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Objectives: Annual influenza vaccinations are recommended for asthma patients to prevent seasonal influenza and influenza-triggered asthma exacerbations. However, data on the beneficial effect of this vaccine on the frequency of asthma exacerbations are conflicting. Therefore, this study aimed to assess the effectiveness of the influenza vaccine in terms of reducing the frequency of asthma-related exacerbations and upper respiratory tract infections among adult patients with asthma. Methods: This retrospective cohort study was performed from January to December 2018 in Muscat Governorate, Oman. A total of 466 patients attending 9 randomly selected primary health centres in Muscat Governorate were enrolled in the study and followed up for one year post vaccination. Results: Most of the patients were female (70.6%) and had moderate persistent asthma (42.9%). There were 203 patients (43.6%) in the vaccinated group and 263 patients (56.4%) in the non-vaccinated group. A proportion of patients in each group had allergic rhinitis (28.6% and 25.5%, respectively). The frequency of upper respiratory tract infections over the one-year follow-up period was significantly lower in the vaccinated group than in the non-vaccinated group (37.9% versus 73%; relative risk [RR]: 2.299; 95% confidence interval [CI]: 1.834-2.882; P <0.001); however, there was no significant difference in terms of the frequency of asthma exacerbations (41.9% versus 45.2%; RR: 0.925; 95% CI: 0.750-1.141; P >0.050). Conclusion: The influenza vaccine significantly reduces the frequency of upper respiratory tract infections over the following year. However, it does not significantly reduce the frequency of asthma exacerbations among Omani adults with asthma. Further studies are recommended to support the protective effect of the vaccine in this regard. [ABSTRACT FROM AUTHOR]

Background: The global outbreak of the COVID-19 pandemic resulted in significant changes in the delivery of health care services such as attendance of scheduled outpatient hospital appointments. This study aimed to evaluate the impact of COVID-19 on the rate and predictors of missed hospital appointment in the Sultanate of Oman. Methods: A retrospective single-centre analysis was conducted to determine the effect of COVID-19 on missed hospital appointments at various clinics at The Royal Hospital (tertiary referral hospital) in Muscat, Sultanate of Oman. The study population included scheduled face-to-face and virtual appointments between January 2019 and March 2021. Logistic regression models were used with interaction terms (post COVID-19) to assess changes in the predictors of missed appointments. Results: A total of 34, 3149 scheduled appointments was analysed (320,049 face-to-face and 23,100 virtual). The rate of missed face-to-face hospital appointments increased from 16.9% pre to 23.8% post start of COVID-19, particularly in early pandemic (40.5%). Missed hospital appointments were more frequent (32.2%) in virtual clinics (post COVID-19). Increases in missed face-to-face appointments varied by clinic (Paediatrics from 19.3% pre to 28.2% post; Surgery from 12.5% to 25.5%; Obstetrics & Gynaecology from 8.4% to 8.5%). A surge in the frequency of missed appointments was seen during national lockdowns for face-to-face and virtual appointments. Most predictors of missed appointments did not demonstrate any appreciable changes in effect (i.e., interaction term not statistically significant). Distance of patient residence to the hospital revealed no discernible changes in the relative effect pre and post COVID-19 for both face-to-face and virtual clinic appointments. Conclusion: The rate of missed visits in most clinics was directly impacted by COVID-19. The case mix of patients who missed their appointments did not change. Virtual appointments, introduced after start of the pandemic, also had substantial rates of missed appointments and cannot be viewed as the single approach that can overcome the problem of missing hospital appointments. [ABSTRACT FROM AUTHOR]

