Selected Dietary Nutrients and the Prevalence of Metabolic Syndrome in Adult Males and Females in Saudi Arabia: A Pilot Study

During the last decade, the rapid economic development in Saudi Arabia resulted in an unbalanced dietary intake pattern within the general population. Consequently, metabolic syndrome was also documented to be highly prevalent in the Middle-East region. We aimed to examine the relationship between selected dietary nutrient intakes and the prevalence of metabolic syndrome in the general adult population of Riyadh, Saudi Arabia. In this cross-sectional study, 185 adult Saudis aged 19 to 60 years (87 males and 98 females (mean age 35.6 ± 13.2 and 37.6 ± 11.7 years, respectively)) were included. The criteria for metabolic syndrome were based on the International Diabetes Foundation (IDF) criteria, and the dietary food intake was assessed by two 24-h dietary recall methods. The odd ratios (ORs) of metabolic syndrome risk across quartiles of selected dietary nutrients were significantly lower for carbohydrates and proteins, as well as for vitamins A, C, E and K, calcium, zinc and magnesium (p < 0.05 for all) in the female group with metabolic syndrome than those without. The pattern of daily dietary intake of selected nutrients among the general population of Saudi Arabia raises concern, and this dietary imbalance could increase the risk of metabolic syndrome, particularly in adult Saudi females.     

Residues of tetracycline compounds in poultry products in the eastern province of Saudi Arabia

Chicken muscle, liver and egg samples were collected from 33 broiler and 5 layer farms in the eastern province of Saudi Arabia over a period of two years starting from January 1996. Antibiotic-residue positive samples were identified in the products of 23 (69.7%) broiler and 3 (60%) layer poultry farms. 87% and 100.0% of the antibiotic-residue positive broiler farms were positive for at least one tetracycline compound in raw muscle and liver respectively, while 73.9% and 95.5% were positive for 2 or more tetracyclines in these two tissues, respectively. Furthermore, 82.6% and 95.5% of the antibiotic-residue-positive farms had mean concentrations of at least one tetracycline compound in excess of the permissible maximum residue limit (MRL) in raw muscle and liver, respectively. These compounds also remained chemically detectable after cooking. Tetracycline levels exceeded MRL in 14.4% of antibiotic-positive raw eggs but the overall mean tetracycline concentration in each farm was below MRL. This study confirmed widespread misuse of tetracycline agents including multiple use of drugs belonging to the same pharmacological group and lack of implementation of recommended withdrawal times. This may be contributing to the high resistance rates to tetracyclines in both chicken and human microbial isolates observed in the region. This study, therefore, stresses the need for stricter regulations for the use of antimicrobial drugs in the poultry industry as well as the inspection of chicken for drug residues prior to marketing.     

Levels of Heavy Metals Pollution in Different Types of Soil of Central Greece

This investigation was performed in order to clarify the degree of heavy metals pollution in forest, agricultural and industrial surface soil samples in relation to pre-anthropogenic soils of Almyros region, in Central Greece. In 2004 and 2005 soil samples were collected and analysed for available (DTPA method) and total (Aqua Regia method) Cd, Cr, Cu, Pb, Zn and Ni concentrations. For each metal the enrichment factor with respect to the levels in pre-anthropogenic soils was calculated. All the types of soils appeared to be less polluted than in other investigations. In agricultural and industrial soils the available Cd concentration was higher than the other metals studied. The enrichment factor of Cu in relation to total concentration has the maximum value of the metals studied. Professor Mitsios is deceased.     

Attitudes towards influenza vaccination of multi-nationality health-care workers in Saudi Arabia

Background

The compliance with influenza vaccination among health-care workers (HCWs) is known to be low. A multi-nationality survey to explore the reasons for such poor compliance has not been studied in depth.

Materials and methods

An epidemiologic survey to evaluate the compliance rates with influenza vaccination and possible associated reasons for compliance.

Results

A total of 450 survey sheets were distributed and 244 (54.2%) were completed. Of the total respondents, 51 (20.9%) were Saudi, 114 (46.7%) were other Arabs, 21 (4%) were North American, 21 (8.6%) were from UK or South Africa and 48 (19.7%) did not indicate their nationalities. There were 32 (13.1%) physicians, and 132 (54.1%) nurses. The overall influenza vaccination rate was 41% in the preceding year and 69% in the preceding 5 years, and 49.2% (n = 110) of the latter group received one to three vaccines. Of the total respondents, 156 (63.9%) report that the influenza vaccine was important, 86 (35%) report that they were not at risk of influenza, 163 (66.8%) report that the influenza vaccine was not safe and 152 (62.3%) report that influenza was not a serious illness. In a multivariate analysis, the following factors were important in choosing vaccinations: being a male, other Arab nationality, and knowing that influenza vaccine is important (P ≤ 0.01). Feeling at risk of influenza, and not using any vaccine alternatives, and that the vaccine is important for self and the patient's protection, were statistically important factors as well (P ≤ 0.05).

