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Middle East respiratory syndrome (MERS) coronavirus (CoV) is a zoonotic virus (7). Approximately 2,266 laboratory-confirmed cases of MERS have been reported to the World Health Organization (WHO) (2) since the [...]

Background and Objectives: A new test (Dr. KSU H1N1 RT-PCR kit) was recently developed to provide a less expensive alternative to real-time reverse transcriptase-polymerase chain reaction (RT-PCR). We report the findings of a validation study designed to assess the diagnostic accuracy, including sensitivity and specificity, of the new kit, as compared to real-time RT-PCR. Design and Setting: Cross-sectional validation study conducted from 18-22 November 2009 at a primary care clinic for H1N1 at a tertiary care teaching hospital in Riyadh. Patients and Methods: Nasopharyngeal swab samples and data on socio-demographic characteristics and symptoms were collected from 186 patients. Swab samples were sent to the laboratory for testing with both real-time RT-PCR and the new Dr. KSU H1N1 RT-PCR kit. We measured the sensitivity and specificity of the new test across the entire sample size and investigated how these values were affected by patient socio-demographic characteristics and symptoms. Results: The outcomes of the two tests were highly correlated (kappa=0.85; PConclusion: The new test seems to provide a cost-effective alternative to real-time RT-PCR for diagnosing H1N1 influenza. However, further testing may be needed to verify the efficacy of the test in different settings and communities.

Background and Objectives : A national plan of management for flu-like illnesses was developed by the Saudi Ministry of Health after the first outbreak in Saudi Arabia in June. We describe the clinical presentation of the H1N1 cases attending King Khalid University Hospital (KKUH) between July through September 2009 and identify the high-risk age groups. Methods : All patients presenting with influenza-like illnesses (ILI) in the H1N1 clinics during the specified period were clinically examined and tested using reverse transcription polymerase chain reaction (RT-PCR). Those who were clinically diagnosed and confirmed positive for novel influenza A (H1N1) were included in the study. Results : Over a 6-week period, 117 cases of laboratory-confirmed cases were reported in KKUH with a mean (SD) age of 19.6 (16.7) years, of whom 72 (62.1%) were males. Most reported cases were Saudis (n=99, 85.3%); 94 (81%) had no travel history outside the country; 100 (86.2%) had had no contact with an H1N1-identified patient; 33% were aged 5-14 years and 28.4% were aged 15-29 years. The most commonly reported symptoms were fever in 99 (85.3%), cough in 9 (81%), runny nose (33.6%) and sore throat (21.3%). All 117 cases were confirmed positive using real time RT-PCR testing. Thirty-one cases (26%) were admitted and 22 of those (71%) recovered after receiving oseltamivir. Two deaths were attributed to the 2009 pandemic. One patient died of chronic pulmonary disease. The other cause of death was unknown. Conclusion : These findings indicate indigenous influenza A (H1N1) transmission, and confirm the urgent need for prevention strategies which specifically target children and young adults, who appear to have a higher risk of infection and hospitalization. Such measures include immunization, improved personal hygiene, and increased ventilation in habitations.

Objectives:To explore potential gender differences in the factors associated with asthma-specific quality of life (AQL).Methods:A cross-sectional study of consecutive series of adult patients attending primary care centers at three major hospitals in Riyadh, Saudi Arabia, was performed. AQL was measured using a standardized version of the AQL questionnaire (min = 1, max = 7), with higher scores indicating a better AQL. Multiple linear regression analysis was performed.Results:The mean AQL was 4.3 (standard deviation [SD] = 1.5) for males and 4.0 (SD = 1.3) for females (p= 0.113). With each unit increase in asthma control, the AQL improved by 0.19 points (95% confidence interval [CI] = 0.14–0.23) in men and by 0.21 points (95% CI = 0.16–0.25) in women. Daily tobacco smoking was associated with a 0.72 point (95% CI = 0.14–1.30) decrease in the AQL among males. Women who had a household member who smoked inside the house had a significantly lower AQL (B = −0.59, 95% CI = −1.0 – −0.19). A monthly household income of 25,000 Saudi Riyals or more was associated with a better AQL among men (B = 0.51, 95% CI = 0.01–1.01), whereas being employed exhibited a protective effect in women (B = 0.48, 95% CI = 0.11–0.84). Higher levels of perceived asthma severity were associated with better AQL in women (B = 0.82, 95% CI = 0.36–1.28).Conclusions:Our findings revealed gender-specific differences in the correlates of AQL in Saudi Arabia, particularly in tobacco exposure, socio-economic factors and perceived asthma severity. [ABSTRACT FROM AUTHOR]

The article discusses research regarding the potential relationships between happiness, physical activity, and smoking initiation among undergraduate medical students in Saudi Arabia. The Oxford Happiness Questionnaire is addressed, along with data which indicates that over 21 percent of the medical students surveyed have tried smoking cigarettes, cigars, waterpipes, or other types of tobacco products. The Global Youth Tobacco Survey is also assessed.

