Relationship Between Quality of Sleep and Psychological Well-being Among Frontline Nurses During the COVID-19 Pandemic in Saudi Arabia.

Background: The coronavirus 2019 (COVID-19) pandemic is a world health emergency crisis that challenges the global health system and healthcare providers, especially frontline nurses' physical and mental well-being. Objective: The aim of the study was to examine the association between depression, anxiety, and sleep quality among nurses working in Saudi Arabian hospitals during the COVID-19 pandemic. Methods: This is an quantitative cross-sectional study. An online self-reported data was collected from 187 nurses who were on duty during COVID-19 pandemic. Results: About 87.2% of the nurses were female nurses; not surprising that 88% had poor sleep quality; 44.4% had moderate anxiety, and 44% of the studied nurses had mild to moderate depression. The study revealed that there was an association between level of anxiety and poor sleep quality. Poor sleep quality and emotional stability of nurses play a major role in quality of care and patients' safety. Conclusion: We conclude that healthcare leaders should adopt an occupational wellbeing program for nurses that focuses on their psychological wellbeing and sleep quality.

The psychological experience of nursing students in their internship year during the COVID-19 pandemic in Saudi Arabia.

The COVID-19 pandemic produced challenges and troubling issues in Saudi Arabia and worldwide. During the height of the pandemic, the psychological status of nursing students was complicated by challenges that affected their educational future. We used qualitative approach to explore the psychological status of 20 Saudi nursing students from Nursing College in their internship program during the COVID-19 pandemic by investigating their perceptions, experiences, and challenges. Thematic analysis methods were used to present the data as themes and subthemes. Themes that emerged during interviews revealed: Interns' experiences from the outbreak; Perceptions of students toward COVID-19; Mental distress associated with the situation; Level of support from either or both university authorities or hospital education and training departments; Financial challenges; and Readiness to complete a nursing internship. COVID-19 presented several challenges to Saudi nursing students in internship year including psychological distress in several aspects such as fear of infection for themselves and their families. However, this study findings do not apply to all nursing students as it only included nursing interns actively engaged in clinical practice. Additional studies are required to examine how the clinical practice of internships varied across the country during any epidemic situation.

Seroprevalence of Varicella Zoster Virus in the Eastern Province of Saudi Arabia in Post-vaccination Era.

Background: Varicella zoster virus (VZV) is a highly contagious virus causing two types of skin infections known as varicella and herpes zoster. Due to its high burden, vaccination is available in almost 42 counties worldwide including Saudi Arabia. Since its introduction, data on the impact of the vaccine from local and neighboring countries is lacking. Objective: This study was done to determine the seroprevalence of anti VZV IgG and IgM antibodies in post-vaccination era fifteen years after varicella vaccine introduction in routine childhood vaccination schedules. Methods: retrospective observational study over seven years on all individual tested for anti VZV IgG and IgM in a tertiary university hospital in the eastern province of Saudi Arabia between Jan 2014 to Dec 2020. Results: 83.69% (6820/8149) of tested population were seropositive with significantly lower positivity in children less than ten years old (44%). Yet no significant difference was found between males and females or among different nationalities tested. Conclusions: varicella continuous to be prevalent in the eastern province of Saudi Arabia fifteen years after the introduction of the vaccine but the level of anti VZV IgG detection is significantly lower in children below ten years of age. Further large-scale studies are needed to assess the impact of universal vaccination on the epidemiology of VZV.

Antibody Dependent Enhancement of SARS-CoV-2 Infection in the Era of Rapid Vaccine Development.

