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PubMedDate not supplied

Seroprevalence of hepatitis C virus and hepatitis B virus among dialysis patients in Bahrain and Saudi Arabia.

Dialysis patients are at risk for contracting blood-borne infections, including hepatitis viruses (HBV and HCV). The aim of this study was to assess the prevalence of HBV and HCV infection among hamodialysis patients in Bahrain and Saudi Arabia. Study subjects comprised 81 Bahraini and 34 Saudi dialysis patients, and as control 7714 Bahraini and 2330 Saudi blood donors. Serologic markers of HBV (HBsAg, anti-HBc) and HCV (anti-HCV) were determined by EIA and confirmed by PCR (HBV) and RT-PCR (HCV). Higher prevalence of HCV (9.240% vs 0.300%, P <.001), HBsAg (5.88% vs 0.620%; P <.001), but not anti-HBc (1.7% vs 4.6%; P =.01) were seen in patients compared to controls, respectively. When compared to Bahrainis, higher prevalence of HBsAg (11.8% vs 3.7%) and anti-HCV (14.7% vs 7.4%) were seen among Saudi patients, respectively. Double HCV infection was frequent, and the most prevalent types were HCV1a/1b plus HCV4 in Bahraini, and HCV 2/2a plus HCV 4 among Saudi dialysis patients. Our results are the first report on viral hepatitis among dialysis patients in Bahrain, and the first to compare HBV/HCV rates among dialysis patients in the Eastern Arabian peninsula, and confirms other results that documented increased HBV and HCV infection among dialysis patients. Future studies aimed at assessing the status and to monitor the progress of viral hepatitis infection among dialyzed and transfused patients will have a strong impact on patient diagnosis, follow-up, and treatment.

Bahrain↗
PubMed2000

Incidence of spontaneous abortion in Bahrain before and after the Gulf War of 1991.

OBJECTIVES: To determine the incidence of spontaneous abortions in the 5 years before and 5 years after the Gulf War of 1991 and to explore the possible causes that may have affected these changes. To analyze the clinical types, associated medical problems, morbidity, length of hospital stay and mortality rate of abortions. DESIGN: Retrospective study for the period starting on 1 January 1987-31 December 1996. SUBJECTS: The study involved 14,850 cases of abortions admitted into Salmaniya Medical complex during this period. SETTING: The Salmaniya Medical Complex (SMC) is the main referral hospital in Bahrain. METHODS: Analysis of medical records of patients admitted with diagnosis of abortion during this period. RESULTS: By comparing the incidence of abortions in the 5 years before (1 January 1987-31 December 1991) and the 5 years after (1 January 1992-31 December 1996) the Gulf War a significant rise was observed--starting from 1992, reaching a peak in 1994, which then began to decline in 1996. CONCLUSION: Several published reports from Iraq, Kuwait and now from Bahrain are suggestive of an increase in the incidence of abortion and adverse outcome of pregnancy after the Gulf War of 1991. The mechanism is not clear, i.e. whether this is affected by toxicity acquired through the food chain, the oil spillage, smoke pollution resulting from the burning of the Kuwaiti oil fields or stress and anxiety caused by the war.

Abortion, Spontaneous↗
PubMed1998

Wegener's granulomatosis. First case report in Bahrain.

Formerly a fatal condition, Wegener's granulomatosis is now treated with good results. Although the annual incidence of Wegener's granulomatosis in the general population is not known, most European and American studies revealed an incidence in the range of one for every 250,000 of the population. The estimated total population of Bahrain as of June 1997 is 586,110; here we report the first diagnosed case of Wegener's granulomatosis in Bahrain. Our patient presented with epistaxis, and from the clinical features, the very high ESR, the operative, histopathological and the radiological findings, and a high index of suspicion we could confirm the diagnosis along with the appropriate immunological test (positive cANCA). Standard treatment with cytotoxic agents and corticosteroids has been used. On follow-up the patient has shown a progressive improvement in her clinical and laboratory parameters.

Bahrain↗
PubMed2003

Achievements and challenges of formulating a strategic plan for nursing development at the national level in Bahrain.

