Rajaa M. Al-Raddadi

Hepatitis C virus infection in Jeddah City, Saudi Arabia: Seroprevalence and knowledge

The infection rate of the hepatitis C virus (HCV) in Saudi Arabia is among the lowest in the world. However, it is likely that poor knowledge and awareness of HCV infection could minimize the effectiveness of prevention and control programs in the kingdom. Thus, the study objective was to estimate the prevalence of HCV infection, and to assess current knowledge about it, in the targeted population. Data on 5482 Saudi people attending primary healthcare centers in Jeddah City in 2014/2015 were analyzed in this cross‐sectional study. Questions that covered the natural history, risk behavior, and prevention, and treatment of HCV were collected using a predesigned questionnaire. HCV seroprevalence was assessed using an enzyme‐linked immunosorbent assay. HCV prevalence of 0.38% (95% confidence interval: 0.22‐0.54) was found. The level of knowledge of the natural history, risk behavior, and prevention and treatment of HCV was poor among the participants. The lowest level of knowledge for all participants pertained to its prevention and treatment. The prevalence of HCV was low in Saudi Arabia (0.38%). However, adequate knowledge of HCV was lacking. Thus, the need to increase knowledge and awareness of HCV in the Saudi population is warranted.

Behaviors affecting bone health among adolescent females and vitamin D level

Introduction: Interventions commonly used in social disciplines that aim to prevent health disparities and enhance population quality of life, such as community-based nutrition and lifestyle interventions, are most frequently complex. These interventions typically operate via a sequence of changes in psychosocial, behavioural, and/or structural processes, targeting multiple outcomes while interacting with local contexts and the mode of intervention delivery. In this light, several researchers argue that evidence synthesis of these complex interventions need to go beyond traditional meta-analysis that yield overall effect estimates. Specifically, reviews of complex interventions should assemble evidence of different types to explore variation in effects across populations, contexts and intervention implementation. This approach may be better suited to tackle health disparities and facilitate policy-relevant evidence synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is the most widely adopted system worldwide for rating the quality of evidence and making healthcare recommendations. This paper outlines the specific challenges of applying GRADE to synthesise and assess the quality of evidence of complex interventions, and describes an ongoing project to extend, i.e. adapt GRADE for these interventions.There is an urgent need to facilitate the development of more effective breastfeeding support strategies. The desired research will focus on knowledge-based service innovation that include intervention in form of computer-based training program aimed for training of health and care professionals involved in breastfeeding support. The intervention in the proposed study will contribute to more effective adoption of new knowledge in healthcare organisations. Further, the proposed project will be organised as an interdisciplinary and crosswise sectorial collaboration and will be customized at a national and international level, by involving decision-makers, researchers, health care professionals and care users. Ambition with this project is to contribute to increased breastfeeding frequency by increasing competence in professional support in related healthcare services and midwife education program. There is also an urgent need for evidence based technical solutions as a professional support for the professionals to more effectively implement new research in practice. This project will contribute health care with high quality and resource use. The overall aim for the project is to implement and evaluate new innovative solutions in order to improve long-term strategies for professional support and quality of care, related to knowledge-based breastfeeding support. The design method for the project is longitudinal randomized controlled intervention trial. The intervention will be computer-based training education program developed in collaboration with decision-makers, professionals and researchers. Data will be gained before and after intervention by using: Breastfeeding attitudes among counselling health professionals (An instrument based on WHO standards was developed to measure breastfeeding attitudes), Mother-to-infant Relation and Feelings (MIRF) scale and Mother-Perceived-Professional-Professional support (MoPPS) scale. For successful intervention, it is important that decision-makers are involved in the research process, so that suggested changes can be possible if they actively participate and encourage the project as well as the adoption of research results in practice. Involvement of stakeholders in the research demand facilitation of the research process. This can enable cooperation by using project management techniques as co-counselling and clinical reflection. The outcome of the project will be multiple may be placed in a regional, national, international or global context. Firstly, the project will contribute to development of knowledge-based professionals’ competence with focus on to support breastfeeding from first breastfeeding time, to minimise usage of infant formula during first week of life, longer exclusive- and predominant breastfeeding and stronger connection between mother and child. This topic will fit with theme Nutrition and Lactation.T Global Burden of Disease Study showed that the years of life lost due to stroke and coronary heart disease were the highest in Japan in 2010. The high morbidity and mortality noted in the Japanese population were given significant cost to the society. Cardiovascular diseases share risk factors with other major non-communicable diseases, including tobacco smoking, unhealthy diet, physical inactivity, history of diabetes, metabolic factors (hypertension, high serum glucose, low high density lipid-cholesterol, hypertriglyceridemia and overweight). The Japan national health and nutrition surveys since 1945 have provided the prominent information for health promotion strategies issued by the health ministry. In Japan, most (63%) dietary sodium came from soy sauce (20%), commercially processed fish/seafood (15%), salted soups (15%) and preserved vegetables (13%). The national campaigns for reducing salt intake, together with other hypertension control programs, resulted in the great reduction of stroke mortality since 1960s. However, because of the westernization of lifestyles such as high-fat diets and sedentary work patterns associated with socioeconomic development, there has a possible increase in the incidence of mortality from coronary heart disease in Japan. For instance, the mean BMI increased in Japanese men with an increment of 0.44 kg/m2 between 1976 and 1995. In 2009, the obesity was 31.7% in men and 21.8% in women aged 20 and above. The prevalence of high total cholesterol (≥220 mg/d L) increased from 15% to 27% for men and 19% to 35% for women.C obesity has reached epidemic levels in many countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. Environmental factors, lifestyle preferences, and cultural environment play roles in the rising prevalence of obesity worldwide. The aim of this study; school-age children’s eating habits, physical activity levels, and to determine the factors affecting the status of obesity. In the study, 172 boys, 186 girls 11-12 years of aged, a total of 358 children examined. Anthropometric measurements were taken and family factors, eating habits, physical activity time has been questioned. The children in the study by gender, age, weight, height, waist circumference, hip circumference, waist-hip ratio and analyzed the distribution of the body mass index (BMI) according to WHO-2007. Overall average BMI for boys 18.9±3.5 kg/m2, for girls 18.4±3.2 kg/m2. Prevalences of overweight (≥85.-<95. percentiles) and obesity (≥95. percentile) for all children %16.2 and %15.4 respectively. Children who are obese individuals in family average body weight of 43.2 ± 10.61 kg, BMI was 19.4 ± 3.91 kg/m2, while non-obese family members of students’ body weight and body mass index respectively was 39.4±7.96 kg to 18.1±2.75 kg/m2 (p<0.05). Eat something before go to sleep and haven’t breakfast affect obesity prevalence negatively. Monitoring of obesity at school age children and developing school health programs will be an investment in public health for the future.Methods: A cross sectional study of a sample of 508 adolescent females were chosen through a stratified randomization technique; where one section from each of the grade 10, 11 and 12 was chosen from each public school (n-6) located in Sharjah in the UAE. All consenting students in the selected classes filled the Eating Attitudes Test (EAT-26) and Body Figure Rating Scale (BFR). From the latter, body dissatisfaction score was calculated. From the students who scored 20 or above on EAT 26 (cut off point for eating disorder) and high on body dissatisfaction, a small sample was selected (n=52) and were included into one to one interviews for further investigation on determinants of DEA.