Background: Antibody dependent enhancement (ADE) is a unique immunopathological phenomenon in which pre-existing immunity to a viral agent accentuate disease severity upon secondary exposure. Multiple viruses have been shown to demsotrate ADE with no clear understanding of the underlying mechansims. Recently, with the emeregence of Sever acute respiratory syndrome-2 (SARS-CoV2) and the need for rapid vaccine prodcution, ADE have emerged as an important issue that need to be assessed. Objective: The aim of this study was to review ADE, proposed mechanisms and impact of ADE in the era of rapid SARS-CoV2 vaccine production. Methods: Review of existing published literature on ADE and SARS-CoV2 and identify facts that support or otherwise contradict the impact of ADE on SARS-CoV2 vaccination. Results: SARS-CoV2 demonstrate high genetic homology to other members of the Coronaviridae viral family and animal studies and studies on SARS-CoV, another member of the Coronaviridae have been shown to induce ADE. In addition sever SARS-CoV2 infection have been associated with high antibody titer. Yet vaccine efficacy studies and studies on breakthrough infection showed reduced severity in individual with preexisting immunity. Conclusion: Although evidence exist to support ADE in SARS-CoV2, multiple studies do not support its occurrence, indicating the need for more case control studies to understand the role of high antibody titer and disease severity and compare disease severity in patient with preexisting immunity vs naïve individuals.

The relationship between nurses' risk assessment and management, fear perception, and mental wellbeing during the COVID-19 pandemic in Saudi Arabia.

During this pandemic, it is crucial to implement early interventions to help nurses manage their mental wellbeing by providing them with information regarding coping skills, preventive risk assessment approaches (such as hospital preparedness and rapid risk assessment), and the ability to respond. This study evaluated the effect of fear and risk assessment management on nurses' mental wellbeing during the COVID-19 pandemic in Saudi Arabia. A total of 507 nurses who worked in tertiary public hospitals were asked to take a descriptive design survey. Three survey scales were used to assess the survey: the Risk Assessment Scale, the Fear of COVID-19 Scale, and the Warwick-Edinburgh Mental Wellbeing Scale. Independent t-tests and a one-way ANOVA were used to examine the association between fear of COVID-19 and nurses' demographic characteristics on their mental wellbeing. A multiple regression analysis was performed to examine the predictors associated with mental wellbeing. Findings revealed that almost half of the participants showed moderate positive mental wellbeing, 49.7%, while only 14% had low levels of fear on the Warwick-Edinburgh Mental Well being Scale. Most of the respondents had low levels of fear on the Fear of COVID-19 Scale, 45%, while only 15% had high levels of fear on the scale. Then, some demographic variables, such as "age," "nationality," "total years of experience in the current hospital," and "region you work at" had statistically significant differences with p < 0.5. Meanwhile, risk assessment is also associated with mental wellbeing scores. All items on the Fear of COVID-19 Scale showed no significant difference with a P > 0.05. In conclusion, most nurses providing direct patient care to a patient with COVID-19 emphasized the importance of wearing PPE and performing hand hygiene before and after any clean or aseptic procedure. Meanwhile, although almost all nurses were vaccinated, they were still afraid of a COVID-19 infection. Additionally, the results reported that the older the nurses are, the better their mental wellbeing scores. Non-Saudi nurses had higher perceived mental wellbeing scores than Saudi nurses, and different working environments corresponded to different mental wellbeing scores. Finally, nurses' risk assessment was associated with mental wellbeing scores.

Prevalence of herpes simplex virus types 1 and 2 antibodies among individuals screened in a tertiary hospital in the Eastern province of Saudi Arabia.

The epidemiology of herpes simplex virus (HSV) infections varies among populations depending on their demographic characteristics and exposure. This study describes the prevalence of HSV 1/2 IgG and IgM antibodies among individuals over a period of 5 years. A retrospective study was conducted to collect data on cases tested for HSV-1 and HSV-2 IgG and IgM antibodies for different medical conditions over five years between January 2014 and December 2018. 620 samples were tested for HSV 1/2 IgG and IgM during the study period. The total HSV seropositivity in the study population was 68% (422/620). The total seropositivity excluding children below 6 months of age was 65.3% (313/479). HSV-IgG seropositivity was significantly higher in married individuals (p<0.001, 95% CI 1.61-3.69). The HSV IgG seropositivity was significantly higher in children under the age of 6 months (N=109, 77.30%) than in children between 7 and 24 months old (27.6%) (Chi-square for linear trend, p<0.001), and it then tends to increase with age more than 24 months (Chi-square for linear trend, p=0.011). Eleven children showed laboratory evidence of recent HSV infection (6.2%) as indicated by HSV IgM antibodies and had diverse clinical conditions. HSV infection is highly prevalent in the Eastern Province of Saudi Arabia. Infection is most probably acquired during early childhood, and the tendency increases with age. However, a significant number of mothers are at risk of infection and transferring the infection to their fetuses.