BACKGROUND: In this paper (initially presented at a symposium during the ICN Centennial Conference, 27 June-1 July 1999, London), we describe nurses' experiences in formulating a strategic plan for nursing development at the national level in Bahrain. AIM: Specifically, we address the process undertaken to produce a comprehensive and integrated strategic plan directed at what nurses in Bahrain need to do in order to contribute to cost-effective and high-quality health service. CONCLUSIONS: The following strategies are addressed: regulation of nursing; reform of nursing education; development of nursing services; development of a nursing information system, and development of nursing leadership.

Bahrain↗
PubMed1990

Epidemiology of rotavirus diarrhoea in children under five years in Bahrain.

A case-control study in children under five years of age was undertaken in Bahrain between February 1984 to March 1986 to study the aetiology of diarrhoea with special reference to rotavirus. During this period fecal samples were collected from 698 hospitalized and non-hospitalized diarrhoea cases and 532 from non-diarrhoea controls. Rotavirus was the enteropathogen most commonly detected (20.8%) and represented 68.7% of the total positives from the cases. Percentage rotavirus infection detected in the hospitalized patients was significantly higher than in non-hospitalized cases. Rotavirus was most frequently detected in the age group 6-11 months (26.6%). Rotavirus was not detected at all above 24 months of age. A higher percentage of rotavirus infection was noticed in males up to 11 months. Children of mothers with university education showed a higher level of rotavirus infection (39.3%) in comparison to children of mothers with school level education (20.4%) or no education (19.6%). Rotavirus was detected more often in patients from higher income homes (25.6%) compared to a lower income group (18.2%). No significant difference in rotavirus positivity was noticed between the children of working and non-working mothers. Rotavirus detection in relation to different feeding habits showed no difference. Rotavirus could be detected throughout the year from diarrhoea cases in Bahrain and showed no seasonal trend. It did not show any correlation with mean monthly temperature and mean monthly relative humidity.

Bahrain↗
PubMed2006

Clinical relevance of virulence genes in Campylobacter jejuni isolates in Bahrain.

There are no data describing the genetic make-up of Campylobacter strains (an important aetiological agent of diarrhoea) circulating in the Arabian Gulf region. Here, the molecular characterization of two virulence genes in Campylobacter jejuni from Bahrain and the relationship with clinical infection are reported. Molecular screening for cytolethal distending toxin (cdtB) and invasion-associated marker (iam) genes was carried out on C. jejuni stool isolates collected from January 2002 to January 2004 in Bahrain. The molecular characterization was correlated with the patients' socio-demographic and clinical parameters. Of the 96 C. jejuni strains tested, 50 (52 %) were cdtB+/iam+, 30 (31 %) were cdtB+/iam- and 16 (17 %) were cdtB-/iam-. Sixty-nine per cent (66/96) of patients were less than 3 years old, with significantly higher detection of cdtB+/iam+ and cdtB+/iam- strains (P < 0.001 and P < 0.01, respectively) in this age group. Seventy patients (73 %) were symptomatic. In the group that were less than 3 years old, 62 and 85 % of those with cdtB+/iam+ and cdtB+/iam- strains, respectively, were symptomatic compared with 100 % for those over 3 years of age. However, the presence of cdtB-/iam- strains still resulted in clinical infection in the children under 3 years but not in the older patients. This is the first report describing the molecular characterization of virulence genes in Campylobacter isolates from this region. The findings indicate that strains of different virulence genetic make-up are circulating in the population, with children under the age of 3 years being most vulnerable. Further work on the molecular characterization, gene expression and determination of the invasive phenotypes of C. jejuni strains circulating in different regions is needed.

Adolescent↗
PubMed2001

Maternal comprehension of home-based growth chart in Bahrain.

