Rabies in a Sand Cat (Felis margarita) in Saudi Arabia: One Health Implications.

We report a case of rabies in a sand cat, Felis margarita, from Saudi Arabia. This incident suggests hitherto undocumented spillover infection in this species. Our report highlights the shortcomings of passive reporting, necessity of wildlife surveillance, and the need for a comprehensive One Health approach to disease prevention and control.

Knowledge, Attitude and Practices of Health Care Workers about Corona Virus Disease 2019 in Saudi Arabia.

BACKGROUND AND OBJECTIVES: Corona Virus Disease 2019 (COVID-19) pandemic is a global health emergency. Health Care Workers (HCWs) with sound knowledge and practices can help curb the pandemic. This study aimed to assess the knowledge, attitude and practices of HCWs about COVID-19 and compare physicians and non-physicians in Saudi Arabia. METHODS: An online survey was conducted among HCWs in Saudi Arabia in March and April 2020. Data were collected using a structured questionnaire having four sections including; socio-demographic and professional profile, knowledge, attitude and practices regarding COVID-19. Questionnaire link was sent through social media. Descriptive analysis was used for assessment of knowledge, attitude and practice and Chi-square test was used for comparing physicians and non-physicians. Data were analyzed using SPSS version 21.0. RESULTS: A total of 398 HCWs completed the questionnaire. Only 45% of the participants had correct knowledge about the agent while about 97% knew that close contact with infected person is the most important risk factor. Only 63% had correct knowledge about the role of antibiotics in COVID-19 treatment. Majority of the HCWs were worried and most frequently reported worry was risk to family. Carrying infection to home was most commonly reported fear, 92%. Cleaning hands often or always was 11.5% and 87% respectively. About 71% wore mask during work. Knowledge was better among physicians compared to non-physicians while attitude and practices were comparable between the two groups. CONCLUSION: We found that there was poor knowledge about causative agent and role of antibiotics for COVID-19 but for mode of transmission and prevention there was good knowledge. There were widely prevalent worries and fears among the participants. Overall, there were good infection control practices among the HCWs. Interventions are needed to improve knowledge and address worries and fears of HCW.

Primary health care physicians' prescribing patterns for children under five in Qassim, Saudi Arabia.

BACKGROUND: Irrational prescription of drugs in children is reported to be widespread. There are scarce studies on the pediatric prescribing pattern especially at primary health care (PHC) level. AIM: To determine the physicians' prescribing patterns for children under five years, to explore completeness of prescriptions' recorded information, and to analyze the core indicators of drug prescribing at primary health care centers (PHCC) in Qassim. METHODS: This cross-sectional study was conducted on 25 randomly selected PHCCs. All prescriptions, for the first week of first six months of the year 1437 Hijrah (October 2015 to April 2016), were reviewed. Among 25 012 prescriptions, 4125 (16.5%) were for children under five years. We randomly selected 1212 prescriptions for the study. World Health Organization (WHO) specified drug use indicators, and index of rational drug prescribing (IRDP) with a maximum value of 5, were calculated. The physicians and pharmacists of sampled PHCCs were also surveyed to explore prescribing issues. FINDINGS: The completeness of recorded date, patient age, and gender was more than 90%. The diagnosis was legibly written in 842 (69.5%), while the patient weight was recorded in 307 (25.3%) prescriptions. The least commonly recorded instruction was the drug strength (26.8%), while the dose and frequency of use were stated for 91.3% and 90.8% of the drugs, respectively. The average number of drugs per prescription was 2.35 ± 0.89; 72.97% drugs were prescribed by generic name; in 65.98% patient encounters, antibiotics were prescribed. The overall IRDP was 3.56. Most of the physicians and pharmacists reported availability of the drug list and Saudi PHC formulary in their PHCCs. CONCLUSION: PHC physicians' drug prescribing was not at the optimal level of rational use, especially regarding prescription of antibiotics. Creating awareness about rational drug use and hazards of overuse of antibiotics is needed.

Primary health care research in Saudi Arabia: A quantitative analysis.

