Blood pressure standards for pre-school children in Saudi Arabia.

The prevalence of hypertension (HTN) in children is increasing. Early detection of HTN in childhood may prevent the occurrence of complications in adult age. Blood pressure (BP) varies between populations according to ethnic and environmental factors. Based on these variations, reference norms developed for one particular population may not be applicable to others. Thus, this study aimed to provide age-, gender-, and height-related BP reference standards using oscillometric techniques for pre-school children in Saudi Arabia. A sub-sample of preschool children aged from 2 to 6 years was selected by multi-stage probability sampling of Saudi population. The samples represented Saudi children from the whole country. Data were collected through a house-to-house survey of all selected households in all 13 regions in the country. Oscillometric devices were used to measure the BP. Data were analyzed to study the distribution pattern of systolic (SBP) and diastolic BP (DBP) and to develop reference values based on age, gender, and height. The values for each age and height percentile were compared with the recent (2017) values of the North American children. A total of 2553 Saudi Arabian children (1299 boys and 1254 girls) aged 2-6 years with complete data on age, gender, height, SBP, and DBP were considered for analysis. Values for SBP and DBP were significantly higher in Saudi children than in the North American children. This study adds evidence to the BP variations between populations with influences such as genetic and environmental factors. The need of every population to define its normal BP standards is essential to avoid unnecessary investigations and anxiety in patients and their parents.

Body mass index in Saudi Arabian children and adolescents: a national reference and comparison with international standards.

BACKGROUND AND OBJECTIVES: Because there are no reference standards for body mass index (BMI) in Saudi children, we established BMI reference percentiles for normal Saudi Arabian children and adolescents and compared them with international standards. SUBJECTS AND METHODS: Data from a stratified multistage probability sample were collected from the 13 health regions in Saudi Arabia, as part of a nationwide health profile survey of Saudi Arabian children and adolescents conducted to establish normal physical growth references. Selected households were visited by a trained team. Weight and length/height were measured and recorded following the WHO recommended procedures using the same equipment, which were subjected to both calibration and intra/interobserver variations. RESULTS: Survey of 11 874 eligible households yielded 35 275 full-term and healthy children and adolescents who were subjected to anthropometric measurements. Four BMI curves were produced, from birth to 36 months and 2 to 19 years for girls and boys. The 3rd , 5 th , 10th , 25th , 50th , 75th , 85th , 90th , 95th , and 97th percentiles were produced and compared with the WHO and CDC BMI charts. In the higher percentiles, the Saudi children differed from Western counterparts, indicating that Saudi children have equal or higher BMIs. CONCLUSION: The BMI curves reflect statistically representative BMI values for Saudi Arabian children and adolescents.

Pattern of celiac disease in infants and children.

This study involved all children with celiac disease admitted and seen in the Paediatric Gastroenterology Clinic at King Khalid University Hospital (KKUH) over a 10-year period. In the first year, we identified 62 cases with celiac disease. Their mean age at presentation, introduction to cereals in the diet, and onset of symptoms were 6.5, 6 and 6 months, respectively, and most of the children belonged to the indigenous population. There were three Arabia families with more than one affected child and most families were of good social status. The main symptoms noted were diarrhoea in 34 (57%), growth failure in 47 (74.6%), abdominal distension in 21 (33%), and vomiting in 14 patients (14%). The significant physical signs at the time of presentation were short stature, seen in 44 patients (69.8%), pallor in 25 (40.3%) and abdominal distention in 21 (33%). The mean haemoglobin, serum feritin, serum folate, calcium, and serum albumin were 10.25 g/dL, 2.49 g/mL, 0.25 ng/mL, 8.86 mg/dL, and 3.7 g/dL. The mean anti-reticulin IgG, anti-endomyseal IgG, IgA and anti-gliadin IgG, IgA were one in 246, 332, 720, 121 and 300 units. There was total villous atrophy in each patient at the time of initial presentation; repeat small bowel biopsies were done in 12 patients of whom 6, 4 and 2 had normal villi, partial villous atrophy and subtotal villous atrophy, respectively. A third biopsy was performed in 2 patients while on gluten containing diet, which revealed villous atrophy. Most of the children improved on gluten-free diet.