The effects of nursing work environment on patient safety in Saudi Arabian hospitals.

Purpose: This study aims to investigate the impact of the nursing work environment on patients' safety in Saudi Arabian hospitals. Methods: This study used a cross-sectional design for collecting the data related to the nursing work environment and patients' safety from nursing staff in Saudi Arabian hospitals. The survey questionnaire included in this study has two pre-validated questionnaires including practice environment scale-nursing work index questionnaire and hospital's survey on patients' safety developed by Surveys on Patients Safety Culture. The survey link was forwarded to HR administrators of 96 hospitals in Saudi Arabia, which included 72 public hospitals, 23 private hospitals, and one public-private hospital. Three hundred sixty-nine responses were received. After removing the incomplete responses, 357 responses were considered for the data analysis, in which t-tests and Pearson's correlation techniques were adopted. Results: Strongest correlations were identified between resource adequacy and work area (r = 0.763, p < 0.01), "participation in management and leadership" and work area (r = 0.712, p < 0.01), "participation in management and leadership" and supervisor/managers' approaches (r = 0.731, p < 0.01), and "nursing care and inter-disciplinary relationships and frequency of events" (r = 0.701, p < 0.01). Conclusion: The nursing work environment factors, especially participation, management and leadership, nursing care, inter-disciplinary relationships, and resource adequacy have to be improved in order to improve the patients' safety.

Nurses' Perception of Safety Culture in Medical-Surgical Units in Hospitals in Saudi Arabia.

Introduction: Patient safety captures the essence of the primary principle of medical ethics, primum non nocere, first do no harm; this is an important concern in the health care system. Nurses are indispensable members of this system and are the largest group of health care providers involved in the direct delivery of patient care. As an integral part of the health care system, it is important to know nurses' opinions on patient safety culture. Objectives: First, to evaluate and measure the existing safety culture and safety of patients in medical-surgical wards (MSW) in hospitals located in the Qassim region, in the Kingdom of Saudi Arabia. Second, to survey the opinion of registered nurses and supervisors/managers about safety culture and issues concerned with safety in hospitals in the region. Materials and Methods: A validated cross-sectional survey, namely the Hospital Survey on Patient Safety Culture (HSOPSC), was used. This survey queried 300 nurses in different MSWs in four hospitals in the Qassim Region. Results: Overall, a positive culture of safety exists in MSWs, with 69% of RNs rating their wards as having great/excellent safety culture. Notably, some participants felt it was problematic that blame was assigned to nurses for reported errors. While 55.9% of participants noted that all errors or narrowly avoided errors had been reported, less than half actually reported errors in the last year. Conclusion: The perceived safety culture was largely positive; however, the results also indicated that a culture of safety comes with some risk and blame.

The Relationship Between Nurses' Quality of Work-Life on Organizational Loyalty and Job Performance in Saudi Arabian Hospitals: A Cross-Sectional Study.

Purpose: The purpose of this study is to analyze the relationship between quality of work-life on the organizational loyalty and job performance in Saudi Arabia. Methods: This study used a cross-sectional design for collecting the data related to the nurses' quality of work-life, organizational loyalty, and job performance from nursing staff in Saudi Arabian hospitals. Three questionnaires were used in this study, which includes Quality of Work Life Scale (QWLS), Organizational Commitment Questionnaire (OCQ), and Individual Work Performance Questionnaire (IWPQ). An online version of the survey questionnaire was generated using the Google survey, to which a link is generated for collecting data. At the end of the survey, 243 responses were received. After removing the incomplete responses, 209 responses were considered for the data analysis. The statistical techniques including t-tests and Pearson's correlation were used in the data analysis. Results: Nurse managers reflected good quality of life, and high loyalty toward their employers, and also reflected good job performance levels. However, staff nurses reflected poor quality of work-life, organizational loyalty, and job performance. Training and development had strong positive correlation with continuance commitment (r = 0.628, p < 0.01). Job satisfaction and job security held strong positive correlation with task performance (r = 0.601, p < 0.01) and contextual performance (r = 0.601, p < 0.01). Conclusion: Quality of work-life, organization loyalty, and job performance are positively correlated, and poor quality of work-life can negatively impact job performance and organizational loyalty of nurses.