Conclusion

Important factors associated with increasing influenza vaccine acceptance include being a male, other Arab nationality, and knowing that influenza vaccine is important. In addition, feeling at risk of influenza, and not using any vaccine alternatives, and that the vaccine is important for self and the patient's protection, were statistically important factors as well. Thus, efforts to increase the acceptance rates should take these factors in consideration.     

Correlations of Physical Activity,Body Mass Index,Shift Duty,and Selected Eating Habits among Nurses in Riyadh,Saudi Arabia

Nurses are the largest group of direct health providers and can serve as role models for their patients. In this cross sectional study we assessed the relationship among physical activity and barriers, shift duty, elevated BMI, and selected eating habits among 362 non-Saudi female nurses in Riyadh, Saudi Arabia. Results showed that 46.7% were either overweight or obese. Marital status, shift duty, education level, and BMI were significant predictors of physical activity. Weather was the most frequently reported barrier to physical activity (88.3%), followed by a lack of transportation (82.6%), and a lack of time (81.3%). Nurses who worked shift duty had significantly (p = 0.004) higher BMIs compared with day shift nurses. Nurses who rarely ate breakfast (p = 0.004) and meals (p = 0.001) and often eat fast food (p = 0.001) were more likely to be overweight or obese. Nurses should be encouraged for a better healthy lifestyles.     

Pulmonary Function of Workers Exposed to Ammonia: A Study in the Eastern Province of Saudi Arabia

Abstract

To determine the effect of chronic exposure to ammonia on pulmonary function among ammonia workers, 77 workers were randomly selected from an ammonia factory in the Eastern Province of Saudi Arabia and 355 were selected as controls from the administrative staffs of four industrial groups in Eastern Province. Spirometry was carried out and FEV₁ FVC, and FEV₁/FVC% were calculated. The ammonia level in the working environment was determined spectrophotometrically. 30% of the air samples had ammonia concentrations that exceeded the threshold limit value. Significant reductions in FEV₁% predicted and FVC % predicted were observed in ammonia workers exposed to higher cumulative ammonia levels (above 50 mg/m³-years). FEV₁% predicted and FEV₁/FVC% were significantly lower in symptomatic than in asymptomatic workers in the exposed group. These findings may raise the possibility that exposure to a high cumulative ammonia level produces a combined restrictive/obstructive ventilatory defect.     

Dietary Supplement Use among Primary Health Care Attendants in Abha City,Southwestern Saudi Arabia

Dietary supplements are commercially available manufactured products used as an addition to the normal diet and involve vitamins, minerals, herbs (botanicals), amino acids, and various other products. With the use of a cross-sectional survey, the present paper intended to analyze dietary supplement usage and its health and sociodemographic determinants among attendants of primary health care centers in Abha City, southwestern Saudi Arabia. The sample was selected randomly using the two-stage cluster sampling technique. The study included 438 participants (115 males and 323 females). Their ages ranged from 18 to 59 years, with an average of 36.2 ± 11.7 years. The study showed that 330 people used dietary supplementation, giving a prevalence of 75.3% (95% CI: 71.1–79.2%). The most commonly used supplements were multivitamins (215, 65.2%), specific vitamins (60, 18.2%), and mineral pills (38, 11.5%). Advice from health care workers was the most frequent reason for using dietary supplements (49.4%). The majority (71.2%) reported feeling a better quality of life after using dietary supplements. The most frequent disadvantages of using dietary supplements were constipation and headache (30%) and the most frequent advantage was increasing appetite (59.8%). The people who most frequently recommended the use of supplements were health care workers (190, 57.6%), followed by friends or family members (62, 18.8%), and people on social media (43, 13%). Females had a significantly higher probability of using dietary supplements than males did (Cor = 2.0, 95% CI = 1.21–3.27), and those with a chronic disease had a considerably higher likelihood of using dietary supplements (cOR = 3.48, 95% CI = 2.04–6.06). Age, educational level, and marital status were not significantly related with dietary supplement usage. In conclusion, health care workers should focus on females and persons with chronic diseases in their practice. They should provide them with evidence-based advice regarding the use of dietary supplements. Continued medical education training programs tailored to the needs of health care staff addressing this issue should be provided. New guidelines should be developed to help health professionals to provide their patients with comprehensive care at the primary health care level.     

