Parental perceptions,attitudes and acceptance of childhood immunization in Saudi Arabia: A cross sectional study

ObjectivesThe widespread availability and use of vaccines have tremendously reduced morbidity, mortality and health care costs associated with infectious diseases. However, parental beliefs about vaccination are one of the major factors in achieving high vaccination rates. Thus, this study aims to assess the perceptions and attitudes regarding routine childhood immunization among Saudi parents.MethodsA cross sectional study with a pre-tested 18-item questionnaire was conducted using 467 randomly selected parents from the Hail region of Saudi Arabia in the period between February 1st, 2016, and February 1st, 2017. The validated questionnaire consisted of three sections that collected information on participants’ demographics, parents’ awareness of vaccine benefits, and parents’ practices regarding the immunization of their children.ResultsFemale and male parents comprised 54.5% (255) and 45.5% (212) of the sample, respectively, and the response and completion rates were 97%. The majority of the respondents had received a formal education (94.1%, 439), were gainfully employed (62.9%, 294) and had a regular monthly income (73.3%). The majority of the respondents were aware of childhood vaccinations (78.9%), completed vaccinations mandated for children up to 5 years (86.2%), encouraged other parents to do so (89.9%), and had easy access to vaccines (90.5%). Sixty to ninety percent of the respondents were knowledgeable regarding the health benefits of vaccinations in children, even though 18.4% of their children had experienced vaccination-related minor adverse effects during or after vaccination of which 23.2% required doctor's visits. Health care professionals were the most frequent source of parents’ vaccine-related information (65.2%), and vaccination reminder services provided by the Ministry of Health (MOH) via mobile phones were cited by 57.5% of respondents.ConclusionsConfidence in and acceptance of childhood vaccinations, perceptions of vaccine-related health benefits and ease of access to immunizations appeared to be quite good among Saudi parents.     

Utilizing the McGill Thyroid Nodule Score to compare between hemithyroidectomy cases who required completion thyroidectomy and cases of hemithyroidectomy alone

ObjectivesThis study aims to evaluate whether the McGill Thyroid Nodule Score (MTNS) accurately helps to decide the extent of surgery (hemithyroidectomy versus total thyroidectomy) based on the malignancy risk and to assess whether its use lowers the rate of completion thyroidectomy in cases of indeterminate thyroid nodules.MethodsWe performed a retrospective cohort study comparing MTNS results of patients undergoing hemithyroidectomy in King Abdulaziz Medical City, NGHA, Jeddah from the period of January 2013 to December 2017. We divided the cases into hemithyroidectomy who required completion and hemithyroidectomy who did not need completion surgery. The pre-operative indeterminate FNA biopsy subgroup comprised of Bethesda type III (atypia of undetermined significance/follicular lesion of undetermined significance) and Bethesda type IV (follicular neoplasm/suspicious for a follicular neoplasm/Hurthle cell neoplasm). Post-operative histopathology was divided into benign or malignant groups.ResultsOf the 501 patient charts reviewed, 111 (22.2%) had an indeterminate FNA biopsy. 97 (87.4%) patients were females and 14 (12.6%) were males. In the hemithyroidectomy group, the pre-operative mean of the MTNS was 6.65, while in the completion thyroidectomy the mean was 11.47. The median MTNS was 7 (32% risk of malignancy) for the hemithyroidectomy group and 11 (63% risk of malignancy) for the completion thyroidectomy group (p < 0.001).ConclusionsBased on the MTNS the risk of malignancy in cases of hemithyroidectomy who required completion surgery was significantly higher than those who underwent hemithyroidectomy only. The MTNS can be of value to thyroid surgeon in the pre-operative decision-making when dealing with an indeterminate thyroid nodule on FNA biopsy.     

Localizing pharmaceuticals manufacturing and its impact on drug security in Saudi Arabia

Local production of pharmaceuticals plays a vital role in maintaining resilience of national healthcare systems, especially when it comes to facilitating access to needed medicines and decreasing exposure to imports and international supply chains. Pharma is a research-intensive industry and the systemic lack of governance and support to R&D activities in this sector, among other host of related issues such as unsupportive regulatory regimes and human resources capacity limitations, is one of the major impediments to the diversifying of locally produced pharmaceuticals portfolio. In this review, an overview of the current pharmaceutical production system in Saudi Arabia, its major challenges, and proposed remedies to address them will be highlighted.     

Access to Online Information by Adult Saudi Cancer Patients

Abstract

The proportion of Saudi cancer patients who utilize online information resources is unknown; therefore, this project was designed to characterize Internet utilization by this group. Saudi cancer patients who met defined eligibility criteria responded to a questionnaire to examine Internet utilization, barriers to access, and information needs. Of the 150 patients included, only 19 (13%) used the Internet to receive online information. From patients' perspectives, inability to use a computer (57%), limited English language proficiency (55%), and not knowing about online resources (44%) were the most frequent barriers. A multivariate analysis showed that owning a personal computer was the only variable that distinguished Internet users from nonusers. This study provides the only available data concerning access to Internet information by cancer patients in Saudi Arabia. The study showed that the access rate is unacceptably low due to several barriers. Prompted by the study results, pragmatic recommendations are provided.     

