Sulaiman A. Al-Shammari

Prevalence and correlates of depression among Saudi elderly.

To assess the prevalence of depression and associated factors in elderly people in Saudi Arabia.

Intestinal parasitic diseases in Riyadh, Saudi Arabia: prevalence, sociodemographic and environmental associates.

Summary Our objectives were to assess the prevalence of intestinal parasitic infections in Riyadh and to determine associated sociodemographic and environmental factors. The study was conducted through a household survey. Three health centres were chosen from each of the five Riyadh urban regions and 15 from rural areas. Based on the average family size, a random sample of households were chosen. All household members were asked to participate in the study. Data were collected using a pre‐designed questionnaire eliciting data on sociodemographic and environmental factors. A stool specimen of each individual was examined microscopically for the presence of trophozoites and cysts. Six thousand and twelve participants with a mean age of 23.3 ± 17.4 (median 19 years, 48.6% males) were studied and 32.2% were infected. The infection rate was high in urban areas (33.3%), among children <12 years (34.4%), non‐Saudis (42.2%), single persons (34.9%), illiterate individuals (33.8%), those who obtained drinking water from tankers (36.1%) and those who disposed of sewage in open channels (47.1%). Stratified analysis showed that for Saudis <12 years parasitic infections were significantly higher among tanker users (39.5%) and septic tank users (36.8%). For Saudis≥12 years low education, water storage and open sewage disposal were statistically associated with parasitic infections (P < 0.05). Among expatriates, infections were high among males (47.6%), urban residents (48.3%), single persons (46.9%), tanker users (39.5%) and septic tank users (78.6%). Multivariate logistic regression analysis showed that age <12 years, non‐Saudi nationalities, educational level below secondary school, tanker as source of water and open sewage disposal were independently associated with high intestinal parasitic infection.

Validity of the Arabic version of the eating attitude test

OBJECTIVES To assess the validity of the Eating Attitude Test (EAT-26) in Arabic as a screening instrument in nonclinical populations. METHODS A representative sample of Grade 7-12 female students in Riyadh, Saudi Arabia, was selected randomly but proportional to various social classes. The girls were independently assessed by the EAT-26 and a structured clinical interview. RESULTS One hundred twenty-nine subjects were included. Twenty-five were identified by EAT-26 as having abnormal eating attitudes. One case was identified as anorexia nervosa by the interview and no cases of bulimia were found. DISCUSSION EAT-26 was found to be highly sensitive and reasonably specific. Like some other studies in non-Western populations, it yielded a high false positive rate and a low positive predictive value. Because of its low cost and practicality, EAT-26 might be a useful tool in screening large populations for eating disorders.

Compliance with short-term antibiotic therapy among patients attending primary health centres in Riyadh, Saudi Arabia

Non-compliance results in several undesired consequences. Admissions due to non-compliance have been estimated to account for up to 10.5% of all admissions to hospi tal. There seems to be very little data about compliance in Saudi Arabia. The present study addressed the problem of non-compliance with short-term antibiotic therapy in patients attending Primary Health Centres (PHC). The data were collected from five different centres selected randomly from the 53 centres in the Riyadh area, Saudi Ara bia. A five-part questionnaire was designed and used to collect data. Different parts were required to be completed by patient, doctor, pharmacist and social worker. At the end of the study period 414 questionnaires were suitable for evaluation. Paediatric patients (< 15 years old) constituted 65.9% of the sample. Compliance was noted in 67.8%. Those who missed three doses or less and more than three doses were 22.7% and 9.4% respectively. Factors which appeared to enhance patient compliance were: parental involvement (p<0.001), un employment (p<0.01), absence of psychiatric illness (p<0.02) and early improvement of symptoms (p<0.05). Reasons most frequently mentioned by patients for non-compliance were: rapid improve ment of symptoms, bitter taste of drug(s), forgetfulness and frequent dosing. These reasons accounted for 73.7% of reasons for non-compliance. Our findings suggest that approximately two thirds of patients were compliant with their medications. It is also worth noting that approximately three quarters of patients were not compliant for reasons which could be minimised or removed by good patient counsel ling and effective communication with patients. At least one third of the patients did not use their drugs appropriately. These findings suggest that the problem of non-compliance needs to be further evaluated in this part of the world.

Arabic version of Skindex‐16: Translation and cultural adaptation, with assessment of reliability and validity

Background  Quality‐of‐life is increasingly recognized as an important measure in dermatology; however, most currently available dermatologic quality‐of‐life measures were originally created for the English language. Skindex‐16 being one, is a self‐administered questionnaire covering the symptoms, emotions and functioning aspects.

The prevalence of obesity among saudi males in the Riyadh region.

