Unveiling the Tapestry of Tobacco Consumption: Exploring the Sociodemographic Factors Impacting Smokers at Smoking Cessation Clinics in Jeddah.

Background The World Health Organization (WHO) has identified tobacco smoking as a global epidemic, causing an estimated three million deaths annually. This study aims to examine the sociodemographic characteristics and smoking-related behaviors among individuals attending smoking cessation clinics in Jeddah during 2022. By identifying these factors, appropriate interventions can be developed to combat the smoking epidemic. Methodology The study enrolled male and female participants who visited the Smoking Cessation Clinics in Jeddah from January 2022 to December 2022. Eligible participants were between 18 and 60 years old and agreed to take part in the study. Data on smoking status, medical history, previous attempts at quitting, and medication use were collected. Statistical analysis, including chi-square tests and P-values, was conducted to assess the associations between participants' medical history and smoking cessation attempts. Results A total of 5,869 participants were included in the study. The findings revealed that approximately one-fifth of the participants had previously attempted to quit smoking, while the majority 4,780 (81.4%) had not made any cessation attempts. Among those who had made quit attempts, the majority had tried quitting between one and four times 968 (16.5%). The duration of successful cessation reported by participants was generally short, with the majority 4,781 (81.5%) not experiencing any extended period of quitting. Common reasons for relapse included cravings, social influences, mood changes, stress, and withdrawal symptoms. The study also found significant associations between specific medical conditions and smoking cessation attempts. Conclusions The study identified significant associations between male gender, older age group (51-60 years), divorced marital status, intermediate educational levels, higher income levels, retired status, extreme body mass index (BMI) categories, and previous attempts at smoking cessation. Healthcare providers and policymakers should consider these findings when developing and implementing smoking cessation programs. The insights gained from this research can contribute to the development of targeted interventions to reduce smoking rates and improve public health outcomes.

Mortality patterns among COVID-19 patients in two Saudi hospitals: Demographics, etiology, and treatment.

Background: Saudi Arabia (SA) reported its first case of COVID-19 on 2 March 2020. Mortality varied nationwide; by April 14, 2020, Medina had 16% of SA's total COVID-19 cases and 40% of all COVID-19 deaths. A team of epidemiologists investigated to identify factors impacting survival. Methods: We reviewed medical records from two hospitals: Hospital A in Medina and Hospital B in Dammam. All patients with a registered COVID-related death between March and May 1, 2020, were included. We collected data on demographics, chronic health conditions, clinical presentation, and treatment. We analyzed data using SPSS. Results: We identified 76 cases: 38 cases from each hospital. More fatalities were among non-Saudis at Hospital A (89%) versus Hospital B (82%, p < 0.001). Hypertension prevalence was higher among cases at Hospital B (42%) versus Hospital A (21%) (p < 0.05). We found statistically significant differences (p < 0.05) in symptoms at initial presentation among cases at Hospital B versus Hospital A, including body temperature (38°C vs. 37°C), heart rate (104 bpm vs. 89 bpm), and regular breathing rhythms (61% vs. 55%). Fewer cases (50%) at Hospital A received heparin versus Hospital B (97%, p-value < 0.001). Conclusion: Patients who died typically presented with more severe illnesses and were more likely to have underlying health conditions. Migrant workers may be at increased risk due to poorer baseline health and reluctance to seek care. This highlights the importance of cross-cultural outreach to prevent deaths. Health education efforts should be multilingual and accommodate all literacy levels.

Demographic Characteristics and Status of Vaccinated Individuals with a History of COVID-19 Infection Pre- or Post-Vaccination: A Descriptive Study of a Nationally Representative Sample in Saudi Arabia.

