Factors associated with the knowledge of obstetric danger signs among pregnant women attending primary health care antenatal care clinics in Abha city.

Introduction: Knowledge of obstetric danger signs would equip women to make the right decisions and appropriate actions timely to have better health care assistance which will impose a significant impact on maternal mortality and morbidity. Hence, this study aimed to know the factors associated with the knowledge of obstetric danger signs among pregnant women who attend the primary health care clinics, which is considered as the first gate to seek health care for pregnant women during antenatal checkups. Methodology: This is a cross-sectional study conducted among 400 pregnant women selected by simple random sampling technique who were attending antenatal clinics at primary health care centers at Abha City by using an interview-based questionnaire.cores of <50%, 50-75%, and >75% were considered to be poor, intermediate, and good scores. Frequencies and percentages were used for descriptive variables, whereas for association, tests of significance (Chi square, t-test, and F-test) were applied. Results: Almost 70.8% of participants received health information on obstetric danger signs. The main sources of information were the Internet (23%), family, relatives or friends (17%), and health care providers. The highest participants' correct responses regarding obstetric danger signs were related to severe vaginal bleeding (93.5%), convulsions (76.8%), and decreased fetal movements (76.5%). Proportions of participants with poor knowledge showed an inverse and significant increase with their educational levels (P < 0.001). The highest percentage of poor knowledge grade was observed among participants with no children (54.6%). Participants who received previous information on danger signs had significantly better knowledge grades than those who have not received previous information (P < 0.001). Conclusions: Women's knowledge was suboptimal regarding obstetric danger signs. 30% of women did not receive information about danger signs. Health education provided on obstetric danger signs to pregnant women should be enforced to those who are illiterate, are unemployed, have a low family income, and are with no or less previous pregnancies.

Validation and Cultural Adaptation of the Parent Attitudes about Childhood Vaccines (PACV) Questionnaire in Arabic Language Widely Spoken in a Region with a High Prevalence of COVID-19 Vaccine Hesitancy.

The parents' attitude toward vaccinating children and adolescents against coronavirus disease 2019 (COVID-19) remains inconsistent and needs further elucidation. The high rates of COVID-19 vaccine hesitancy in the Middle East and North Africa (MENA) region require intensive research to understand the determinants of this phenomenon. This study aimed to validate a version of the Parent Attitudes about Childhood Vaccines (PACV) tool in Arabic, the most widely spoken language in the MENA. The study objectives included the investigation of Arab-speaking parents' views regarding COVID-19 vaccination of their children. Parents living in Egypt with at least one child aged 5−18 years were eligible to participate in the study that was conducted through an online survey with 15 PACV items. The PACV tool was translated into Arabic using forward and backward translation. To assess the psychometric properties of the Arabic version of PACV, Pearson's correlation coefficient and exploratory and confirmatory factor analysis (EFA and CFA) were performed. A total of 223 parents participated in the study: 59.82% aged 30−39 years, 69.20% were females, 46.19% were university-educated, and 40.63% had one child. The overall Cronbach's alpha for the Arabic version of PACV was 0.799. The EFA of the 15 items showed that three domains were most conceptually equivalent. All items had a positive significant correlation with the mean score of each subscale except for item 4 (r = 0.016, p = 0.811). Regression analyses results indicated that education, previous COVID-19 infection, vaccine status of parents, and PACV score were significantly associated with the intention of the parents to vaccinate their children against COVID-19. The CFA results showed that most of the factor loadings were statistically significant (p < 0.010) except for items 4 and 7. However, the root mean square error of approximation (RMSEA = 0.080) and the standardized root mean squared residual (SRMR = 0.080) indicated that the model had a reasonable fit, and the three factors were good in reproducing each correlation. Our study results indicated the validity and reliability of the PACV instrument in Arabic language. Consequently, the PACV can be used to assess COVID-19 vaccine hesitancy in a majority of MENA countries for better delineation of this highly prevalent phenomenon in the region.

A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population.