BACKGROUND: The World Health Organization (WHO) was notified by China on December 31, 2019, of a pneumonia outbreak severe acute respiratory syndrome-associated coronavirus-19 virus infection in Wuhan. This outbreak was declared by the WHO from the Public Health Emergency of International Concern to formal declaration as a pandemic on March 11, 2020. Because the public health measures like lockdown, the eye care delivery system was markedly impacted. The aim of this study was to find out if any pattern change of red eye cases among patients who attended eye accident and emergency (A and E) in a tertiary care hospital during COVID-19 pandemic in 2020 compared to 2019 and 2018. MATERIALS AND METHODS: This was a cohort retrospective study which included all patients who presented to eye A and E clinic with red eye from March 1 to July 31 in 2018, 2019, and 2020. Data were analyzed using statistical tools in the SPSS software. Furthermore, the clinical records of 578 inpatients with proven COVID-19 were reviewed for any red eye problem. RESULTS: Out of 7895 eye patients attended eye A and E clinic during March-July of 2018, 2019, and 2020, 1573 (19.9%) patients had red eye. Males were slightly dominant with 59%, and unilateral cases were the majority among them. The most common causes of red eye in 2018 and 2019 were injury, conjunctivitis, and keratitis; whereas in 2020, a clear dominance of injury and keratitis cases was found. Only 10 (2.03%) patients out of the 493 outpatients with red eye during the 5-month period in 2020 reported a prior contact to a COVID-19 positive case; of whom nine patients had conjunctivitis, and one had a right eye open globe injury. Of the 578 inpatients with proven COVID-19, only 1 (0.17%) patient had red eye with the diagnosis of conjunctivitis. CONCLUSION: There was relatively increased number of adults reporting with red eye in 2020. Eye injuries were the most common among all years, followed by conjunctivitis and keratitis. Ocular problems, however, might be a primary or secondary COVID-19 complaint and seem to be relatively uncommon in COVID-19 individuals. [ABSTRACT FROM AUTHOR]

This study aimed at investigating aircraft noise exposure levels, their annoyance, and potential health effects among communities living within airport catchment areas during the COVID-19 pandemic. Both field measurements and an online survey approach were used to investigate aircraft noise exposure levels, annoyance, and general health effects among residents living near Muscat International Airport (MCT) in Muscat, Oman, amid the COVID-19 period. The study found a drastic decline in aircraft noise levels due to the introduction of COVID-19 intervention measures such as lockdowns, social distancing, and closure of airports. In June 2020, during the COVID-19 pandemic, average daily aircraft noise levels of LAeq (39.9 dB(A)) and Lmax (49.7 dB(A)) was observed compared to the previous year (April–May 2019) of 58.5 and 76.8 dB(A), indicating aircraft noise reductions level of 32% and 35%, respectively. The results of the online social survey among 187 participants showed that most (58.8%) of the respondents did not feel that the level of noise produced by aircraft causes annoyance. During the day, the vast majority of the interviewees did not complain of any annoyance during the morning (45.5%), afternoon (39.6%), and evening (31%) with only < 4% of residents have reported a very high degree of annoyance of during COVID-19 pandemic period. Very few people (17%) did complain of experiencing general health problems while 29% did not know of any potential health effects that could be attributed to aircraft noise exposures. Aircraft noise annoyance complaints among the As-Seeb residents during the pre-COVID-19 pandemic periods were reported to be extremely high reaching about 84% compared to 41% during this current COVID-19 pandemic period. These findings support the need to develop future sustainable noise mitigation policies in order to help reduce noise exposures and improve human health during post-COVID-19 pandemic periods. [ABSTRACT FROM AUTHOR]

Objectives: To describe the epidemiological characteristics of the first 69,382 patients with COVID-19 infection in Oman. Methods: A retrospective case series study of patients diagnosed with SARS-CoV-2 infection in Oman from 24 February to 23 July 2020. The data were obtained from the National surveillance COVID-19 network. Results: The overall mean age of patients was 34 (± 14) years, 74% (n = 51,391) were males, 40,859 (59%) were Omani citizens, and 28,523 (41%) were foreign-born individuals. The most common symptoms at presentation were fever 50% (n = 34,600), cough 46% (n = 32,062), sore throat 46% (n = 31,953) and shortness of breath (SOB) 35% (n = 24,567). Overall, 8,960 (12.9%) patients required hospitalization with 1189 (13.3%) individuals requiring admission to the intensive care unit (ICU) and mechanical ventilation (MV). Patients hospitalized with COVID-19 infection were mostly Omani nationals and males between 30 and 39 years old (p < 0.001). The mortality rate was 7.7 per 100,000 population (n = 359) with rates of 9.4 (n = 278) and 4.8 (n = 81) deaths per 100,000 population in Omani nationals and foreign-born individuals, respectively. Females hospitalized with COVID-19 had a mean age of 64 (± 18) years versus a mean age of 55 (± 17) years in males. Mean age of patients with COVID-19-related mortality was 58 (± 18) years with significant differences in mean age between females and males 64 (± 18) versus 55 (± 17) years, respectively. Conclusions: Young Omani males accounted for the highest incidence of COVID-19 infection and hospitalization, while mortality rates were higher among males and the older age (> 50 years). Identifying the epidemiological characteristics and outcomes of COVID-19-infected patients is essential for developing targeted intervention strategies and preparing for the resurgence of anticipated second and third waves of this pandemic. [ABSTRACT FROM AUTHOR]

