Prevalence of Glucose Intolerance in Urban and Rural Communities in Saudi Arabia

The prevalence and associated factors for glucose intolerance among Saudi populations in urban and rural communities were investigated among 13177 subjects, 15 years and over, from different regions of Saudi Arabia. The data were standardized using the known age structure of the Saudi population. The sample was randomly selected from subjects who participated in the National Epidemiological Household Study for Chronic Metabolic Diseases. Medical and social history was ascertained from all the study population during house visits. All subjects were then requested to attend a local primary care centre for physical examination and phlebotomy for measurement of random plasma glucose (RPG). A 75 g oral glucose tolerance test was employed for subjects with borderline values. WHO criteria for diagnosis of diabetes mellitus (DM) and impaired glucose tolerance (IGT) were applied. Mean RPG from the urban population was significantly higher than in the rural population. Age adjusted prevalence of DM was significantly higher in the urban population (males 12 %, 95 % CI 11–13 and females 14 %, 95 % CI 13–15) than in the rural population (males 7 %, 95 % CI 7–8 and females 7.7 %, 95 % CI 7–9) and is among the highest in the world. The prevalence of DM increased with age. The lowest and highest prevalences of DM in the urban population were 2 % for subjects aged 15–20 years and 49 % for female subjects aged 51–60 years. The lowest and highest prevalences of DM among rural population were 1 % for subjects aged 15–20 years and 29 % for female subjects over the age of 60 years. Fifty-six per cent of diabetic patients were newly diagnosed at the time of the study. Age adjusted prevalence of IGT was not significantly higher in the urban population. The highest prevalence of obesity, BMI>30, was among urban female subjects. Age, obesity, and family history of DM were associated with DM. Considering the young nature of Saudi population, the prevalence is expected to increase in the near future. There is a need to develop a multi-disciplinary approach for the general population with special attention to female subjects for prevention through controlling modifiable risk factors such as obesity and sedentary life style, improving glycemic control of the diabetic population, and early identification and treatment of diabetic complications. © 1997 John Wiley & Sons, Ltd.     

Prevalence of radiographic knee osteoarthritis in Saudi Arabia

In this cross-sectional study we looked at the radiographic evidence of osteoarthritis (OA) of the knee in 300 randomly chosen patients attending 14 primary care facilities for different medical conditions. Radiographic OA was seen in 89 out of 167 males (53.3%) and in 81 out of 133 females (60.9%). The patella was involved with radiographic osteoarthritic changes in 80.7% and 87.8% of female and male OA patients, respectively. In most cases the medial compartment joint space was narrowed. Radiographic OA of the knee is very common in Saudi patients, especially in the patellofemoral compartment. Received: 18 April 2001 / Accepted: 10 September 2001     

Epidemiology of gastroesophageal reflux disease in Tehran, Iran

BACKGROUND AND AIM: Epidemiological studies have indicated an increase in the prevalence of gastroesophageal reflux disease in Western countries; however, there is a lack of information about its prevalence in Iran. The aim of this study was to measure gastroesophageal reflux disease prevalence in a representative sample of the Tehran population in 1999. METHODS: In a cross-sectional study, 700 people, with a male : female ratio of 1:1, were selected by stratified randomization based on the probability of 20% prevalence of gastroesophageal reflux disease and 3% error. They were divided equally into seven age groups. Heartburn and acid regurgitation were considered as the most common symptoms of gastroesophageal reflux disease. The severity and frequency of heartburn and the role of personal habits in the appearance of this symptom were determined. The prevalence of gastroesophageal reflux disease in samples was measured, and its actual prevalence in society was estimated. RESULTS: Of 700 people, 350 were male and 350 were female. The major symptoms of gastroesophageal reflux disease were observed in 278 (39.7%) people. The prevalence of gastroesophageal reflux disease of smokers was twice that of non-smokers. CONCLUSIONS: Gastroesophageal reflux disease is a serious and unresolved problem in Western countries, and its increasing prevalence correlates with an increasing prevalence of adenocarcinoma of distal esophagus. The prevalence of gastroesophageal reflux disease appears to be increasing in Iran also; therefore, it is recommended that major attention be paid to this disease.     

