Immunological Factors Associated with Adult Asthma in the Aseer Region, Southwestern Saudi Arabia.

BACKGROUND: The prevalence of asthma is on the rise in Saudi Arabia. Data regarding the immunological profile of asthma in adults in the Aseer region, in southwestern Saudi Arabia, have not been well studied. OBJECTIVES: Our aim was to study the immunological factors associated with sensitization to asthma among adults in the Aseer region. METHODS: A cross-sectional study with a nested case control design in a 1:1 ratio was conducted on a sample of adults attending primary health care centers in the Aseer region. The study used a validated Arabic version of the International study of asthma and allergies in childhood (ISAAC) questionnaire. The presence of wheezing in the past 12 months was used as a proxy for bronchial asthma. Matched age and sex controls were selected. Both groups were tested for complete blood count (CBC), total and differential white blood cell (WBC) count including eosinophils, total immunoglobulin E (IgE) measurement, allergen-specific immunoglobulin E (IgE), and cytokine levels. RESULTS: The present study included 110 cases and 157 age- and sex-matched controls. Rye wheat was found to be a significant outdoor sensitizing agent ((odds ratio) OR = 5.23, 95% CI: 1.06-25.69). Indoors, house dust mites Dermatophagoides petronyssinus (OR = 2.04, 95% CI: 1.04-3.99) and Dermatophagoides farinae (OR = 2.50, 95% CI: 1.09-5.75) were significant. Higher total IgE (OR = 1.84, 95% CI: 1.10-3.06) and eosinophil levels (OR = 2.85, 95% CI: 1.14-7.15) were significantly associated with adult bronchial asthma in Aseer. On the other hand, the role of cytokines was not significant. CONCLUSIONS: In the present study, certain environmental agents were found to be important with regards to sensitization to bronchial asthma in adults. Knowledge about these sensitization agents should be disseminated to health providers and treating physicians in order to enhance preventive environmental control measures and asthma management. Asthma-treating physicians in the region should be alerted to the use of targeted biological therapies in selected asthmatics with difficult-to-control courses.

Tobacco use among health care workers in southwestern Saudi Arabia.

The present study targeted health care workers (HCWs) in Governmental Hospitals and Primary Health Care Centers in Abha City, southwestern Saudi Arabia. An anonymous self-report questionnaire was used to assess tobacco use and the reasons for smoking. The present study included 736 HCWs. The overall prevalence of tobacco use amounted to 26.3% (14.8% current and 11.5% former users). In a binary logistic regression analysis, males were found significantly more prone to smoke compared to females (aOR = 3.081, 95% CI: 2.004-4.739). Similarly, parental history of tobacco use was found to be a significant risk factor (aOR = 1.540, 95% CI: 1.040-2.278). Among current users, 89.9% were interested in quitting and 66.1% tried before to quit. The prevalence of smoking among HCWs in the present study, besides being a public health problem, represents a potential barrier in involving this group as a first line for tobacco control. There is a need for a national intervention programme in the country in a tailored manner for HCWs to control tobacco use parallel to the running national program for public. These interventions should begin early in basic medical education and to be applied continually during one's medical career.