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PubMed2004

A comparison of leachate treatment between Rhode Island and Kuwait.

The main objectives of this article were to present data on the characteristics of landfill leachate of Rhode Island Central landfill and those of Kuwait's Sulaibya landfill site, and to compare different experimental pilot plant studies for the treatment of sanitary landfill leachate, which was generally characterized by high concentration of heavy metals. The data obtained on the chemical analysis of leachate generated from two landfills in Rhode Island and Kuwait, identified variations in leachate quality due to landfill composition. Pilot Plant studies using physical/chemical and biological treatments (i.e., rotating biological contractor) were used to examine the treatment efficiency.

Databases, Factual↗

PubMed2004

Characterization of high-level aminoglycoside-resistant enterococci in Kuwait hospitals.

This study investigated the distribution of genes for aminoglycoside-modifying enzymes (AME) and the genetic relatedness of high-level aminoglycoside-resistant enterococci isolated in Kuwait hospitals. A total of 117 enterococci, consisting of 109 Enterococcus faecalis, seven Enterococcus faecium, and one Enterococcus casseliflavus were studied. The MICs of gentamicin, kanamycin, amikacin, tobramycin, and streptomycin were determined by agar dilution and the genes encoding the AAC(6')- APH(2"), ANT(4'), APH(3'), APH (2")-Ib, APH (2")-Ic, APH (2")-Id, and ANT(6) enzymes were amplified by PCR. They were typed by pulsed-field gel electrophoresis (PFGE). Filter mating was used to transfer gentamicin resistance determinants. They were all resistant to kanamycin (MIC 2000 mg/L). Fifty-five isolates were resistant to gentamicin (MIC 500 mg/L), 72 were resistant to tobramycin (MIC 64 mg/L), 115 were resistant to amikacin (MIC 64 mg/L), and 97 were resistant to streptomycin (MIC 1000 mg/L). The aac(6')-Ie-aph(2")-Ia was detected in all isolates with gentamicin MIC 500 mg/L and in 15 isolates with gentamicin MIC 256 mg/L. The aph(3')-IIIa gene was detected in 101 isolates, whereas the ant(6')-Ia gene was detected in 85 of the 97 streptomycin-resistant isolates with MIC 1000 mg/L. The aac(6')-Ii gene was detected only in the seven E. faecium isolates. None of them contained ant(4')-Ia, aph(2")-Ib, aph(2")-Ic and aph(2")-Id. PFGE revealed heterogeneous patterns with no dominant clone. The results demonstrated that AME are common in aminoglycoside-resistant enterococci isolated in Kuwait. However, the absence of a dominant clone suggests that they acquired high-level aminoglycoside independently.

Aminoglycosides↗

PubMed1998

Incidence of hip fracture in Kuwait.

BACKGROUND: Hip fracture as a consequence of osteoporosis is an important cause of morbidity and mortality among the elderly. Due to improving life expectancy, the number of elderly individuals is increasing more rapidly in the developing countries of Asia, the Middle East, Africa, and South America. Incidence of hip fracture, which rises exponentially with age, varies substantially between countries and according to the age, sex, and ethnic distribution of the population. Highest rates are observed in Scandinavia and in whites in the US, intermediate in western Europe, and the lowest rates in Asia. Little is known about the epidemiology of hip fractures in the Middle Eastern populations. In particular, there are no published reports from any of the Arab countries. We have therefore estimated the incidence of hip fracture in Kuwait and compared it with other populations. METHODS: The study was conducted at a specialized orthopaedic hospital which provides services to residents in the three governorates--representing about 70% of the total population of Kuwait. All new hip fracture patients who were operated on or treated conservatively during the 4-year period (1992-1995) were included in the study. Hip fracture was defined as clinical and radiological evidence of fracture of the proximal femur. For comparison with other populations, age-specific incidence rates in females and males aged > or =50 years were standardized to the 1985 US population. RESULTS: A total of 513 cases of hip fracture (205 females, 308 males) were recorded during the study period: 293 (57.1%) cases occurred among Kuwaiti nationals and 220 (42.9%) among non-Kuwaitis (expatriates). Age-standardized rates (per 100,000) of hip fractures were, in Kuwaitis, 295 for females (95% CI: 238.8-350.8) and 200 for males (95% CI: 163.3-236.5)--much higher than those observed in other Asian countries such as Korea, Singapore, China, Malaysia, and Japan (41-202 for females, 49-100 for males). Rates in Kuwaiti females were similar to those observed in some of the European countries (Italy, UK, France) and in Asian females in the US. In contrast, rates in Kuwaiti males, which were relatively high, were almost equal to those observed in white males in the US. Rates of hip fracture in non-Kuwaitis (374 for females [95% CI: 247.6-500.8], 215 for males [95% CI: 126.5-302.9]), who predominantly (96%) originate from southeast Asian and Arab countries, were similar to those observed in Kuwaiti nationals. CONCLUSIONS: The incidence of hip fracture in the Kuwaiti population is higher than that reported from other countries in Asia and is comparable to the incidence in some of the western European and North American populations.

