Ibrahim Kabbash

HIV Case Notification Rates in the Kingdom of Saudi Arabia over the Past Decade (2000–2009)

Objective To study trends in HIV case notification rates in the Kingdom of Saudi Arabia. Design A ten year retrospective review of annual HIV case notification returns to the Ministry of Health, Kingdom of Saudi Arabia. Methods Annual Registry statistics covering the period 2000 to 2009 were reviewed. Annual incidence trends were stratified according to the following demographics: age, nationality, geographical region of residence, gender, and mode of disease acquisition. Results 10,217 new HIV cases (2,956 in Saudi nationals and 7,261 in non-Saudis) were reported. Africans of Sub-Saharan Africa origin accounting for 3,982/7,261 (53%) of non-Saudi cases constituted: Ethiopians (2,271), Nigerians (1,048), and Sudanese nationals (663). The overall average annual incidence was <4 cases per 100,000; 1.5 cases per 100,000 for Saudis (range 0.5–2.5), and 13.2 per 100,000 for non-Saudis (range 5.7–19.0). Notifications increased yearly from 2000 for both groups until a plateau was reached in 2006 at 1,390 new cases. Case notification in Saudi nationals increased from 20% in the early 2001 to 40% in 2009. 4% (124/2,956) of cases were reported in Saudi children. The male to female ratio was 1.6∶1 for non-Saudi nationals (43.8% male, 27.3% female) and 4.4∶1 for Saudis (23.5% male, 5.4% female). Conclusions Whilst the numbers of reported HIV cases have stabilised since 2006, HIV/AIDS remains an important public health problem in KSA, both in migrants and Saudi nationals. HIV transmission to Saudi children is also of concern. Optimization of data collection, surveillance, and pro-active screening for HIV is required.

Prevalence of hepatitis C infection among children with β-thalassaemia major in Mid Delta, Egypt: a single centre study

BACKGROUND Transfusion dependant patients are at a higher risk of acquiring bloodborne infections even under conditions of safe transfusion. This study was designed to determine sero-prevalence of hepatitis C infection and possible associated risk factors in thalassaemic children. METHODS One hundred and twenty five children with β thalassaemia major (β-TM) were recruited from the Haematology/Oncology Unit, Paediatric Department, Tanta University Hospital, Egypt, between April 2010 and October 2011. Patients underwent history taking, full clinical examination, routine investigations and venous blood sampling. Serum was stored at -20°C till tested for hepatitis C (HCV Ab) and B (HBsAg) by ELISA. HCV Ab positive cases were confirmed by PCR. RESULTS All patients were HBsAg negative. HCV Ab ELISA was positive in 76%, negative in 20% and equivocal in 4%. Fifty patients (40%) had positive PCR for HCV. PCR showed low viraemia in 78%, moderate viraemia in 20% and high viraemia in 2%. A positive family history of HCV, history of minor operative intervention and/or dental procedures were significantly associated with higher frequency of HCV infection in thalassaemic children, while amount and frequency of transfused blood, age at transfusion and chelation state were not. CONCLUSION HCV infection is highly prevalent in children with β-TM in Egypt despite strict pre-transfusion blood testing. This should arouse the attention for environmental and community acquired factors. Quality management to insure infection control in minor operative procedures and adding more sensitive tests for blood screening are recommended.

Evaluation of syndromic management of sexually transmitted infections in Saudi Arabia.

BACKGROUND STIs can lead to acute symptoms, chronic infection and serious delayed consequences such as infertility, ectopic pregnancy, cervical cancer and the untimely death of infants and adults. OBJECTIVES To identify the points of strength and weakness in the system for management of sexually transmitted infections (STIs) and pattern of distribution of reported cases in Saudi Arabia. METHODS Data of 5377 reported cases of STIs from all regions of the kingdom during the year 2009 were collected. The original data collection sheets were collected from primary health care centers in all regions of the kingdom, entered into Epi-Info software computer program, organized and statically analyzed. RESULTS Average monthly reporting was variable between 163.4 cases and 3.3 cases. Age group of 20-40 represented 70.7% of reported cases with the majority Saudis (92%), females (92.9%), literate (59.2%) and married (91.0%). Housewives represented 62% followed by the unemployed (17.3%). The age at first sexual experience ranged from 15 to 25 (81.0%) which was mostly with other sex (95.1%). HIV testing was performed by only 3.0% of reported cases. Vaginal discharge was the most frequent diagnosis (77.6%) followed by lower abdominal pain (42.3%). Urethral discharge and lower abdominal pain differed significantly in relation to sex while scrotal swelling and lower abdominal pain were statistically different in relation to nationality. Vaginal discharge, cervical inflammation and abdominal pain differed significantly in relation to age. CONCLUSION Syndromic surveillance of STIs is essential to decrease STIs and control human immunodeficiency virus (HIV) infections. There is a need to build capacity of primary health care workers to collect accurate and valid data. Monitoring and evaluation activities are essential to promote program activities.

