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Introduction For Oman, a country targeting tuberculosis (TB) elimination, TB among expatriates is a major challenge. Thus, screening for active TB using chest X-ray was made mandatory for expatriates’ residency renewals. Objective To estimate the incidence of bacteriologically confirmed TB and assess impact of chest X-ray based TB screening among expatriates in Muscat Governorate. Methods Applicants for residency and renewals were mandated for chest X-ray-based TB screening in 2018. We collected data of screened subjects with radiological suspicion of TB who were subjected to further bacteriological evaluation. Results Of 501,290 applicants screened during the study period, 436 (0.09%) had X-ray findings suggestive of TB. Among the 436, TB was confirmed in 53 (12.2%; 95% CI 9.2–15.6), giving an overall prevalence of 10.6 (95% CI 8–13.9) per 100,000 applicants (number needed to be screened 9458). Among renewals, the point prevalence of TB was 10.5 per 100,000 expatriates screened (95% CI 6.9–14.04 per 100,000), with a mean follow-up period of 11.8 years. Conclusion Our findings are consistent with the recommendation for utilization of chest X-ray as a preferred tool for active case finding in the setting of expatriate screening. Our findings are also suggestive of the need for latent TB screening and ruling out TB prior to latent TB treatment.

Nearly two years since the start of the SARS-CoV-2 pandemic, which has caused over 5 million deaths, the world continues to be on high COVID-19 alert. The World Health Organization (WHO), in collaboration with national authorities, public health institutions and scientists have been closely monitoring and assessing the evolution of SARS-CoV-2 since January 2020 (WHO 2021a; WHO 2021b). The emergence of specific SARS-CoV-2 variants were characterised as Variant of Interest (VOI) and Variant of Concern (VOC), to prioritise global monitoring and research, and to inform the ongoing global response to the COVID-19 pandemic. The WHO and its international sequencing networks continuously monitor SARS-CoV-2 mutations and inform countries about any changes that may be needed to respond to the variant, and prevent its spread where feasible. Multiple variants of the virus have emerged and become dominant in many countries since January 2021, with the Alpha, Beta, Gamma and Delta variants being the most prominent to date. (Table 1).

Objectives To highlight the importance of molecular testing on characterizing extensively drug-resistant (XDR) Salmonella Typhi (S. Typhi) and link it to the current outbreak in Sindh, Pakistan. Methods We report three travel-related typhoid fever cases caused by XDR S. Typhi that presented between January 2019 and August 2019. Antimicrobial susceptibility and genotyping with pulse-field gel electrophoresis (PFGE) were performed. Whole genome sequencing (WGS) was performed to characterise the genomic clonality in relation to the emerging outbreak of S. Typhi in Sindh, Pakistan and to study the molecular resistance profiles. Results Laboratory testing revealed resistance to all first-line antibiotics (i.e ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole), as well as to quinolones and third-generation cephalosporins, leading the patients’ therapy to be changed to use carbapenems. Classical MLST (cMLST) revealed that the strains were of sequence type 1 (ST1) and the core genome sequence (cgWGS) analysis closely clustered our strains with internationally reported strains from Pakistan, India, and the UK. The strains were found to carry a blaCTX-15 gene-harbouring IncY plasmid, which encodes resistance to ceftriaxone. Conclusions This report alerts clinicians to the use of appropriate empirical treatments in such scenarios and highlights the significance of the global spread of XDR Salmonella Typhi.

Background In Oman, many extended families tend to live in one household. Some families can include 20–30 individuals with the majority of them being children. This study investigates the role of children in spreading SARS-CoV-2 causing COVID-19 within family clusters in Oman. Methods This retrospective study includes data of 1026 SARS-CoV-2 positive children (≤18 years) collected from the national surveillance database for COVID-19 between 1 February 2020 and 30 May 2020. Results We included 1026 patients. Most, 842 were Omani (82%), 52% male, and 28.5% asymptomatic. Close to the half of symptomatic 419 (40%), patients presented with fever associated with other respiratory symptoms. Fifty pediatric patients were index cases who transmitted the virus to 107 patients in total (86 adults and 21 children) with a mode of 1. There is no statistical significance of all studied risk factors in the transmission of the SARS-CoV-2 virus including age, gender, and cycle threshold (CT) value. Conclusions According to this study, children are not to be considered a significant driver of transmission of SARS-CoV-2 in Oman.

Among the challenges to public health systems imposed by coronavirus disease 2019 (COVID-19) have been vaccine scarcity and the prioritization of high-risk groups. Countries have been prompted to accelerate the pace of immunization campaigns against COVID-19 to deploy the immunization umbrella to the largest possible number of target groups. In this paper, we share the perspective of Oman regarding the impact of accelerating the administration of the first dose of the COVID-19 vaccine in one border governorate (Musandam) by comparison to another border governorate (Al-Buraimi) where this approach was not applied.Daily admissions data (April 10, 2020 to June 24, 2021) and vaccination data (January 1 to June 24, 2021) were collected systematically. For each governorate, the cumulative doses (first and second doses) and vaccination coverage were calculated daily.Within 1 month, first dose vaccination coverage increased from 20% to 58% in Musandam, reducing the incidence of hospital admission by 75%. In comparison, vaccination coverage plateaued at 20% in Al-Buraimi, and the incidence of hospital admission increased by 500%.Given the peculiarity of the geographical location and being the first line of access for imported cases, border regions should be a priority for vaccine deployment as a preventive measure. The two different approaches reported here, implemented in broadly similar cross-border governorates, provide evidence of the significant effect of accelerating the first dose of vaccine in reducing hospitalizations.

We used routinely collected programme data on people living with HIV in Oman who started ART in 2014–2018 to assess retention on ART, viral suppression, attrition (mortality or loss to follow-up [L...

Tetrodotoxin (TTX) is a potent sodium channel blocker, with significant neurotoxicity, found in marine animals like pufferfish and blue-ringed octopus. The severity of toxicity depends on the amount of toxin ingested and the outcome depends on the time-lapse to appropriate medical care.We report five patients who presented with tetrodotoxin poisoning after consuming fried internal organs of local pufferfish from the coast of Oman. The patients' clinical manifestations were consistent with the expected TTX toxidrome of perioral and generalized paresthesia, weakness of upper and lower extremities, gastrointestinal manifestations, dyspnea, dysarthria, ascending paralysis, hypotension, bradycardia and coma. The severity varied among the patients who recovered completely except one patient who developed a subarachnoid hemorrhage without underlying aneurysms on computed tomography-angiogram. This complication was potentially related to TTX poisoning and has not been previously reported. In addition to standard supportive management, patients with severe illness should potentially receive the intravenous acetylcholinesterase inhibitor neostigmine, and intermittent dialysis. Urine specimens were sent to CDC in Atlanta, where they were analyzed using online solid phase extraction (SPE) with LC-MS/MS and confirmed the diagnosis in all five cases.In general, the patients' clinical manifestations were consistent with the expected TTX toxidrome except patient 3 who developed a subarachnoid hemorrhage early during his clinical course. Two patients received neostigmine and underwent dialysis with complete recovery.