The objectives of this study were to assess Bahrain mothers' understanding and interpretation of currently used home-based growth monitoring chart, and how their education effects their comprehension of it. A sample of 472 mothers of children who were less than 6 years old were selected from 18 health centres in Bahrain. About 73% brought the growth chart with them during their visits. The education of the mothers had a significant effect on the comprehension of the growth chart. Highly-educated mothers were more likely to read the information in the growth chart (69%) than middle (52%) and low-educated mothers (16%) (P<0.0001). Also highly-educated mothers got more benefit from the growth chart (P<0.0001) and more of them understood the reason for the colour in the chart (P<0.0001) than other groups. The majority of husbands (85%) showed no interest in reading the growth chart. Of the mothers, 42% did not know at which age the growth chart should be used. It is important, therefore, that the current growth chart should be reviewed and the mothers and health workers should be involved in the process of designing the chart. Suggestions for improvement of the growth chart currently used were provided.

Adult↗
PubMed2004

Health status, lifestyle and nutrient intake of home resident elderly in Bahrain.

The elderly are more susceptible to chronic diseases which reduce functional capacity. Researches on health and nutritional status, therefore, are needed to prevent and control these chronic diseases. The objective of this study was to find out the health, lifestyle, ability to carry out daily living tasks, and intake of nutrients among home-resident Bahraini elderly. Data were based on a cross-sectional community study of 201 Bahraini elderly aged 65 years, which were selected proportionally from all geographical regions of Bahrain (88 men and 113 women). They were visited and interviewed at home by trained female workers, using a pre-tested questionnaire. There was no statistically significant difference between men and women in the history of chronic diseases. However, the proportion of chronic diseases was higher among women, except for peptic ulcer. Men were more likely to smoke (38.6%) than women (24.8%) (p = 0.0353). Dietary supplements were more common among men (19.3%) than women (12.4%). Mean nutrient intakes for energy, iron and calcium were below the USA Recommended Daily Allowances. Men had more capability to do daily activities without help than women. In conclusion, there is a need to establish a national plan of action to promote health and nutritional status among the elderly of Bahrain. This study can provide some baseline data for further in depth study of health status of Bahraini elderly.

Aged↗
PubMed1990

Chemical quality of drinking water in Bahrain.

Chemical quality of five types of water used for drinking purposes in Bahrain were studied. There are three main sources of drinking water: tap, private treated, and bottled waters. The findings revealed that tap water had highest level of all chemicals studies (except silica) compared to other waters. Sodium level in tap water ranged from 100 to 545.9 mg/l, with an average of 309.4 mg/l. This average exceeds the drinking water standard as recommended by WHO (200 mg/l), making this water unsuitable for hypertensive people. Average level of fluoride ranged from 0.28 in carbonated mineral water to 0.85 mg/l in tap water. The high usage of bottled mineral water for drinking purposes may deprive the public, especially the children, from one of the protective elements (fluoride) for dental caries. This disease is highly prevalent in Bahrain. A programme to control chemical quality of drinking water in the country is highly recommended.

Bahrain↗
PubMed1990

Growth patterns of adolescents in Bahrain.

Weight and height of adolescents in Bahrain (15.5-19.5 years) was measured to evaluate their growth patterns. A cross-sectional survey was done on 825 students that represented 5% of total secondary students. The results showed that median height and weight of Bahraini adolescents were below the 50th percentiles of the Western standard. However, when compared with earlier surveys in Bahrain, the growth pattern has improved. This is because of improvement in health and in the environment.

Adolescent↗
PubMedDate not supplied

Status of malaria in the Kingdom of Bahrain: a 10-year review.

