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Bahkali K.,King Khalid University | Choudhry A.J.,Field Epidemiology Training Program
International Journal of Diabetes in Developing Countries | Year: 2015

Children with type 1 diabetes (T1D) are at a very challenging situation; they are required to deal with a demanding daily treatment while conscious of possible complications. Data on quality of life (QoL) among children with T1D in Saudi Arabia is lacking. The objective of the current study was to assess QoL and disease-specific challenges among children with T1D. We conducted a cross-sectional study among mothers of children 6–12 years with T1D. Mothers who brought their children to one of three identified outpatient clinics in Riyadh between September and October 2007 were asked to fill a study questionnaire. A transformed score (percent) was calculated for each domain. A total of 140 mothers completed the study. The studied children were 9.7 ± 2.1 years old and were on average 3.8 ± 2.5 years after diabetes diagnosis. About 53.6 % were females. The scores of different domains in decreasing order were as follows: school cooperation (86.1 %), psychosocial status (84.1 %), activity (74.0 %), aspects of mother education (73.8 %), medical and emergency care (68.2 %), aspects of child education (54.7 %), diet (41.9 %), and organizational and social support (22.3 %). Finding suitable diet and better activity were associated with higher family income. Better support was associated with longer diabetic years while better care was associated with older age. We are reporting generally good QoL in multiple domains among children 6–12 years with T1D. Major challenges were observed in finding a suitable food, receiving social and organizational support, and medical and emergency care. The results emphasized the need of better health education. © 2015, Research Society for Study of Diabetes in India. Source


Chuang J.-H.,Epidemic Intelligence Center | Chuang J.-H.,National Yang Ming University | Huang A.S.,Field Epidemiology Training Program | Huang W.-T.,Epidemic Intelligence Center | And 6 more authors.
PLoS ONE | Year: 2012

Introduction: Although WHO declared the world moving into the post-pandemic period on August 10, 2010, influenza A(H1N1) 2009 virus continued to circulate globally. Its impact was expected to continue during the 2010-11 influenza season. This study describes the nationwide surveillance findings of the pandemic and post-pandemic influenza periods in Taiwan and assesses the impact of influenza A(H1N1) 2009 during the post-pandemic period. Methods: The Influenza Laboratory Surveillance Network consisted of 12 contract laboratories for collecting and testing samples with acute respiratory tract infections. Surveillance of emergency room visits and outpatient department visits for influenza-like illness (ILI) were conducted using the Real-Time Outbreak and Disease Surveillance system and the National Health Insurance program data, respectively. Hospitalized cases with severe complications and deaths were reported to the National Notifiable Disease Surveillance System. Results: During the 2009-10 influenza season, pandemic A(H1N1) 2009 was the predominant circulating strain and caused 44 deaths. However, the 2010-11 influenza season began with A(H3N2) being the predominant circulating strain, changing to A(H1N1) 2009 in December 2010. Emergency room and outpatient department ILI surveillance displayed similar trends. By March 31, 2011, there were 1,751 cases of influenza with severe complications; 50.1% reported underlying diseases. Of the reported cases, 128 deaths were associated with influenza. Among these, 93 (72.6%) were influenza A(H1N1) 2009 and 30 (23.4%) A(H3N2). Compared to the pandemic period, during the immediate post-pandemic period, increased number of hospitalizations and deaths were observed, and the patients were consistently older. Conclusions: Reemergence of influenza A(H1N1) 2009 during the 2010-11 influenza season had an intense activity with age distribution shift. To further mitigate the impact of future influenza epidemics, Taiwan must continue its multifaceted influenza surveillance systems, remain flexible with antiviral use policies, and revise the vaccine policies to include the population most at risk. © 2012 Chuang et al. Source


Kabbash I.A.,Field Epidemiology Training Program | Al-Mazroa M.A.,Ministry of Health | Memish Z.A.,Ministry of Health
Journal of Infection and Public Health | Year: 2011

