Prevalence of mental retardation among children in Saudi Arabia.

This survey determined the prevalence and regional distribution of mental retardation among children in Saudi Arabia. Data were analysed from a population-based national survey conducted during 1996-99, in which 60,630 children aged up to 18 years were screened using IQ tests and questionnaires completed by physicians. The prevalence of mental retardation was 8.9 per 1000 children, a rate similar to that reported in other countries. Moderate or severe retardation was classified in 70.9% of these children. Of the mentally retarded children in the 0-18 years age range, 83.2% were not attending school. Special educational programmes are needed to improve the quality of life of mentally retarded children.

Prevalence of mental retardation among children in Saudi Arabia

This survey determined the prevalence and regional distribution of mental retardation among children in Saudi Arabia. Data were analysed from a population-based national survey conducted during 1996-99, in which 60,630 children aged up to 18 years were screened using IQ tests and questionnaires completed by physicians. The prevalence of mental retardation was 8.9 per 1000 children, a rate similar to that reported in other countries. Moderate or severe retardation was classified in 70.9% of these children. Of the mentally retarded children in the 0-18 years age range, 83.2% were not attending school. Special educational programmes are needed to improve the quality of life of mentally retarded children

Seroepidemiology of hepatitis B virus infection in Saudi children 8 years after a mass hepatitis B vaccination programme.

OBJECTIVES: On October 1 1989, a programme was begun in Saudi Arabia in which the HBV vaccine was added as the 'seventh' primary immunogen of the Extended Programme of Immunization (EPI). In 1990, another programme was launched by the Ministry of Health to vaccinate all school children. Eight years after this mass vaccination programme, the efficacy of HBV vaccine was evaluated in a community-based study. METHODS: A community-based study was carried out in Saudi children in urban and rural areas, covering all the regions of Saudi Arabia. After informed consent, blood samples were obtained and tested for HBV markers. RESULTS: Among 4791 vaccinated Saudi children aged 1-12 years, only 15 were found to be HbsAg-positive (0.31%). HbsAg-positivity was 0.16% in children vaccinated at birth compared with 0.7% in those vaccinated at school entry. The overall HbsAg carrier rate dropped from 6.7% in 1989 to 0.3% in 1997 (P<0.00001). Similarly, there was a significant reduction in the prevalence of anti-HBc from 4.2% in 1989 to 0.46% in 1997 (P<0.00001). The overall seroconversion rate to HB vaccine among 4087 Saudi children up to 12 years of age was about 77%. Seroconversion rate in those vaccinated at birth was 77% compared with 71% in those vaccinated at school entry. After 8 years of receiving the third vaccine dose, close to 65% of the children had an anti-HBs titre of more than 10 IU/l compared with about 28% who had an anti-HBs titre of more than 100 IU/l after the same period. CONCLUSION: The result of this study demonstrates the tremendous impact of the mass HB vaccination programme on the seroepidemiology of HBV infection in Saudi Arabia. The ultimate goal of preventing HBV-related chronic liver disease and hepatocellular carcinoma in Saudi Arabia is foreseeable in the near future.

Lipids and related parameters in Saudi type II diabetes mellitus patients.

BACKGROUND: Non-insulin dependent diabetes mellitus (type II DM) is frequently associated with abnormal levels of lipids, particularly in patients with poor diabetic control. This study was designed to investigate the influence of type II DM on levels of plasma lipids and other related parameters in Saudi patients. Saudi Arabia has a high prevalence of diabetes mellitus in the adult population. Since the Saudi population presents a unique group with different dietary habits, lifestyle and genetic make-up, we investigated the lipids, lipoprotein and apolipoprotein pattern in Saudi type II DM patients. MATERIALS AND METHODS: This study was conducted on 2835 diabetic patients (1361 males, 1474 females) and 200 age-matched healthy adults from the same areas with no history of diabetes mellitus. Data collected included height, weight, body mass index (BMI), blood pressure and other relevant parameters. Lipids, lipoproteins and apolipoproteins were estimated, and correlation studies were carried out between these parameters. Lipids, lipoproteins and apolipoproteins were also correlated with the fasting blood glucose. RESULTS: Our results showed significant elevation in cholesterol and triglyceride, apo A and apo B levels in the diabetic males and females compared to the controls. Approximately 37% of the total DM patients fell in the borderline risk group, while 28.4% fell in the high-risk group for development of cardiovascular disease. Lipoproteins did not differ significantly. Cholesterol, triglyceride, VLDL, LDL and Hb A1c correlated positively with glucose (P<0.05), while triglyceride, VLDL, HDL, LDL, apo A and apo B showed significant correlation with cholesterol, where all parameters increased with cholesterol except HDL, which decreased as cholesterol increased. CONCLUSION: The findings point toward high prevalence of dyslipidemia in type II DM Saudi patients.

Hepatitis A in Saudi Arabia: A comparative sero-epidemiological study.

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Etiology of end-stage renal disease in two regions of saudi arabia.

A total of 127 patients with end-stage renal disease (ESRD) including 45 from Al-Madinah and 82 from the Gizan regions of Saudi Arabia were studied to determine the etiology of ESRD. The categorization into various diagnoses were according to established criteria. A total of 22 renal biopsies were also obtained to aid in the diagnosis. The mean age of the study patients was 50 years in Al-Madinah region and 37 years in Gizan region. Overall, the etiology could be established in 56 patients (44.1%) including 31 patients (68.9%) in Al-Madinah and 25 patients (30.5%) in Gizan regions. Diabetic nephropathy was the commonest cause of ESRD in Al-Madinah (45.2%) while obstructive nephropathy was the commonest identifiable cause in Gizan (24%). Our study suggests that diabetes and obstruction are the main conditions against which strategies for prevention and treatment should be directed.