Objective: Little information is available about the etiology, pathophysiology, risk factors, and epidemiologic features of Bone Tuberculosis (Bone-TB). In this work, we present the epidemiological data about the Bone-TB in the Sultanate of Oman. Methods: Retrospectively, we identified and assessed those patients who were diagnosed with Bone-TB between January 2002 and December 2019 at Khoula Hospital. The following data were collected: demographics, clinical presentation, anatomical location, diagnosis, and treatment of the Bone-TB. Results: During the study period, 115 cases of Bone-TB were diagnosed. Males were affected more than females (57.4% and 42.6%, respectively). About 30% of Bone-TB cases were primary diagnosed in other organs particularly the lungs and then after disseminated to the bone. However, the Bone-TB was detected in hip, leg, hand, shoulder, and skull bones, the most detected Bone-TB was in spine (66% of cases). After vaccination the Bacillus Calmette–Guérin (BCG) strains were identified in the bones of eight babies. Tubercle bacilli were detected by Acid-Fast Stain (AFS) in 59% of cases, and the rest of cases were confirmed using polymerase chain reaction (PCR) tests. There are two used treatment regimens, with 12.4% relapse. The gastrointestinal tract (GIT) disturbances were the most related side effects. The resistance has been detected to pyrazinamide in six cases, rifampicin in three cases, and isoniazid, streptomycin and kanamycin were detected in one case. Conclusion: The most predominant Bone-TB cases were spine-TB that were mainly disseminated from the lungs. AFS failed to detect tubercle bacilli in 40% of cases. There is no statistical significance in relapse between the used two regimens. The death was predominant among skull-TB cases. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic is a global emergency that requires the implementation of drastic measures to halt the disease's fast spread. Students commitment to preventive measures is impacted by their knowledge, attitudes, and practices toward the disease. Method: We sought to determine the level of knowledge, attitudes, and practices regarding COVID-19 pandemic among Omani nursing students. A cross-sectional study was conducted at college of nursing, Sultan Qaboos University. A valid and reliable online survey was used to gather the data. Conclusion: We found that 96.9% of nursing students have moderate to high level of knowledge about COVID-19. The majority of nursing students held optimistic attitudes about the successful control of COVID-19 (78.5%) and the ability of Oman to conquer the virus (75.5%). While 87.7% of nursing students stayed away from crowded places, only 47.9% wore a mask when leaving their homes. Predictors of good knowledge included being a clinical student, wearing a mask while leaving home, and having a positive attitude about controlling the pandemic (p<0.001). Predictors of good preventive practices included being a woman and having higher knowledge scores (p=0.05). Omani nursing students have satisfactory knowledge and held positive attitudes regarding COVID-19. However, they do not maintain adequate practice measures. [ABSTRACT FROM AUTHOR]

Health authorities are focused on swiftly alleviating the spread of COVID-19 infections to support the overburdened healthcare system and reduce the mortality rates associated with the ongoing pandemic. Across Oman, there are 243 primary healthcare (PHC) clinics that act as the first point of contact for providing a comprehensive range of healthcare services. Further, they provide access to more than 30 programs that are delivered by well-trained primary care staff from different categories. PHCs adopted the strategy of providing healthcare services directly related to positive COVID-19 cases, preventing the likely spread of COVID-19 infection among healthcare workers, and reducing the spread of COVID-19 in the community. This review outlines four major challenges that were observed and informally reported by the healthcare workers at PHCs in Oman from January to December 2020. Understanding the nature of these challenges can help health authorities in preparing effectively for any future viral outbreaks and mitigating them in a timely and efficient manner. One of the major challenges faced by PHCs was the reduction in outpatient services from January to December 2020 in comparison with the same time period in the last year. PHCs addressed the main health problems in the community through health promotion, as well as preventive, curative, and rehabilitative services under unusual circumstances. However, there is a need for a modified approach during circumstances such as the COVID-19 pandemic. This will help us cope with possible future viral outbreaks in a better manner. [ABSTRACT FROM AUTHOR]