Changing prevalence of gastroesophageal reflux with changing time: longitudinal study in an Asian population

BACKGROUND: The purpose of the present paper was to study previously obtained population-based data on the prevalence of reflux symptoms in a random sample of community adults in Singapore. This sample was re-investigated 5 years later to determine changes in the prevalence of reflux symptoms. METHODS: In 1999, 237 (34%) of the original cohort of 696 persons who were interviewed in 1994, were re-interviewed using a validated Gastrointestinal Symptoms Questionnaire. The original cohort was a race-stratified random sample of residents in a Singaporean town. Reflux was defined as heartburn and/or acid regurgitation occurring at least once a month. RESULTS: Among the 237 respondents (aged 25-89 years; male : female, 49:51; Chinese n = 106, 45%; Malay n = 69, 29%; Indian n = 60, 25%), reflux was reported by 25 respondents, giving a prevalence of 10.5 +/- 2.0%. This compared with the prevalence of 5.5 +/- 1.5% (odds ratio [OR], 2.2; 95% confidence interval [CI]: 1.0-5.2; P = 0.05) among the same 237 respondents in the 1994 survey. Of the 25 subjects who reported reflux in the current survey, 22 (88.0%) did not complain of reflux symptoms in the 1994 survey. The ethnic-adjusted prevalence of reflux in 1999 was estimated to be 9.9 +/- 1.9%. This was an increase above the prevalence in 1994 of 1.6 +/- 1.0% (P = 0.051). The upward trend in the prevalence of reflux was not related to age, smoking, alcohol consumption, or increase in bodyweight. CONCLUSIONS: There is a rising trend of reflux symptoms frequency in the general population of Singapore over a 5-year period.     

Clinical Symptoms in Endoscopic Reflux Esophagitis: Evaluation in 8031 Adult Subjects

This study aimed to evaluate the correlation between symptoms and endoscopic findings in reflux esophagitis. Subjects, 8031 persons without medication for gastrointestinal disease, were briefly asked about the presence of heartburn, dysphagia, odynophagia, and acid regurgitation by associated medical staff before endoscopy for assessment of esophagitis utilizing the Los Angeles Classification. Endoscopically, 1199 (14.9%) were classified as positive reflux esophagitis, and 2223 (27.7%) had heartburn, 1522 (19.0%) had dysphagia, 493 (6.1%) had odynophagia, and 1466 (18.3%) had acid regurgitation. Multivariate analysis indicated that the symptom most related to esophagitis was heartburn (odds ratio: 2.46), although approximately 40% of subjects with grade C or D did not complain of heartburn. Regarding the other symptoms, less than 30% subjects with severe esophagitis complained of the symptoms and the odds ratio was approximately 1. These results indicate that endoscopic esophagitis was not equivalent to any reflux symptoms from which subjects suffered in their daily lives.     

Nutrition, Physical Activity, and Gender Risks for Adolescent Obesity in Southwestern Saudi Arabia

Background/Aim:

The aim of the study was to investigate gender differences in obesity and related behavior among adolescent school boys and girls in southwestern Saudi Arabia.

Patients and Methods:

A cross-sectional study on a stratified sample of 1,249 adolescent boys and 620 adolescent girls, was conducted in southwestern Saudi Arabia. They were interviewed and examined for weight and height using standardized techniques.

Results:

The prevalence of obesity and overweight in the present study amounted to 23.2% among boys and 29.4% among girls. The following significant risk factors were identified; being a female [adjusted odds ratio (aOR) =1.372, 95% confidence interval (CI) =1.099-1.753] and lack of class physical exercise (aOR =1.452, 95% CI =1.149-2.117).

Conclusion:

Obesity among adolescents is a public health problem in Southwestern Saudi Arabia. The problem is more prevalent among girls. Thus, there is a need for a national programme in the country to prevent and control obesity among adolescents.     