BACKGROUND: Malaria was eradicated in Bahrain about 20 years ago. However, because of a large immigrant population, cases of imported malaria continued to be seen. This paper presents an evaluation of the data from 1992 to 2001 to assess the levels of indigenous and imported malaria cases and the potential for reemergence of malaria transmission in the country. METHODS: Epidemiologic and parasitologic data on confirmed malaria cases during the review period were analyzed. Data on vector breeding activity were also analyzed to determine the potential for reemergence of local transmission. RESULTS: From 1992 to 2001, 1,572 cases of malaria were reported. All were imported malaria cases. There was a consistent decline in the number of cases, from 282 (the peak level) in 1992 to 54 in 2001. Eighty-four percent (1,318/1,572) of infections were contracted as a result of travel to or previous domicile in five countries, namely India, Pakistan, Sri Lanka, Bangladesh and Sudan. Plasmodium vivax was the etiologic agent in 85.6% (1,346/1,572) of cases, with Plasmodium falciparum accounting for 14% (220/1,572). During this period, the percentage of examined breeding sites where Anopheles mosquito larvae were identified remained fairly constant, ranging between 0.05% and 0.1%. CONCLUSIONS: From 1992 to 2001, there was a consistent decline in the number of imported malaria cases in Bahrain. There were no cases of locally acquired malaria during this period. The low level of vector breeding spots with Anopheles mosquito larvae suggests that the potential for reemergence of local transmission remains low.

Animals↗
PubMed1991

Prenatal serologic screening in Bahrain.

Between 1988 and 1990, serological surveys designed to study local disease prevalence and assess the clinical value of various prenatal screening tests were undertaken at Salmaniya Medical Center in Bahrain. High maternal antibody prevalence (greater than 85%) to cytomegalovirus (CMV), herpes simplex virus (HSV) and rubella was demonstrated, and 28% showed antibodies to Toxoplasma gondii. The lowest seroprevalence values were found for HBsAg (1.2%) and Treponema pallidum (0.9%). Routine testing for rubella, syphilis, and hepatitis B are advocated for all pregnancies in Bahrain. In contrast, CMV and HSV serologies are not recommended. Toxoplasma antibody testing remains controversial, but the lack of a proven agent to prevent congenital toxoplasmosis coupled with the high cost of serial testing mitigates against its routine use at this time.

Animals↗
PubMedDate not supplied

A population-based screening for gestational diabetes mellitus in non-diabetic women in Bahrain.

BACKGROUND: Maternal hyperglycemia is considered a risk factor for fetal morbidity. Since there is a high prevalence of diabetes mellitus among the population of Bahrain, we conducted a prospective population-based study of gestational diabetes mellitus (GDM) in non-diabetic pregnant women. SUBJECTS AND METHODS: All non-diabetic pregnant women attending antenatal clinics during January 2001 to December 2002 (n=10,495) were screened for GDM during the 24th to 28th weeks of gestation. All positive subjects based on a 50-g glucose challenge test (GCT) were further evaluated by a diagnostic 75-g oral glucose tolerance test (OGTT). The birth weight of the child and post-delivery insulin resistance were monitored. The homeostasis model of insulin resistance (HOMA-IR) was used to assess insulin resistance. RESULTS: Of 10,495 non-diabetic pregnant women screened, 32.8% (n=3443) had plasma glucose > or = 7.8 mmol/L (140 mg/dL) in the GCT. The 75-g OGTT found a prevalence of GDM of 13.5%. There were twice as many Bahrainis as expatriates. Of children born to women with GDM, 6.5% had a birth weight > 4000 g. Post-delivery evaluation of insulin resistance indicated that 33% of women with GDM had a HOMA-IR value > 2. CONCLUSION: The population of Bahrain is a high-risk ethnic group for GDM. The association of insulin resistance in the post-gravid state with GDM among 33% of the study population suggests that insulin resistance, the possible cause of the pathophysiological mechanism underlying the development of gestational diabetes, continues in the post gravid state.

Bahrain↗
PubMed2003

Trends in ophthalmic antimicrobial utilization pattern in Bahrain between 1993 and 2000: a resurgence of chloramphenicol?