We conducted a cross-sectional analysis to determine the rate of retention in HIV care and the factors associated with loss to follow-up (LTFU) among Omani adults living with HIV who were linked to care as of 31 December 2019. Patients (n = 1610) were identified from a central national HIV surveillance dataset. The majority (68.3%) of patients were male, and the median age was 39 years (IQR, 31-48 years). A total of 1480 patient (91.9%) were retained in care. On multivariate analysis, compared to those who received antiretroviral therapy (ART), patients who had never been on ART were 6.8 (95% CI: 3.05-15.16) times more likely to be lost to follow-up. Patients who had a latest HIV viral load (VL) of 200-999 copies/ml (adjusted odds ratio [aOR]: 4.92, 95% CI: 2.27-10.69) and ≥ 1000 copies/ml (aOR: 15.03, 95% CI: 8.31-27.19) compared to those who had a latest HIV VL of

In January 2016, the National AIDS Programme (NAP) in Oman introduced a package of interventions, including capacity building for service providers, to improve the quality of HIV services.To report the impact of these interventions on the rate of vertical HIV transmission in the period from January 2016 to December 2019. We also describe the virological and obstetric outcomes for HIV-infected pregnant women.This was a medical record review of 94 HIV-positive pregnant women (median age 32 years; interquartile range 25-34 years) reported to NAP in 2016-2019.There were 110 pregnancies in 94 women. The majority (75.3%, 61/81) of women were diagnosed with HIV infection from routine antenatal screening, with 60% (66/110) of pregnancies occurring in women who knew their HIV status at conception. Caesarean section was the most common (50%) mode of delivery. The preterm labour and low birth weight rates were 21.2% and 15.9%, respectively. The antiretroviral coverage during pregnancy was 95.5%, with most (87.8%) women reporting excellent or good adherence. The majority (81.6%) of women achieved HIV viral load of400 copies/ml at or near delivery. Almost all infants (99%) were given prophylactic antiretrovirals. The rate of mother-to-child transmission of HIV was 1%.The obstetric and virological outcomes for HIV-infected pregnant women delivered in 2016-2019 were favourable, with a low rate of mother-to-child transmission of HIV. Oman is now in the process of finalizing application of World Health Organization validation of elimination of mother-to-child transmission of HIV.القضاء على انتقال فيروس العوز المناعي البشري من الأم إلى الطفل في عُمان: قصة نجاح من الشرق الأوسط.علي القالب، فاطمه الهنائي، جميله العبري، سمير شاه، زيانه الحبسي، مها الفروي، ريتشارد لاو، حنان الكندي، عادل الوهيبي، أمال المعاني، بدر الرواحي، سعيد اللمكي، سيف العبري.في يناير/كانون الثاني 2016 ، قدَّم البرنامج الوطني للإيدز في عُمان حزمة من التدخلات، اشتملت على بناء قدرات مقدمي الخدمات، بغرض تحسين جودة الخدمات الخاصة بفيروس العوز المناعي البشري.هدفت هذه الدراسة الى الإبلاغ عن تأثير التدخلات على معدل الانتقال الرأسي لفيروس العوز المناعي البشري في الفترة من يناير/كانون الثاني 2016 إلى ديسمبر/كانون الأول 2019. أيضًا وصفنا النتائج الفيروسية والتوليدية للحوامل المصابات بفيروس العوز المناعي البشري.روجعت السجلات الطبية ل 94 حاملً مصابات بفيروس العوز المناعي البشري (العمر الوسيط 32 سنة؛ المدى الرباعي للعمر 25-34 سنة) اللواتي أُبلغ عنهن إلى البرنامج الوطني للإيدز في الفترة 2016-2019.حدثت 110 أحمال لدى 94 امرأة. وشُخِّصت إصابة غالبية النساء (٪75.3، 61/ 81) بفيروس العوز المناعي البشري من خلال الفحص الروتيني قبل الولادة، مع حدوث حمل لدى ٪60 (66/ 110) من نساء كن يعرفن إصابتهن بالفيروس عند الحمل. وكانت العملية القيصرية أكثر طرق الولادة شيوعًا (٪50). وبلغت معدلات الولادة المبتسرة وانخفاض وزن المواليد ٪21.2 و٪15.9 على التوالي. وبلغت التغطية بمضادات الفيروسات القهقرية خلال الحمل ٪95.5 ، مع التزام معظم النساء (٪87.8) التزامًا ممتازًا أو جيدًا بالعلاج. وحققت غالبية النساء (٪81.6) حملً فيروسيًّا لأقل من 400 نسخة/ مل عند الولادة أو بالقرب منها. وأُعطِيَ جميع الرضع تقريبًا (٪99) مضادات الفيروسات القهقرية الوقائية. وبلغ معدل انتقال العدوى بفيروس العوز المناعي البشري من الأم إلى الطفل ٪1.لقد كانت النتائج التوليدية والفيروسية للحوامل المصابات بفيروس العوز المناعي البشري التي جرت في الفترة 2016-2019 مب ةِّش، مع انخفاض معدل انتقال فيروس العوز المناعي البشري من الأم إلى الطفل. ان عُمان الآن بصدد وضع اللمسات الأخيرة على تطبيق مصادقة منظمة الصحة العالمية على القضاء على انتقال فيروس العوز المناعي البشري من الأم إلى الطفل.Élimination de la transmission mère-enfant du VIH à Oman : un exemple de réussite au Moyen-Orient.En janvier 2016, le Programme national de lutte contre le sida à Oman a mis en place un ensemble d’interventions, comprenant le renforcement des capacités des prestataires de services, afin d’améliorer la qualité des services de lutte contre le VIH.Signaler l’impact de ces interventions sur le taux de transmission verticale du VIH au cours de la période comprise entre janvier 2016 et décembre 2019. Nous décrivons également les résultats virologiques et obstétricaux pour les femmes enceintes touchées par le VIH.Il s’agissait d’un examen des dossiers médicaux, notifiés au Programme national de lutte contre le sida de 2016 à 2019, pour 94 femmes enceintes séropositives (âge médian : 32 ans ; intervalle interquartile : 25-34 ans).Il y avait 110 grossesses chez 94 femmes. La majorité (75,3 %, 61/81) des femmes ont reçu un diagnostic d’infection par le VIH lors du dépistage prénatal systématique, et 60 % (66/110) des grossesses se sont produites chez des femmes qui connaissaient leur statut sérologique au moment de la conception. La césarienne était le mode d’accouchement le plus courant (50 %). Les taux de travail prématuré et de faible poids de naissance étaient respectivement de 21,2 % et 15,9 %. La couverture antirétrovirale pendant la grossesse était de 95,5 %, la plupart des femmes (87,8 %) signalant une excellente ou une bonne observance. La majorité (81,6 %) des femmes ont atteint une charge virale VIH inférieure à 400 copies/ml à l'accouchement ou à proximité. Presque tous les nourrissons (99 %) ont reçu des antirétroviraux prophylactiques. Le taux de transmission mère-enfant du VIH était de 1 %.Les résultats obstétricaux et virologiques des femmes enceintes séropositives ayant accouché entre 2016 et 2019 étaient favorables, avec un faible taux de transmission mère-enfant du VIH. Oman finalise actuellement l’application de la validation de l’élimination de la transmission mère-enfant du VIH par l’Organisation mondiale de la Santé.

