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Growth pattern of Qatari preschool children.

AIM: To compare the growth patterns of Qatari preschool children aged 0-5 years with the growth reference charts developed by the American National Center for Health Statistics and Centers for Disease Control and Prevention (NCHS/CDC). METHODS: The demographic data of weight, height, and age were collected in a cross-sectional study among 8,231 Qatar children aged 0-5 years. There were 4,136 (50.2%) boys and 4,095 (49.8%) girls. The children were selected by a cross-sectional stratified random sampling procedure based on the stratification on the location and a socio-economic status. The measured data were compared with NCHS/CD growth charts. RESULTS: The boys were significantly taller than girls in age groups 0-6 months (58.3+/-4.1 vs 57.4+/-4.0 cm, respectively; p<0.001), 6-12 months (66.7+/-4.0 vs 66.2+/-5.1 cm, respectively; p=0.018), 48-54 months (102.1+/-3.6 vs 100.9+/-3.9 cm, respectively; p<0.001), and 54-60 months (106+/-4.8 vs 103.1+/-3.5 cm, respectively; p<0.001). The boys had significantly heavier weight pattern than the girls in all age groups (p<0.001). The height for boys ranged from 58.3 cm to 106 cm, and for girls from 57.4 cm to 103.1 cm. The weight range for boys was 5.4-17.6 kg and 5.1-16.8 kg for girls. More than 11% of the children had stunted growth, 5.4% of the children were taller than normal for their age, 4.4% of the children were undernourished, and 0.6% were severely undernourished. CONCLUSION: A combination of height for age (as an indicator of stunting) and weight for height (as an indicator of wasting) showed - that a sizeable proportion of Qatari children had normal or slightly above normal nutritional status. The growth pattern we presented may suffice as a standard for monitoring the growth of Qatari children in particular, and those in the Gulf region in general.

Body Height↗

Genetics and environmental risk factors associated with asthma in schoolchildren.

OBJECTIVES: The objective of this study was to investigate the genetic and environmental risk factors associated with asthma among Qatari school children aged 6-12 years. DESIGN: A cross-sectional study was performed. The International study of asthma and allergies in childhood (ISAAC) and some additional questionnaires were used to collect the data of the school children between Feb 2003 and Feb 2004. SETTING: Government primary schools in the State of Qatar. SUBJECTS: A multistage sampling design was used and a representative sample of 3500 children were targeted for this study. Of these, 3204 parents (91.6%) of the children agreed to participate in this study. RESULTS: Of the total study sample 3204 school children living in urban and semi urban areas, 51.9% were boys and 48.1% girls. Their mean age was 8.92 +/- 1.89. The population sample had a high prevalence rate of asthma (19.8%) and allergic rhinitis 30.3%. The frequency of asthma, allergic rhinitis and eczema among parents reflected the same pattern as that seen in the children. Environmental risk factors associated with asthma were pets at home, allergic to certain food or medicine, smoking history among parents or elder siblings (p<0.0001). A stepwise logistic regression analysis results showed that allergic to food and medicine, history of asthma in father, mother, siblings and asthma in second degree relatives and smoking habit of father were significant predictors for asthma after adjusting age and sex and other confounding covariates in the model. CONCLUSION: The present study revealed that the family history of asthma contributed more to childhood asthma than indoor and outdoor environmental factors. Boys were found more asthmatic than girls. The results of this study support the hypothesis that asthma is a multi-factorial disease related to both familial and environmental influences.

Air Pollution↗

The presence of dental fluorosis in the permanent dentition in Doha.

The main purpose of this study is to draw attention to the presence and the severity of dental fluorosis in Doha (Qatar) through the high level of registered cases of fluorosis found among the groups examined. Of 4800 people aged 8-50 years, 2654 (55.29%) had dental fluorosis of some degree. This problem urgently requires more studies throughout the country to provide an accurate assessment.

Adolescent↗

Incidence, etiology, and impact of diarrhea among deployed US military personnel in support of Operation Iraqi Freedom and Operation Enduring Freedom.