Cutaneous leishmaniasis in Al Hassa,Saudi Arabia: Epidemiological trends from 2000 to 2010

ObjectiveTo study epidemiological trends related to cutaneous leishmaniasis (CL) in Al Hassa, an endemic area in Saudi Arabia.MethodsThis retrospective study included the spatial/temporal analysis of the reported cases of CL using the available surveillance database for the disease at the regional Vector Control Unit, from 2000 to 2010.ResultsThe incidence of CL was declining at a stable rate especially during the last 3 years of the study (2008-2010). An interesting finding was the percentage of expatriates affected was increasing over the last 10 years compared to that of the Saudis.ConclusionsA definite declining trend in the incidence of CL was observed in Al Hassa. Further studies are warranted to assess whether special public health measures are needed for better control of CL in expatriate populations in Saudi Arabia.     

Rabeprazole Versus Omeprazole in Preventing Relapse of Erosive or Ulcerative Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a chronic condition, with 50–80% of patients experiencing recurrence within one year of completing initial treatment. In patients with erosive GERD, proton-pump inhibitors (PPI) provide faster healing and symptom relief than do H₂-receptor antagonists and have become the treatment of choice. Rabeprazole is a new PPI with demonstrated efficacy in both the acute and maintenance treatment of erosive GERD. The primary objective was to compare efficacy and tolerability of rabeprazole and omeprazole in preventing relapse of healed erosive GERD. Secondary objectives included comparison of efficacy in preventing GERD relapse symptoms and in maintaining quality of life. In this multicenter, double-blind, parallel-group study, 243 patients with healed erosive GERD were randomised to receive rabeprazole 10 mg once daily in the morning (QAM) (N = 82); rabeprazole 20 mg QAM (N = 78); or omeprazole 20 mg QAM (N = 83). Endoscopies were performed at weeks 13, 26, 39 (if clinically indicated), and 52, or when symptoms suggested recurrence. Corpus biopsies were performed at each endoscopy, and antral biopsies were performed at study entry and exit. Rabeprazole 10 mg and 20 mg QAM were equivalent to omeprazole 20 mg QAM for all efficacy parameters. At week 52, relapse rates in the intent-to-treat populations were 5%, 4%, and 5% for rabeprazole 10 mg and 20 mg and omeprazole 20 mg, respectively. All treatments were well tolerated. In conclusion, both rabeprazole 10 mg and 20 mg QAM are equivalent to omeprazole 20 mg QAM in preventing recurrence of erosive GERD.     

Prevalence of gastroesophageal reflux disease in Moscow

Limited data exist to determine the prevalence and clinical spectrum of gastroesophageal reflux disease (GERD) in the Russian population, which might be different from those in Western countries. This study was performed in Moscow on randomized 1065 adults aged ≥15 years. A validated reflux questionnaire comprising 72 questions and an additional 29 sub‐questions were used. The questions assessed (heartburn and regurgitation) and related (dyspepsia, dysphagia, odynophagia and chest pain) symptoms, the triggering factors of these symptoms, family history and data on demographic and socioeconomic features. GERD was defined as heartburn and/or regurgitation once a week or common. Of the 1065 participants, 42.1% were male and 57.9% were female. The prevalences of frequent and occasional symptoms were 17.6 and 22.1% for heartburn and 17.5 and 21.8% for regurgitation, respectively, over the last 12 months. The prevalence of GERD was found to be 23.6%. The rate of GERD was significantly higher in females than in males (15.4 vs. 29.5%, P < 0.001) and significantly increased as the age of the participants increased (P = 0.011). GERD was present in 20.4% of smokers, 24.2% of coffee drinkers, 21.5% of alcohol consumers and 45.9% of stressed participants. Although the rate of alcohol consumers was lower in those with GERD compared with those without GERD, the rate of coffee drinkers and stressed participants was higher among those with GERD. The rate of additional symptoms was higher even in participants complaining of regurgitation/heartburn rarely, compared with those without complaints. Using the same questionnaire, which makes it possible to compare the present results with those from different countries, we found the prevalence of GERD in Moscow to be 23.6%, one of highest in the Western populations. The rates of heartburn and regurgitation were found to be similar, which constitutes a different result than has been found in similar studies. Additional symptoms should be assessed, in all GERD patients even in the presence of rare complaints of regurgitation/heartburn.     