Influence of gender and age of onset on the outcome in children with systemic lupus erythematosus

The objective of our study was to determine the influence of gender and age of onset on the outcome in Saudi children with systemic lupus erythematosus (SLE). Medical records of children with SLE treated at King Faisal Specialist Hospital and Research Center were reviewed. Outcome measures included Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index score (SLICC/ACR), renal disease requiring dialysis, or transplant and death related to SLE. Patients were classified based on age at disease onset into early onset (<5 years) and late onset (>5 years). Data were analyzed, and comparison was made according to the gender and age groups. Eighty-nine patients (76 female and 13 male) were included. The median disease duration was 5 years. Twelve patients had early-onset disease. There was no difference in the mean age, age at diagnosis, disease duration, and follow-up between the different groups. Logistic regression analysis showed significant association of high SLICC/ACR score with early-onset disease and male gender, while renal disease requiring dialysis and renal transplant was associated significantly with male gender independently of age of disease onset. In contrast, death related to SLE was influenced by early-onset disease. Male children and early onset disease of this cohort had poorer outcome. This finding indicates that gender and early-onset disease influence the long-term outcome of SLE in children.     

Road towards promoting patient safety practices among hospital pharmacists: Hospital-based baseline patient safety culture assessment cross-sectional survey

Patient safety is a fundamental aspect of a healthcare system. The aim of this study was to assess the perception and determinants of the patient safety culture of pharmacists in hospitals, in Riyadh, Saudi Arabia.A survey was conducted with pharmacists in the pharmacies of governmental, /military and private hospitals in Riyadh, Saudi Arabia. The pharmacy survey on patient safety culture questionnaire developed by Agency for Healthcare Research and Qualtity, a hard copy was distriuted to the pharmacists. The positive response rate (RR) was calculated and compared across hospitals using a chi-square test. The predictors of patient safety grades were identified using the generalized estimating equation. The data was analyzed using SAS.A total of 538 questionnaires were distributed, of which 411 responded (RR 76.4%). Of the participants, 229 (56%) were females. The majority 255 (62%) were in the 18 to 34 years age range, and 361 (88%) had a bachelor''s degree. The majority of the sample 376 (92%) was a pharmacist. The Positive RR (PRR) ranged between (25.6%–74%). The highest PRR was observed in teamwork (74.4%), followed by ‘staff, training and skills’ (68%), and ‘organizational learning continuous improvement’ (66%). The lowest PRR was observed in ‘staffing, work pressure, and pace’ (25.5%). Comparing the PPR of the various healthcare sectors, the governmental hospitals scored the highest in all patient safety domains. Generalized Estimating Equation analysis showed that with increase in scores of all patient safety culture domains increased the likelihood of reporting a better patient safety grade, whereas respondents’ demographic characteristics had no effect except the working experience years 6 years and above had odds of poor reporting of the patient safety grade (odds ratio = 2.54, 95% confience interval (1.543, 4.194), (P = .0003).The grades achieved in the various domains of patient safety culture by pharmacists in Riyadh are below the expected standard. The highest scores were achieved in teamwork, with the lowest scores in staffing, work pressure and pace. Overall, pharmacists in government hospital settings have a better perception of patient safety than their peers in other settings. These results provide the baseline evidence for developing future interventional studies aiming at improving patient safety culture in hospital pharmacy settings.     

Comparison of Cepheid® Xpert Flu and Roche RealTime Ready Influenza A/H1N1 Detection Set for detection of influenza A/H1N1

Objective

To compare two influenza polymerase chain reaction (PCR) methods.

Molecular Epidemiology of Hospital Outbreak of Middle East Respiratory Syndrome,Riyadh, Saudi Arabia, 2014

We investigated an outbreak of Middle East respiratory syndrome (MERS) at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, during March 29–May 21, 2014. This outbreak involved 45 patients: 8 infected outside KFMC, 13 long-term patients at KFMC, 23 health care workers, and 1 who had an indeterminate source of infection. Sequences of full-length MERS coronavirus (MERS-CoV) from 10 patients and a partial sequence of MERS-CoV from another patient, when compared with other MERS-CoV sequences, demonstrated that this outbreak was part of a larger outbreak that affected multiple health care facilities in Riyadh and possibly arose from a single zoonotic transmission event that occurred in December 2013 (95% highest posterior density interval November 8, 2013–February 10, 2014). This finding suggested continued health care–associated transmission for 5 months. Molecular epidemiology documented multiple external introductions in a seemingly contiguous outbreak and helped support or refute transmission pathways suspected through epidemiologic investigation.