Descriptive epidemiology of physical activity among Omani adults: the Oman World Health Survey, 2008.

There is an increasing burden of obesity and obesity-related noncommunicable diseases in Gulf Cooperation Council countries, including Oman. This descriptive, epidemiological study assessed physical activity among 2977 Omani adults using a population-based household survey in 2008. Overall, 54.2% of men and 41.6% of women were physically active; the rate was higher in younger cohorts and varied significantly by region of residence. Physical activity related to the transportation (walking and cycling) domain was higher than in the leisure or work domains. Unmarried men aged 30-39 years were twice as likely to be physically active (OR 2.25) and unmarried women aged 40+ years were half as likely to be active (OR 0.58) than their married counterparts. Young women not working were less active (OR 0.18) than working women. Higher education was significantly associated with leisure activity for men aged 30+ years and women aged 40+ years. Further research to understand regional variations and to identify culturally appropriate strategies to promote physical activity is required.

Descriptive epidemiology of physical activity among Omani adults:the Oman World Health Survey, 2008

هناك تزايد في عبء السمنه والامراض غير الساريه المرتبطة بالسمنه في بلدان مجلس التعاون الخليجي بما فيها سلطنه عمان وقد قيمت هذه الدراسة الوبائيه الوصفيه النشاط البدني لدى 2977 بالغا عمانيا باستخدام مسح اسري سكاني في عام 2008 فكان بالاجمال 54.2% من الرجال و 41.6% من النساء نشيطين بدنيا وكان المعدل أعلى لدى الفئات الاصغر سنا وشديد التباين باختلاف منطقة الاقامه وكان النشاط البدني المرتبط بمجال المواصلات ( المشي وركوب الدراجات ) اعلى من النشاط الذي يبذل في مجالات الترفيه او العمل وكان النشاط البدني لدي الرجال غير المتزوجين ممن هم باعمار 39-30 عاما ضعف نشاط نظرائهم المتزوجين OR=2.25 ولدي النساء غير المتزوجات اللواتي تجاوزن الـ 40 سنه نصف نشاط نظيراتهن المتزوجات OR=0.58 وكانت الشابات اللواتي لايعملن اقل نشاطا OR=0.18 من النساء العاملات وكان هناك ارتباط كبير بين التعليم العالي وبين النشاط الترفيهي لدى الرجال الذين تزيد اعمارهم عن 30 سنه والنساء اللواتي تجاوزن الـ 40 سنه هناك حاجة الى مزيد من البحوث لفهم التباينات الاقليميه ولتحديد استراتيجيات ملائمه ثقافيا لتعزيز النشاط البدني

There is an increasing burden of obesity and obesity-related noncommunicable diseases in Gulf Cooperation Council countries, including Oman. This descriptive, epidemiological study assessed physical activity among 2977 Omani adults using a population-based household survey in 2008. Overall, 54.2% of men and41.6% of women were physically active; the rate was higher in younger cohorts and varied significantly by region of residence. Physical activity related to the transportation (walking and cycling) domain was higher than in the leisure or work domains. Unmarried men aged 30–39 years were twice as likely to be physically active (OR 2.25) and unmarried women aged 40+ years were half as likely to be active (OR 0.58) than their married counterparts. Young women not working were less active (OR 0.18) than working women. Higher education was significantlyassociated with leisure activity for men aged 30+ years and women aged 40+ years. Further research to understand regional variations and to identify culturally appropriate strategies to promote physical activity is required.

Le fardeau de l’obésité et des maladies non transmissibles liées à l’obésité est en augmentation dans les pays du Conseil de Coopération du Golfe, notamment à Oman. La présente étude épidémiologique descriptive a évalué l’activité physique de 2977 adultes omanais à l’aide d’une enquête de population auprès des ménagesen 2008. Globalement, 54,2 % des hommes et 41,6 % des femmes avaient une activité physique ; le taux était supérieur dans les cohortes plus jeunes et variait significativement en fonction de la région de résidence. L’activité physique liée aux déplacements (marche et vélo) était plus fréquente que l’activité physique professionnelle ou de loisir. Les hommes célibataires entre 30 et 39 ans étaient deux fois plus susceptibles d’être physiquement actifs (OR 2,25) alors que les femmes célibataires âgées de plus de 40 ans étaient deux fois moins actives (OR0,58) que les femmes mariées. Les femmes jeunes sans emploi étaient moins actives physiquement (OR 0,18) que les femmes occupant un emploi. Un niveau d’études supérieur était nettement associé à une activité physique de loisir chez les hommes de plus de 30 ans et les femmes de plus de 40 ans. Des recherches plus approfondies pour comprendre les variations régionales et identifier des stratégies culturellement appropriées visant à promouvoir l’activité physique sont nécessaires.