Background: STIs can lead to acute symptoms, chronic infection and serious delayed consequences such as infertility, ectopic pregnancy, cervical cancer and the untimely death of infants and adults. Objectives: To identify the points of strength and weakness in the system for management of sexually transmitted infections (STIs) and pattern of distribution of reported cases in Saudi Arabia. Methods: Data of 5377 reported cases of STIs from all regions of the kingdom during the year 2009 were collected. The original data collection sheets were collected from primary health care centers in all regions of the kingdom, entered into Epi-Info software computer program, organized and statically analyzed. Results: Average monthly reporting was variable between 163.4 cases and 3.3 cases. Age group of 20-40 represented 70.7% of reported cases with the majority Saudis (92%), females (92.9%), literate (59.2%) and married (91.0%). Housewives represented 62% followed by the unemployed (17.3%). The age at first sexual experience ranged from 15 to 25 (81.0%) which was mostly with other sex (95.1%). HIV testing was performed by only 3.0% of reported cases. Vaginal discharge was the most frequent diagnosis (77.6%) followed by lower abdominal pain (42.3%). Urethral discharge and lower abdominal pain differed significantly in relation to sex while scrotal swelling and lower abdominal pain were statistically different in relation to nationality. Vaginal discharge, cervical inflammation and abdominal pain differed significantly in relation to age. Conclusion: Syndromic surveillance of STIs is essential to decrease STIs and control human immunodeficiency virus (HIV) infections. There is a need to build capacity of primary health care workers to collect accurate and valid data. Monitoring and evaluation activities are essential to promote program activities. © 2011 King Saud Bin Abdulaziz University for Health Sciences. Source


Pane M.,Hajj Health Subdirectorate | Imari S.,Hajj Health Subdirectorate | Alwi Q.,National Health Research Institute | Nyoman Kandun I.,Field Epidemiology Training Program | And 3 more authors.
PLoS ONE | Year: 2013

Background:Indonesia provides the largest single source of pilgrims for the Hajj (10%). In the last two decades, mortality rates for Indonesian pilgrims ranged between 200-380 deaths per 100,000 pilgrims over the 10-week Hajj period. Reasons for high mortality are not well understood. In 2008, verbal autopsy was introduced to complement routine death certificates to explore cause of death diagnoses. This study presents the patterns and causes of death for Indonesian pilgrims, and compares routine death certificates to verbal autopsy findings.Methods:Public health surveillance was conducted by Indonesian public health authorities accompanying pilgrims to Saudi Arabia, with daily reporting of hospitalizations and deaths. Surveillance data from 2008 were analyzed for timing, geographic location and site of death. Percentages for each cause of death category from death certificates were compared to that from verbal autopsy.Results:In 2008, 206,831 Indonesian undertook the Hajj. There were 446 deaths, equivalent to 1,968 deaths per 100,000 pilgrim years. Most pilgrims died in Mecca (68%) and Medinah (24%). There was no statistically discernible difference in the total mortality risk for the two pilgrimage routes (Mecca or Medinah first), but the number of deaths peaked earlier for those traveling to Mecca first (p=0.002). Most deaths were due to cardiovascular (66%) and respiratory (28%) diseases. A greater proportion of deaths were attributed to cardiovascular disease by death certificate compared to the verbal autopsy method (p<0.001). Significantly more deaths had ill-defined cause based on verbal autopsy method (p<0.001).Conclusions:Despite pre-departure health screening and other medical services, Indonesian pilgrim mortality rates were very high. Correct classification of cause of death is critical for the development of risk mitigation strategies. Since verbal autopsy classified causes of death differently to death certificates, further studies are needed to assess the method's utility in this setting. © 2013 Pane et al. Source


Tsou T.-P.,Field Epidemiology Training Program | Tsou T.-P.,Research and Diagnostic Center | Liu C.-C.,Centers for Disease Control | Huang J.-J.,Centers for Disease Control | And 2 more authors.
Vaccine | Year: 2011

Taiwan started to immunize children in 30 indigenous townships against hepatitis A since June 1995. The program was further expanded to 19 non-indigenous townships with higher incidence or increased risk of epidemic in 1997-2002, covering 2% of total population. Annual incidence of hepatitis A decreased from 2.96 in 1995 (baseline period) to 0.90/100,000 in 2003-2008 (vaccination period). The incidence in vaccinated townships and unvaccinated townships declined 98.3% (49.66-0.86/100,000) and 52.6% (1.90-0.90/100,000). In 2003-2008, incidence doubled in people aged >=30 years, mostly in unvaccinated townships (0.42-0.92). During 2003-2008, travel to endemic countries was the most commonly reported risk factor (13.5%). First dose vaccine coverage was 78.8% in 1994-2005 birth cohort. Taiwan's experience demonstrates the great, long-term efficacy of hepatitis A vaccine in disease control in vaccinated townships, and out-of-cohort effect in unvaccinated townships. Further reduction can be achieved by improving vaccination coverage of adults at risk. © 2011 Elsevier Ltd. Source

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