Aged↗

PubMed1999

Trisomy 18 in Kuwait.

BACKGROUND: Trisomy 18 (Edwards' syndrome, T18) is the second most common trisomy in man. We describe 118 children with regular T18 who were ascertained clinically and cytogenetically in the Kuwait Medical Genetics Centre during 1980-1997. METHODS: Ascertainment of T18 cases was performed shortly after birth. Chromosomal studies were carried out in addition to other relevant investigations. To investigate the factors associated with T18, a case-control study was carried out with 131 normal healthy newborns. Studied factors included maternal and paternal age, birth order, abortion, associated malformation, and survival. Multiple logistic regression analysis was used to adjust for confounding between variables. RESULTS: There was a preponderance of females among T18 cases (female:male ratio 2.1:1). The majority of T18 cases (53%) died before the second week of life. The most common associated anomalies were: congenital heart (38.1%) and gastrointestinal (25.4%). Multiplicity of malformations was also observed. Significant seasonal variation in T18 cases was detected with a peak in spring. Of the 118 T18 cases, 59 were delivered during 1994-1997 (average overall T18 birth prevalence rate 8.95 per 10 000 live births [95% CI: 6.66-11.23]). Concerning maternal age, 30.5% of the T18 cases' mothers were > or =35 years compared to 10.7% in the control group. The difference was statistically significant, P = 0.002. Logistic regression analysis showed that maternal age >30 years was a significant risk factor for T18, after adjusting for confounding with paternal age. Paternal age and abortion were not found to be significant risk factors. CONCLUSION: Trisomy 18 birth prevalence rate is high in Kuwait with advanced maternal age as a significant risk factor.

Abnormalities, Multiple↗

PubMed1978

Seroepidemiology of rubella in Kuwait: an alternative vaccination policy.

1054 females of child-bearing age in Kuwait were screened for rubella antibodies. 56 or 5.4% were found seronegative. In view of this relatively low rate of susceptibility, a large-scale rubella vaccination campaign in Kuwait may not be necessary. An alternative vaccination policy is suggested.

Adolescent↗

PubMed1980

Rotavirus and non-bacterial infantile gastroenteritis in Kuwait.

The role of rotavirus in non-bacterial gastroenteritis in Kuwait was investigated. Employing electronmicroscopy (EM) and enzyme-linked-immuno-sorbent-assay (ELISA) techniques, the virus was detected in the stools of 42 of 274 (15.3%) infants with the disease. A statistically significant association (P less than 0.05) was found between virus excretion and age since 37 of 42 (88.1%) of rotavirus positive cases were aged 2-12 months. 57.1% of all rotaviruses detected were among specimens collected during the first 3 days since onset of clinical symptoms. In addition a highly significant relationship (P less than 0.01) was found between virus excretion and seasonal variation since highest virus excretion rates (76.1%) were detected in specimens collected during the autumn and early winter months, and coincided with the annual gastroenteritis season in Kuwait. Diarrhoea and vomiting were the most frequently encountered clinical symptoms being present in 92.9% and 76.2% of all rotavirus positive patients, respectively.

Age Factors↗

PubMed1983

Frequency of delta agent infections in Kuwait.

Antibodies to delta antigen have been found among all populations in the world studied so far. The prevalence is high (40%-47%) in chronic HBsAg carriers in southern Italy. In other parts of the world, the prevalence is low (less than 5%); however, 30%-75% of polytransfused hemophiliacs and drug addicts in Europe and the United States have antibodies to delta antigen [2]. Most Arab nationalities are well represented in the population of Kuwait. Among 144 HBsAg-positive sera studied, 58 (40%) were positive for antibodies to delta antigen. Data regarding diagnosis, age, sex, and nationality were available for 80 of the patients investigated. Among these, 32 (40%) were antibody-positive. The highest number of positive patients was among those with chronic liver disease; all except two of the positive patients were Gulf or Mediterranean Arabs. Thus, infection with delta agent is an important cofactor in the pathogenesis of chronic liver disease in this region, because delta agent is known to become chronic [2]. The patients who had chronic liver disease and those who had illnesses other than liver disease or acute hepatitis are probably all chronic HBsAg carriers; however, it was not possible to differentiate between chronic and transient carrier states. Some of the patients with acute hepatitis also probably carried HBsAg with a superimposed delta infection. The carriage rate of HBsAg in the normal population in Kuwait is 2.8%-4% [3]. The only fatal case of acute hepatitis in this study occurred among the patients who were positive for delta antibody.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗

PubMed1995

Increased frequencies of sister chromatid exchange in soldiers deployed to Kuwait.

