Evaluation of capillary blood glucose versus a high-risk questionnaire for screening for undiagnosed diabetes mellitus in Eastern province, Saudi Arabia.

This study compared 2 screening tests for detecting undiagnosed diabetes mellitus when applied in a mass-screening campaign in the Eastern province of Saudi Arabia in 2004-05. Of 15 082 individuals screened, 65.8% were positive by the American Diabetes Association risk-score questionnaire and 71.3% by determination of capillary blood glucose (CBG) using a portable glucometer. Type 2 diabetes mellitus was confirmed in 20.3% of participants and pre-diabetes in 33.9% using fasting venous blood testing. The risk-score questionnaire did not perform well versus fasting and random CBG. Optimal cut-offs for fasting and random CBG were 120 mg/dL and 160 mg/dL respectively. Fasting CBG had higher sensitivity, specificity and discriminating ability than random CBG for detection of diabetes and pre-diabetes in this population.

Control of diabetes mellitus in the Eastern Province of Saudi Arabia: results of screening campaign.

To assess the status of diabetes mellitus (DM) control in the Eastern province of Saudi Arabia, all Saudi Arabian residents aged 30 years and above were invited to participate in a screening campaign. Of 197 681 participants screened 15.7% had a previous diagnosis of DM. Sociodemographic and clinical data were collected from these patients. Only 33.8% of patients were achieving their glycaemic control target (fasting or random capillary blood glucose < 130 mg/dL or < 180 mg/dL respectively). Multiple logistic regression analysis showed that higher age, current smoking and lower level of physical activity were significantly associated with uncontrolled DM. Hypertension was positively associated with glycaemic control. The overall rate of diabetes control is unacceptably low in the general population of this province.

Prevalence of current smoking in Eastern province, Saudi Arabia.

All Saudi Arabian residents of the Eastern province of Saudi Arabia aged 30+ years completed a structured interview questionnaire about smoking. The prevalence of current smoking (smoked > 100 cigarettes or any tobacco products including waterpipe in lifetime and still smoking daily or occasionally for 1 month or more) among 196 268 respondents was 16.9% (28.7% among men and 4.5% among women). There was a significantly higher prevalence of smoking at younger ages in men and older ages in women. Multiple logistic regression analysis showed that factors independently associated with smoking were lower socioeconomic tatus, lower education, being divorced and occupations such as the military and self-employed.

Prevalence of diabetes mellitus and impaired fasting glucose levels in the Eastern Province of Saudi Arabia: results of a screening campaign.

INTRODUCTION: This study aimed to estimate the prevalence of diagnosed and undiagnosed diabetes mellitus (DM) in the Eastern Province of Saudi Arabia, and to study its relationship with socioeconomic factors. METHODS: The study targeted all Saudi subjects aged 30 years and above who resided in the Eastern Province in 2004. DM screening was conducted by taking the capillary fasting blood glucose (CFBG) after eight hours or more of fasting, or the casual capillary blood glucose (CCBG). A positive screening test for hyperglycaemia was defined as CFBG more than or equal to 100 mg/dl (5.6 mmol/l), or CCBG more than or equal to 140 mg/dl (7.8 mmol/l). A positive result was confirmed on another day through the measurement of fasting plasma glucose (FPG) levels from a venous sample. A diagnosis of DM was considered if FPG was more than or equal to 126 mg/dl (7.0 mmol/l), or when there was a history of a previous diagnosis. RESULTS: Out of 197,681 participants, 35,929 (18.2 percent) had a positive history of DM or a positive screening test for hyperglycaemia. After confirmation by venous blood testing, the prevalence of DM dropped to 17.2 percent while the prevalence of newly diagnosed DM was 1.8 percent. The prevalence increased with age and was higher in women, widows, divorcees, those who had a low education level and the unemployed. CONCLUSION: The prevalence of DM in Saudi Arabia is one of the highest reported in the world, and its yield of screening is high.

Evaluation of capillary blood glucose versus a high-risk questionnaire for screening for undiagnosed diabetes mellitus in Eastern province, Saudi Arabia

This study compared 2 screening tests for detecting undiagnosed diabetes mellitus when applied in a mass-screening campaign in the Eastern province of Saudi Arabia in 2004-05. Of 15 082 individuals screened, 65.8% were positive by the American Diabetes Association risk-score questionnaire and 71.3% by determination of capillary blood glucose [CBG] using a portable glucometer. Type 2 diabetes mellitus was confirmed in 20.3% of participants and pre-diabetes in 33.9% using fasting venous blood testing. The risk-score questionnaire did not perform well versus fasting and random CBG. Optimal cut-offs for fasting and random CBG were 120 mg/dL and 160 mg/dL respectively. Fasting CBG had higher sensitivity, specificity and discriminating ability than random CBG for detection of diabetes and pre-diabetes in this population

Prevalence of current smoking in Eastern province, Saudi Arabia

All Saudi Arabian residents of the Eastern province of Saudi Arabia aged 30+ years completed a structured interview questionnaire about smoking. The prevalence of current smoking [smoked > 100 cigarettes or any tobacco products including waterpipe in lifetime and still smoking daily or occasionally for 1 month or more] among 196 268 respondents was 16.9% [28.7% among men and 4.5% among women]. There was a significantly higher prevalence of smoking at younger ages in men and older ages in women. Multiple logistic regression analysis showed that factors independently associated with smoking were lower socioeconomic status, lower education, being divorced and occupations such as the military and self-employed

Control of diabetes mellitus in the Eastern province of Saudi Arabia: results of screening campaign

To assess the status of diabetes mellitus [DM] control in the Eastern province of Saudi Arabia, all Saudi Arabian residents aged 30 years and above were invited to participate in a screening campaign. Of 197 681 participants screened 15.7% had a previous diagnosis of DM. Sociodemographic and clinical data were collected from these patients. Only 33.8% of patients were achieving their glycaemic control target [fasting or random capillary blood glucose < 130 mg/dL or < 180 mg/dL respectively]. Multiple logistic regression analysis showed that higher age, current smoking and lower level of physical activity were significantly associated with uncontrolled DM. Hypertension was positively associated with glycaemic control. The overall rate of diabetes control is unacceptably low in the general population of this province

Some epidemiological aspects of needle stick injuries among the hospital health care workers: Eastern Province, Saudi Arabia.