BACKGROUND: Saudi Arabia expedited the approval of some COVID-19 vaccines and launched mass vaccination campaigns. The aim of this study was to describe the demographics of vaccinated COVID-19 cases and compare the mortality rates of COVID-19 cases who were infected post-vaccination in Saudi Arabia. METHODS: This was a retrospective cohort study. We retrieved data for COVID-19 cases who were infected pre- or post-vaccination and had received at least one injection of the Oxford-AstraZeneca or Pfizer-BioNTech vaccine from 4 December 2020 to 15 October 2021. RESULTS: The number of patients who were infected and had received at least one dose of a COVID-19 vaccine was 281,744. Approximately 45% of subjects were infected post-vaccination, and 75% of subjects had received the Pfizer-BioNTech vaccine. Only 0.342% of the patients who were infected post-vaccination died, and 447 patients were admitted to ICUs. Most of the patients who were infected with COVID-19 post-vaccination and were admitted to ICUs (69.84%) had received only one dose of the vaccine (p < 0.0001). The mean time to infection for patients who had received one and two doses of the Oxford-AstraZeneca vaccine were 27 and 8 days longer than their counterparts who had received one and two doses of Pfizer-BioNTech vaccine, respectively. No difference in the odds of mortality between the Pfizer-BioNTech and Oxford-AstraZeneca vaccines was found (OR = 1.121, 95% CI = [0.907-1.386], p-value = 0.291). Patients who had received two doses of the vaccine had significantly lower odds of mortality compared to those who had received one dose (p < 0.0001). CONCLUSIONS: Vaccines are vital in combating the COVID-19 pandemic. The results of this study show no difference between the Pfizer-BioNTech and Oxford-AstraZeneca vaccines in the rate of mortality. However, the number of vaccine doses was significantly associated with a lower risk of mortality. Future studies should examine the effectiveness of different COVID-19 vaccines using real-world data and more robust designs.

Public health workers' knowledge, attitude and practice regarding COVID-19: the impact of Field Epidemiology Training Program in the Eastern Mediterranean Region.

BACKGROUND: This study aimed to compare knowledge, attitude and practice (KAP) regarding COVID-19 between public health workers (PHWs) attended field epidemiology training program (FETP-trained) and those who did not attend FETP (non-FETP trained). METHODS: Multi-country cross-sectional survey was conducted among PHWs who participated in COVID-19 pandemic in 10 countries at EMR. Online questionnaire that included demographic information, KAP regarding COVID-19 pandemic was distributed among HCWs. Scoring system was used to quantify the answers, bivariate and Multivariate analysis performed to compare FETP-trained with non-FETP trained PHWs. RESULTS: Overall, 1337 PHWs participated, with 835 (62.4%) < 40 years of age, and 851 (63.6%) males. Of them, 423 (31.6%) had FETP, including that 189 (44.7%) had advanced level, 155 (36.6%) intermediate and 79 (18.7%) basic level training. Compared with non-FETP trained, FETP trained were older, having higher KAP scores. FETP participation was low in infection control, and PH laboratories. KAP mean scores for intermediate level attendees are comparable to advanced level. CONCLUSIONS: FETP-trained are having better KAP than non-FETP PHWs. Expanding the intermediate level, maintain the Rapid Response training and introduce the laboratory component are recommended to maximize the benefit from FETP. Infection control, antimicrobial resistance and coordination are areas where training should include.

Drug Resistance to Anti-Tuberculosis Drugs: A Cross-Sectional Study From Makkah, Saudi Arabia.

Aim The aim of this study was to investigate the patterns and determinants of drug resistance to tuberculosis (TB) in a large population from Makkah, Saudi Arabia. Methods A retrospective, cross-sectional cohort study was conducted on all patients with TB who were referred to the National Tuberculosis Prevention Program in Makkah, Saudi Arabia, between January 2016 and September 2020. For each TB case, demographic data were collected in addition to the results of drug susceptibility testing (DST) for anti-TB drugs. The Statistical Package for Social Sciences (SPSS) software for Windows, version 23 (IBM Corporation, Armonk, NY, USA), was used for the statistical analysis. Results A total of 472 TB-confirmed cases were included in the analysis. The mean ± standard deviation of the age was 38.5 ± 17.7 years. The vast majority of patients were male (62.7%) and had pulmonary TB (91.7%). Only a small proportion of the patients with TB had diabetes mellitus (8.5%). Overall, the prevalence of monodrug-resistant TB ranged from 2.1% to 3.4%. Specifically, the prevalence of monodrug-resistant TB to isoniazid and streptomycin was ranked first and was equal to 3.4%. Pyrazinamide had the lowest prevalence of monodrug-resistant TB (2.1%). The prevalence of polydrug-resistant TB (PDR-TB) and multidrug-resistant TB (MDR-TB) was 1.5%. In the univariate analysis, sex (male) was the only sociodemographic factor that significantly correlated with a higher prevalence of MDR-TB. Conclusions This is the second study from Makkah to analyze the prevalence and associated risk factors of MDR-TB among patients from Makkah. Our data demonstrated that the prevalence of monodrug-resistant TB and MDR-TB was low (2.1%-3.4% and 1.5%, respectively). Diabetes mellitus was not a substantial factor correlated with a higher occurrence of MDR-TB. Additional epidemiologic studies are required to validate our results.