BACKGROUND: Population-based studies on COVID-19 have important implications for modeling the pandemic and determining vaccination policies. Limited data are available from such surveys in Egypt. METHODS: This cross-sectional was conducted throughout the period between January and June 2021, which coincided with the second and third waves of the COVID-19 pandemic in Egypt. At that time, vaccines against COVID-19 were not available to the general population. The study was carried out in eight Egyptian governorates and included 2360 participants, who were recruited through a multistage stratified cluster sample technique, based on gender, age, and district followed by a random sample within each district. Socio-demographic data were recorded and serum samples were collected and tested for SARS-Co-V2 spike (S) antibodies. RESULTS: The overall adjusted prevalence of anti-S was 46.3% (95% CI 44.2-48.3%), with significant differences between governorates. Factors associated with anti-S seropositivity were: being female (p = 0.001), living in a rural area (p = 0.008), and reporting a history of COVID-19 infection (p = 0.001). Higher medians of anti-S titers were significantly associated with: extremes of age (p < 0.001), living in urban areas, having primary education (p = 0.009), and reporting a history of COVID-19 infection, especially if based on chest CT or PCR (p < 0.001). CONCLUSIONS: High seroprevalence rates indicate increased COVID-19 infection and immune response among a considerable percentage of the community. Age, gender, residence, educational level, and previous PCR-confirmed COVID-19 infections were all determinants of the immune response.

Prevalence of severe acute respiratory syndrome coronavirus 2 spike antibodies in some healthcare settings in Egypt.

BACKGROUND: Healthcare workers (HCWs) are at the front line in battling infection transmission, such as that in coronavirus disease 19 (COVID-19). Additionally, they may act as potential carriers passing the virus on to others. Anti-spike (anti-S) antibodies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are formed either as a result of infection or vaccination with both indicating immunity against future COVID-19 infection. AIM: This study aimed to identify the prevalence of COVID-19 seropositivity among HCWs. METHODS: This cross-sectional study included 559 HCWs from 39 hospitals with variable degrees of COVID-19 exposure risk (depending on the occupation, department, and hospital type). Demographic data were recorded as well as history of COVID-19 infection and vaccination. Serum samples were collected and tested for SARS-CoV-2 spike antibodies. RESULTS: Anti-S positivity was found in 59.0% of the participating 559 HCWs, indicating a high level of seroprotection. Of the 559 HCWs, 34.1% had reported previous infection with COVID-19. Following infection, only 46 (24.0%) of those affected received vaccination. Anti-S seropositivity was found in 39.1% of participants who were unvaccinated and had no history of infection. Physicians had the highest median anti-S titers (58.0 relative units (RU)/mL), whereas pharmacists and office staff had the lowest (25.7 and 38.2 RU/mL, respectively). CONCLUSIONS: Overall, 59.0% of the 559 HCWs were anti-S positive, indicating a relatively high seroprotective status. Among those who were unvaccinated and had no history of infection, 39.1% were seropositive for anti-S, denoting a high rate of silent/asymptomatic infections. Screening of HCWs for SARS-CoV-2 anti-S is recommended, along with the vaccination of seronegative individuals.

Determinants of the Development of SARS-CoV-2 Anti-Spike Immune-Response after Vaccination among Healthcare Workers in Egypt.

BACKGROUND: Understanding the factors affecting humoral immune response to COVID-19 vaccines among healthcare workers (HCWs) is essential to predict their level of protection. Vaccination elicits antibodies against SARS-CoV-2 spike protein (anti-S). AIM: To investigate the factors associated with the presence of SARS-CoV-2 anti-S antibodies among vaccinated HCWs. METHODS: This cross-sectional study included 143 vaccinated HCWs, with or without a history of previous COVID-19 infection (clinically, radiologically, or by laboratory results) from different departments. Socio-demographic, clinical, as well as vaccine-related data, were recorded. Serum samples were collected and tested for SARS-CoV-2 spike antibodies. RESULTS: Vaccination provoked an immunogenic response, where the overall anti-S positivity was 83.9% (95% CI: 77.8-90.0%). The response was not affected either by the age or gender of HCWs. Out of the 143 HCWs, 46 (32.1%; 95% CI: 24.4-39.9%) reported a previous history of COVID-19 infection, and seropositivity was significantly higher among them (p = 0.002), and it was associated with the frequency of infection (p = 0.044) and duration since diagnosis of COVID-19 infection (p = 0.065). They had higher median anti-S titers (111.8 RU/mL) than those without infection (39.8 RU/mL). Higher seropositivity was observed with Oxford/AstraZeneca vaccine (AZD1222) (88.9%; 95% CI: 83.1-95.0%) than Sinopharm (BBIBP-CorV) (67.7%; 95% CI: 50.3-85.2%), and with receiving two doses of vaccine (92.3%; 95% CI: 87.1-97.5%). CONCLUSIONS: Antibody positivity was significantly affected by the previous history of COVID-19 infection, type of vaccine, the number of doses received, and duration since vaccination.