There are currently no reliable epidemiological data for estimating the burden of sexually transmitted infections (STIs) in Oman. STIs such as gonorrhoea and chlamydia are often asymptomatic and associated with sexual and reproductive morbidity. An exploratory study was conducted in an antenatal clinic in Muscat, Oman, to assess the acceptability and feasibility of testing for gonorrhoea and chlamydia. Two hundred and twenty-one women were recruited over 14 weeks between July and October 2020. There were three cases of chlamydia (3/221, 1.36%); no cases of gonorrhoea were identified. Acceptability and feasibility for testing in this cohort of pregnant women were good despite anticipated cultural sensitivities surrounding sexually transmitted infections.

Highlights • P323L (94.7%) is the most common mutation, followed by D614G (92.6%) Spike protein mutation. • A unique mutation, I280V, was first reported in Oman and was associated with a rare lineage, B.1.113 (10.6%). • The study revealed a good agreement between genetic and epidemiological data. • Oman’s robust surveillance system was very efficient to guide the outbreak investigation processes in the country, • The study illustrates the future importance of molecular epidemiology to lead the national response to outbreaks and pandemics., Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been proven to be lethal to human health, which affects almost every corner of the world. The objectives of this study were to add context to the global data and international genomic consortiums, and to give insight into the efficiency of the contact tracing system in Oman. Methods We combined epidemiological data and whole-genome sequence data from 94 samples of SARS-CoV-2 in Oman to understand the origins, genetic variation, and transmissibility. The whole-genome size of sequence data was obtained through a customized SARS-COV-2 research panel. Amplifier methods ranged from 26 Kbp to 30 Kbp and were submitted to GISAID. Findings The study found that P323L (94.7%) is the most common mutation, followed by D614G (92.6%) Spike protein mutation. A unique mutation, I280V, was first reported in Oman and was associated with a rare lineage, B.1.113 (10.6%). In addition, the study revealed a good agreement between genetic and epidemiological data. Interpretation Oman’s robust surveillance system was very efficient in guiding the outbreak investigation processes in the country, the study illustrates the future importance of molecular epidemiology in leading the national response to outbreaks and pandemics.

Following the detection of the first human case of avian influenza A subtype H9N2 in 1998, more than 40 cases were diagnosed worldwide. However, the spread of the virus has been more remarkable and significant in global poultry populations, causing notable economic losses despite its low pathogenicity. Many surveillance studies and activities conducted in several countries have shown the predominance of this virus subtype. We present the case of a 14-month-old female in Oman with an A(H9N2) virus infection. This is the first human case of A(H9N2) reported from Oman and the Gulf Cooperation Countries, and Oman is the second country outside of southern and eastern Asia to report a case (cases have also been detected in Egypt). The patient had bronchial asthma and presented with a high-grade temperature and symptoms of lower respiratory tract infection that necessitated admission to a high dependency unit in a tertiary care hospital. It is of urgency that a multisector One Health approach be established to combat the threat of avian influenza at the animal–human interface. In addition to enhancements of surveillance and control in poultry, there is a need to develop screening and preventive programs for high-risk occupations. Keywords: Avian influenza A, One Health, A(H9N2), Virus infection, Oman

We used population-based data on all diagnosed people living with Human Immunodeficiency (HIV) reported to the National AIDS Programme in 1984–2018 to describe the HIV epidemiology in Oman. A total of 3060 Omanis were diagnosed with HIV from 1984 to 2018. The proportions of new infections attributed to sexual contact accounted for 56.3% (376/668) in 1984–1996 compared with 80.7% (630/780) in 2013–2018. Of 1417 patients with a documented CD4 count at the entry of care, 45.3% had a baseline CD4 count of

Objective: To evaluate the cascade of HIV care in Oman in 2018 and the longitudinal change in each step from 2015 to 2018. Methods: Population-based data on all diagnosed people living with HIV reported to the National AIDS Programme in 1984–2018 were used. Results: As of December 31, 2018, the estimated number of people living with HIV in Oman was 3030; 1532 (50.6%) were aware of their infection. Of the diagnosed patients, 95.9% were linked to care, 85.8% were retained in care, and 84.3% were on ART. The proportions of patients with viral suppression out of all people with HIV, the diagnosed persons, and those on ART were 37.3%, 73.7%, and 87.5%, respectively. The proportion of patients linked to care increased from 72.6% in 2015 to 95.6% in 2018 (p

Background Significant nosocomial transmission of SARS-CoV-2 has been demonstrated. Understanding the prevalence of SARS-CoV-2 carriage amongst HCWs at work is necessary to inform the development of HCW screening programmes to control nosocomial spread. Methods Cross-sectional ‘snapshot’ survey from April-May 2020; HCWs recruited from six UK hospitals. Participants self-completed a health questionnaire and underwent a combined viral nose and throat swab, tested by Polymerase Chain Reaction (PCR) for SARS-CoV-2 with viral culture on majority of positive samples. Findings Point prevalence of SARS-CoV-2 carriage across the sites was 2.0% (23/1152 participants), median cycle threshold value 35.70 (IQR:32.42–37.57). 17 were previously symptomatic, two currently symptomatic (isolated anosmia and sore throat); the remainder declared no prior or current symptoms. Symptoms in the past month were associated with threefold increased odds of testing positive (aOR 3.46, 95%CI 1.38–8.67; p = 0.008). SARS-CoV-2 virus was isolated from only one (5%) of nineteen cultured samples. A large proportion (39%) of participants reported symptoms in the past month. Interpretation The point-prevalence is similar to previous estimates for HCWs in April 2020, though a magnitude higher than in the general population. Based upon interpretation of symptom history and testing results including viral culture, the majority of those testing positive were unlikely to be infectious at time of sampling. Development of screening programmes must balance the potential to identify additional cases based upon likely prevalence, expanding the symptoms list to encourage HCW testing, with resource implications and risks of excluding those unlikely to be infectious with positive tests. Funding Public Health England.

Background The aim of this study was to determine the proportions and predictors of late presentation (LP) and advanced HIV disease (AD) in Oman. LP and AD were defined as presenting with a baseline CD4 count of Methods We conducted a retrospective database analysis of the National HIV Surveillance System to identify Omani people (≥ 13 years old) who were diagnosed with HIV in the period between January 2000 and December 2019 and had a documented baseline CD4 cell count. We calculated the rates and trend over time of LP and AD. A logistic regression was carried out to determine the predictors of LP and AD. Results A total of 1418 patients, who were diagnosed with HIV in the period from January 2000 to December 2019, were included; 71% were male and 66% were heterosexuals. The median (IQR) age at diagnosis was 33 (25–39) years. Overall, 71% (95% CI: 68–73) and 46% (95% CI: 44–49) of patients had LP and AD at presentation, respectively. The LP percentage decreased from 76% in 2000–2004 to 69% in 2015–2019; AD percentage decreased from 57 to 46% over the same period. The proportions of men with LP and AD were higher than women (74% vs. 62 and 50% vs. 36%, respectively). The percentages of persons with LP among people aged 13–24, 25–49, and ≥ 50 years were 65, 71, and 84%, respectively. The proportions of persons with AD among people aged 13–24, 25–49, and ≥ 50 years were 39, 46, and 65%, respectively. Logistic regression showed that male sex, older age, having an “unknown” HIV risk factor, and living outside Muscat were independent predictors of AD. Male sex also independently predicted LP. Conclusions This analysis indicates that a significant proportion of new HIV cases in Oman continue to present late. This study identified patient subgroups at greatest risk of late HIV diagnosis such as men and older people. Targeted interventions and greater efforts to scale up HIV testing services in Oman are needed.