Launching COVID-19 vaccination in Saudi Arabia: Lessons learned, and the way forward.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV- 2) emerged in Wuhan City, China. The SARS-CoV-2 crossed borders and quickly transformed into a "Public health emergency of international concern". Countries around the globe are in the race to achieve herd immunity. We describe the steps taken by Saudi Arabia to achieve this goal.

Assessment of Preventative Measures Practice among Umrah Pilgrims in Saudi Arabia, 1440H-2019.

:Background: Annually, approximately 10 million pilgrims travel to the Kingdom of Saudi Arabia (KSA) for Umrah from more than 180 countries. This event presents major challenges for the Kingdom's public health sector, which strives to decrease the burden of infectious diseases and to adequately control their spread both in KSA and pilgrims home nations. The aims of the study were to assess preventative measures practice, including vaccination history and health education, among Umrah pilgrims in Saudi Arabia. Methods: A cross sectional survey was administered to pilgrims from February to April 2019 at the departure lounge at King Abdul Aziz International airport, Jeddah city. The questionnaire comprised questions on sociodemographic information (age, gender, marital status, level of education, history of vaccinations and chronic illnesses), whether the pilgrim had received any health education and orientation prior to coming to Saudi Arabia or on their arrival, and their experiences with preventative practices. Results: Pilgrims (n = 1012) of 41 nationalities completed the survey. Chronic diseases were reported among pilgrims (n = 387, 38.2%) with cardiovascular diseases being the most reported morbidity (n = 164, 42.3%). The majority of pilgrims had been immunized prior to travel to Saudi Arabia (n = 770, 76%). The most commonly reported immunizations were influenza (n = 514, 51%), meningitis (n = 418, 41%), and Hepatitis B virus vaccinations (n = 310, 31%). However, 242 (24%) had not received any vaccinations prior to travel, including meningitis vaccine and poliomyelitis vaccine, which are mandatory by Saudi Arabian health authorities for pilgrims coming from polio active countries. Nearly a third of pilgrims (n = 305; 30.1%) never wore a face mask in crowded areas during Umrah in 2019. In contrast, similar numbers said they always wore a face mask (n = 351, 34.6%) in crowded areas, while 63.2% reported lack of availability of face masks during Umrah. The majority of participants had received some form of health education on preventative measures, including hygiene aspects (n = 799, 78.9%), mostly in their home countries (n = 450, 44.4%). A positive association was found between receiving health education and practicing of preventative measures, such as wearing face masks in crowded areas (p = 0.04), and other health practice scores (p = 0.02). Conclusion: Although the experiences of the preventative measures among pilgrims in terms of health education, vaccinations, and hygienic practices were at times positive, this study identified several issues. These included the following preventative measures: immunizations, particularly meningitis and poliomyelitis vaccine, and using face masks in crowded areas. The recent COVID-19 pandemic highlights the need for further studies that focus on development of accessible health education in a form that engages pilgrims to promote comprehensive preventative measures during Umrah and Hajj and other religious pilgrimages.

Controlling COVID-19 Pandemic: A Mass Screening Experience in Saudi Arabia.

A highly accelerating number of people around the world have been infected with novel Coronavirus disease 2019 (COVID-19). Mass screening programs were suggested by the World Health Organization (WHO) as an effective precautionary measure to contain the spread of the virus. On 16 April 2020, a COVID-19 mass screening program was initiated in Saudi Arabia in multiple phases. This study aims to analyze the number of detected COVID-19 cases, their demographic data, and regions most affected in the initial two phases of these mass screening programs. A retrospective cross-sectional study was conducted among the high-risk population as part of the COVID-19 mass screening program across all regions in Saudi Arabia during April and May 2020. A Chi-square-test was used to determine the associations between positive cases and various demographic variables. Out of 71,854 screened individuals, 13.50% (n = 9701) were COVID-19 positive, of which 83.27% (n = 59,835) were males. Among positive cases, in the 30-39 years age group, 6.36% were in the active phase, and 2.19% were in the community phase. Based on our experience, launching mass screening programs is crucial for early case detection, isolation, and pattern recognition for immediate public interventions.