Prevalence and predictors of hepatitis B in Jeddah City, Saudi Arabia: a population-based seroprevalence study

INTRODUCTION Despite solid preventive strategies to reduce the risk of hepatitis B virus (HBV) infection, recent reports about its prevalence and predictors are lacking in several Saudi cities at the community level. This study aimed to assess the seroprevalence of HBV and to identify the most important predictors among the Saudi population in Jeddah city, Saudi Arabia. METHODOLOGY A cross-sectional study was conducted among 5,584 Saudi people attending primary health-care centers in Jeddah city during 2012/2013. Sociodemographic and hepatitis-related data were collected. HBV was diagnosed by ELISA test. The seroprevalence of HBV was estimated, and appropriate statistical analyses were performed, including univariate and multivariable regression analyses. RESULTS The seroprevalence of HBV was 2.2% (95% CI = 1.82-2.58) in the studied participants. The prevalence was higher among non-governmental workers (3.5%), male participants (3.4%) and those aged ≥ 25 years (2.4%). The most important predictors for increasing the risk of HBV in this study were HBV contacts, male sex, history of dental procedures and blood transfusion. The significant positive risks associated with these predictors were 3.3, 2.5, 2.0 and 1.65, respectively. HBV vaccination, on the other hand, was associated with a significant risk reduction of 88% (OR = 0.12; 95% CI = 0.03-0.51). CONCLUSIONS The seroprevalence of HBV was relatively low among the Saudi population in Jeddah city reflecting the actions taken by health authorities to control HBV infection. However, more efforts, particularly in relation to health education programmes, strict control of blood banks and dental clinics, are still needed.

Quality of healthcare for hemodialysis patients in various health sectors in Jeddah, Saudi Arabia.

BACKGROUND AND OBJECTIVE We compared the adequacy of the management of hemodialysis patients in different health sectors in a major city in Saudi Arabia. DESIGN AND SETTING Cross-sectional analytic study conducted in three different health sectors in Jeddah, Saudi Arabia. METHODS Data was collected from nine hemodialysis centers, which represent three sectors: Ministry of Health, governmental (but not health ministry) hospitals, and charity centers. A simple random sampling technique was employed for gathering data from the participating centers. Medical records were reviewed and all the relevant data were retrieved using a pre-designed form. RESULTS In the 587 subjects, hypertension, diabetes mellitus and an idiopathic etiology accounted for 85.3% of end-stage renal disease. Only 25.4% of the patients had a hemoglobin level of 110–120 g/L and 12.1% achieved target levels of ferritin and transferrin saturation. The percentage of patients meeting targeted levels of calcium (2.1–2.38 mmol/L), phosphorous (1.13–1.78 mmol/L) and albumin (≥40 g/L) were 54.2%, 38.7% and 23.5%, respectively. The variation between different health sectors was statistically significant (P<.001). Arteriovenous fistula was used for 84% of the patients and catheter for 15.7%. CONCLUSION The quality of healthcare for hemodialysis patients in Jeddah needs improvement to meet the recommendations of the Kidney Disease Outcomes Quality Initiative guidelines.