Objective The primary objective of our study was to estimate the prevalence of hepatitis B infection among pregnant women in Oman. The secondary objectives were to test for other hepatitis B virus (HBV) serological markers and to determine hepatitis B viral load. Methods In this cross-sectional study conducted from June 2019 to December 2020, we randomly selected 2210 Omani women who attended antenatal clinics across the country. Pregnant women were tested for HBV surface antigen (HBsAg) using a commercial enzyme immunoassay; those who tested positive were further analyzed for other HBV serological markers: HBV core total antibody (anti-HBc), HBV core antibody IgM (immunoglobulin M) (anti-HBc IgM), hepatitis B virus e antigen (HBeAg) and hepatitis B virus e antibody (anti-HBe). They were also tested for hepatitis B viral load. Results This study included 2210 women with a mean age of 39 years. Ninety-five percent of the women who were invited to participate consented and were included in the study. Thirty-three (1.49%) tested positive for HBsAg. All participants tested negative for HBeAg and anti-HBc IgM and positive for anti-HBc and anti-HBe, and 30 (90.9%) women had their hepatitis B viral load measured. Three (10.0%) had undetectable viral loads, 23 (76.7%) had low viral loads of Conclusion Our study shows that the HBV prevalence in pregnant women is 1.49%, which is lower than what was reported earlier. Nevertheless, antenatal screening is still warranted, as there are vital interventions for the newborn and the mother.

Tuberculosis (TB) does not respect borders, and migration confounds global TB control and elimination. Systematic screening of immigrants from TB high burden settings and—to a lesser degree TB infection (TBI)—is recommended in most countries with a low incidence of TB. The aim of the study was to evaluate the views of a diverse group of international health professionals on TB management among migrants. Participants expressed their level of agreement using a six-point Likert scale with different statements in an online survey available in English, French, Mandarin, Spanish, Portuguese and Russian. The survey consisted of eight sections, covering TB and TBI screening and treatment in migrants. A total of 1055 respondents from 80 countries and territories participated between November 2019 and April 2020. The largest professional groups were pulmonologists (16.8%), other clinicians (30.4%), and nurses (11.8%). Participants generally supported infection control and TB surveillance established practices (administrative interventions, personal protection, etc.), while they disagreed on how to diagnose and manage both TB and TBI, particularly on which TBI regimens to use and when patients should be hospitalised. The results of this first knowledge, attitude and practice study on TB screening and treatment in migrants will inform public health policy and educational resources.

Background: Non-pharmaceutical interventions (NPIs), particularly mobility restrictions, are mainstay measures for the COVID-19 pandemic worldwide. We evaluated the effects of Oman’s mobility restriction strategies to highlight their efficacy in controlling the pandemic. Methods: Accessible national data of daily admissions and deaths were collected from 1 April 2020 to 22 May 2021. Google Community Mobility Report (CMR) data were downloaded for the same period. Among six CMR categories, three were used and reduced to one index—the community mobility index (CMI). We used a generalised linear model with a negative binomial distribution combined with a non-linear distributed lag model to investigate the short-term effects of CMI on the number of admitted PCR-confirmed COVID-19 cases and deaths, controlling for public holidays, day of the week, and Eid/Ramadan days. Results: We demonstrated the feasibility of using CMRs in the evaluation and monitoring of different NPIs, particularly those related to movement restriction. The best movement restriction strategy was a curfew from 7 p.m. to 5 a.m. (level 3 of CMI = 8), which had a total reduction of 35% (95% confidence interval (CI), 25–44%) in new COVID-19 admissions in the following two weeks, and a fatality reduction in the following four weeks by 52% (95% CI, 11–75%). Conclusion: Evening lockdown significantly affected the course of the pandemic in Oman which lines up with similar studies throughout the world.

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To highlight the importance of molecular testing in characterizing extensively drug-resistant (XDR)Our study reports three travel-related typhoid fever cases caused by XDRLaboratory testing revealed resistance to all first-line antibiotics (i.e ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole), as well as to quinolones and third-generation cephalosporins, leading to a change in the patients' therapy to the use of carbapenems. Classical MLST (cMLST) revealed that the strains were of sequence type 1 (ST1) and the core genome sequence (cgWGS) analysis closely clustered our strains with internationally reported strains from Pakistan, India, and the UK. The strains were found to carry aOur report alerts clinicians to the use of appropriate empirical treatments in such scenarios, and highlights the significance of the global spread of XDR

We describe the case of a 47 years old Sri Lankan man living in Oman with melioidosis and the resultant occupational risk of exposure to 5 laboratory staff members to the causative agent, Burkholderia pseudomallei. Widely reported as an endemic disease in tropical and subtropical areas, B. pseudomallei was imported to Oman by our patient who had risk factors of diabetes mellitus and alcoholic cirrhotic liver disease. Microbiological and biochemical tests identified the gram negative bacillus, B. pseudomallei, in the patient’s blood sample. Five laboratory workers had occupational exposure to Burkholderia pseudomallei and received post-exposure prophylaxis. Our report highlights the importance of early suspicion of the infection and managing the patient with the correct international protocols for melioidosis especially for patients with severe sepsis and septic shock in the Intensive Care Unit (ICU). Furthermore, the importance of increased awareness among laboratory personnel and the need for good laboratory practices is reported. Furthermore, improved surveillance is essential to guide early diagnosis and prompt treatment.

Objective: This study was undertaken to determine the serotype distribution and drug susceptibility patterns in pneumococcal isolates recovered from patients with invasive pneumococcal disease (IPD). Methods: All invasive pneumococcal isolates received between June 2014 and June 2016 were included in the study as part of a national laboratory-based IPD surveillance program. Isolates recovered from clinical specimens of normally sterile body sites were included. Results: A total of 41 different serotypes were identified among the 132 pneumococcal isolates included in this study. The most prevalent serotypes/serogroups were 12 (8.3%), 15 (8.3%), 19 F (7.6%), 3 (6.1%), and 19A (6.1%);. It was observed that overall vaccine coverage rates for pneumococcal conjugate vaccines (PCV), PCV7, PCV10 and PCV13 were 15.9%, 24.2% and 37.1% respectively. 56.8% (n = 75) of the isolates were non-susceptible to at least one antibiotic and 40.9% (n = 54) of the isolates were resistant to PEN (M). 18.9% (n = 25) of the isolates were multi-drug resistant (MDR).The case fatality rate was 15.9%. Conclusion: Our study results call for broader vaccine coverage, emphasizes the need to introduce the conjugate pneumococcal vaccine for the high risk adult population and stress the importance of continuous surveillance of serotypes and antimicrobial resistance to guide vaccine development and antimicrobial stewardship activities. Keywords: Streptococcus pneumoniae, IPD, Serotype, Antibiotic resistance, Oman, Vaccination