A health assessment survey was collected from US military personnel deployed to the Middle East taking part in the "Rest and Recuperation" program or on temporary assignment to Camp As Sayliyah Doha, Qatar, from January to December 2004. In addition, a concurrent clinic-based observational study was conducted to determine pathogen etiology and potential risk factors. From 28,322 health assessment surveys, overall self-reported incidence of diarrhea was 4.9 cases per 100 person-months. Disease incidence increased with rank and was higher in Iraq compared with Afghanistan. During this period, 109 US military personnel with acute diarrhea and 85 asymptomatic personnel were enrolled in the observational study. Enterotoxigenic E. coli (ETEC) was the predominant pathogen (32%), followed by enteroaggregative E. coli (12%) and Salmonella spp. (6%). These data are consistent with previous reports implicating ETEC as the primary cause of acute diarrhea for military personnel deployed to this region.

Adult↗

Five adults with mild sickle cell anemia share a beta S chromosome with the same haplotype.

Five adult SS patients from Qatar, Turkey, and South Africa with mild disease, had greatly elevated Hb F and specific patterns of polymorphic sites on their beta S chromosomes. One subject had an alpha-thalassemia (-alpha/-alpha). The haplotypes were the common type #19, associated with severe disease, and type #31, not seen thus far in an SS patient (numbering system of Antonarakis et al). The data suggest that modifications in the DNA of the beta S #31 chromosome promotes the synthesis of gamma chains.

Adolescent↗

A novel missense mutation in the galactosyltransferase-I (B4GALT7) gene in a family exhibiting facioskeletal anomalies and Ehlers-Danlos syndrome resembling the progeroid type.

The Ehlers-Danlos syndrome (EDS) is a heterogeneous group of heritable connective tissue disorders characterized by skin hyperextensibility, joint hypermobility, and tissue fragility. Several genes have been implicated to result in EDS phenotypes. The progeroid type of EDS is characterized by wrinkled, loose skin on the face, curly fine hair, scanty eyebrows and eyelashes, in addition to the classical features of EDS. Here we describe two similarly affected individuals in two sibships of a large consanguineous family from Qatar. DNA samples from affected and unaffected members of the family were analyzed for homozygosity of polymorphic markers associated with genes that have been implicated in EDS. Among 28 markers analyzed, homozygosity was only observed for D5S469 and D5S2111, which were markers for galactosyltransferase-I (B4GALT7) located on chromosome 5q35.2, where the previously reported progeroid-like variant of EDS has been mapped. Exons harboring the coding regions and exon-intron junctions of B4GALT7 were amplified by PCR and examined for mutations. A homozygous misssense C to T substitution at nucleotide 808 in the coding region was discovered in both affected individuals. The carrier parents were heterozygous for this mutation, which was not found among 76 DNA samples from control individuals of the same ethnicity. Segregation of this novel mutation in the family further confirmed the allelic variant and its recessive mode of inheritance in this type of EDS. The C to T substitution results in an arginine to cysteine change at amino acid residue 270 that is located in the catalytically active extracellular C-terminal domain. This change could result in abnormal protein folding and/or aberrant interactions of mutated galactosyltransferase-I with other extracellular matrix proteins leading to the development of a progeroid-like phenotype in affected individuals.

Adult↗

Laparoscopy for ovarian pathology in infancy and childhood.

Conventionally, adnexal pathology in pediatric patients is treated by open laparotomy. As laparoscopic procedures are constantly finding wider application in pediatric surgery, the female child presenting with a suspected acute or chronic ovarian lesion may be an ideal candidate for laparoscopic surgery. From June 1994 to June 1996, eight girls aged 4 months to 11 years (mean 6.1 years) underwent laparoscopic procedures for various ovarian pathologies at King Khalid University Hospital (7) and Hamad Medical Corporation in Qatar (1). Four children had emergency laparoscopic surgery for lower abdominal crises; three of them were managed successfully for twisted adnexal lesions (2 simple ovarian cysts, 1 benign cystic teratoma), the fourth patient was converted to an open salpingo-oophorectomy. The other four patients had elective laparoscopic excision of adnexal lesions (two antenatally diagnosed ovarian cysts and two mature ovarian cystic teratomas). There were no operative complications; the mean operative time was 76.25 min, the mean hospital stay 2.25 days. Our initial experience and technique are presented. It appears that the laparoscopic approach to ovarian lesions in infancy and childhood is an effective and safe method for diagnosis as well as definitive therapy.

Child↗

Phytomonitoring and management of tar piles on the Qatari coastal marshes, Arabian Gulf.