Prevalence of Gastroesophageal Reflux Disease Symptoms and Uninvestigated Dyspepsia in Korea: A Population-Based Study

Various reports on the prevalence of gastroesophageal reflux disease (GERD) and uninvestigated dyspepsia have been conducted in Western countries. We sought to determine the frequency of GERD symptoms and uninvestigated dyspepsia in Korea. Telephone interviews were conducted with 1,044 individuals. Of all subjects, 7.1% reported that GERD symptoms were present at least once a week, and 3.8% at least twice a week. The prevalence of heartburn according to educational level and acid regurgitation according to age was significantly different (P < 0.05). The prevalence of uninvestigated dyspepsia was reported as 12.2%. Dyspepsia was divided into subgroups of 34% ulcer-like, 56% dysmotility-like, and 10% nonspecific. The occurrence of dyspepsia did not vary according to age, gender, educational level and household income. As frequency of GERD symptoms increased, quality of life significantly decreased. We concluded that GERD symptoms and uninvestigated dyspepsia were prevalent in Korea. The prevalence was similar to that of other Asian countries.     

Determinants of Symptoms Suggestive of Gastroesophageal Reflux Disease in the Elderly

The study material consisted of 487 subjects from a stratified random sample of the non-institutionalized population of Turku aged 65 years or more (n = 24,937). The study was based on a population study on health status and sleeping habits of the elderly. Information on health status and medications was obtained by means of interviews and from the national health insurance records of the subjects. A postal questionnaire inquired about symptoms suggestive of gastroesophageal reflux disease (GERD). In univariate analyses, perceived poor health, insomnia, disability, depression, previous peptic ulcer, cholelithiasis, and bronchial asthma were associated with daily symptoms suggestive of GERD. Moreover, the symptoms were associated with the use of beta-blocking agents, benzodiazepines, and neuroleptic agents. In multivariate analyses, previous peptic ulcer, perceived poor health, insomnia, and use of benzodiazepines were independently associated with symptoms suggestive of GERD. In conclusion, the determinants of symptoms suggestive of GERD in the elderly differ from those reported in young and middle-aged subjects.     

Parental Smoking and the Risk of Respiratory Symptoms Among Schoolboys in Al-Khobar City, Saudi Arabia

The objective of this study was to measure the prevalence of parental smoking and its association with respiratory symptoms among 6- through 15-year-old schoolboys in Al-Khobar City, Saudi Arabia. This was a cross-sectional study. The methodology included the distribution of a self-administered questionnaire, which was completed by the parents of 1482 schoolboys who satisfied the selection criteria of the study. The overall rate of smoking among parents of this sample was 18.2% (32% among fathers and 4% among mothers). There was an increased risk associated with parental smoking and respiratory symptoms among asthmatic and nonasthmatic children. The magnitude of this risk was variable for different respiratory symptoms. The smoking rate among parents of asthmatic children was significantly higher than that of parents of normal children. The logistic regression model showed paternal smoking to be significantly associated with asthmatic children. The study concluded that there is an increased risk of respiratory symptoms among asthmatic and nonasthmatic children because of parental smoking. The smoking rate and trend among fathers and mothers were comparable to those reported earlier, indicating an ongoing problem. Schoolchildren with smoking parents may be better screened for bronchial asthma. Management of children presenting with respiratory symptoms should include an inquiry about exposure to passive smoking. Tobacco smoking should be considered a public health problem with serious implications, and the importation of tobacco should be banned.     

Changing patterns of hepatitis A prevalence within the Saudi population over the last 18 years

AIM： To determine the seroprevalence of Hepatitis A （HAV） amongst Saudi children and compare it with previously reported prevalence data from the same population. METHODS： A total of 1357 students were randomly selected between the ages of 16 and 18 years （689 males and 668 females） from three different regions of Saudi Arabia （Madinah, AI-Qaseem, and Aseer） and tested for anti-HAV-IgG.RESULTS： The overall prevalence of anti-HAV-IgG among the study population was 18.6%. There was no difference between males and females but there was a significant difference in the seroprevalence （P = 0.0001） between the three different regions, with Madinah region showing the highest prevalence （27.4%）. When classified according to socioeconomic status, lower class students had a prevalence of 36.6%, lower middle class 16.6%, upper middle class 9.6%, and upper class 5.9% （P = 0.0001）. Comparing the current study results with those of previous studies in 1989 and 1997 involving the same population, there was a marked reduction in the overall prevalence of HAV from 52% in 1989, to 25% in 1997, to 18.6% in 2008 （P 〈 0.0001）.CONCLUSION： Over the last 18 years, there has been a marked decline in the prevalence of HAV in Saudi children and adolescents. The current low prevalence rates call for strict adherence to vaccination policies in high-risk patients and raises the question of a universal HAV vaccination program.     