Oman is witnessing an increase in outbound and inbound travelers.This study was undertaken to assess the current knowledge, attitude, and practice of travel medicine among primary care physicians (PCPs) working in the Muscat Governorate.We conducted a cross-sectional survey of 108 primary healthcare physicians in primary healthcare institutions in the Muscat Governorate in December 2014 using a self-administered questionnaire.We had a response rate of 81%, 78% (n = 84) were females, 56.5% (n= 61) were Omani nationals. More than 50% (n= 54) of study participants had been in practice for more than 8 years. Sixty-eight (58.3%) reported having pre-travel consultations during the previous 1-month period and 86 (79.6%) had post-travel consultations. Most of the PCPs were aware of the issues that needed to be addressed in pre-travel consultation.This study showed that travel health is in an early stage of development in Oman and supports the need for the establishment of travel medicine services.معلومات واتجاهات وممارسات أطباء الرعاية الأولية بخصوص طب السفر في عُمان: الحاجة إلى التدخل.بادماموهان كوروب، سيف سالم العبري، فاطمة العجمي، هدى خميس، جيفري سميث.تشهد عُمان زيادة في عدد السكان المسافرين منها وإليها.أُجريت هذه الدراسة لتقييم معلومات واتجاهات وممارسات أطباء الرعاية الأولية العاملين في محافظة مسقط.أجرينا استطلاعًا مقطعياً شمل 108 طبيباً للرعاية الأولية في مؤسسات الرعاية الأولية في محافظة مسقط في ديسمبر/كانون الأول 2014 باستخدام استبيان ذاتي الإجابة.حصلنا على معدل استجابة 81 %، حيث كان 78% (84 = n) من الإناث، وكان 56.5% (61 = n) مواطنين عُمانيين. وكان أكثر من 50% (54 = n) من المشاركين في الدراسة ممارسين لمدة تزيد على 8 سنوات. وذكر ثمانية وستون شخصًا (58.3 %) تقديمهم لاستشارات خلال شهر قبل السفر، بينما قدم 86 شخصًا (79.6 %) استشارات بعد السفر. وكان معظم أطباء الرعاية الأولية على علم بالأمور التي يجب تناولها في استشارات قبل السفر.توضح هذه الدراسة أن الصحة أثناء السفر لا تزال في مرحلة مبكرة من التطور في عُمان، وتدعم الحاجة إلى إنشاء خدمات طب السفر.Connaissances, attitudes et pratiques concernant la médecine des voyages chez les médecins de soins de santé primaires à Oman : besoin d’intervention.Oman est confronté à une augmentation du nombre de voyageurs qui entrent dans le pays ou qui en sortent.La présente étude a été réalisée pour évaluer les connaissances, les attitudes, les pratiques courantes en matière de médecine des voyages parmi les médecins de soins de santé primaires travaillant dans le gouvernorat de Mascate.Nous avons mené une enquête transversale auprès de 108 médecins de soins de santé primaires dans des établissements de ce niveau de soins dans le gouvernorat de Mascate en décembre 2014 à l’aide d’un auto-questionnaire.Nous avons eu un taux de réponse de 81 %; 78 % (n = 84) étaient des femmes, 56 % (n = 61) étaient des ressortissants omanais. Plus de 50 % (n = 54) des participants de l’étude exerçaient depuis plus de huit ans. Soixantehuit médecins (68,3 %) signalaient avoir eu des consultations préalables au voyage durant le mois qui précédait et 86 médecins (79,6 %) avoir eu des consultations au retour du voyage. La plupart des médecins de soins de santé primaires connaissaient les points à aborder lors des consultations préalables au voyage.Cette étude a montré que la médecine des voyages est à un stade de développement précoce à Oman et vient étayer la nécessité de mise en place de services pour ce type de médecine.

Oman is globally acknowledged for its well-structured immunization program with high vaccination coverage. The massive spread of misinformation brought on by the COVID-19 pandemic, as well as the easy access to various media channels, may affect acceptance of a vaccine, despite the inherent trust in the local system. This cross-sectional study evaluated the knowledge, attitudes, and practice (KAP) in Oman toward COVID-19 vaccines. It included 3000 randomly selected adults answering a structured questionnaire via telephone. Participants were 66.7% Omani, 76% male, and 83.7% without comorbidities. Their mean age was 38.27 years (SD ± 10.45). Knowledge of COVID-19′s symptoms, mode of transmission, and attitudes toward the disease was adequate, 88.4% had heard of the vaccine, 59.3% would advise others to take it, 56.8% would take it themselves, and 47.5% would take a second dose. Males (CI = 2.37, OR = (2.00–2.81)) and non-Omanis (CI = 0.49, OR = (0.42–0.57)) were more willing to be vaccinated. The history of chronic disease, source of vaccine knowledge, and education level were factors that affected the willingness to accept the vaccine. The Omani community’s willingness to take the COVID-19 vaccine can be enhanced by utilizing social media and community influencers to spread awareness about the vaccine’s safety and efficacy.

OBJECTIVE: To determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare workers (HCWs) based on risk of exposure to COVID-19 patients. METHOD: This was a SARS-CoV-2 seroprevalence cross-sectional study in risk-stratified HCWs randomly selected from three main district hospitals in Oman. RESULTS: 1078 HCWs were included, with an overall SARS-CoV-2 seroprevalence of 21%. The seropositivity rates in low-, variable-, and high-risk groups were 29%, 18%, and 17%, respectively (p-value < 0.001). The study found higher positivity in males (crude odds ratio [COR] 1.71, 95% confidence interval [CI] 1.28-2.3), and workers residing in high-prevalence areas (COR 2.09, 95% CI 1.42-3.07). Compared with doctors, workers from supporting services, administration staff, and nurses were more likely to test positive for SARS-CoV-2 antibodies (COR 9.81, 95% CI 5.26-18.27; 2.37, 95% CI 1.23-4.58; 2.08 95% CI 1.14-3.81). The overall rate of previously undetected infection was 12%, with higher values in low-risk HCWs. High district prevalence was a driving factor for seropositivity in the low-risk group (adjusted odds ratio [AOR] 2.36, 95% CI 1.0-5.59). CONCLUSION: Low-risk supporting services workers can drive SARS-CoV-2 transmission in hospitals. More attention and innovation within this area will enhance the safety of health care during epidemics/pandemics.