Most of the shores in Qatar and other oil producing countries have had a long history of crude oil pollution from different sources. This pilot study was to assess the problem and suggest a management programme for disposing of the collected tar or lessening the impact of tar accumulation. The vegetation on the sites used for dumping tar was used in a field survey to identify bioindicators of tar pollution and of the natural recovery of polluted sites. The phytomonitoring results indicate that recovery of polluted sites can be quite rapid after clean-up and restoration. To facilitate natural plant invasion and colonization, and the restoration of tar piles, the dumping sites must have plant communities with high species diversity and a high percentage of annual plants. Depending on the sand-tar ratio in the piles, artificial seeding of selected plant species (listed) can be applied by using species mixes or single species seeding. Management techniques are suggested to optimize the natural recovery and revegetation of tar-affected coastal marshes.

Journal Article↗

The epidemiology of self-reported diarrhea in operations Iraqi freedom and enduring freedom.

Diarrhea remains a potential cause of compromised military effectiveness. To assess diarrhea rates and mission impact in operations in Iraq and Afghanistan, a survey was administered to soldiers participating in the "Rest and Recuperation" program in Doha, Qatar. Between October and December 2003, 2,389 volunteers completed a questionnaire designed to assess the occurrence and impact of diarrhea. The median length of deployment was 7.2 months, 70% reported at least one episode, and 56% had multiple episodes of diarrhea. Overall, 43% reported decreased job performance for a median of 2 days, and 17% reported being on bed rest for a median of 2 days. While this survey showed high rates of diarrhea associated with decreased operational effectiveness, the results are consistent with prior military operations in this region. Further research is needed to develop better methods for illness prevention and its minimization on operational impact.

Adult↗

Safety of vaginal birth after cesarean delivery.

OBJECTIVE: To compare the outcomes of labor induction in women with a history of 1 cesarean section (CS) who undergo trial of labor. METHODS: A prospective observational study of 702 pregnant women who had 1 previous CS was conducted at Women's Hospital, Hamad Medical Corporation, Doha, Qatar, between April 2003 and April 2004. Those with no history of vaginal delivery were assigned to one group and those with a history of vaginal delivery were assigned to another group, and the latter group was then divided into 2 subgroups according to the results of trial of labor. RESULTS: Of these 702 women with a history of 1 CS, 62.4% also had a history of vaginal delivery. After trial of labor, vaginal delivery occurred more often among women with no history of vaginal delivery (64.8%). Moreover, trial of labor resulted in a vaginal delivery more often in women who were delivered only once and by CS (87.7%) than in women who also had a history of vaginal delivery (79.2%). CONCLUSION: These findings indicate that women who have had a CS should strongly consider natural delivery for subsequent pregnancies.

Adult↗

Is there any association between consanguinity and hearing loss.

BACKGROUND: Hearing loss (HL) and its complications appear to be increasingly common in developing countries. Previous studies have supported the association between hearing loss and consanguinity. OBJECTIVE: The aim of the present study was to determine the frequency of hearing loss and its association with consanguinity among Qatari population. In addition, correlation between hearing loss and Rhesus (Rh) blood groups has been investigated. DESIGN: This is a cross-sectional study. SETTING: The study conducted at the Hamad General Hospital, Hamad Medical Corporation. SUBJECTS: Total sample of 2800 infants screened and 2277 subjects were eligible to be included in the study. METHODS: The neonatal screening for hearing loss was conducted from January 2003 to November 2003 among all the 2800 infants born during that period. Some of them were admitted to neonatal intensive care unit (NICU). The hearing loss was screened using otoacoustic emission (Garson Stadler Incorporation, GSI-70), auditory brain stem responses (ABR) and tympanogram. RESULTS: Out of 2277 infant screened, the prevalence of hearing loss was (119/2277) 5.2%. The prevalence of HL was more common in boys (2.7%) than in girls (2.5%). We did not find any statistical significance differences between genders with the respect of HL. Parental consanguinity was more common among HL cases compared with non-HL 60.5% versus 25.3% (p < 0.0001). Family history of hearing loss did not show any differences between the two groups. 4.2% versus 4.3%. Risk factors like caesarean section, prenatal smoking and prenatal high blood pressure did not show any significant differences between the two groups. However, admission to NICU is associated with increase prevalence of HL 8.4% versus 4.4% (p = 0.043). The present study revealed that strong correlation between hearing loss, consanguineous (r = 0.217, p < 0.01), father education level illiterate (r = 0.293, p < 0.01), mothers consanguineous (r = 0.206, p < 0.01), mothers educational level illiterate (r = 0.228, p < 0.01), mother blood group positive (r = 0.476, p < 0.01), family history of HL among first or second degree of relatives (r = 0.620, p < 0.01) and father hypertension (r = 0.570, p < 0.01). Furthermore, a significant correlation between hearing loss and Rh blood groups has been discovered. CONCLUSION: The present study was directed at determining the prevalence and risk factors of HL in the infant population of Qatar. The data revealed that parental consanguinity was more common among hearing loss cases. There is a strong correlation between hearing loss and baby's age.

