Breast feeding in a Saudi Arabian community. Profile of parents and influencing factors.

OBJECTIVE: Although bottle feeding is the main infant feeding mode in most societies, human milk is considered the most appropriate food for human infants. The aim of this study is to gather statistics regarding breast feeding prevalence, influencing factors for engaging in, and demographic characteristics of breast feeding in general population. METHODS: This is a random cross-sectional questionnaire study conducted in Al Kharj Health Centre, Kingdom of Saudi Arabia between the period of November 2000 through to February 2001. Mothers of childbearing age with at least one child were interviewed by trained interviewers. The sample was divided into 3 groups according to the mode of feeding: exclusive breast feeding, partial breast feeding, which included some breast feeding and some bottle feeding and exclusive bottle feeding. A statistical analysis was performed using statistical package for social sciences software package, (version 10.0). The response data were subjected to chi-square test, and Spearman's correlation analyses. RESULTS: Seven hundred and four mothers were interviewed. The mean age of mothers, fathers, and most recently born child were 30-years, 37-years, and 15.7-months. Partial breast feeding was the most common mode of infant feeding in this sample, with 66.1% of mothers engaging in this mode (p<0.00001). Exclusive breast feeding was the next most common, with 27.3% of mothers engaging in this mode. Finally, exclusive bottle feeding was the least common (6.7%). Four main demographic factors significantly related to the exclusive mode of breast feeding were husbands' educational level, advice received regarding breast feeding, whether or not a milk sample given at discharge from hospital, and whether or not contraception used. A positive significant correlation was found between breast feeding and mother's age, father's age, age of most recently born child, parity, number of children previously breast fed, and duration of previous breast feeding. CONCLUSION: Partial breast feeding is the dominant mode of feeding in our community, although the influencing factors and behavioral factors are similar in breast feeding and partial breast feeding groups. The most significant factors affecting the outcome of breast feeding are modifiable by health education.

Population based study of serum lipid levels in Al-Kharj Health Center, Saudi Arabia.

OBJECTIVE: Previous studies have shown high prevalence of diabetes mellitus, hypertension, obesity and smoking in this community. The aim of this study is to determine the prevalence and factors associated with hyperlipidemia. METHODS: A questionnaire was administered on all patients < or =13-years of age seen by investigators between April 2002 and October 2002 in Al-Kharj Health Centre, Kingdom of Saudi Arabia. Questions were asked regarding demography; weight and height were measured and blood was collected after 14 hours fasting for lipid levels. RESULTS: Four hundred and twenty-three (56.7%) of the study population had cholesterol level <5.2 mmol/L. Three hundred and twenty-three (43.3%) had cholesterol level >5.2 mmol/L (desirable level according to National Cholesterol Education Program [NCEP]). Mean serum cholesterol level for males and females were 5.08 mmol/L and 5.19 mmol/L; 462 (59.80%) had triglycerides level <1.7 mmol/L and 311 (40.20%) had level >1.7 mmol/L (NCEP). Age <50 years, education less than high school (12 years), family history of hyperlipidemia and high triglyceride levels were strongly associated with hyperlipidemia. CONCLUSION: The study points to high prevalence of total cholesterol, triglyceride and low density lipoprotein in this population. We suggest further studies and steps to reverse these factors, which are modifiable by changes in lifestyle.

Prevalence of mental illness among Saudi adult primary-care patients in Central Saudi Arabia.