Deceased donor renal transplantation and the disruptive effect of commercial transplants: the experience of Oman.

The Oman Renal Transplantation Program was established in 1988 as a joint venture between Sultan Qaboos University and the Ministry of Health. It began with both living related donor (LRD) and deceased donor (DD) transplants. Over the next nine years, while the LRD programme progressed relatively well, there were only thirteen DD transplants. Two of the DD kidneys were obtained from overseas via an active collaboration with the Euro-transplant organisation, and one DD kidney was obtained from Saudi Arabia within the Gulf Cooperative Council exchange programme. The rest of the DD kidneys were obtained in Oman. The Omani DD programme, although it was a pioneering effort in the Gulf region at the time, was not entirely sustainable. In this paper we focus on the challenges we encountered. Among the major challenges was the absence of resources to establish a dedicated DD programme and particularly the failure to develop a cadre of dedicated transplant coordinators.

Cancer incidence in Oman, 1998-2006.

BACKGROUND: This paper gives a profile of the cancer incidence in Oman for a nine-year period from 1998-2006. METHODS: Data from the population-based national cancer registry were consolidated for the said nine-year period and analyzed. A breakdown of the incidence by year and gender have been given. Age-standardized incidence of common cancers in Oman and their age-specific rates have been tabulated. Further, a graphical comparison between common cancers in Omani men and women have been made with those of other Gulf countries and some developed countries. RESULTS: There were a total of 8,005 (4,224 males and 3,781 females) cases reported and registered in the registry from January 1998 till December 2006 with a male female ratio of 1.1:1. The crude incidence rate was 49.4 per 100,000 males and 45.7 per 100,000 females. The corresponding age-standardized rates were 91.4 and 80.4 per 100,000 in males and females respectively. CONCLUSIONS: Incidence of cancer in Oman is lower than in some Gulf countries and many developed countries. Stomach cancer, non-Hodgkin lymphoma and leukemia are three commonest cancers in males and breast, thyroid and cervical cancers are the most common in females in the nine-year period.

Attitude of the Omani population toward organ transplantation.

UNLABELLED: Transplantation from deceased donors is still scarce in Oman, mainly due to family refusal. We conducted a survey to learn the attitudes of the Omani population regarding transplantation. SUBJECTS AND METHODS: Among 500 individuals who were distributed, a questionnaire 304 responded including 247 (81%) Omani and 57 (19%) foreign residents. There were 213 (70%) male respondents of the 304 subjects, 256 individuals (84%) were between 18 and 50 years of age, and 270 (89%) had at least a high school education. RESULTS: Thirty-eight percent and 32% of Omani individuals had a family member or a friend with kidney disease or a renal transplantation, respectively. Only 42% of respondents knew that renal transplantation is performed in Oman. It was encouraging to note that 65% of Omanis knew that commercial transplantations are against Islamic and international standards. Sixty-four percent of the respondents stated that they would donate a kidney to a relative with renal failure. Nevertheless, only 49% knew that donation after death is permitted by Islam; 42% respondents would accept a kidney from a deceased person. Only 35% would donate a kidney or an organ after death. We concluded that the awareness of the Omani people toward donation after death is low, with a great need for public education and awareness programs, particularly for high school and university students.

Incidence of cancer in Gulf Cooperation Council countries, 1998-2001.

We describe the patterns of cancer incidence for common cancers in Gulf Cooperation Council countries during 1998-2001. A total of 32,291 cases of cancer were diagnosed (16,342 in males; 15,949 in females). Male preponderance was observed only in Saudi Arabia and Oman. The age-standardized incidence of all malignancies per 100,000 in both sexes was highest in Qatar followed by Bahrain, Kuwait, Oman, UAE and Saudi Arabia. Paediatric cancer ranged from 9.5% of total cancers in Saudi Arabia and UAE to 4.0% in Bahrain. In all countries, the mean age at diagnosis was higher in males than females; cancer of the lung and prostate were commonest among males, and cancer of breast and thyroid among females. Lung cancer ranked second among Bahraini women.