In this paper, we present a multicentre record-based descriptive study used to estimate the incidence and characterize the spectrum of confirmed bacille Calmette–Guérin (BCG) vaccine-related disease among children in Oman. This study included all children (age ≤ 14 years) who had culture and/or polymerase chain reaction (PCR)-confirmed BCG disease from January 2006 to December 2018, as identified from Central Public Health Laboratory data and International Classification of Diseases coding of an electronic patient information system. In total, 88 children confirmed to have BCG disease were included in the study, making an average incidence of 9.2 cases per 100,000 vaccinated neonates. The males comprised 65.9%, Omanis 93.2%, and the median age of presentation was 4 months in children with BCG disease. The most common type of disease was BCG abscesses (72.4%). Children with immunodeficiency and those presenting within 6 months were found to have a more severe and disseminated disease. In total, 28 children had immunodeficiency. The age of presentation and type of BCG disease was significantly associated with immunodeficiency status. The majority of cases required therapy (both medical and surgical) and recovered well. The incidence of laboratory-confirmed BCG vaccine-related disease was low in Oman supporting continuing the use of the BCG vaccination practice at birth.

We conducted a cross-sectional analysis to determine HIV virologic failure and its associated factors among Omani people living with HIV who are on ART for > 6 months. Patients (n = 1427) were identified from a central national HIV surveillance dataset. Two-thirds (67%) of patients were male, and the median age was 39 years (IQR, 32-48 years). Out of 1427 patients, 14.4% had virologic failure (HIV viral load [VL] ≥ 200 copies/ml). The multivariate analysis showed that patients aged 25-49 years (adjusted odds ratio [aOR]: 1.76, 95% CI: 1.01-3.08) were significantly more likely to fail treatment, compared to those aged ≥ 50 years. Besides, having “Other” HIV risk factor (compared to heterosexuals, aOR: 1.82, 95% CI: 1.02-3.24) and receiving HIV care outside the capital Muscat (compared to those cared for in Muscat, aOR: 1.73, 95% CI: 1.11-2.7) were independently associated with virologic failure. HIV viral suppression (85.6%) in Oman is encouraging; however, further strategies, mainly targeting patients who are young (

Background: Candida auris (C. auris) is an emerging healthcare-associated pathogen resulting in significant morbidity and mortality. The aim of this study is to report data from the national C. auris surveillance system for 2019 and conduct a survival analysis of the reported cohort. Methods: a retrospective analysis was conducted for all C. auris cases reported nationally to the Oman Antimicrobial Surveillance System (OMASS) in 2019, and isolates were sent to the Central Public Health Laboratories (CPHL). Clinical and demographic data were obtained through the E-Surveillance reporting system and the Electronic System (NEHR Al-Shifa) at CPHL. Statistical analysis was done using Kaplan–Meier analysis and Cox proportional hazard models. Results: One hundred and twenty-nine isolates of C. auris were grown from 108 inpatients; 87% were isolated from clinical samples, of which blood was the most common (38.9%). Forty (37%) were ≥65 years of age, 72 (66.7%) were males, and 85 (78.7%) were Omani nationals. Of the total isolates, 43.5% were considered as colonization; 56.5% were considered infection, of which 61.8% of them were candidemia. At least one risk factor was present in 98.1% of patients. The mean time from admission to infection was 1.7 months (SD = 2.8), and the mean length of hospital stay was 3.5 months (SD = 4). Totals of 94.8% and 96.1% of the isolates were non-susceptible to fluconazole and amphotericin, respectively. The variables found to be significantly associated with longer survival post C. auris diagnosis (p < 0.05) were age < 65 years, absence of comorbidities, length of stay < 3 months, colonization, and absence of candidemia. The infection fatality rate was 52.5%. Conclusion: Including C. auris in an ongoing antimicrobial surveillance program provides important data for the comprehensive management of this growing public health threat. The current study shows health care outbreaks of C. auris are ongoing, with 52.5% infection fatality, although our isolates remained sensitive to Echinocandins in vitro.

Highlights • Rt can be used to closely monitor the non-pharmaceutical interventions (NPI) of COVID-19 epidemic. • Generally, the activity of the epidemic in Oman. • Other factors, like the return of overseas students, have increased the epidemic activity. • Responses to NPI is different between migrants and natives., Background COVID-19’s emergence carries with it many uncertainties and challenges, one of which is epidemic management strategies. Oman has implemented non-pharmaceutical interventions (NPIs) to mitigate the impact of COVID-19. However, responses to NPIs may be different across different populations in a country with a large number of migrants like Oman. This study investigates the different responses to NPIs assessing the use of time-varying reproduction number (Rt) to monitor it. Methods Polymerase chain reaction (PCR) laboratory-confirmed COVID-19 data from Oman was used from February 24th to June 3rd, 2020 and included demographic and epidemiological information. Data were arranged into pairs of infector–infectee, and two main libraries of R software were used to estimate reproductive number (Rt). Rt was calculated for both Omanis and non-Omanis. Findings A total of 13,538 cases were included, 44·9% of which were Omanis. Among all, we identified 2769 infector–infectee pairs to calculate Rt. There was a sharp drop in Rt from 3·7, (95% confidence interval [CI] 2·8-4·6) mid-March to 1·4 (95% CI 1·2–1·7) in late March in response to NPIs. Then Rt decreased to 1·2 (95% CI 1·1–1·3) late April when it rose, corresponding to the easing up of NPIs. Comparing the two groups, the response to major public health controls was more evident in Omanis in reducing the Rt to 1·09 (95% CI 0·84–1·3) at the end of March. Interpretation Use of real-time estimation of Rt has allowed us to follow the effect of NPIs. The migrant population responds differently than the Omani population.

Objectives: The aim of the current study was to describe COVID-19’s epidemiological characteristics in Oman during the initial stages of the outbreak and compare findings with other countries’ reports. Methods: Data were drawn from a descriptive, records-based review of reported cases of COVID-19 collected through the national COVID-19 Surveillance System from February to April 2020. Results: A total of 2,443 confirmed cases were reported during the study period. The overall first-time testing rate for this period was 851.7 per 100,000, the positivity rate was 53.1 (confidence intervals [CI]: 51.0–55.2) and the death rate was 0.32 (CI: 0.20–0.54) per 100,000 population, respectively. The overall national positive ratio was 5.7% and ranged from 2.2–7.1% across various governorates. Muscat Governorate had the highest positive ratio (12.5%). People in the 51–60 year old age group (RR = 1.97), males (RR = 1.24), non-Omanis (RR = 2.33) and those living in Muscat (RR = 2.14) emerged as categories with significant demographic risk for COVID-19 cases when compared to the national average. The mean age was 35.6 ± 13.4. Asymptomatic cases accounted for nearly 16%. Conclusion: The overall rate of COVID-19 cases and deaths were low in Oman compared to the rest of the world during the study period. Keywords: Coronavirus; COVID-19; SARS-CoV2; Epidemiology; Pandemic; Oman.

Background SARS-CoV-2 presents a large risk to healthcare personnel. Quantifying the risk of coronavirus infection associated with workplace activities is an urgent need. Methods We assessed the association of worker characteristics, occupational roles and behaviors, and participation in procedures with the risk of endemic coronavirus infection among healthcare personnel who participated in the Respiratory Protection Effectiveness Trial (ResPECT), a cluster randomized trial to assess personal protective equipment to prevent respiratory infections and illness conducted from 2011 to 2016. Results Among 4,689 HCP-seasons, we detected coronavirus infection in 387 (8%). HCP who participated in an aerosol generation procedure (AGP) at least once during the viral respiratory season were 105% (95% CI 21%, 240%) more likely to be diagnosed with a laboratory-confirmed coronavirus infection. Younger individuals, those who saw pediatric patients and those with household members under the age of five were at increased risk of coronavirus infection. Conclusions Our analysis suggests the risk of HCP becoming infected with an endemic coronavirus increases approximately two-fold with exposures to AGP. Our findings may be relevant to the Coronavirus Disease 2019 (COVID-19) pandemic; however, SARS-COV-2, the virus that causes COVID-19, may differ from endemic coronaviruses in important ways.