Objective: To evaluate the role of the rapid influenza diagnostic test (RIDT) and clinical decision in the diagnosis of H1N1., Methods: In November 2009, 290 suspected influenza patients were examined for H1N1 during an outbreak in Riyadh, Saudi Arabia. Nasopharyngeal swabs were analyzed using Directigen EZ Flu A+B kit. Monoclonal anti-human influenza A/B and reverse transcription- polymerase chain reaction (RT-PCR) were used. Positive and negative controls were used in each run of specimens. Validity indices were calculated for RIDT and clinical diagnostic criteria., Results: The sensitivity and specificity of RIDT were 40.5% (95% confidence interval [CI]: 33.0-48.5), and 94.5% (95% CI: 88.6-97.6). The sensitivity of clinical decision was 66.3% (95% CI: 58.4-73.4), and the specificity was 65.4% (95% CI: 56.3-73.4). The sensitivity of clinical decision was higher in early presenters (79.2%; 95% CI: 57.3-92.1). The RIDT sensitivity was higher in younger patients (48.4%; 95% CI: 35.7-61.3). The positive predictive value (PPV) was 90.4% (95% CI: 80.7-95.7) for RIDT, and 71.1% (95% CI: 63.1-78.0) for clinical decision. The PPV for RIDT was greater for older (94.7%; 95% CI: 80.9-99.1) and late (90.7%; 95% CI: 76.9-97.0) presenters. The adjusted odds ratio for clinical decision was significant for cough, headache, and fatigue., Conclusion: The RIDT can be useful in epidemics and high prevalence areas, whereas clinical decision, and RT-PCR complement the diagnosis of H1N1 in any setting.

Objective: To measure the prevalence of obesity among military personnel in the Kingdom of Saudi Arabia (KSA), and to identify its risk factors., Methods: This nationwide cross-sectional study covered all 5 military regions of KSA. It included a multistage stratified random sample of 10,500 active military personnel. The World Health Organization STEP wise approach to chronic disease risk factor surveillance (STEPS) was used in the design of the data collection tool. The project lasted from January 2009 to February 2011., Results: The response rate was 97.4%; 40.9% of the participants were overweight, 29% obese, and 42.4% had central obesity. Multivariate analysis revealed age, education years, and family history of diabetes or hypertension as statistically significant positive predictors of body mass index, while higher military rank, smoking, eating fruits more than twice per week, and heavy physical activities were negative predictors., Conclusion: Obesity is a major health problem among military personnel in this survey especially among soldiers, and is associated with unhealthy dietary and physical activity habits. Prompt action must be taken by the military medical services department in terms of intervention programs primarily directed to soldiers and overweight personnel to control obesity and mitigate its consequences. Review of the anthropometric standards for recruitment, continuation, and promotion in military service is recommended.

Objective: To determine the meningitis and influenza vaccination coverage rates among Saudi military personnel in Riyadh (Central Military Region [CMR]), Kingdom of Saudi Arabia, (KSA) and the socio-demographic factors that influence vaccination., Methods: This cross-sectional descriptive study was carried out on a sample of 2286 military personnel from different army forces and different military ranks in CMR in KSA selected by a 2-stage stratified random sampling technique. A self-administered questionnaire designed for the National Military Health Survey was used with a section added for assessment of vaccination status. Data collection was carried out from May to August 2009., Results: The response rate was 97.6%. The vaccination coverage was higher for meningitis (51.7%) compared with influenza (17.8%). A high percentage lacked awareness of their vaccination status. Vaccination rates were higher in the Land Forces, and increased with more years of education, and lower crowding index., Conclusion: The proportion of vaccination coverage among military personnel in CMR of KSA is low, especially for influenza, along with their awareness of their vaccination status. A vaccination program that includes awareness promotion of vaccine-preventable diseases is recommended, with changes in the policies to mandate vaccination against meningitis and influenza.

Objective: The prevalence of obstructive sleep apnea OSA has not been assessed in Saudi Arabia. We aimed to assess the prevalence of individuals who were at risk of OSA in a sample of middle-aged Saudi males, using the Berlin questionnaire at primary care settings., Methods: The study was conducted at King Khalid University and King Fahd National Guard primary health care clinics in Riyadh, Kingdom of Saudi Arabia between December 2005 and March 2006. Berlin Questionnaire was administered by trained medical students to consecutive Saudi male patients in the age group 30-65 years attending the primary health care clinics, after explaining the procedure of the study. Based on the data collected and defined criteria, patients were stratified into high risk and low risk according to responses., Results: Five hundred and seventy-eight middle-aged Saudi males with a mean age of 45.02 +/- 9.3 year were surveyed in this study. Snoring was present in 52.3%, and breathing pauses more than once per week was noticed in 11.3%. Based on the Berlin questionnaire stratification for risk of OSA, 33.3% were considered as high risk patients for OSA. The occurrence of daytime tiredness >once/week was reported by 35.5%. The prevalence of snoring and risk for OSA is similar to that reported in the US., Conclusion: In primary care setting, one in 3 middle-aged Saudi males is at risk for OSA.