Socioeconomic factors affecting the prevalence of obesity among female patients attending primary health centers in Jeddah,Saudi Arabia

A sample of 852 Saudi women who attended the primary health care centers in Jeddah seeking medical care were examined. Obesity was defined as a value for the body mass index (kg/m2) ≥ 25.0. The prevalence of obesity in the examined sample was high (64.3%). Obesity was significantly related to age, marital status, parity, level of education, level of work, women's income levels, who is the householder and the number of servants. There was no significant association between obesity and the following factors: being the only or youngest daughter, inhabitant's number, number of cars, time spent watching television, eating while watching television, number of times per week inviting or being invited to meals, householder's income, and his education or work. Multiple regression analysis indicated that five variables were significant predictors: age, marital status, number of servants, giving birth, and parity. Knowledge of the social factors associated with obesity will help to identify high risk groups. Those most vulnerable to the development of obesity, should then be the focus of a vigorous preventive program.     

Middle East Respiratory Syndrome Coronavirus in Bats,Saudi Arabia

The source of human infection with Middle East respiratory syndrome coronavirus remains unknown. Molecular investigation indicated that bats in Saudi Arabia are infected with several alphacoronaviruses and betacoronaviruses. Virus from 1 bat showed 100% nucleotide identity to virus from the human index case-patient. Bats might play a role in human infection.     

Current trends of Mycobacterium tuberculosis molecular epidemiology in Saudi Arabia and associated demographical factors

Data are scarce on demographical factors related to the population structure of Mycobacterium tuberculosis in Saudi Arabia. A study was conducted on 902 clinical isolates to explore current trends in the phylogeography and associated demographical factors of tuberculosis by using spoligotyping and 24 loci based MIRU-VNTR typing. Young male patients (aged 16–29 and 30–44) were predominant in this cohort. The phylogenetic diversity among M. tuberculosis isolates was found high, as almost all known genetic lineages were identified. Delhi/CAS (26.4%), EAI (13.7%) and Haarlem (11.3%) were the most common lineages observed, particularly among the low age groups (16–29 and 30–44 years), whereas elderly patients (>60 years) showed a predominance in the lineages S, Ghana, TUR and Uganda-I. A statistically significant association was observed between gender of the patients and lineages of EAI (p value 0.026) and LAM (p value 0.005). Overall, molecular strain cluster rate was 34.4% with an elevated rate among patients aged below 15 years (43.1%), while cases among the elderly (>60 years) showed the lowest degree of clustering (12.5%). The largest level of clustering was noticed among cases caused by strains of the lineages Haarlem (59.8%), Beijing (55.8%) and LAM (42.8%). The current population structure of M. tuberculosis in Saudi Arabia is highly diverse with significant associations to demography, transmission dynamics and origin of the patients. The difference in genotype distributions among low and high aged patients reflects the ongoing change in the strain population structure in the country.     

Pulmonary Effects of Occupational Exposure to Portland Cement: A Study from Eastern Saudi Arabia

Abstract

A cross-sectional study was conducted in a randomly selected factory producing Portland cement in eastern Saudi Arabia to determine the prevalence of respiratory symptoms and diseases and chest x-ray changes consistent with pneumoconiosis in the employees. A sample of 150 exposed and 355 unexposed employees was selected. A questionnaire about respiratory symptoms was completed during an interview. Chest x-rays were read according to the ILO criteria for pneumoconiosis. Dust level was determined by the gravimetric method. Concentrations of personal respirable dust ranged from 2.13 mg/m³ in the kilns to 59.52 mg/m³ in the quarry area. Cough and phlegm were found to be related to cigarette smoking, while wheezing, shortness of breath, and bronchial asthma were related to dust levels. It is recommended that engineering measures be adopted to reduce the dust level in this company, together with health monitoring of exposed employees.     