This study was conducted to provide some epidemiological aspects of needle stick injuries among health care workers in the eastern province in Saudi Arabia. Data about 282 injuries reported from the hospitals of the Eastern Province of Saudi Arabia were collected through specially designed questionnaire retrospectively from 1995 to 1997. Results showed that 50% of injuries occurred in the first 3 years of employment. Workers in medical and surgical specialties suffered an equal degree of reported exposure. The highest percentage (46.8%) of injuries occurred during syringe related actions. Patients' wards were the major location of incidents (48.5%) followed by ICUs and dialysis units (17.7%), theatres (15.6%) and accidents and emergency departments (13.8%). There was no significant association between injuries and type of shifts. The middle hours of the shifts showed a significant association with injuries. The pattern of injuries was significantly associated with over loaded periods of medical practices. Deficiencies in implementing the standard recommendations for prevention and control of needle stick injuries were noted in the studied hospitals.

Standardized national growth chart of 0-5-year-old Saudi children.

A national survey was carried out to achieve the following objectives: (1) construction of national standards for Saudi children, 0-5 years old, with regard to weight, height and head circumference for males and females; (2) construction of a growth chart for weight, height and head circumference for 0-5-year-old Saudi children that can be used at hospitals and health centres in the Kingdom for routine follow-up of the growth of these children. To achieve these objectives, the WHO recommendations were applied. A total of 24,000 Saudi children, 12,000 males and 12,000 females, were selected randomly representing the five regions of the Kingdom with 200 children in each monthly age group. Demographic data as well as the anthropometric measurements were recorded by well-trained personnel using a pretested questionnaire and new, well calibrated equipment. The current study showed that Saudi boys (0-5 years old) were heavier and taller than Saudi girls in the same age group, and that the median weights and heights of Saudi boys and girls (0-5 years old) were more than those of the Harvard standards. A growth chart was constructed which was suitable for growth monitoring programmes all over the Kingdom.

Frequency of and prevention measures for needle-stick injuries among hospital healthcare workers in Saudi Arabia.

This study was undertaken to determine the frequency of needle-stick injuries among healthcare workers in hospitals in the Eastern Province of Saudi Arabia from 1995 to 1997, and to gather information about the measures these hospitals are taking to protect their employees against these injuries. Precautionary measures taken to protect healthcare workers from injury and the follow-up after injuries were surveyed. The total overall prevalence rate of needle-stick injuries was significantly lower among healthcare workers in governmental hospitals than among those in private hospitals. The extremely low prevalence rate of needle-stick injuries indicated that there were serious defects in the reporting systems of the hospitals studied. All hospitals should have a mandatory, clear, and unified policy to help reduce the number of needle-stick injuries. Hospitals must adopt a policy to ensure that precautions are taken to reduce healthcare workers' accidental exposures to potentially infected blood.

Seasonal, nontoxigenic Vibrio cholerae O1 Ogawa infections in the Eastern Region of Saudi Arabia.

BACKGROUND: Surveillance for Vibrio cholerae in the Eastern Region of Saudi Arabia has been ongoing since 1985 to detect and prevent local proliferation of imported cholera. In 1996 and 1997 the authors performed additional microbiologic and epidemiologic assessment of V. cholerae surveillance to better characterize a recurrent summertime pattern of V. cholerae infections in the Eastern Region of Saudi Arabia. METHODS: All health facilities routinely submitted stool or rectal swab specimens for isolation of V. cholerae from patients with gastroenteritis. In addition, specimens were taken from expatriate workers and household contacts of persons with confirmed V. cholerae infection. Forty-two isolates were evaluated for cholera enterotoxin by enzyme-linked immunosorbent assay, cholera toxin polymerase chain reaction, and Y1 adrenal cell assay; 12 isolates also were characterized by pulsed-field gel electrophoresis (PFGE). Interviews about potential exposures were done for all V. cholerae infections. RESULTS: Vibrio cholerae O1 serotype Ogawa biotype El Tor was identified in 113 gastroenteritis patients (6.0 per 100,000 population per year), 28 asymptomatic expatriate workers, and 16 of 982 household contacts of index patients. All symptomatic infected persons had mild illness that was not typical of cholera, and all 42 isolates evaluated were nontoxigenic. All 12 isolates evaluated by PFGE had an indistinguishable pattern (pattern 81). Infections appeared in late May, decreased in mid-July through August, increased again in September, and disappeared from December through April. Infections had a uniform geographic distribution and affected all ages. No linkage was identified between affected households, or between community cases and food-handlers or domestic servants. DISCUSSION: Surveillance in the Eastern Region of Saudi Arabia has identified a novel strain of nontoxigenic V. cholerae O1 Ogawa. This strain probably has a local environmental reservoir. Since cholera toxin is the primary virulence factor involved in the cause of cholera, assays for cholera toxin should be included in cholera surveillance.