Evaluation of the Patient Experience with the Mawid App during the COVID-19 Pandemic in Al Hassa, Saudi Arabia.

(1) Introduction: The objective of this study was to evaluate the patient experience with the Mawid application during the COVID-19 pandemic in Al Hassa, Saudi Arabia. (2) Methodology: A quantitative cross-sectional survey was designed to evaluate the patient experience with the Mawid app during the COVID-19 pandemic in Al Hassa, Saudi Arabia. A total of 146 respondents completed the questionnaire. (3) Results: More than half of the participants (65.8%) opined that application was easy to use. Furthermore, 65.1% of the participants considered it to be very easy and easy to search for the required information; and 63.7% of the respondents reflected that it was easy to book an appointment. There was a statistically significant difference between the ease of searching for the required information (p-value = 0.006); the ease of undoing an unwanted move and gender (p-value = 0.049); the ease of searching for the required information and educational level (p-value = 0.048); the ease of booking an appointment and educational level (p = 0.049); and the ease of searching for the required information and the labor sector of the respondents (p value= 0.049) among the genders. No significant differences were identified among the age groups. (4) Conclusions: Overall, most participants suggested that the Mawid app was easy to use and had a potentially useful set of features to help mitigate and manage the COVID-19 pandemic in Al Hassa, Saudi Arabia.

Leadership Style, Work Engagement and Organizational Commitment Among Nurses in Saudi Arabian Hospitals.

Purpose: The purpose of this paper is to examine how nurse managers' leadership styles, work engagement, and nurses' organizational commitment are related in Saudi Arabia. Methods: This study used a cross-sectional design using an online survey instrument targeted at nurse managers and nurses working in Saudi Arabian hospitals. Multi-factor leadership questionnaire (MLQ), organizational commitment questionnaire (OCQ), and Utrecht Work Engagement Scale (UWES) were used in the Questionnaire. The survey link is forwarded to HR administrators of 71 hospitals, which includes public, private, and public-private partnership hospitals. The survey link was active from 27th November 2021 to 18th December 2021, and at the end of the survey, 394 responses were received. After removing the incomplete responses, 390 participant responses are considered for data analysis. t-tests and correlation analysis are used to analyze the data. Results: Among the participants, 84.4% of the participants were nurses and 15.6% were nurse managers. Significant difference (p < 0.05) of opinions is observed among nurse managers in relation to transformational and transactional leadership styles and engagement. Transformational and transactional leaderships are positively correlated with organizational commitment and nurses' engagement. Conclusion: Differences in leadership style perceptions among nurses and nurse managers reflected issues in nursing management, which have to be addressed in light of rapid infrastructural changes owing to Saudi vision 2030.

Scope of Nursing Practice as Perceived by Nurses Working in Saudi Arabia.

The absence of scope of practice guidelines may lead to role ambiguity and legal consequences in nursing practice. This study measures the scope of practice of nurses in Saudi Arabia. The study utilized a descriptive cross-sectional design using an electronic version of the Arabic Actual Scope of Nursing Practice (A-ASCOP) questionnaire among 928 nurses. Descriptive analysis was followed by a t-test and an analysis of variance (ANOVA). Significance was assured through the Bonferroni test; the effect size was measured through partial η2 when appropriate. The A-ASCOP mean score of each dimension ranged from 4.29 to 4.72 (overall mean = 4.59). Significant overall ASCOP score variations were evident, with higher ASCOP among expatriate nurses, females, Hospital Operation Program (HOP) nurses, and nurses with postgraduate qualifications. Partial η2 showed a small effect of <0.016. Low-complexity nursing tasks showed insignificant differences no matter the nurse's position, but were less practiced by Bachelor of Science in Nursing (BSN) and advanced-degree nurses than by those with a diploma education. High complexity of ASCOP was practiced significantly more often by postgraduate-prepared nurses than by diploma-educated nurses. The study showed that there is a range of variation in nursing practice, but that the lack of internal regulations (nursing scope of practice) has no effect on nursing duties. In a country such as Saudi Arabia, where massive national improvement initiatives are frequent, clearly defining the scope of practice for nurses is essential and needs to be done through government mandates. Further studies are essential to define what the scope of practice should include.