Prevalence of gastroesophageal reflux disease and gastroesophageal reflux disease symptoms in Japan

Background and Aim:  Epidemiological studies have shown that 10–48% of people in developed countries have gastroesophageal reflux disease (GERD) symptoms such as heartburn and acid regurgitation. The present study aimed to examine the prevalence of GERD symptoms and GERD in Japanese subjects.
Methods:  A cross-sectional study of Japanese subjects who visited a clinic for a routine health check up was carried out. Subjects were asked to fill out a self-report questionnaire. GERD was defined as the presence of heartburn and/or acid regurgitation at least twice per week.
Results:  Of the 6035 eligible subjects, 2662 (44.1%) reported having had heartburn and/or acid regurgitation during the past year: 124 (2.1%) daily, 275 (4.6%) twice per week, 773 (12.8%) twice per month and 1490 (24.7%) less than twice per month. Three hundred and ninety-nine (6.6%) subjects were diagnosed as having GERD and there was no relationship between the prevalence of GERD and either sex or age. The prevalence of bothersome GERD symptoms was significantly higher in subjects with GERD than in those without GERD.
Conclusion:  Approximately 6.6% of Japanese have GERD and most persons with GERD described heartburn or acid regurgitation as bothersome.     

Prevalence of gastroesophageal reflux disease and gastroesophageal reflux disease symptoms in Japan

BACKGROUND AND AIM: Epidemiological studies have shown that 10-48% of people in developed countries have gastroesophageal reflux disease (GERD) symptoms such as heartburn and acid regurgitation. The present study aimed to examine the prevalence of GERD symptoms and GERD in Japanese subjects. METHODS: A cross-sectional study of Japanese subjects who visited a clinic for a routine health check up was carried out. Subjects were asked to fill out a self-report questionnaire. GERD was defined as the presence of heartburn and/or acid regurgitation at least twice per week. RESULTS: Of the 6035 eligible subjects, 2662 (44.1%) reported having had heartburn and/or acid regurgitation during the past year: 124 (2.1%) daily, 275 (4.6%) twice per week, 773 (12.8%) twice per month and 1490 (24.7%) less than twice per month. Three hundred and ninety-nine (6.6%) subjects were diagnosed as having GERD and there was no relationship between the prevalence of GERD and either sex or age. The prevalence of bothersome GERD symptoms was significantly higher in subjects with GERD than in those without GERD. CONCLUSION: Approximately 6.6% of Japanese have GERD and most persons with GERD described heartburn or acid regurgitation as bothersome.     

Prevalence and Associated Features of Gastroesophageal Reflux Symptoms in a Caucasian-Predominant Adolescent School Population

OBJECTIVE: To determine the prevalence of esophageal symptoms and associated symptoms of gastroesophageal reflux symptoms in 14-18 year-old high school students and the percentage of symptomatic adolescents who saw a physician or received medications. DESIGN AND SETTING: A cross-sectional questionnaire administered to students at two high schools. PARTICIPANTS: 1,286 completed questionnaires were analyzed. The study sample consisted of 57% Caucasians and 57% males, with a mean age of 15.7 (+/-1.3) years. INTERVENTION: No intervention was used. Participants completed questionnaires only. RESULTS: 714 students (56%) reported at least one esophageal or respiratory symptom. Esophageal symptoms reported were: heartburn (22%), regurgitation (21%), and dysphagia (15%). Respiratory symptoms reported were: shortness of breath (24%), wheezing (20%), and cough (18%). Students with at least one esophageal symptom were more likely to experience at least one respiratory symptom than were students with no esophageal symptoms (52% vs. 25%; p < 0.001). Cigarette, alcohol, and non-steroidal anti-inflammatory drug use were risk factors for both respiratory and esophageal symptoms. Of those experiencing one or more of these symptoms, 4% reported that the symptoms affected their daily activities, 23% visited a physician, and 25% took medication in the past year. CONCLUSIONS: Esophageal symptoms of gastroesophageal reflux are frequent in adolescents. Fewer than 25% of students with gastroesophageal reflux symptoms consulted a physician and/or took medications.     