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Objective: This article describes the situation analysis of endemic and emerging zoonoses, and includes prevention and control of zoonoses in Oman. It also suggests possible recommendations toward elimination and risk reduction of emerging zoonoses. Methods: Epidemiologic information has been drawn from official to assess the situation. There has been significant progress in reducing the risk of brucellosis, Middle East Respiratory Syndrome Coronavirus, Crimean–Congo hemorrhagic fever, and cutaneous leishmaniasis. Rabies, West Nile fever, Q fever, and cystic hydatid disease have been confined to wildlife or livestock. Results: There is an increasing threat of emerging and re-emerging zoonoses in Oman due to globalization of travel and trade, development activities, and impact of climate change and vector bionomics. Prevention, control, and subsequent elimination of zoonoses on a sustainable basis shall not be possible without intersectoral collaboration between the human and animal health sectors. There are challenges for establishing such strong collaboration and coordination mechanisms in Oman. Institutional and cultural barriers, data and resource sharing, and national capability for rapid and effective investigation of zoonotic infections and emerging zoonoses in humans and animal reservoirs are among others. Conclusions: In the light of achievements made on the prevention and control of zoonoses in Oman during the past decades, priority zoonoses should be identified for elimination, and continuous efforts should be made to further strengthen a holistic multidisciplinary and multisectorial approach for controlling zoonoses at source. Pivotal interventions would include urgent adoption of "One Health" strategic approach as well as establishment of a robust, integrated surveillance system with a strong laboratory investigation capacity to eliminate priority zoonoses and minimize the risk of entry, establishment, and spread of emerging zoonoses in Oman. [ABSTRACT FROM AUTHOR]

Background: Understanding the current surveillance activity and the challenges is important to ensure a continuous success toward the elimination goal for tuberculosis (TB). South Batinah Governorate (SBG) ranked the fourth on the top reporting governorates in the period 2010–2016 in Oman. The objective of this study is to describe the epidemiological profile and activities of the surveillance program of TB in the SBG in the years 2017 and 2018. Methods: A retrospective quantitative analysis and a qualitative review were performed to the surveillance data present in the department of disease surveillance and control in the SBG in the years 2017 and 2018. Results: A total of 39 pulmonary TB (PTB) and 21 extrapulmonary TB (EPTB) cases were diagnosed in 2017 and 2018. More Omanis (22, 56.4%) were diagnosed with PTB compared to non-Omanis; however, the EPTB was solely diagnosed among Omanis (P < 0.001). Majority of the TB patients (35%) were between 30 and 49 years. More than 50% of the TB cases of both the types were diagnosed in <3 months, and the median of diagnosis delay was 33.5 (standard deviation = 95.5). Bacillus Calmette–Guérin vaccine scar was present in only 20.5% of the PTB patients, compared to 57.1% of EPTB (P = 0.004). Patients with PTB presented mainly with cough (31, 79.5%), loss of weight and appetite (25, 64.1%), and fever (22, 56.4%). Enlarged lymph nodes and loss of weight and appetite were the common symptoms among EPTB patients, 38.1 for each (P < 0.001). Staffing, incomplete notifications, difficulty in tracing the results, and absence of regular feedbacks are the major existing challenges. Conclusion: SBG continues to sustain low incidence rate of tuberculosis; however, additional strategies are urgently required for further reduction. Hence, the priority is to enhance all essential components of the surveillance system at this stage. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to understand the epidemiology of meningitis cases admitted to hospitals in Oman and to identify any changing microbial patterns from the introduction of the new vaccines. Methods: A retrospective analysis of all cases of meningitis reported through a national surveillance system. Meningitis is a notifable disease. Results: Of a total of 581 cases of meningitis from the period between January 1, 2005 and December 31, 2013, 15% (88) were confrmed to be bacterial in origin and 7.2% (42/581) viral. In 50.9% (296) of patients with suspected pyogenic meningitis, no specific bacterial pathogen were identified, and in 26% of cases (151) a cerebrospinal fluid study could not be undertaken. Among 88 cases with confirmed bacterial pathogens the organisms identified were Streptococcus pneumoniae (65.9%), Neisseria meningitides (18.2%), Haemophilus influenzae (6.8%), and other organisms (9.1%). The peak incidence was in children <2 years of age (39.4%). It showed notable decline in H. influenzae cases as well as pneumococcal meningitis cases, possibly indicative of the successful immunization program. Conclusion: A drop in H. Influenzae and pneumococcal meningitis cases was possibly the effect of the introduction of vaccines. It shows the need for improving diagnostic accuracy, laboratory capacities, and quality of surveillance reporting. [ABSTRACT FROM AUTHOR]