Susceptibility to Rubella Infection and Incidence of Congenital Rubella Infection: 6 Years Retrospective Study.

Introduction: Rubella is considered one of the most serious and most common congenital infections. Despite global efforts for elimination, rubella cases are still being reported in many parts of the world. The purpose of this study is to determine the level of immunity to rubella in the community and most importantly among women at childbearing age in the eastern province of Saudi Arabia and compare it with the target set by the World Health Organization (WHO) along with the incidence of acute rubella infection and the associated congenital rubella infection and congenital rubella syndrome. Methods: This is a retrospective cross-sectional study over the six years period (Jan 2014-Jun 2020) on all individuals tested for rubella IgM and IgG in a university teaching hospital. Results: Nighty one percent (15,894/17,469) of the population tested showed evidence of rubella immunity with 8.8% (1546/17,469) being susceptible. Among women at childbearing age, susceptibility to rubella was higher with 9.2% (1220/13,278) of women showing no evidence of immunity. In addition, acute rubella infection was reported for 0.17% (29/17,469) of the population tested and 0.15% (20/13,278) in women at childbearing age. No cases of congenital rubella infection were reported in the study period. Discussion: The level of Rubella immunity in the population is 91% and is less than the WHO target for rubella control therefore, risk of resurge of cases is present, indicating the need for continued national surveillance and more efforts to improve vaccination coverage in the kingdom.

Low levels of soluble DPP4 among Saudis may have constituted a risk factor for MERS endemicity.

Most of the cases of Middle East respiratory syndrome coronavirus (MERS-CoV) were reported in Saudi Arabia. Dipeptidyl peptidase-4 (DPP4) was identified as the receptor for the virus. The level of soluble DPP4 (sDPP4) was found to be reduced in MERS-CoV infected patients while high levels of sDPP4 were suggested to be protective against MERS-CoV in animal models. We investigated whether the Saudi population has lower levels of sDPP4 which makes them more susceptible to MERS-CoV infection and, therefore, could explain the larger number of cases from the country. Blood samples were collected from 219 Saudi blood donors and 200 blood donors from other ethnic groups. The plasma level of sDPP4 was measured by ELISA and the following SNPs in the DPP4 gene; rs35128070, rs1861978, rs79700168, and rs17574, were genotyped by TaqMan SNP genotyping assay. The average level of plasma sDDP4 was significantly lower in Saudis than other Arabs and non-Arabs (P value 0.0003 and 0.012, respectively). The genotypes AG of rs35128070 and GT of rs1861978 were significantly associated with lower sDPP4 among Saudis (P value 0.002 for each). While both genotypes AA and AG of rs79700168 and rs17574 were associated with significantly lower average sDPP4 level in Saudis compared to other ethnic groups (P value 0.031 and 0.032, and 0.027 and 0.014, respectively). Herein, we report that the Saudi population has lower levels of plasma sDPP4 than other ethnic groups, which is associated with genetic variants in the DPP4 gene. This may have contributed to increase the susceptibility of the Saudi population to MERS-CoV infection and could be a factor in the long-lasting persistence of the virus in the country.

Evaluation of the Mawid mobile healthcare application in delivering services during the COVID-19 pandemic in Saudi Arabia.

PURPOSE: The purpose of this study is to evaluate MAWID mobile application developed by the Ministry of Health, Saudi Arabia, which is used for primary care hospitals appointments management and for tracking and tracing COVID-19. PARTICIPANTS AND METHODS: An online questionnaire-based survey was used for collecting data related to three major factors including Ease of Use, Satisfaction, and Benefits of MAWID application among its users. Out of total 2542 participants, 345 participants completed only a part of the survey, and 204 participants did not use the application. After removing, 549 invalid responses, a final sample of 1993 was included for the data analysis. RESULTS: 82.1% of the participants referred MAWID as easy to use application, 79.8% were highly satisfied with the application, and majority of the participants reflected potential benefits of using the application. T-test results have revealed that significant differences existed between males and females, and young and older participants in relation to the Ease of Use and Satisfaction levels associated with MAWID application. CONCLUSION: Mobile applications can be very effective in delivering the healthcare services during pandemics. However, there is a need for regular evaluation and assessment to trach the change in users' needs and update the app according to the changing requirements.