WhatsApp-based intervention for promoting physical activity among female college students, Saudi Arabia: a randomized controlled trial.

BACKGROUND: Social media are increasingly being used by young adults worldwide. The question is whether they can be successfully incorporated into health programmes to promote physical activity. AIMS: To measure the effect of a WhatsApp-based intervention for promoting physical activity among female college students in Abha, Saudi Arabia. METHODS: This randomized controlled trial from November 2019 to January 2020 included 110 students. The intervention group received a brief orientation on exercise and up to 4 physical activity promotion messages per week via WhatsApp for 10 weeks. The messages were obtained from the websites of the US Centers for Disease Control and World Health Organization (WHO). Physical activity was assessed at baseline and at 10-weeks' follow-up using the WHO Global Physical Activity Questionnaire. RESULTS: The 2 groups were similar in sociodemographic and baseline physical activity levels. Postintervention data analysis revealed significant improvement in the proportion of participants with moderate-intensity physical activity in the work and recreation domains. Compared with the control group, mean metabolic equivalents/week of the intervention group improved significantly. The mean difference in total physical activity before and after intervention was significant in all domains and in all categories of activity. The proportion of participants who met the WHO criteria for minimum physical activity per week increased from 69.8% to 90.5% after intervention. CONCLUSION: Social-network-based interventions improve physical activity and may be incorporated into youth-targeted health programmes.

Domestic Saudi Arabian Travellers' Understanding about COVID-19 and Its Vaccination.

BACKGROUND: There is a lack of data on Saudi domestic air travellers' understanding regarding COVID-19 and their attitude towards the COVID-19 vaccination. OBJECTIVES: This study aimed to assess Saudi domestic air travellers' understanding regarding COVID-19 and attitude towards mandating the COVID-19 vaccination for travellers. METHODS: A survey using a self-administered, structured, and closed-ended questionnaire was conducted among domestic air travellers in Saudi Arabia. Participants' socio-demographic information, travel history, health status, and attitudes and willingness to accept the COVID-19 vaccination were collected and analysed. RESULTS: Of the 2236 respondents who participated in the survey, 542 (24.25%) had a history of COVID-19, 803 (35.9%) were exposed to a COVID-19 case, 1425 (63.7%) were concerned about catching COVID-19 during air travel, 796 (35.6%) thought the COVID-19 vaccination should be obligatory for travellers, 1105 (49.4%) thought it should be optional, and 335 (15.0%) thought the vaccination was unnecessary. Being of the male gender (adjusted odds ratio [aOR] 1.41, 95% confidence interval [95% CI] 1.14-1.69), being concerned about contracting COVID-19 (aOR 1.34, 95% CI 1.12-2.10) and frequent travelling (aOR 1.40, 95% CI 1.10-3.40) were predictors of vaccination uptake. CONCLUSION: This study demonstrates that although domestic Saudi travellers were concerned about COVID-19 infection, vaccine hesitancy was prevalent among them.

Patients' perceptions and preferences for physicians' attire in hospitals in south western Saudi Arabia.

PURPOSE: Data regarding patients' perception and satisfaction about physicians providing the medical care based on their attires in Southern Region of Saudi Arabia are scarce and even lacking. The aim of this study was to assess the patients' opinion regarding the suitable attires of physicians. MATERIALS AND METHODS: A descriptive cross-sectional survey was performed on a random sample of patients from Aseer Central Hospital, Southern Military Hospital and Abha Maternity Hospital. The questionnaire collected data on their perception of physicians' attire as well as reflection of dress on trust and willingness to discuss personal issues. RESULTS: The study included 248 patients. The majority (81.9%) of the participants agreed on the importance for physicians to wear their medical attires. Also 84.3% of them confirmed that physician's appearance is important source of their confidence. Skirt plus lab coat was the most favored for female physicians (39.3%). As for male physicians, scrub plus lab coat was the most preferred (33.6%) attire. CONCLUSION: Patients attending hospitals in southwestern Saudi Arabia preferred for their physicians to wear formal attire with white coats, rather than the Saudi national dress. Skirt plus lab coat was the most preferred for female physicians. As for male physicians, scrub plus lab coat was the most preferred attire. Patients approved the importance for physicians to wear their medical attires and confirmed that physician's appearance is important source for their confidence. The study recommends that physicians should adopt formal attire and the institutional dress code policy should be modified to fit these preferences.