Prevalence and factors associated with Internet gaming disorder among adolescents in Saudi Arabia: A cross-sectional study

This study aimed to assess the prevalence of internet gaming disorder (IGD) and its associated factors among a sample of adolescents in the Faifa governorate in the south of Saudi Arabia.This was a cross-sectional study targeting intermediate and secondary school adolescent students in the Faifa governorate. Multistage sampling was performed to reach the required sample, where 9 schools were randomly selected, followed by the distribution of the questionnaire to all students at all levels. IGD was assessed using a validated Arabic version of the 20-item IGD scale. A chi-square test was used to evaluate the presence of statistical differences between sample demographic data and IGD.Four hundred and fifty students participated in the current study, where 132 (29.3%) of them were classified as having IGD. The prevalence of IGD was associated with gender, year of study, maternal education status, and the number of hours spent online and playing with friends (P values 0.05). Analysis of the IDG items among the current sample indicated that most were at the conflict stage of IGD.The IGD level identified in our sample is high compared to the published literature. Faifa is a mountainous region and, due to its geographical nature, there are limited public entertainment areas. Adolescents tend to spend more time at home, where they may be more exposed to IGD. This suggests the need for strategies to ensure early identification of those at risk of IGD and to provide preventive and treatment options for these students.     

Seroprevalence of celiac disease among healthy adolescents in Saudi Arabia

AIM: To identify the seroprevalence of celiac disease among healthy Saudi adolescents. METHODS: Between December 2007 and January 2008, healthy students from the 10th to 12th grades were randomly selected from three regions in Saudi Arabia. These regions included the following: (1) Aseer region, with a student population of 25512; (2) Madinah, with a student population of 23852; and (3) Al-Qaseem, with a student population of 16067. Demographic data were recorded, and a venous blood sample (5-10 mL) was taken from each student. The blood samples were tested for immunoglobulin A and immunoglobulin G endomysial antibodies (EMA) by indirect immunofluorescence.RESULTS: In total, 1167 students (614 males and 553 females) from these three regions were randomly selected. The majority of the study population was classified as lower middle class (82.7%). There were 26 (2.2%) students who had a positive anti-EMA test, including 17 females (3.1%) and 9 males (1.5%). Al-Qaseem region had the highest celiac disease prevalence among the three studied regions in Saudi Arabia (3.1%). The prevalence by region was as follows: Aseer 2.1% (10/479), Madinah 1.8% (8/436), and Al-Qaseem 3.2% (8/252). The prevalence in Madinah was significantly lower than the prevalence in Aseer and Al-Qaseem (P=0.02). CONCLUSION: Our data suggest celiac disease prevalence might be one of the highest in the world. Further studies are needed to determine the real prevalence.     

A Study of Reflux Esophagitis in an Apparently Healthy Population

Abstract: To study reflux esophagitis in the general population, we reviewed the records of 64,171 apparently healthy Japanese adults, 48, 706 men and 15,465 women, who had undergone automated multiphasic health testing and services (AMHTS), a comprehensive routine medical health check, that includes double-contrast upper gastrointestinal roentgenograms. All subjects suspected of having gastrointestinal disease underwent a flexible fiberscopy as indicated. Reflux esophagitis was thus confirmed in 101 subjects. The prevalence of refla esophugitis was 0.20% among men and 0.04% among women (men vs. women p<0.001) and its frequency increased with age in both men (p<0.001) and women (p<0.05). Endoscopic classification according to the Savary-Miller criteria yielded 48, 27, 23, and patients in Stage I, II, III and IV, respectively. In this series, 49/101 (48.5%) of the esophagitis patients had concurrent upper gastrointestinal abnormalities. The incidence of heavy smoking and excessive drinking of alcohol was significantly higher in the patients with reflux esophagitis (p<0.001 and p<0.005, respectively) as compared with the normal population.