Predictors of Illness Severity in COVID-19 Cases in Saudi Arabia.

PURPOSE: Multiple studies worldwide have reported the clinical and epidemiological features of coronavirus disease 2019 (COVID-19), with limited reports from the Middle East. This study describes the clinical and epidemiological features of COVID-19 cases in the Eastern Province of Saudi Arabia and identified factors associated with the severity of illness. PATIENTS AND METHODS: This was an observational study of 341 COVID-19 cases. These cases were reported in the first three months after the first case in the country was identified. Clinical and demographic data were analyzed and described to identify the effects of age, sex, and ethnicity on illness severity. In addition, the duration of viral shedding and cycle threshold (Ct) values of real-time PCR were evaluated as predictors of severity. RESULTS: The median age was 45 years. Males were twice as likely to be infected than females (p <0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Critical cases were significantly higher in men (23% vs 8.7%), senior adults (>65 years), individuals of Bengali ethnicity, and in patients with comorbidities including diabetes, hypertension, and dyslipidemia (p =0.001). The case fatality rate was found to be 10%. The fatality was significantly higher in males than females (13.8% vs 2.6%), and in Asians (17.9%) than Arabs (6%) and Africans (0) (p =0.002). No association was found between viral load, represented by the RT-PCR cycle threshold (Ct) values, and severity of illness. CONCLUSION: Age, sex, and ethnicity are important predictors of COVID-19 severity. The cycle threshold (Ct) of the SARS-CoV-2 RT-PCR test cannot be used as a predictor of the criticality of illness.

Prevalence of Hepatitis E Virus Infection Among Blood Donors in the Eastern Province of Saudi Arabia.

PURPOSE: Hepatitis E virus (HEV) causes acute hepatitis in humans and constitutes a major problem for immunocompromised patients, patients with hematological diseases, and pregnant women. It is transmitted mainly through fecal oral route; however, transmission through blood and blood products is reported globally and becoming a health concern. We sought to determine the prevalence of HEV among blood donors in the Eastern Province of Saudi Arabia using molecular as well as serological assays to assess the safety of blood transfusion and the need for HEV screening among blood donors. PATIENTS AND METHODS: A total of 806 whole blood samples were collected from blood donors between May and November 2020 and tested for anti-HEV IgG and IgM antibodies by ELISA and for HEV RNA by RT-PCR. RESULTS: The overall seroprevalence of HEV IgG antibodies was 3.2% with no statistically significant difference between the non-Saudis (3.28%) and Saudis (3.17%) (p value 0.929) or between males (3.14%) and females (4.88%) (p value 0.527). None of the IgG positive individuals had IgM antibodies. HEV RNA was not detected in any of the blood donors. CONCLUSION: HEV seroprevalence is low among blood donors in the Eastern Province of Saudi Arabia and may constitute minimal risk for transfusion associated infections.

Correlation of High-Risk HPV Genotypes with Pap Test Findings: A Retrospective Study in Eastern Province, Saudi Arabia.