Awareness and Attitude of University Students About Screening and Testing for Hemoglobinopathies: Case Study of the Aseer Region, Saudi Arabia.

Hemoglobinopathies can disturb a patient's life style leading to community problems. Premarital screening is an important tool to control and minimize hemoglobinopathies. This study aimed to assess and improve the awareness and attitude of King Khalid University (KKU) [Abha, Kingdom of Saudi Arabia (KSA)] students in the Aseer Region, regarding hemoglobinopathies and the National Premarital Screening Programme (NPMS) in addition to screening for hemoglobin (Hb) variants of students who agreed to participate. This study was an interventional educational prospective study of electronic-lectures (e-lectures) that addressed some important issues of hemoglobinopathies and premarital screening. Six hundred and eleven students were interviewed during the academic year 2017/2018, using closed-ended questionnaires that distributed before and after intervention. Blood samples were taken from 114 students who agreed to check their Hb type by the D-10 Hemoglobin Testing System. The results revealed significant changes in knowledge and attitude of students toward hemoglobinopathies and premarital counseling after intervention. These results reflected the need for easily accessible and continuous health education programs for students to increase their awareness and attitude toward hemoglobinopathies. Laboratory results for 114 students revealed seven cases with microcytic hypochromic anemia (6.1%); they were all females. Blood screening for Hb variants revealed another two females (1.75%) with sickle cell trait (Hb AS). Electronic-health (E-health) is an efficient tool for improving the awareness and attitude of the community toward hemoglobinopathies. Screening blood tests for detection of hemoglobinopathies should be provided to young adults at an earlier stage (before marriage) to decrease the incidence of hereditary diseases in the community.

Validation of EGCRISC for Chronic Hepatitis C Infection Screening and Risk Assessment in the Egyptian Population.

Chronic HCV infection, a highly endemic disease in Egypt, is usually asymptomatic for decades after infection. Prediction questionnaire tool was proofed to be a valuable, feasible and efficient instrument for the screening of several diseases. We previously developed an Egyptian HCV risk screening tool (EGCRISC). This study aims to validate/modify EGCRISC. A cross-sectional study testing 4579 individuals by EGCRISC as well as ELISA/PCR was performed. The sample was a stratified cluster sampling from urban and rural areas in Upper and Lower Egypt using a proportional allocation technique. The degree of agreement and positive and negative posttest probabilities were calculated. ROC curve was done and the cutoff points were customized for best performance. The total score was further classified into three levels according to the risk load. The mean age of the participants was 41.1±12.2 in whom HCV prevalence was 8.6%. EGCRISC, particularly after modifying the cutoff points, has a good discriminating ability. The degree of agreement was at least 68.1% and the positive posttest probability ranged from 5% to 37.2% whereas the negative posttest probability was in the range 1% to 17%. We conclude that EGCRISC is a valid tool that can potentially screen for HCV infection risk in Egypt and could diminish the demand for mass serologic screening in those apparently at minimal risk. Extensive use of electronic and self- or interviewer-administered risk-based screening strategy may simplify and promote overall screening and detection of HCV dissimilar communities.

Toward a simple risk assessment screening tool for HCV infection in Egypt.

Asymptomatic patients with HCV infection identified through screening program could benefit not only from treatment but also from other interventions such as counseling to maintain health and avoid risk behaviors. This might prevent the spread of infection and result in significant public health benefits. However, mass screening would quickly deplete resources. This work aims to develop a brief HCV risk assessment questionnaire that inquires initially about a wide range of risk factors found to be potentially associated with HCV infection in order to identify the few most significant questions that could be quickly used to facilitate cost-effective HCV case-finding in the general population in Egypt. An exhaustive literature search was done to include all reported HCV risk factors that were pooled in a 65 item questionnaire. After an initial pilot study, a case-control study was performed that included 1,024 cases and 1,046 controls. In a multivariable model, a list of independent risk factors were found to be significant predictors for being HCV seropositive among two age strata (<45 and >45 years) for each gender. A simplified model that assigned values of the odds ratio as a weight for each factor present predicted HCV infection with high diagnostic accuracy. Attaining the defined cut-off value of the total risk score enhances the effectiveness of screening. HCV risk factors in the Egyptian population vary by age and gender. An accurate prediction screening tool can be used to identify those at high risk who may benefit most from HCV serologic testing. These results are to be further validated in a large scale cross-sectional study to assess the wider use of this tool. J. Med. Virol. 88:1767-1775, 2016. © 2016 Wiley Periodicals, Inc.