Attendees of 15 health centers in urban and rural areas in the Riyadh region were screened for obesity during May and June 1994. Systemic selection yielded 1580 Saudi males for analysis. The mean age was 33.6 +/- 13.5 years and body mass index (BMI) was 26.9 +/- 5.7 kg/m(2). Only 36.6% of subjects were their ideal weight (BMI < 25 kg/m(2)), while 34.8% were overweight (BMI 25-29.9 kg/m(2)), 26.9% were moderately obese (BMI 30-40 kg/m(2)) and 1.7% were morbidly obese (BMI > 40 kg/m(2)). Middle age, lower education and joblessness predicted a higher risk for obesity. Patients living in a rural areas had greater BMIs than those living in urban areas (P <0.01). Forty percent of overweight participants did not think they were so. The high prevalence of obesity and the lack of awareness among those afflicted emphasizes the need for community-based programs for preventing and reducing obesity, since weight control is effective in ameliorating most of the disorders associated with obesity, such as Type II non-insulin-depedent diabetis mellitus, hypertension, stroke, heart disease, sleep apnea syndrome and osteoarthritis of the knees. Young parents who are at risk of developing obesity and who play a central role in perpetuating it in their offspring should be the target of obesity-prevention programs.

CUTANEOUS LEISHMANIASIS IN RIYADH REGION: FOUR‐YEAR STUDY OF THE EPIDEMIOLOGIC AND CLINICAL FEATURES

A retrospective study of 11,802 patient records with cutaneous leishmaniasis in Riyadh region was conducted during the period 1987 to 1990. The following findings resulted from the study. The incidence rate declined from 244.2 to 106.5 per 100,000 population. The infection was mainly among non‐Saudi men in their working years. The Saudis represented 33% of the total number of patients. The Saudi patients were mainly young, below 15 years of age, with almost equal men/women distribution. The non‐Saudis were found to have more multiple lesions; 65% of them had three or more lesions compared with 10% in Saudis. The lesions were mainly on the exposed parts of the body such as the face (20%), neck (3.3%), upper limbs (23.3%), and lower limbs (15%). Agricultural areas such as Riyadh vicinity, Al‐Kharj, Shagraa, and Al‐Koweeya showed consistently the highest foci of infections. The infections were highest in winter and lowest in summer.

Community-based study of obesity among children and adults in Riyadh Saudi Arabia.

Nowadays obesity is a major public health problem. It is a main risk factor for many fatal diseases. Our study aimed to determine the prevalence of obesity among children and adults in Riyadh and to investigate the associated sociodemographic factors. A cross-sectional, population-based sample of Riyadh was selected through the two-stage cluster sampling technique. All participants attended the local primary health-care center, and a questionnaire interview to obtain sociodemographic data was completed for each. Anthropometric measurements of weight and height were performed. Body mass index (BMI) was calculated, and children having a BMI ≥ 95th age- and sex-specific percentile and adults with a BMI ≥ 30 were considered obese. There were 4,775 participants: 1,848 children and 2,927 adults. Among the children, 10.5% were overweight and 8.7% were obese. Among the adults, 32.4% were overweight and 21% were obese. Among children, a multivariate logistic regression analysis showed that age 6 to 10 years (odds ratio, 2.21; 95% confidence interval, 1.4–3.5) and non-Saudi nationality (odds ratio, 2.2; 95% confidence interval, 1.31–3.7) were associated with childhood obesity. Among adults, urban residence (odds ratio, 1.5; 95% confidence interval, 1.23–1.83), female sex (odds ratio, 2.03; 95% confidence interval, 1.64–2.53), and marriage (odds ratio, 2.11; 95% confidence interval, 1.57–2.82) were associated with obesity in adults, as was Saudi nationality and age above 30 years. Obesity is an important public health problem in Riyadh.

Sickness Absenteeism among Employees of a Teaching Hospital in Saudi Arabia

The sickness absence records of workers at the King Khalid University Hospital over a period of two years (1990-1991) were analysed to identify the category of workers at high risks. The records of each staff who went on sick-off are available at the Employee Health Clinic of the hospital. There were 861 workers with sickness absence records during the period of study and 86% are expatriates on contract. The prevalence of sickness absence is higher among contract workers than non- contract workers about 16% and 9% respectively. The sex ratio was 1:2 in favour of females among contract employees but 1.2:1 in the males favour for the Saudis. The observed sex differential in the rate of sickness absence in each occupational group is statistically significant (P<0.01). Females have more spells of sickness than males and the duration of sickness absence is significantly higher in females. However, the average spell of sickness which is generally low is not different between contract and non-contract workers although slightly higher in the former. There was no significant occupational effect on the spells and duration of sickness absence. Respiratory infections and diseases of the digestive and musculoskeletal systems are the major diseases causing sickness absence. The implications of these findings are discussed in the paper. But for a good monitoring of sickness absence records, a health record surveil lance card for each employee is recommended.

Anxiety and Depression Among Primary Care Patients in Riyadh

Primary care physicians deal with a large proportion of mentally ill patients. Emotional disturbances such as depression and anxiety may coexist with physical illnesses, leading to complicated clinical presentations, poor response to treatment, and frequently, unnecessary investigations, procedures, and referrals to special