Risk factors and diagnostic criteria of brucellosis in an endemic area in Egypt

Abstract: A case-control study was conducted during the year 2003 in Tanta Fever Hospital within an endemic area for brucellosis (Br) in Egypt. One hundred forty-nine cases of Br and 298 patients with other infectious diseases were consecutively enrolled. Risk factors of Br (adjusted odds ratio) were having sheep (6.2 folds), high-risk occupation such as farmers and butchers (4.5 folds), having an aborted animal (3.5 folds), and increasing age (1.04 fold per year). Previous admission into a fever hospital within a year (6.5 folds), arthritis (2.9 folds), and positive C-reactive protein (1.1 fold) were significant predictors for Br. Rose bengal panel test showed 100% performance agreement with tube agglutination test for diagnosis of Br. Adding 2-mercaptoethanol to tube agglutination test did not increase its sensitivity or specificity for acute Br; neither did Coombs test. In conclusion, laboratory confirmation by tube agglutination test that should be preceded by rose bengal panel test as a screening test is absolute requirement for diagnosis of Br. Considering the previously mentioned risk factors could be useful in developing an algorithm for diagnosis of Br, particularly among those with atypical clinical presentation.

Validation and cross-cultural adaptation of the arabic version of the nasal obstruction symptom evaluation scale

Validation and cross‐cultural adaptation of the Nasal Obstruction Symptom Evaluation (NOSE) scale into the Arabic language with studying of its psychometric properties.

After successful hepatitis C virus antiviral therapy: It looks that normal alanine aminotransferase level is not the normal

Normal serum alanine aminotransferase (ALT) levels differ with age, gender, and body mass index. Adjusting the upper limits of normal (ULN) for ALT needs further research in different populations. Aim of this work was to monitor the effect of successful chronic hepatitis C (CHC) treatment on the ALT levels in patients with normal pretreatment ALT.

Perception and practices of tobacco smoking among medical students in the Nile Delta, Egypt

This study was conducted to identify medical students’ perception and practices towards tobacco smoking, as well as to identify factors affecting their adoption to smoking habit, among medical students in the Nile Delta. From December 2014 to February 2015, a questionnaire-based cross-sectional study was conducted at the four faculties of medicine in the Nile Delta. A total of 1715 students were targeted from the 2nd to 6th academic years to represent different levels of knowledge, awareness, and the influence of medical education on their attitude towards smoking. 5.6 and 1.2% of the students reported being smokers and ex-smokers, respectively, with a higher prevalence among 6th-year students, 40% of them reported to be involved with substance abuse. In general, medical students had positive antismoking attitude. The prevalence of smoking among medicine students was not high. However, there is a need to address smoking cessation programs during their study.

Physical hazard safety awareness among healthcare workers in Tanta university hospitals, Egypt

Hospital workers are exposed to many occupational hazards that may threaten their health and safety. Physical hazards encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. To assess the awareness of healthcare workers (HCWs) about physical hazards in Tanta university hospitals, this cross-sectional study included 401 HCWs (physicians, nurses, technicians, and workers) from seven departments (general surgery, orthopedics, radiology, ophthalmology, kitchen, incinerator, and laundry). Data were collected through interview questionnaire to assess six types of physical hazards (noise, electric hazards, temperature, radiation, fire, and lighting,). Most of the physicians (63.7%) were aware of the level of noise. All physicians, nurses, technicians, and majority of workers reported that hearing protective devices were not available, and all HCWs reported that periodic hearing examination was not performed. Most of the nurses (75.2%) and workers (68.5%) did not attended emergency training, and more than two thirds of all HCWs were not briefed about emergency evacuation. Most HCWs were not given appropriate radiation safety training before starting work (88% of workers, 73.7% of nurses, 65.7% of physicians, and 68.3% of technicians). The majority of physicians, nurses, and technicians (70.5, 65.4, and 53.7%) denied regular environmental monitoring for radiation level inside work place. Health education programs on health and safety issues regarding physical hazards should be mandatory to all healthcare workers to improve their awareness and protect them from undue exposures they may face due to lack of adequate awareness and knowledge. There is urgent need of expanding the occupational healthcare services in Egypt to cover all the employees as indicated by the international recommendations and the Egyptian Constitution, legislation, and community necessity.