Frequencies of sister chromatid exchange (SCE), a measure of genotoxic exposure, were assessed in military troops deployed to Kuwait in 1991. Soldiers completed health questionnaires and had blood collected prior to, during and following deployment to Kuwait. Frequency of spontaneous SCE was determined on blood samples as a measure of mutagenic exposure. Compared to pre-deployment baseline SCE frequency means, levels obtained 2 months into the Kuwaiti deployment were significantly increased (P < 0.001) and persisted for at least 1 month after return to Germany. Outcome was unaffected by known personal SCE effect modifiers including smoking, age and diet. Potential sources of the apparent mutagenic exposure are discussed.

Air Pollutants↗

PubMed2003

Overweight and obesity among Kuwait Oil Company employees: a cross-sectional study.

BACKGROUND: Overweight and obesity are considered major risk factors for many diseases, and their prevalence is known to be high in Kuwait from previous studies. AIM: To assess the prevalence of overweight and obesity and related risk factors among Kuwait Oil Company (KOC) employees. METHOD: A cross-sectional study of full-time KOC employees was carried out using a structured questionnaire that was completed during periodic medical examinations. The questionnaire included demographic details, frequency and duration of physical activity, history of chronic diseases and medication. All participants were counselled and examined. Blood pressure, body mass index and fasting glucose were recorded. RESULTS: Some 3282 out of 3900 employees completed the study; 85% of participants were male, 62%were field workers and 38%were office workers. The overall prevalence of overweight and obesity among KOC employees was 75%. Males showed a higher level of overweight and obesity (79%) than females (56%). Field workers had a higher level of overweight and obesity (78%) and higher inactivity (65%) than office workers (72% and 56%, respectively). CONCLUSION: Overweight and obesity, together with inactivity, are highly prevalent among KOC employees, and more so among field workers than office workers. Encouraging an active lifestyle, healthy eating habits and weight control programmes are all possible interventions to reduce the prevalence of overweight and obesity.

Adult↗

PubMed1982

Hemolytic streptococci and streptococcal antibodies in normal schoolchildren in Kuwait.

A total of 1041 asymptomatic "normal" schoolchildren in Kuwait, aged 6-16 years, were investigated over six months from November 1978 through April 1979 for hemolytic streptococcal throat carriage and for streptococcal immune response. A high carrier rate of beta-hemolytic streptococci (47%) with an unusually high prevalence of group C (32%) was found. Group A was isolated in 10%, group B in 2%, and group G in 3% of the children. Comparison of the prevalence of the different serogroups of beta-hemolytic streptococci in our study with that of similar studies reported from temperate, subtropical, and tropical zones showed a high prevalence of groups C and G and a lower prevalence of group A in subtropical and tropical countries in contrast to a high prevalence of group A and lower prevalence of groups C and G in countries with temperate climate. The geometric mean titer of antistreptolysin O in group A carriers in our study was 270 Todd units and significantly higher than that in group C carriers (p less than 0.001), while the geometric mean titer of antihyaluronidase in group A carriers was 240 units and significantly higher than that in groups B, C, and G carriers (p less than 0.0005). The high magnitude of the streptococcal immune response probably reflects a high frequency of streptococcal infections in schoolchildren in Kuwait and possibly indicates a high attack rate of rheumatic fever in the country.

Adolescent↗

PubMed1998

Findings of colonoscopy in children: experience from Kuwait.