Cohort Studies↗

Distribution of heavy metals in marine bivalves, fish and coastal sediments in the Gulf and Gulf of Oman.

An assessment of marine contamination due to heavy metals was made in the Gulf and Gulf of Oman based on marine biota (fish and various bivalves) and coastal sediment collected in Bahrain, Oman, Qatar, and the United Arab Emirates (UAE) during 2000-2001. Sediment metal loadings were generally not remarkable, although hot spots were noted in Bahrain (Cu, Hg, Pb, Zn) and on the east coast of the UAE (As, Co, Cr, Ni). Concentrations of As and Hg were typically low in sediments and the total Hg levels in top predator fish commonly consumed in the region were < 0.5 microg g(-1) and posed no threat to public health. Very high Cd concentrations (up to 195 microg g(-1)) in the liver of some fish from southern Oman may result from food-chain bioaccumulation of elevated Cd levels brought into the productive surface waters by upwelling in the region. Very high As concentrations (up to 156 microg g(-1)) were measured in certain bivalve species from the region. Although not certain, the As is probably derived from natural origins rather than anthropogenic contamination.

Animals↗

Chlorinated hydrocarbons in marine biota and coastal sediments from the Gulf and Gulf of Oman.

The spatial distribution of various organochlorinated compounds was investigated in the Gulf and Gulf of Oman based on marine biota (fish and various bivalves) and coastal sediment collected in Bahrain, Oman, Qatar and the United Arab Emirates (UAE) during 2000-2001. Several potential organic contaminants from agricultural (e.g., DDT and its breakdown products, lindane, endrin, dieldrin, endosulfan) and industrial (PCBs) sources were measured. Sediment burdens for all compounds, even for an apparent hot spot near a refinery in Bahrain, were amongst the lowest reported for surface sediments from other seas. Concentrations of DDTs were low in the muscle and liver of all fish (orange spotted grouper and the spangled emperor) analysed. Similarly, the levels of chlorinated hydrocarbons were low in the various bivalve species, notably rock oysters and pearl oysters. These results contribute to the sparse regional database for organochlorinated compounds in the marine environment. Moreover, they can be used as the most recent end point for elucidating temporal trends. Whereas the levels, albeit relatively low, SigmaDDTs in the rock oysters from the Gulf of Oman have remained uniform, there has been an irregular but generally decreasing trend in concentrations of summation SigmaPCBs during the last two decades.

Animals↗

Aliphatic and aromatic hydrocarbons in marine biota and coastal sediments from the Gulf and the Gulf of Oman.

The composition and spatial distribution of aliphatic and polycyclic aromatic hydrocarbons (PAHs) were investigated in biota and coastal sediments from four countries surrounding the Gulf (Bahrain, Qatar, United Arab Emirates and Oman). The levels of total petroleum hydrocarbons (TPH), aliphatic unresolved mixture and PAHs in sediments and biota were relatively low compared to world-wide locations reported to be chronically contaminated by oil. Only in the case of the sediments collected near the BAPCO oil refinery in Bahrain, having concentrations of 779 microg g(-1) total petroleum hydrocarbon equivalents and 6.6 microg g(-1) Sigma PAHs, can they be categorized as chronically contaminated. Some evidence of oil contamination was also apparent in sediments and bivalves around Akkah Head and Abu Dhabi in the UAE, and near Mirbat in Oman. Contaminant patterns in sediments and biota indicated that the PAHs were mainly from fossil sources, with the exception of the high PAH concentrations in sediments near the BAPCO refinery that contained substantial concentrations of carcinogenic PAH combustion products.

Animals↗

Assessment of organotin contamination in marine sediments and biota from the Gulf and adjacent region.