OBJECTIVES: The occurrence of aplastic anemia following topical administration of ophthalmic chloramphenicol is controversial and debated internationally. We have determined the influence of such debate on the utilization of ophthalmic chloramphenicol in Bahrain, through studying the utilization patterns of ophthalmic antimicrobial preparations by the Ministry of Health, with an emphasis on chloramphenicol, between 1993 and 2000. Cost-implications of these patterns are examined. MATERIAL AND METHODS: Information on the annual purchase of ophthalmic antimicrobial drug preparations and their unit price was obtained from the Directorate of Materials Management, Ministry of Health, and analyzed. RESULTS: In 1993, the 3 most commonly purchased ophthalmic antibacterial preparations were oxytetracycline 1% eye ointment (40.1%); sulfacetamide 10% and 20% eye drops (25.3%); and chloramphenicol 0.5% eye drops and 1% eye ointment (10.8%). In 2000, oxytetracycline remained the most frequently purchased preparation (33%), followed by chloramphenicol (21.2%). Between 1993 and 1999, chloramphenicol purchases fluctuated between 10% to 16.4% with a remarkable increase to 21.2%, in 2000. Chloramphenicol accounted for 8.6% and 15.1% of cost of total ophthalmic preparations purchased in 1993 and 2000, respectively. CONCLUSION: Despite continued concerns of potential risks of ophthalmic chloramphenicol, this preparation is extensively utilized in Bahrain. We are of the opinion that for minor infections, chloramphenicol ophthalmic preparations should be replaced by safer alternatives. Further, we recommend that their use be reserved for ocular infections that are resistant to other antimicrobials, and that ophthalmologists, at the secondary care level, should supervise such treatment.

Administration, Topical↗
PubMed1997

Epidemiology of HIV and AIDS in Bahrain.

Between 1986 and 1996, 378 HIV cases were identified in Bahrain, of whom 51% were foreign nationals. Intravenous drug abuse was a major risk factor (38.8%) among Bahraini nationals, while transmission through sexual contact was more common (45.7%) among foreigners. Other well known risk factors were also represented in the two communities. The male to female ratio for the two communities were very different with 10:1 for nationals compared to 1:1.4 for foreigners. Among the AIDS defining manifestations, Pneumocystis carinii pneumonia was the commonest (50%), followed by tuberculosis (21%), oro-esophageal candidiasis, cryptosporidiosis and toxoplasmosis. Transmission through sex and maternal-foetus route could emerge as significant contributors in the spread of AIDS in Bahrain unless appropriate preventive steps are taken.

Adult↗
PubMed1999

Breast cancer: patient characteristics and survival analysis at Salmaniya medical complex, Bahrain.

Breast cancer is the most common malignant neoplasm affecting women in Bahrain. We studied the demographic characteristics and clinical presentation of patients with breast cancer and conducted survival analyses based on various factors. Data on all the 117 breast cancer patients at the Salmaniya Medical Complex who had been discharged during the period 1982-94 were audited. When first seen by a physician 70% of the patients had a lump size > 2 cm, with 51.3% presenting in clinical stage II, 21.4% in clinical stage III and 11.1% in clinical stage IV. Only 6.8% of patients presented in clinical stage I. Cumulative survival rates calculated using the Kaplan-Meier method were 68.8%, 57.33% and 36.44% after 5, 7 and 10 years respectively. Our study highlights the need for increased awareness about breast cancer by women in Bahrain, and the need for early detection through regular screening.

Adult↗
PubMed1999

Review of the spectrum of genetic diseases in Bahrain.

This paper looks at some of the studies on genetic disorders conducted in Bahrain. The disorders covered include: genetic blood disorders, metabolic disorders, chromosomal disorders, including Down syndrome, and cystic fibrosis. The rate of consanguinity in Bahrain and the results of premarital counselling are also discussed.

Bahrain↗
PubMedDate not supplied

National study on the prevalence of iodine deficiency disorders among schoolchildren 8-12 years of age in Bahrain.

A cross-sectional survey of primary-school children in Bahrain was conducted to estimate the prevalence of goitre and iodine deficiency according to age, sex and area of residence. During January-May 1999, 1600 children were randomly chosen from all government schools. Children were examined for goitre and of those, 50% were randomly selected for urinary iodine level assessment. Only 26 children (1.7%) had goitre. Although median urinary iodine was above 100 microg/L, 121 of 749 children (16.2%) had low urinary iodine levels. Although iodine deficiency does not pose a significant public health problem in Bahrain, education about the nutritional value of iodized salts in the prevention of this disorder could increase public awareness.

Age Distribution↗