The importance of hand hygiene education on primary schoolgirls' absence due to upper respiratory infections in Saudi Arabia. A cluster randomized controlled trial.

OBJECTIVES: To quantify the reduction in absence due to upper respiratory infections (URIs) among primary schoolgirls attending Riyadh's schools after delivering a hand hygiene workshop intervention over a period of 5 weeks. Methods: A cluster randomized trial was conducted among girls attending 4 primary schools between January and March 2018. The participants attended a hand hygiene workshop. The schoolgirls' absences were followed up for 5 weeks. Incidence rate, percentage of absence days, and absence rate were calculated for total and URIs absences. Result: Total number of participating schoolgirls was 496. Upper respiratory infections accounted for 15.3% of absence episodes. Schoolgirls lost 521 days of school and 19.4% of them were URIs-related. Absence rate due to URIs were 12.4 and 23.4 as well as 5.62 and 11.72 per 100 schoolgirls in the control (CG) and experimental (EG) groups, respectively. Percentage of absence days were lower in the experimental group (CG: 0.86% and 1.39% versus EG: 0.39% and 0.72%). Incidence rates of absence due to URIs were 0.54 and 1.02 in CG versus 0.24 and 0.51 in EG per 100 schoolgirls per day. Conclusion: There could be further reduction in school absences if education was accompanied by hand soap dissemination. The study could serve as a pilot for major studies in the future. Sustainability of the intervention can be tested in studies with longer durations.

Comparative outcomes after unprotected left main stem percutaneous coronary intervention: a national linked cohort study of 5,065 acute and elective cases from the BCIS Registry (British Cardiovascular Intervention Society).

OBJECTIVES: The goal of this study was to report outcomes from percutaneous coronary intervention (PCI) to an unprotected left main stem (UPLMS) stenosis according to presenting syndrome, including ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation acute coronary syndrome (NSTEACS), and chronic stable angina (CSA). BACKGROUND: There are no published whole-country data concerning patient outcomes following PCI to UPLMS. METHODS: This study is a prospective national cohort study using data from the British Cardiovascular Intervention Society (BCIS) registry from January 1, 2005, through December 31, 2010. RESULTS: Of 5,065 patients having PCI to an UPLMS, 784 (15.5%) presented with STEMI, 2,381 (47.0%) with NSTEACS, and 1,900 (37.5%) with CSA. Crude 30-day and 1-year mortality rates were STEMI: 28.3% and 37.6%, NSTEACS: 8.9% and 19.5%, and CSA: 1.4% and 7.0%, respectively. Unadjusted in-hospital major adverse cardiovascular and cerebrovascular event rates were STEMI: 26.6%, NSTEACS: 6.6%, and CSA: 3.3%. Risk of 30-day mortality was much greater for STEMI and NSTEACS patients than CSA (STEMI adjusted odds ratio [aOR]: 29.45, 95% confidence interval [CI]: 19.37 to 44.80, NSTEACS aOR: 6.45, 95% CI: 4.27 to 9.76). More than 40% of patients presenting with STEMI had cardiogenic shock, in whom mortality was higher than in STEMI cases without shock (30 days: 52.0% vs. 11.7%, 1 year: 61.1% vs. 20.9%). Radial access, compared with the femoral approach, was associated with a lower risk of 30-day mortality (STEMI aOR: 0.37, 95% CI: 0.21 to 0.62; NSTEACS aOR: 0.66, 95% CI: 0.45 to 0.97). CONCLUSIONS: More than one-half of the patients who received UPLMS PCI were acute where outcomes were much worse than elective cases. Cardiogenic shock is common in STEMI patients, of whom more than one-half die at 30 days. The radial approach was associated with reduced early mortality in acute cases.