Epidemiological transition of some diseases in Oman: a situational analysis.

During the past 35 years Oman has undergone a rapid socioeconomic and epidemiological transition leading to a steep reduction in child and adult mortality and morbidity due to the decline of various communicable diseases, including vaccine-preventable diseases. Good governance and planning, together with leadership and commitment by the government, has been a critical factor in this reduction. However, with increasing prosperity, lifestyle-related noncommunicable diseases have emerged as new health challenges to the country, with cardiovascular diseases, diabetes and obesity in the lead among other chronic conditions. Appropriate prevention strategies for reducing the burden of noncommunicable diseases are discussed.

Incidence of cancer in Gulf Cooperation Council countries, 1998-2001

We describe the patterns of cancer incidence for common cancers in Gulf Cooperation Council countries during 1998-2001. A total of 32 291 cases of cancer were diagnosed [16 342 in males; 15 949 in females]. Male preponderance was observed only in Saudi Arabia and Oman. The age-standardized incidence of all malignancies per 100 000 in both sexes was highest in Qatar followed by Bahrain, Kuwait, Oman, UAE and Saudi Arabia. Paediatric cancer ranged from 9.5% of total cancers in Saudi Arabia and UAE to 4.0% in Bahrain. In all countries, the mean age at diagnosis was higher in males than females; cancer of the lung and prostate were commonest among males, and cancer of breast and thyroid among females. Lung cancer ranked second among Bahraini women

Diabetes risk score in Oman: a tool to identify prevalent type 2 diabetes among Arabs of the Middle East.

We used Oman's 1991 National Diabetes Survey data (n=4881) to develop a simple diabetes risk score for identification of individuals at high risk of having diabetes mellitus. The logistic regression model used included age, waist circumference, body mass index, family history of diabetes and hypertension status at the time of the survey for individuals aged > or =20 years. The validity of the model was assessed in another cohort (2001 Nizwa study n=1432). On applying this model to both cohorts, the area under the receiver-operating characteristic curve was 0.83 (95% confidence interval (CI) 0.82-0.84) for the 1991 cohort and 0.76 (95%CI 0.74-0.79) for the 2001 cohort. The Risk Score of >10 was depicted as the optimal cut-point to predict diabetes diagnosed by serum glucose > or =11.1 mmol/L 2-h post 75 g oral glucose load. This score had a sensitivity of 78.6 and 62.8% and specificity of 73.4 and 78.2% in the two cohorts, respectively. Test of the Thai, Dutch, Finnish and Danish diabetes risk scores showed poor performance of these models among Omani Arabs. In comparison, the self-administered diabetes risk score of Oman could identify most individuals at high risk of having type 2 diabetes in community-based settings in Oman.

A family study in Oman: large, consanguineous, polygamous Omani Arab pedigrees.

OBJECTIVE: To establish a suitable human model for the study of the genetics of complex diseases. METHODS: We have selected an Omani Arab population to provide the statistical power required to study the genetics of complex diseases with confidence. This model consists of five multigenerational highly inbred pedigrees, descending from a small number of founders just a few generations ago with environmental homogeneity, restricted geographical distribution, detailed records and well-ascertained and -validated pedigrees. Stringent criteria were adopted for defining the phenotypes of hypertension, diabetes mellitus, dyslipidemias and obesity. The SOLAR genetic software package was used to draw the pedigree structure. RESULTS: Outstanding statistical power to detect susceptibility loci was obtained. CONCLUSIONS: This model represents a large homogeneous human family-based population for the study of genetic and environmental factors contributing to complex diseases.

Increasing prevalence of diabetes mellitus in Oman.

