 months and 12 months, the second dose incorporated with MMR, were integrated into the expanded programme of immunization (EPI). Since 1993, vaccination coverage for the second dose has been above 90 per cent. While measles incidence remains stable in infants below 6 months of age, the incidence in children 9-11 months of age dropped by 50 per cent. The greatest impact was seen in the 6-8-month age group where the incidence dropped by more than 75 per cent. Moreover this two-dose strategy resulted in a situation in which 80 per cent of the measles cases were in children above the age of 5 years, mostly those who had not had two doses of measles vaccine. Further control measures should include non-selective vaccination of school children against measles. The two-dose measles vaccination policy is visualized as a necessity if the goal of measles elimination is to be achieved. Routine monthly reports validated by surveys using the WHO standard 30 cluster technique was used for the study.

Evaluation of National Immunization Days in high risk area of Saudi Arabia.

Full text is available as a scanned copy of the original print version.

Immunogenicity study for Tetra and Penta component vaccines in infants.

Full text is available as a scanned copy of the original print version.

The second campaign for poliomyelitis vaccination in the eastern province: different strategy with similar success.

PURPOSE: To determine whether the change from the door-to-door strategy of administering the Oral Polio Vaccine (OPV) to designated vaccination points has led to less than optimal vaccination coverage. METHODS: The Second Bi Annual Poliomyelitis Vaccination ended on 28 Rajab 1417N (9 December 1996G). To minimize the high cost in terms of staff and financial resources, the local authority in the Eastern Province offered the vaccinations at various primary health and commercial centers, schools and private hospitals. The WHO cluster sampling technique was used to conduct a survey in the Al-Khobar and Qatif areas to verify the percentage coverage using the new strategy. RESULTS: A total population of 1399 including 644 adults and 755 children (317 Al-Khobar, 438 Qatif) was surveyed. There were 153 children aged less than 5 years in Al-Khobar and 179 in Qatif Of these, 148 (96.7%) in Al-Khobar were vaccinated compared to 179 (100%) in Qatif. Only 5 of the eligible children were not vaccinated, two of whom were Saudis and three non-Saudis. CONCLUSIONS: The study shows an overall percentage coverage of 98.4 in the Eastern Province which is well above the WHO's minimal 80% target for success. This method of vaccination at assigned points may be used in areas where the literacy rate is high and public cooperation is at a maximum.

Congenital hypothyroidism: increased incidence in Najran province, Saudi Arabia.

Neonatal screening for congenital hypothyroidism using cord serum thyroid-stimulating hormone (TSH) was initiated in Najran health region in September 1990. A total of 30810 newborn infants were screened by April 1995. Of the 24 infants with abnormal thyroid function tests on recall, 22 had permanent primary congenital hypothyroidism (incidence; 1:1400) and in two male siblings transient congenital hypothyroidism (incidence; 1:15400) was proved on follow-up. There was a significantly higher incidence of dyshormonogenesis. Eight (57 per cent) of the 14 infants who were adequately studied thyroid scan revealed ectopic glands with increased 99mTc uptake, while thyroid ectopy and aplasia were present only in three (22 per cent) infants each. Furthermore, goiter was evident clinically in two other patients.

Neonatal screening for congenital hypothyroidism in Riyadh: Analysis of six year's experience.

The regional screening program for congenital hypothyroidism (CH) in Riyadh Province was started as a pilot study in December 1988. By September 1990, the program covered all deliveries at the Ministry of Health (MOH) and King Saud University hospitals. The program utilizes cord serum thyroid-stimulating hormone (TSH) with a low recall rate of 0.1%. The average cost per specimen was SR 12 (US$ 3.20). Among 283,647 infants screened, 83 infants were confirmed to have CH (incidence 1:3417). In 17 infants, however, the diagnosis was not confirmed due to difficulties in recall. Eleven infants with cord serum TSH of more than 100 mU/L proved to be clinically and biochemically euthyroid at recall. Three of these were secondary to maternal proplthiouracil (PTU) therapy. The female to male ratio was 1.5:1. The majority of infants lacked clinical symptoms and signs of hypothyroidism. Thyroid scans showed the most common etiology to be thyroid ectopy (50%), followed by dyshormonogenesis (26%) and athyrosis (24%). Although there was no significant difference in the mean cord T4 values among the different groups, the mean T4 value at recall in the athyrotic group was significantly (P <0.001) lower than the cord results (14.8 versus 62.7) and that is of recall for the ectopic and dyshormonogenesis groups (14.8 versus 47.0 and 51.3 respectively0. There was bo significant difference in the mean TSH among the different groups in the cord and recall samples. Skeletal maturation was more delayed in the athyrotic group. The mean age at the time of recall was 16.4 days (range 4 to 64), and the mean age at the start of therapy was 17.8 days (range 5-64).