Butyltin species were measured in sediments from coastal locations in the Gulf and Gulf of Oman. Both butyltin and phenyltin species were measured in biota samples from four countries in this region. With tributyltin (TBT) concentrations up to 60 ngSng(-1), some sediments could be classified as contaminated (i.e. TBT>1.3 ngSng(-1)), namely Dukhan (Qatar), the BAPCO industrial complex and Askar (Bahrain), and Hilf and the Raysut Port Area (Oman). Higher concentrations of total butyltins were found in oysters relative to fish, but ranging from 6.5 to 488 ngSng(-1) dry weight they are nonetheless relatively low. Diphenyltin and triphenyltin were found in some fish and bivalves from the Gulf, but not in biota from the Gulf of Oman. The environmental levels of organotin species are comparatively low by global standards and pose no immediate public health problems.

Animals↗

HLA and hepatitis B infection.

The mechanism underlying the development of chronic infection with hepatitis B virus is not known. We have done two independent studies in Qatar, where such infection is common, to determine whether immunity to this virus is influenced by the HLA phenotype of an individual. The first study generated a hypothesis to test in the second. In both studies, there was a significant deficiency of HLA-DR2 and an excess of HLA-DR7 in patients with chronic persistent infection with hepatitis B virus. We conclude that HLA phenotype is one of the factors influencing the response to infection with this virus.

Adolescent↗

Interferon-alpha therapy in HCV hepatitis: HLA phenotype and cirrhosis are independent predictors of clinical outcome.

Interferon-alpha therapy is effective in only approximately 20% of individuals with chronic HCV infection. A knowledge of the genetic and/or environmental factors that underlie this heterogeneity of response should provide useful predictors of clinical outcome. HCV infected patients and healthy subjects were selected from the expatriate Egyptian population living in Qatar, where chronic HCV infection poses a serious health problem. HCV infection was confirmed by ELISA and RT-PCR. Fifty five patients received interferon-alpha therapy for 6 months and their response was assessed by liver enzyme activity and histology of liver biopsies; the patient responses were followed during treatment and for 1 year afterwards. Twenty five patients were characterised as responders, and the remaining 30 as non-responders. All individuals in the study were typed for HLA class II alleles. Data were analysed by univariate and multivariate statistical methods. Expression of the HLA DR2 Major Histocompatibility class II allele is significantly associated with a beneficial response to interferon-alpha therapy in Egyptian patients (p < 0.005). This association is independent of cirrhosis, the absence of which also showed a significant association with response to therapy (p < 0.005). Our results therefore provide evidence that HLA DR2 is an important additional factor for predicting a long term response to interferon-alpha therapy in chronic HCV hepatitis.

Adult↗

Bottom sediments of the Arabian Gulf--II. TPH and TOC contents as indicators of oil pollution and implications for the effect and fate of the Kuwait oil slick.

Measurements of total petroleum hydrocarbon (TPH) concentrations in 77 core samples collected in 1992 from the bottom sediments of the Arabian Gulf were used to delineate oil pollution levels and their distribution in the region. Seven chronic moderately (TPH 50-89 microg g(-1)) and heavily (TPH 266-1448 microg g(-1)) polluted areas were identified; three in the northern part of the region and four in the southern part. Oil pollution in these areas was attributed to natural oil seepage, accidental damage to pipelines, accidental spillage from tankers, the Nowruz oil slick, and tanker deballasting. Present-day intermediate (TPH 50-114 microg g(-1)) and high (TPH 200-1122 microg g(-1)) pollution levels were identified in 10 areas. Of these, three polluted areas in the northeastern corner, offshore Saudi Arabia and offshore Bahrain, Qatar and United Arab Emirates are probably directly affected by the Kuwait oil slick. A new scenario is suggested for the movement and fate of the oil slick, in which additional large oil discharges from northern sources, as well as substantial quantities of eroded oiled sediments and oil floating from heavily impacted tidal flats along the Saudi Arabian coastline, serve as sources of oil pollution. A definite relationship exists between the grain-size distribution and the TPH content of bottom sediments, with the highest TPH concentrations in the muddy sediments, suggesting that adsorption onto muds is the primary mechanism of oil pollutant accumulation in the Arabian Gulf. Total organic carbon measurements do not correlate positively with the grain-size distribution and TPH contents of the sediments, and hence cannot be used as indicators for petroleum hydrocarbon pollution in the Arabian Gulf.

Journal Article↗