AIMS: To determine the prevalence of diabetes mellitus and impaired fasting glucose by age, gender, and by region and compare results with the 1991 survey; and estimate previously undiagnosed diabetes mellitus in the Omani population. METHODS: Cross-sectional survey containing a probability random sample of 5838 Omani adults aged >or= 20 years. Diabetes and impaired fasting glucose (IFG) were assessed by fasting venous plasma glucose using 1999 World Health Organization's diagnostic criteria (normoglycaemia < 6.1 mmol/l, IFG >or= 6.1 but < 7 mmol/l,and diabetes >or= 7 mmol/l). The 1991 survey was reanalysed using the same diagnostic criteria, and results were compared. RESULTS: In 2000, the age-adjusted prevalence of diabetes among Omanis aged 30-64 years reached 16.1% (95% confidence interval (CI) 14.7-17.4) compared with 12.2% (95% CI11.0-13.4) in 1991. IFG was found among 7.1% (95% CI6.2-8.1) of males and 5.1% (95% CI 4.4-6.0) of females. Generally, diabetes was more common in urban then rural regions. Only one-third of diabetic subjects knew that they had diabetes. Nearly half of the study population had a body mass index > 25 kg/m2. CONCLUSIONS: The prevalence of diabetes is high in Oman and has increased over the past decade. The high rate of abnormal fasting glucose together with high rates of overweight and obesity in the population make it likely that diabetes will continue to be a major health problem in Oman. Primary prevention programmes are urgently needed to counteract major risk factors that promote the development of diabetes.

Diabetes in Oman: comparison of 1997 American Diabetes Association classification of diabetes mellitus with 1985 WHO classification.

BACKGROUND: Diabetes mellitus (DM) is a major public health problem in Oman. We evaluated the impact of the revised diagnostic criteria for DM adopted by the American Diabetes Association (ADA) on the prevalence of diabetes and impaired glucose tolerance (IGT), and on the classification of individuals among the Omani population. SUBJECTS AND METHODS: We used the dataset of the National Diabetes Survey, conducted in 1991 and involving 4682 subjects who did not have any missing data on fasting and 2-hour glucose. The subjects comprised 2002 males and 2680 females aged 20 years or above. Data were analyzed using the ADA criteria (diabetes as fasting plasma glucose [FPG] > or =7 mmol/L, impaired fasting glucose [IFG] as FPG > or =6.1 mmol/L and <7 mmol/L), and compared these with the World Health Organization (WHO) criteria (diabetes as FPG > or =7.8 mmol/L and/or 2-hour post-glucose load > or =11.1 mmol/L, IGT as FPG <7.8 mmol/L, and 2-hour post-load 7.8-11.1 mmol/L). RESULTS: Applying the ADA criteria on the Omani population resulted in an overall reduction of diabetes prevalence by 2.2% (95% confidence interval [CI] 1.6% to 2.8%), and a 4.8% reduction of IGT (95% CI 3.8% to 5.8%). Over 29% of diabetics classified by the WHO criteria were reclassified as being normal or having IFG by the ADA criteria. Around 3.6% of those who were normoglycemic by the WHO criteria were classified as having diabetes or IFG by the ADA criteria. In all but one region of Oman, the prevalence of diabetes and IFG using the ADA criteria was lower compared to the prevalence using the WHO criteria. Gender, age and body mass index did not seem to pose an increased risk to the probability of being diagnosed by one criteria or the other or both together. CONCLUSION: The adoption of the ADA criteria in Oman will significantly reduce the prevalence of diabetes and IGT. In addition, the glycemic status of a substantial number of individuals will be changed from normal to either being diabetic or having IGT.

Body fat distribution and the risk of non-insulin-dependent diabetes mellitus in the Omani population.

Anthropometric measures of overall and central obesity as predictors of non-insulin-dependent diabetes mellitus (NIDDM) risk were studied. Data for 4728 Omanis were taken from the 1991 National Diabetes Survey. Diabetes mellitus was assessed using a 2-hour post glucose load. After adjusting for age, sex, family history of diabetes, physical activity and blood pressure, body mass index (BMI) was positively associated with increased risk of diabetes mellitus. Controlling for BMI and other potential confounders, waist-to-hip ratio and waist circumference were positively associated with increased risk of diabetes mellitus. Waist measurement (alone or with hip circumference) is a simple and independent tool for assessing the risk of NIDDM.

Body fat distribution and the risk of non-insulin-dependent diabetes mellitus in the Omani population

Anthropometric measures of overall and central obesity as predictors of non-insulin-dependent diabetes mellitus [NIDDM] risk were studied. Data for 4728 Omanis were taken from the 1991 National Diabetes Survey. Diabetes mellitus was assessed using a 2-hour post glucose load. After adjusting for age, sex, family history of diabetes, physical activity and blood pressure, body mass index [BMI] was positively associated with increased risk of diabetes mellitus. Controlling for BMI and other potential confounders, waist-to-hip ratio and waist circumference were positively associated with increased risk of diabetes mellitus. Waist measurement [alone or with hip circumference] is a simple and independent tool for assessing the risk of NIDDM