Current dietetic practices of obesity management in Saudi Arabia and comparison with Australian practices and best practice criteria

Aim:  To describe the dietetic practices of the treatment of obesity in Saudi Arabia and compare this with best practice criteria and the practice in Australia.
Methods:  Anonymous questionnaires were completed by dietitians in Saudi Arabia. The topics included barriers to obesity management, demand and level of service and strategies and approaches used for weight management. Best practice scores were based on those used to assess Australian dietitians.
Results:  A total of 253 dietitians participated in the survey. Of these, 175 (69%) were involved in the management of obesity. The best practice score for Australian dietitians was slightly greater than the scores of Saudi dietitians (median 43 vs 39). There was also a significant correlation between the best practice score and years of experience (r = 0.26, P < 0.001). The most common assessment approaches were assessment of body mass index (87%) and exercise habits (81%), while the most common strategies for obesity management were: dietary total fat reduction (92%) and increase incidental daily activity (92%). The major barrier for establishment of a weight management clinic reported by 49% of participants was inadequate resources.
Conclusion:  Saudi Arabian dietetic practice for the management of obesity does incorporate most best practice recommendations, but some specific elements are rarely used.     

Effect of the introduction of pneumococcal conjugate vaccines on serotype prevalence in Kuwait and Saudi Arabia

BackgroundStreptococcus pneumoniae infection is a major cause of morbidity and mortality. Although pneumococcal disease burden in Kuwait and Saudi Arabia is considered high, comprehensive surveillance data on pneumococcal conjugate vaccine (PCV) effects are lacking.MethodsSterile isolates from patients in Kuwait (2003–2016) and Saudi Arabia (aged ≤5 years, 2000–2010; all patients, 2011–2015) were included. Serotyped isolates were classified by inclusion in the 7-valent (PCV7) or 13-valent PCV (PCV13); isolates of other serotypes were classified as “non-PCV13”. Isolate frequency (number of isolates/year) and classification of isolates according to vaccine type were assessed by period (before PCV, after PCV7, and after PCV13 introduction).ResultsIn Kuwait, the frequency of collected isolates was highest after PCV7 introduction. Decreased frequency of PCV7 serotypes was seen after PCV13 introduction compared with before PCV and after PCV7 introduction. Increased frequency of the 6 additional serotypes in PCV13 and non-PCV13 serotypes was observed after PCV7 introduction with a subsequent decrease in the 6 additional serotypes in PCV13 and non-PCV13 serotypes after PCV13 introduction. The percentage of isolates of vaccine serotypes in Kuwait decreased over time. In Saudi Arabia, the frequency of collected isolates was highest after PCV7 introduction. An increased frequency of PCV7 serotypes was observed after PCV7 introduction, with a further decrease after PCV13 introduction. For the 6 additional serotypes in PCV13, an increased frequency was seen after PCV7 and PCV13 introduction compared to before PCV introduction. For non-PCV13 serotypes, an increased frequency was observed after PCV13 introduction compared to after PCV7 introduction. The percentage of isolates covered by PCV13 serotypes was similar across periods, while a substantial decrease in isolates covered by PCV7 was seen after PCV13 introduction.ConclusionPCVs in Kuwait and Saudi Arabia resulted in decreased frequency of some vaccine serotypes and an emergence of some non-PCV13 serotypes. Further investigation is warranted.     

A Discussion of Professional Issues of Hospital Social Workers in Saudi Arabia

Health care has evolved rapidly in Saudi Arabia, based on a Western model of service that incorporates multidisciplinary professional teams. Social work practice forms part of patient care. Within the cultural context of Saudi Arabia, social work education is developing and so too is the role of the practitioner in the hospital system. However, little is known about how social workers are integrated into the hospital setting. This study explores how Saudi social workers perceive their role and how they describe their practice. A quantitative methodology was employed using a self-administered questionnaire design. Analyses showed a number of perceived limitations that precluded effective performance in practicing social workers; these included difficulties related to updating job skills, followed by a perceived deficiency in current supervisory support.     

Environmental risk factors for diarrhoea among male schoolchildren in Jeddah City, Saudi Arabia

Diarrhoeal disease is still one of the major causes of mortality and morbidity of children in developing countries. Our objective was to assess the prevalence of diarrhoeal disease among male schoolchildren in Jeddah and to identify the associated risk factors, especially those related to drinking water and sanitation disposal. This cross-sectional study was conducted randomly where self-administered questionnaires were issued to parents through the schools. The data were collected from 1,064 respondents indicating that 14.9% of the children had diarrhoea during the previous month. The main risk factors were: the number of children under five years living in the same house (OR per child 1.34, 95% confidence intervals 1.15–1.56), being of Saudi nationality (OR 1.75, 1.08–2.84), reporting sewage spillage near the home (OR 1.69, 1.14–2.53), eating out after school hours (OR 1.74, 1.16–2.60), not drying hands after washing them (OR 1.66, 1.10–2.51), using reusable cloths or sponges to dry dishes (OR 1.70, 1.14–2.52).