Jaafar Behbehani

PREVALENCE AND SOCIAL CORRELATES OF CONSANGUINITY IN KUWAIT

BACKGROUND Kuwait has one of the highest consanguinity rates in the world. Our objectives in this study were to assess the frequency and trend in consanguineous marriages, and to identify factors associated with inbreeding. PATIENTS AND METHODS A representative sample of 482 households from the most developed (the Capital), and the least developed (Jahra), of the five governorates in Kuwait was selected. The study involved only Kuwaiti nationals. A structured questionnaire was administered by previously trained team members through a household face-to-face interview. RESULTS Data were obtained for 959 current or previous marriages. Frequency of total (first and second cousin) consanguinity was much higher in Jahra governorate (42.1%) than the Capital (22.6%). Over the last decade, the inbreeding has decreased in the Capital but not in Jahra. Bivariate analysis indicated that several socioeconomic and demographic variables were significantly associated with consanguinity. The control of confounding factors by logistic regression showed, however, that Bedouin origin and year of marriage were the only variables significantly related to consanguinity. CONCLUSION There is a widening gap between Bedouins and non-Bedouins in the practice of consanguinity in Kuwait.

Prevalence and Correlates of Major Chronic Illnesses among Older Kuwaiti Nationals in Two Governorates

Objective: To provide community-based information on the prevalence of diabetes, hypertension and heart disease and to highlight their significant correlates. Materials and Methods: Data were collected in a cross-sectional household survey of 2,487 Kuwaiti nationals aged 50 and over in 2005/2006. A proportionately representative sample of 1,451 respondents from a relatively more urban area (Capital) and 1,036 respondents from a relatively less urban area (Ahmadi) were interviewed. A proxy respondent was used in 5.4% of cases. Among the 2,605 potentially eligible persons approached, 2,487 (95.5%) participated. Results: Doctor-diagnosed prevalences of hypertension, diabetes and heart disease in the two governorates were reported to be 53.4, 50.6 and 17.5%, respectively. If the prevalence in the two governorates is reflective of the nation, a remarkable increase seems to have occurred since 1996. The prevalence of each of the three diseases increased linearly by age among both sexes. Comorbidity of the three diseases increased from 3.6 to 9.4 and to 20.9% among those aged 50–59, 60–69 and ≧70 years, respectively. Logistic regression showed the prevalence of chronic illnesses to be significantly higher among persons who were older, retired, non-Bedouin, less educated, had higher income, were less socially active, were obese and had poorer exercise behavior. The prevalence of diabetes and heart disease was significantly lower among women than men. Conclusion: Judging from data on two governorates, the prevalence of diabetes, hypertension and heart disease is likely to have increased to alarmingly high levels among older Kuwaitis, highlighting the need for focused intervention programs in order to reduce morbidity and increase healthy life years.

Trends, Patterns and Correlates of Contraceptive Use among Kuwaitis, 1984-1999

Objective: To document the changes in trends and patterns of contraceptive use from 1984 to 1999 and analyze the sociodemographic correlates of contraceptive use. Methods: A nationally representative household survey of Kuwaiti women of reproductive age was conducted in 1999 and compared with published data from three earlier national surveys. Results: About 52% of Kuwaiti women were currently using some form of contraception and 79% had used it at some time in their life (ever-use). Three fourths were using a modern method of contraception at the time of the survey. Oral contraceptive pills were the leading method, followed by IUCDs. Oral contraceptive use declined from 79 to 45% in the period 1984–1999. Use of withdrawal increased from 2% in 1987 to 11% in 1999. Multivariate analysis indicated that a higher age and parity, a higher level of education of both spouses, urban residence, and a lower desired fertility were associated with higher contraceptive use. Conclusion: Contraception is generally used for spacing children, with the wife being the main user. There is a continuing need to provide services and accurate information about the various methods of contraception.