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.

Sickle cell gene in the population of Saudi Arabia.

A comprehensive screening program was initiated in Saudi Arabia in 1982 to determine the frequency of the sickle cell (Hb S) gene in the different regions of Saudi Arabia. Over a period of 10 years 30,055 samples were collected from 36 areas in the five provinces of Saudi Arabia; these were screened using electrophoretic techniques in alkaline and acid pH for the presence of Hb S in heterozygous and homozygous states. The overall prevalence of Hb AS was 7.36% and Hb SS was 1.06%, giving an Hb S gene frequency of 0.047. The results from the different regions were separated and the prevalence of Hb AS and Hb SS and Hb S gene frequencies were calculated in each province and each region. The prevalence of Hb AS and Hb SS cases ranged from O to 25.88% and O to 5.27%, respectively. No case of Hb AS or Hb SS were identified in certain areas of the central province (Al-Russ, Al-Unaiza, Al-Mesnab and Bkaria) and northern province (Qurayat and Al-Jouf). In the southern province both Hb S homozygotes and heterozygotes were encountered in all regions except Farasan Island. In all other regions the Hb S gene was encountered, but at a variable frequency. Applying Hardy-Weinberg equilibrium it was observed that in the majority of the regions the observed Hb S homozygotes were significantly higher compared to the number expected (p < 0.0001). This was believed to be due to bias as the samples were collected in the hospital. The Hb S gene frequency in the different regions ranged from 0 to 0.17 when the frequency was calculated on the basis of both Hb AS and Hb. SS cases, and 0 to 0.13 if the gene frequency was calculated after eliminating the Hb SS cases. A close correlation was observed between the Hb S gene frequency and malaria endemicity. This study shows that the Hb S gene occurs frequently in several regions of Saudi Arabia and there is an urgent need to implement control and prevention programs to reduce the number of Hb S homozygous cases.

Diabetes mellitus and impaired glucose tolerance in Saudi Arabia.

This study was undertaken to determine the prevalence of diabetes mellitus (DM), insulin-dependent diabetes mellitus (IDDM), noninsulin-dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) in different areas of Saudi Arabia. A household survey was conducted in 34 different areas of Saudi Arabia. Demographic data and medical history were taken and filled. Fasting and two-hour "post-glucose load" blood samples were collected from 23,493 Saudi males and females and blood glucose was estimated immediately. The diagnoses of DM and IGT were made based on the criteria of the World Health Organization (WHO). Diabetic patients were subgrouped as IDDM and NIDDM on the basis of age of onset and mode of treatment. In the overall group (two to 70 years), the prevalence of IDDM, NIDDM and IGT was 0.193%, 5.503% and 0.498% in the Saudi males and 0.237%, 4.556% and 0.900% in the Saudi females. When grouped on the basis of age, there were 8762 children (<14 years). Of these children, 15 (0.171%) had IDDM and 13 (0.148%) had maturity onset diabetes of the young (MODY). The prevalence of IGT in this group was 0.250%. In the 14-70-year age group, the prevalence of IDDM, NIDDM and IGT was 0.239%, 9.50% and 0.717% in the males and 0.248%, 6.820% and 1.347% in the females, respectively. A significant increase (P<0.001) was obvious in the age group >30 years, where the prevalence of NIDDM and IGT rose to 17.32% and 1.30% in the males and 12.18% and 2.2% in the females, respectively. IDDM showed a slight decrease in those over the age of 60 years. These results place Saudi Arabia among the countries that have a high prevalence for DM and a moderate risk for IGT. In light of these findings, it is clear that carefully planned programs are needed to achieve control and prevention of diabetes mellitus in Saudi Arabia.

Survey of opinion of secondary school students on organ donation.

We conducted a survey of opinion of a sample of senior high school students in Saudi Arabia to evaluate their awareness of the importance of organ donation and concept of brain death. There were 839 students from nine schools, 745 males and 94 females. The participants were not primed about these topics before answering the questionnaire, which was answered at school. The study group declared the level of education of the parents. Twenty three percent knew about the Saudi Center for Organ Transplantation, but 61% could only guess its function. Fifty eight percent could not differentiate between "natural 11 death and brain death and 93% were not aware of how to document it. Elaboration on these questions showed variable explanations. Sixty eight percent agreed to donate organs of relatives in case of brain death, and 91% would donate a kidney to their relatives. However, 38% agreed to donate organs of their own to organ failure patients other then relatives. Thirty five percent knew about the organ donation cards, but only 12% carried them, and only 48% would consent to include the word "donor" on their driving licenses. Forty two percent knew about the opinion of Islamic religion toward organ donation. Thirty one percent agreed to send patients for organ transplantation abroad due to their belief that transplantation technology in Saudi Arabia is lacking, There were no significant differences in the answers according to schools, gender, students of different curricula, having a friend or relative with organ failure, or the level of the education of the parents. This study suggests the great need for education of the new generation about the importance of organ donation and the concept of brain death. We believe that including these topics in the curricula of schools would help disseminating this knowledge to the public in Saudi Arabia.