INTRODUCTION: High-risk human papillomavirus (HR HPV) is found to be responsible for 4.5% of cancer in general, primarily cervical cancer. We aim here to highlight the prevalence and genotypes of HR HPV and correlate its association with Pap tests' results, which are still not well known in the Eastern Province of Saudi Arabia. METHODS: Over 7 years (2013-2019), the results of 164 Saudi women coinvestigated for HR HPV along with Pap tests were collected from the archive of King Fahd University Hospital. Only women who had atypical squamous cells of undetermined significance (ASCUS) on the Pap test and those at elevated risk of infection were cotested for HR HPV; otherwise, the Pap test was the only screening modality for cervical cancer. Data were organized and statistically analyzed using IBM SPSS v26. RESULTS: Out of 164 Saudi women, 14.5% (n = 24/164) showed positive results for HR HPV (8 patients had HPV16 and 2 had both HPV16 and HPV18/45, while the remaining 14 had other HR HPV); among them, 41.5% (n = 10/24) had an abnormal Pap test (5 ASCUS and 5 LSIL), while 58.5% (n = 14/24) had a negative Pap test. On the other hand, 21% (n = 35/164) of patients, in the study, had an abnormal Pap test (24 ASCUS, 8 low-grade squamous intraepithelial lesion [LSIL], and 3 atypical glandular cell [AGC]). In 80% (n = 19/24) of ASCUS cases, HR HPV was not detected; however, 20% (n = 5/24) were positive for other HR HPV. Concerning LSIL cases, 62.5% (n = 5/8) were positive for HR HPV (1 case showed HPV16 and HPV18/45, 2 cases showed HPV16, and 2 cases showed other HR HPV), while in the remaining 37.5% (n = 3/8) LSIL cases, HR HPV was negative; similarly, all AGC cases were negative for HR HPV. Statistical analysis showed a significant correlation between HPV status and Pap test findings (p value <0.001). DISCUSSION/CONCLUSION: HR HPV frequency and genotype distribution, in this study, might reflect a different regional infection pattern. The high association of HR HPV with negative cytology emphasizes the need to add the HR HPV test to screening modalities of cervix cancer.

Pooled Specimen Testing Using Automated Cartridge-Based System for COVID-19: The Cost on Sensitivity.

BACKGROUND: Pooled specimen screening for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can improve laboratory testing capacity. This study assessed the impact of pooling and retesting individual swabs on the overall detection rate and reduction in the frequency of retesting. METHODS: One hundred respiratory swabs specimens were tested individually and in pools of three or five samples using the Cepheid's Xpert® Xpress SARS-CoV-2 test kit. The optimum number of samples per pool was calculated using the application 'A Shiny App for Pooled Testing'. RESULTS: Twenty-five pools were generated from 101 samples. Out of 13 pools that contained five samples each, three pools gave true positive results. While out of the 12 pools that contained three samples each, five pools gave true positive results. Four samples gave a false negative pool result. The overall sensitivity and specificity of the assay in the pools were 66.6% and 100%, respectively. The cycle threshold was reduced in most of the pools compared to individual sample tests. CONCLUSION: The overall pooled test had a remarkable impact on laboratory resources. Yet, caution is warranted when selecting the cases for pooled testing, since the reduction in sensitivity can significantly impact and increase the risk of exposure to infection.

Awareness, Attitudes, Prevention, and Perceptions of COVID-19 Outbreak among Nurses in Saudi Arabia.

The newly discovered coronavirus (COVID-19) has become a pandemic, infecting thousands of people around the world. This study examines nurses' demographic information (age, gender, marital status, area of practice, total years of experience in the current hospital, work region, monthly salary, educational level, workplace, nationality, working hours per day, total nursing experience, and the respondents' main source of information on COVID-19), awareness, attitudes, prevention, and perceptions of COVID-19 during the outbreak in Saudi Arabia. A cross-sectional descriptive design of 500 nurses working at government and non-governmental hospitals in five regions in Saudi Arabia were selected using convenience sampling. The Kruskal-Wallis test was applied and the Mann-Whitney test was utilized as a post hoc test. The majority of nurses in this study, 96.85%, had excellent knowledge of COVID-19. Some (83.2%) of nurses reported significant prevention knowledge and treatment skills about COVID-19, while 7.6% had little knowledge about prevention. More than half of the nurses (60.4%) had high positive attitudes toward caring for COVID-19 patients. In conclusion, female nurses, married nurses, and bachelor's degree nurses had greater awareness, better attitude, and prevention clinical experience towards COVID-19. Meanwhile, non-Saudi nurses had higher self-reported awareness, positive attitudes, optimal prevention, and positive perceptions compared to Saudi nurses. This study provides baseline information immediately needed to enable health authorities to prioritize training programs that support nurses during the COVID-19 pandemic.