Ethnic differences in contraceptive use in Kuwait: A clinic-based study

The Arab, Muslim, oil-rich nation of Kuwait has achieved unusually high levels of knowledge and use of contraception for a developing, high fertility country. Almost all women know of contraceptive pills without prompting, and 57-86% report having ever used a method (usually the oral pill or IUD) in recent studies. Based on a survey of six randomly selected clinics the present study compares the knowledge and use levels of two major ethnic groups--the Beduins and non-Beduins. It also analyses preference for various contraceptive methods and probable reasons for this. While Census or Survey data do not provide information about the size of ethnic groups analyzed in this paper, it is estimated that at least one-third of the population of Kuwait is Beduin. There is a significant difference between the levels of knowledge and use of contraception between the Beduin and non-Beduin women; current use being 42% and 65%, respectively. The differentials between the two groups are particularly marked among women of lower socioeconomic status, and tend to reduce notably once variables such as education and income are controlled. Within the subgroup of non-Beduins, socioeconomic differences in contraceptive use have virtually disappeared; the illiterate and relatively less affluent women are as likely to use a contraceptive method as the university educated, and richer women. However, among the Beduins, the usually expected differences by socioeconomic characteristics still persist. The oral pill is the best known and most commonly used method. Male sterilization is the least known and not practiced at all.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of smoking among currently married Kuwaiti males and females

A structured questionnaire was administered to a random sample of 608 Kuwaiti couples through a household face-to-face interview. Both spouses were non-smokers in more than half (50.8%) of all the couples, and there was a single couple (0.2%) with both spouses currently smoking. Only 0.5% of the wives reported current smoking. The prevalence of smoking was 3.2% among divorced/widowed women from the same households. The difference between the two groups of women remained significant upon controlling for the confounding effect of age. Among the husbands, frequencies of current and ex-smokers were 37% and 11%, respectively. Younger respondents consumed more tobacco and were initiated to smoking at an earlier age. Logistic regression showed that people with one to 11 years of formal education were more likely to be current smokers as compared to the rest of the respondents (adjusted relative risk: 2.07, 95% confidence interval (CI): 1.46–2.93). Reasons for the observed findings have been discussed.

Dental Education in Kuwait

For a long time there has been a need to establish a dental school in Kuwait, due to the fact that the majority of dentists working in Kuwait are expatriates from various countries. An Amiri decree in 1996 made it possible, and the first dental students were admitted to the Kuwait University Faculty of Dentistry in 1998. The mission of the Faculty of Dentistry is ‘to promote oral health in Kuwait through education, research and cooperation with other professional health care institutions as well as the community at large’. A 6.5-year dental curriculum was completed after 2 years of committee work and was accepted by the University Council in 2001. This curriculum incorporates current trends in medical and dental education, such as the evidence-based and community-based approaches, problem-solving methodology for outcome-based learning, and competency achieved through comprehensive patient care.

Mental Deficiency and Unstable Bladder in a Case ofMarfan’s Syndrome

We report a case of Marfan’s syndrome in a 23-year-old Arab man presenting with unstable bladder, and who was also found to have a mental deficiency. Familial occurrence of marfanoid habitus and heart abnormalities were detected. This is the first report of Marfan’s syndrome in a patient from Kuwait and the Gulf region.

Patient Perception of Health and Emergency Room Utilization before and after the Iraqi Occupation of Kuwait

This paper analyzes whether patients visiting the Medical Emergency Rooms (ERs) perceive their general health to have deteriorated, improved or stayed the same one year before the Iraqi occupation and one year after the liberation. The paper also examines the impact of such perceptions on the utilization of an ER. Data were collected by means of a survey of the ER attendees in Kuwait’s six general hospitals during January and February 1993. Sixty percent of the respondents perceived their health to have been better one year before the invasion, about 30% perceived no change, while 10% said their health had improved one year after the liberation. A significantly larger percentage of women and wealthier people perceived a deterioration. Regarding ER utilization, 56% reported at least one visit before and after the occupation. The average number of visits was 9.68 before the invasion and 10.09 after the liberation. Perception of health was not significantly associated with the number of visits.