OBJECTIVE: To determine the prevalence of mental illness morbidity among Saudi adult primary care patients from Al-Kharj, Kingdom of Saudi Arabia. METHODS: This is a cross-sectional epidemiological study of the prevalence of mental illness morbidity in a randomly selected sample of 609 Saudi adult patients, aged from 15 years to 65 years who attended Family and Community Medicine Clinic, Armed Forces Hospital, Al-Kharj, Kingdom of Saudi Arabia, from July 2000 to November 2000. The Rahim Anxiety-Depression Scale was used in the evaluation. RESULTS: In this study, 609 Saudi patients were screened. Their mean age standard deviation was 33.72 13.39. Of these, 46.6% were men and 53.4% were women. The prevalence of the minor mental illness morbidity was 18.2%, (30.5% when the sub-threshold mental illness are included). It was significantly higher in women (22.2%) than men (13.7%) with p-value=0.0073. The prevalence rate was high in the younger age group, (p<0.0001). In patients aged 15 years to 29 years it was 23.2%, and in those aged between 30 years and 44 years it was 17.8%, whereas, in patients aged 45 years to 65 years the prevalence was 7.1%. Also, the rate was high in divorcees (40%) and widows (43.8%). The prevalence rate in patients with diabetes mellitus was 16% (p=0.562), with hypertension, 22.2% (p=0.303), and with bronchial asthma, 28.3% (p=0.008). Multiple logistic regression analysis showed that age, gender and bronchial asthma were associated with mental illness. CONCLUSION: Our study shows that one 3rd of primary health care patients have mental illness. Due to the high prevalence of mental illnesses among primary health care clinic attendants and screening for such problems by using Rahim Anxiety-Depression scale could be time consuming, exploring the psychiatric dimension and effect of diseases should be included during any consultation.

Utilization of emergency services in a community hospital.

OBJECTIVE: Over utilization of emergency room services by patients with non-urgent complaints is a global problem. It results in a waste of resources, stress among the emergency room staff and an increase in waiting time for patients requiring attention. This study was carried out to establish the extent of inappropriate emergency room attendance in a Saudi community. METHODS: Data was collected from the emergency room register, regarding the age, sex, presenting complaints, time of presentation and disposal of patients, from January 1st 1999 to March 31st 1999 at Al-Kharj Military Hospital, Al-Kharj, Kingdom of Saudi Arabia. Patients were classified in different categories according to the triage criteria of the hospital. EPI-INFO statistical software was used for calculating x(2) and p vales. RESULTS: Among the 3928 patients, 2183 (55%) were males and 1745 (44.4%) were females, while 2335 (59.4%) of the patients had primary care or non-urgent problems. In both males and females categories, 21% of the patients had respiratory tract infection followed by miscellaneous complaints like mild conjunctivitis, allergic rash, represcription for medications, minor burns (500, 12.7%, x(2) = 97.49, p < 0.00001), gastrointestinal tract problems (434, 11%, x(2) = 146.55, p < 0.00001) and aches and pains (304, 7.7%, x(2) = 283.39, p < 0.00001). In male and female categories the 2nd most common complaints were trauma (487, 22.3%) and obstetrics and gynecological problems (325, 18.6%). The majority of the patients, 1806 or 46%, attended the emergency room during night shift (2300 hours-0700 hours). Referral rates for male and female patients were 211 (9.6%) and 331 (18.9%). CONCLUSION: Similar to the findings of other nations, inappropriate utilization of the emergency room is a big problem in the Saudi community. The majority of the patients come with minor self-limiting complaints. Maximum rush was seen at night time. There is a need for health education of such groups of patients as well as finding alternative solutions.

Use of a hospital-based accident and emergency unit by children (0-12 years) in Alkharj, Saudi Arabia.

This cross-sectional study was carried out in order to define the extent and nature of inappropriate use of the accident and emergency (ER) unit in our community. Data were collected for all children aged < or = 12 years who attended the ER from 1 January to 31 March 1999. A total of 3329 children (2010 boys and 1339 girls) attended the ER during the study period. Respiratory tract infection was the most common presenting complaint (33.5%), followed by trauma (15.3%), bronchial asthma (13.7%) and gastro-intestinal problems (6.6%). Using the triage criteria of Alkharj Military Hospital, most of the boys (57%) and 32.6% of the girls were considered to be simple, primary care cases. The rate of referral to specialist clinics was 9.5% and only 4.7% were actually admitted. Attendance at night (53.5% boys, 59.8% girls) was significantly greater (p < 0.00001) than during the morning (0700-1500) and afternoon shifts (1500-2300 hours). This study shows that a large number of children attend the ER with non-urgent complaints.