Aim The purpose of this perspective is to review the options countries have to exit the draconian “lockdowns” in a carefully staged manner. Methods Experts from different countries experiencing Corona Virus Infectious Disease 2019 (COVID-19) reviewed evidence and country-specific approaches and the results of their interventions. Results Three factors are essential: 1. Reintroduction from countries with ongoing community transmission; 2. The need for extensive testing capacity and widespread community testing, and 3. An adequate supply of personal protective equipment, PPE, to protect health care workers. Discussed at length are lifting physical distancing, how to open manufacturing and construction, logistics, and the opening of higher educational institutions and schools. The use of electronic surveillance is considered. Conclusion Each country should decide on the best path forward. However, we can learn from each other, and the approaches are, in reality, very similar.

Aim: The purpose of this viewpoint is to summarize the advantages and constraints of the tools and strategies available for reducing the annual incidence of tuberculosis (TB) by implementing the World Health Organization (WHO) End TB Strategy and the linked WHO TB Elimination Framework, with special reference to Oman. Methods: The case-study was built based on the presentations and discussions at an international workshop on TB elimination in low incidence countries organized by the Ministry of Health, Oman, which took place from September 5 to September 7, 2019, and supported by the WHO and European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Results: Existing tools were reviewed, including the screening of migrants for latent TB infection (LTBI) with interferon-gamma release assays, clinical examination for active pulmonary TB (APTB) including chest X-rays, organization of laboratory services, and the existing centres for mandatory health examination of pre-arrival or arriving migrants, including examination for APTB. The need for public-private partnerships to handle the burden of screening arriving migrants for active TB was discussed at length and different models for financing were reviewed. Conclusions: In a country with a high proportion of migrants from high endemic countries, screening for LTBI is of high priority. Molecular typing and the development of public-private partnerships are needed. (C) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. Funding Agencies|WHOWorld Health Organization; ESCMID; Qiagen; Cepheid; Advanced Healthcare Solutions; PfizerPfizer; MSD; QIAGEN Sciences Inc.

To fulfil the World Health Organization (WHO) End TB strategy, screening for tuberculosis (TB) in immigrants is an important component of the strategy to reduce the TB burden in low-incidence countries. Oman has an annual TB incidence rate of 5.7 per 100000 and transmission from migrants with activated latent TB infection (LTBI) to nationals is a concern. The aim of this study was to determine the proportion of migrants to the Sultanate of Oman with LTBI. The study used an interferon-gamma release assay (IGRA) to assess previous exposure to TB, defining LTBI and a positive IGRA with a normal chest X-ray. 1049 subjects were surveyed. Six participants were excluded from the analysis as they had been recently vaccinated and 1 had an indeterminate result, thus 1042 subjects were included. The overall IGRA-positive rate was 22.4% (234/1042), 30.9% and 21.2% of African and Asian migrants, respectively, were IGRA-positive. Fifty-eight of the participants had a strong IGRA reactivity defined as more than 4 IU/ml. The study shows the proportion of migrants from Asia and Africa with LTBI and 24.7% (58/234) of IGRA-positive migrants had an IGRA of >4 IU/ml, defining a subpopulation with a high risk of developing active TB in the first two years of arrival to the country.

EDITORIAL

Objective Guillain–Barre's syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy seen in all ages but mostly in the adult population. We aim to report the incidence of GBS in children under 15 years of age in Oman, a Gulf country. Materials and Methods All children with GBS under 15 years of age were included in the study from January 2002 to December 2016. The data were compiled in Microsoft Excel format and analysis was performed using SPSS, version 17.0. Population-based age- and sex-specific rates of GBS were calculated using the estimated population for each 5-year period based on 2004, 2009, and 2014 mid-year population, respectively. Relative risk and 95% confidence intervals of GBS at different age categories were calculated using the overall incidence of GBS in those under 15 years as reference. Results The average annual incidence in those under 15 years was 3.1/100,000. Age-specific incidence was 4.0/100,000 in the age group 0 to 9 years and 4.7/100,000 in age group 0 to 4 years. Sixty percent had evidence of preceding infections, and the male to female ratio was 1.8:1. Fifty percent had cranial nerve involvement and 18% needed mechanical ventilation. Five percent had residual weakness. Intravenous immunoglobulins (IVIGs) were used in all, and 3.3% required plasmapheresis when they did not improve with IVIG. Clinical profile of the GBS was not different from the rest reported in the literature. Conclusion The incidence of GBS in Oman was 3.1/100,000 (range: 2.7–3.5 cases/100,000) in children under 15 years of age. The GBS is a smaller proportion among the total acute flaccid paralysis cases.

Objective: To assess the impact of capacity-building interventions introduced by the Oman National AIDS Programme on the quality of HIV care in the country. Methods: HIV viral load (VL) suppression and loss to follow-up (LTFU) rates were calculated for the period before (in December 2015; n = 1098) and after (in June 2017; n = 1185) the introduction of the interventions: training, support, and care pathway development. Three HIV VL cuts-offs at last measurement in the year of interest were used to define VL suppression. Results: In the intention-to-treat (ITT) analysis, rates of VL