OBJECTIVES: The objective of this study was to analyze the published primary health care (PHC) research conducted in Saudi Arabia quantitatively and to determine the distribution of these research publications according to the topic, time, geographical location, and institution. METHODS: In this descriptive study, we conducted literature search in PubMed and Google Scholar. The Medical Subject Headings terms: "Primary Health" AND "Saudi" and "Primary Care" AND "Saudi" were used for searching relevant journal articles. Relevant information about the journal articles, published till December 2011, was recorded on a coding instrument. RESULTS: From 1983 to 2011, a total of 655 PHC research articles were found. The publication output showed an increase with time. Original research articles (85.6%) were the main type of publications, and the most common study design was cross-sectional (93.4%). "Chronic diseases" and "health services research" were the main topics addressed. Riyadh province had the highest proportion (46.3%) of publications, and the universities (56.2%), followed by the Saudi Ministry of Health (24.9%), were the main institutions publishing the research. CONCLUSION: Despite a well-established PHC setup in Saudi Arabia, the research outputs are low. Most of the published articles are cross-sectional studies and are conducted by the universities. Enhancing the PHC research by creating a supportive environment will lead to an increased evidence base for PHC and its effective translation into service delivery.

Attitudes to statistics in primary health care physicians, Qassim province.

UNLABELLED: Aim To investigate primary health care (PHC) physicians' attitudes to statistics, their self-reported knowledge level, and their perceived training needs in statistics. BACKGROUND: In spite of realization of the importance of statistics, inadequacies in physicians' knowledge and skills have been found, underscoring the need for in-service training. Understanding physicians' attitudes to statistics is vital in planning statistics training. METHODS: The study was based on theory of planned behavior. A cross-sectional survey of all PHC physicians was conducted in Qassim province, from August to October 2014. Attitudes to statistics were determined by a self-administered questionnaire. The attitudes were assessed on four subscales including general perceptions; perceptions of knowledge and training; perceptions of statistics and evidence-based medicine; and perceptions of future learning. Findings Of 416 eligible participants, 338 (81.25%) responded to the survey. On a scale of 1-10, the majority (73.6%) of the participants self-assessed their level of statistics knowledge as five or below. The attitude scores could have a minimum of 20 and a maximum of 100, with higher scores showing a positive attitude. The participants showed a positive attitude with the mean score of 71.14 (±7.73). Out of the four subscales, 'perceptions of statistics and evidence-based medicine' subscale scored the highest, followed by 'perceptions of future learning'. CONCLUSION: PHC physicians have a positive attitude to statistics. However, they realize their gaps in knowledge in statistics, and are keen to fill these gaps. Statistics training, resulting in improved statistics knowledge is expected to lead to clinical care utilizing evidence-based medicine, and thus improvement to health care services.

Measles outbreak in Qassim, Saudi Arabia 2007: epidemiology and evaluation of outbreak response.

BACKGROUND: Worldwide efforts for measles elimination are made possible due to the availability of a highly effective measles vaccine. In spite of highly vaccinated population, a measles outbreak occurred in Qassim province of Saudi Arabia, during January-August 2007. METHODS: An outbreak investigation was conducted to describe the epidemiology of outbreak. An audit of performance of control measures taken by the Primary Health Care team was done according to World Health Organization standards. RESULTS: Of 230 cases reported, more than one-third (37.8%) patients were 0-4 years of age. Children aged 6-11 months accounted for 51.7% cases amongst 0-4 years age group. The performance indicator targets of >or=80% for outbreak control measures were achieved regarding investigation of cases within 48 hours, and blood sample extraction within the optimal period. However, 66.8% cases reported within 48 hours of rash onset and only 16.4% of laboratory test results were received within 7 days of receipt of the specimen in laboratory. CONCLUSION: This outbreak demonstrates the increased susceptibility of unvaccinated children aged 6-11 months. To prevent future outbreaks, community awareness, review of measles vaccination schedule, enhanced surveillance and measles 'catch-up' mass immunization campaign to interrupt chains of transmission, are required.