In 1996, Oman launched its surveillance programme for adverse events following immunization (AEFI) to address vaccine safety concerns. In 2010, an analysis of surveillance activities for AEFI was done for 10 years (1996-2005).The main objective of the study was to describe the trend of AEFI over the 10-year period, 2006-2015, and compare the findings with a previous report in Oman and reports from other countries.A descriptive record-based review of AEFI was carried out using the national AEFI surveillance database for the study period, 2006-2015.A total of 890 adverse event reports were received, giving an annual rate during the review period of 21.4 per 100 000 population or 8.3 per 100 000 doses administered. The most frequently reported AEFI were BCG adenitis and local reactions - 31.1 and 4.1 per 100 000 doses respectively. There were no reported deaths. Pentavalent vaccine was responsible for the greatest proportion of adverse events (30%). Local reaction was the most common adverse event among all vaccines administered. The Hexa vaccine caused fewer adverse events compared with the pentavalent vaccine, probably due to the acellular pertussis component - 0.8 versus 1.5 per 100 000 doses administered respectively.The overall rate of AEFI (8.3 per 100 000 doses administered) is comparable to the rate (10.8/100 000 doses) in the previous decade (1996-2005) in Oman. The reported rates for individual vaccines are similar to or below international rates.ترصُّد الأحداث الضارة التالية للتطعيم في عُمان، 2006-2015.براكاش باتل، بدر الرواحي، عذاري الجواري، إدريس العبيداني، سيف العبري.أطلقت عُمان في عام 1996 برنامجها لترصُّد الأحداث الضارة التالية للتطعيم بغية التصدي لمخاوف سلامة اللقاحات. وفي عام 2010 ، أُجري تحليل لأنشطة الترصد المتعلقة بالأحداث الضارة التالية للتطعيم لمدة عشر سنوات (1996-2005).تمثلت الأهداف الرئيسية للدراسة في وصف اتجاهات الأحداث الضارة التالية للتطعيم خلال فترة عشر سنوات، 2006-2015 ، ومقارنة استتنتاجاتها بتقرير سابق صدر في عمان وبتقارير من بلدان أخرى.أُجري استعراض وصفي مستند إلى سجلات الأحداث الضارة التالية للتطعيم باستخدام قاعدة البيانات الوطنية للأحداث الضارة التالية للتطعيم خلال فترة الدراسة 2006-2015.ورد ما مجموعه 890 بلاغاً عن أحداث ضارة، مما وصل بالمعدل السنوي خلال الفترة المشمولة بالاستعراض إلى 21.4 حادثة لكل 000 100 شخص أو 8.3 حادثة لكل 000 100 جرعة معطاة. وشملت أكثر الأحداث الضارة المبلغ عنها التهاب العقد اللمفية التالي للقاح المضاد لعصيات كالميت - جوران والتفاعلات الموضعية - 31.1 و 4.1 لكل 000 100 جرعة على التوالي. ولم يُبلغ عن أي وفيات. ويتحمل التطعيم الخماسي النسبة الأكبر من المسؤولية عن الأحداث الضارة (30 %). وشكّل التفاعل الموضعي أكثر الأحداث الضارة شيوعاً بين جميع التطعيمات المعطاة. وجاءت الأحداث الضارة الناجمة عن اللقاح السداسي أقل من التطعيم الخماسي، وربما يعود السبب في ذلك إلى مكون السعال الديكي اللاخلوي - 0.8 مقابل 1.5 لكل 000 100 جرعة معطاة على التوالي.يمكن مقارنة المعدل الكلي للأحداث الضارة التالية للتطعيم (8.3 لكل 000 100 جرعة معطاة) بالمعدل (10.8 / 000 100 جرعة) المسجل في العقد السابق (2005 - 1996) في عمان. وتُاثل معدلات اللقاحات الفردية المبلغ عنها المعدلات الدولية أو تقل عنها.Surveillance des manifestations postvaccinales indésirables à Oman, 2006-2015.En 1996, Oman a lancé son programme de surveillance des manifestations postvaccinales indésirables (MAPI) afin de répondre aux préoccupations sur la sécurité des vaccins. En 2010, une analyse des activités de surveillance des MAPI a été menée sur une période de 10 ans (1996-2005).La présente étude avait pour objectif principal de décrire la tendance de la surveillance des MAPI sur une période de 10 ans (2006-2015) et de comparer les résultats obtenus avec un rapport produit antérieurement à Oman ainsi que des rapports provenant d’autres pays.Un examen descriptif des MAPI basé sur les dossiers médicaux de patients a été réalisé à l’aide de la base de données nationale de la surveillance des MAPI sur la période de l’étude (2006-2015).Au total, 890 rapports de manifestations indésirables ont été reçus, correspondant à un taux de 21,4 pour 100 000 personnes, soit 8,3 pour 100 000 doses administrées sur la période de l’examen. Les MAPI les plus fréquemment rapportées étaient l’adénite à BCG et les réactions locales − 31,1 et 4,1 pour 100 000 doses respectivement. Il n’y avait pas de cas rapportés de décès. Le vaccin pentavalent était responsable de la plus grande proportion de manifestations indésirables (30 %). Les réactions locales étaient la manifestation indésirable la plus courante parmi tous les vaccins administrés. Le vaccin hexavalent était à l’origine de moins de manifestations indésirables que le vaccin pentavalent, probablement du fait du composant anticoquelucheux acellulaire − 0,8 contre 1,5 pour 100 000 doses administrées respectivement.Le taux global de MAPI (8,3 pour 100 000 doses administrées) est comparable au taux (10,8/100 000 doses) de la décennie précédente (1996-2005) à Oman. Les taux rapportés pour les vaccins individuels sont similaires ou inférieurs aux taux internationaux.

Background Influenza is a serious vaccine-preventable disease with high incidence, hospitalization, and mortality in high-risk groups. The epidemiology, seasonality, and risk factors for influenza are well defined in most of the temperate countries, but estimating influenza burden in the World Health Organization (WHO) Region for the Eastern Mediterranean is scarce. In Oman, despite the advancements in influenza surveillance, the clinical burden and seasonality of influenza remain not fully understood. Objectives To estimate the incidence of influenza-associated hospitalizations and in-hospital death in Oman. Patients and methods Influenza-associated hospitalizations and in-hospital deaths were estimated using hospital discharge records based on ICD-10 codes (J09-J18), results of virological analysis and population census for the period between 2012 and 2015. Results During 2012 and 2015, we identified a total of 19 405 influenza-associated hospitalization and 847 deaths. Influenza positivity percentage ranged from 6.4% in 2013 to 20.6% in 2015. Influenza-associated hospitalization incidence rate was 7.3 (95% CI: 6.4-8.1) per 100 000 in 2013 and 27.5 (95% CI: 25.9-29.1) per 100 000 in 2015 with an overall rate of 20.6 (95% CI: 19.9-21.3) per 100 000. The highest incidence of influenza-associated death was among those aged ≥65 years and ranged between 39.5 (95% CI: 27.3-51.8) per 100 000 in 2014 and 11.3 (95% CI: 7.5-15.1) in 2015. Conclusions Influenza causes a substantial number of hospitalizations and deaths in Oman. Hospitalization rates were highest among children, and adults ≥65 years showed the highest death rate. The potential value of using seasonal influenza vaccine in these groups should be considered.

Background: Immunological cross-reactivity between common cold coronaviruses (CCC) and SARS-CoV-2 might account for the reduced incidence of COVID-19 in children. Evidence to support speculation includes in vitro evidence for humoral and cellular cross-reactivity with SARS-CoV-2 in specimens obtained before the pandemic started. Method: We used retrospective health insurance enrollment records, claims, and laboratory results to assemble a cohort of 869,236 insured individuals who had a PCR test for SARS-CoV-2. We estimated the effects of having clinical encounters for various diagnostic categories in the year preceding the study period on the risk of a positive test result. Findings: After adjusting for age, gender and care seeking behavior, we identified that individuals with diagnoses for common cold symptoms, including acute sinusitis, bronchitis, or pharyngitis in the preceding year had a lower risk of testing positive for SARS-CoV-2 (OR=0.76, 95%CI=0.75, 0.77). No reduction in the odds of a positive test for SARS-CoV-2 was seen in individuals under 18 years. The reduction in odds in adults remained stable for four years but was strongest in those with recent common cold symptoms. Interpretation: While this study cannot attribute this association to cross-immunity resulting from a prior CCC infection, it is one potential explanation. Regardless of the cause, the reduction in the odds of being infected by SARS-CoV-2 among those with a recent diagnosis of common cold symptoms may have a role in shifting future COVD-19 infection patterns from endemic to episodic.