This report summarizes our retrospective analysis of 173 colonoscopic examinations performed on 159 children over a period of 9 years in Kuwait. Ninety-six children were males, with a male to female ratio of 1.5:1. The main indications for colonoscopy were rectal bleeding, polyps, and suspected inflammatory bowel disease. Examination was done under sedation or anaesthesia. One hundred and fifty-one (87 per cent) examinations were complete up to the caecum and 89 (51 per cent) up to the terminal ileum. The most common pathology was polyps in 42 children. All but one polyp were hamartomatous and mainly localized to the rectum and sigmoid colon. The majority had a single polyp. One child had adenomatous polyposis coli. One hundred and forty-two polyps were removed endoscopically with no complications. Inflammatory bowel disease was present in 34 (21 per cent) children (17 Crohn's disease, 11 ulcerative colitis, and 6 indeterminate colitis). Tuberculosis of the ileo-caecal region was diagnosed in two cases. Seven patients had rectal ulcers presenting as rectal bleeding. In 11 (7 per cent), the lesions were limited to the right side of the colon or terminal ileum. These results suggest that colonic pathology is not uncommon in children in Kuwait. The disease pattern is similar to that reported in western countries. As we have observed in adults, inflammatory bowel disease is seen in significant numbers among children in this region. In this survey we have observed a change in the disease frequency, Crohn's disease being more common that ulcerative colitis. Without adequate examination, the existence of inflammatory bowel disease and this possible changing pattern of disease would have gone unrecognized.

Adolescent↗

PubMed1990

Weighted concentration of 137Cs equivalent in foodstuffs in Kuwait from June 1986 to December 1988.

The weighted monthly concentration of 137Cs equivalent (WMC) for various types of foodstuffs imported from June 1986 to December 1988 are discussed. The data presented are based on total concentration of 137Cs equivalent. The concentration was found below the disqualifying level applied in Kuwait. The radioactive contamination was higher in milk and baby milk relative to other types of foodstuffs. The calculation of Kuwait's disqualifying levels are based on the annual dose equivalent of 1 mSv (100 mrem). The measured WMC for most types of foodstuffs represents a small fraction to the annual dose limit recommended for the general public.

Accidents↗

PubMedDate not supplied

Transactional versus transformational style of leadership--employee perception of leadership efficacy in public and private hospitals in Kuwait.

OBJECTIVES: To determine whether employees working for a transformational leader perceive their leader as more effective than do those working for a transactional leader. To assess whether employees in private hospitals are more likely to perceive their leaders as transformational than are employees in public hospitals. DESIGN: A questionnaire study of a random sample of employees working at 4 hospitals (private and public) in Kuwait; 266 respondents included. RESULTS: Analysis of varience and regression analysis showed that the transformational style of leadership was linked to high level of employee perception of leadership efficacy. Also, the employees in private hospitals were more likely to perceive their leaders as transformational than were employees in public hospitals. CONCLUSIONS: Hospitals in Kuwait may benefit by recruiting leaders with a transformational style, as it is directly related to quality, employee satisfaction, increased productivity, and employee perception of leadership efficacy.

Cross-Sectional Studies↗

PubMed2003

Tinea capitis among children and adolescents in the Farwaniya region of Kuwait.

Analysis of 325 patients (182 males, 143 females) of mycologically proven tinea capitis (TC) seen over a period of two years from January 2001--December 2002 in the Farwaniya region of Kuwait is presented in this study. The age range was 8 months to 17 years. Peak incidence was observed in the 3-14 year age group (79.6%). Positive family history and contact with pets were noted in 22% and 36.7% of the cases, respectively. The non-inflammatory 'gray patch' variety was the most common clinical type, seen in 163 (50.2%) children, followed by the black-dot variant in 100 (30.2%) patients. A significant proportion of the cases (16.6%) had the uncommonly reported seborrheic dermatitis or dandruff like pattern. Highly inflammatory kerion was encountered infrequently (2.5%). Seven species of dermatophytes were isolated; Trichophyton violaceum in 135 (41.5%), followed by Microsporum canis in 89 (27.4%), Microsporum audouinii in 48 (14.8%), Trichophyton mentagrophytes var. mentagrophytes in 31 (9.5%), Trichophyton verrucosum in 15 (4.6%), Trichophyton tonsurans in 6 (1.9%) and Microsporum gypseum in 1 (0.3%) patient. T. violaceum was the most common fungus responsible for the black-dot variety (89/100) and kerion (4/8) patients. Three cases of kerion (33.3%) grew T. verrucosum. M. canis was the most common species isolated from the 'gray patch' cases (79/163; 48.5%) followed by almost equal prevalences of T. violaceum (16.6%), M. audouinii (15.3%), and T. mentagrophytes var. mentagrophytes (12.3%). Among the seborrheic type of cases, M. audouinii was the most common fungus isolated in 20/54 (37%) followed by T. violaceum in 15 (27.8%), T. mentagrophytes var. mentagrophytes in 9 (16.7%), M. canis in 8 (14.8%) and T. verrucosum and T. tonsurans in one (0.3%) patient each. The results are significantly different from those in earlier studies in Kuwait.

Adolescent↗

PubMed2006

Impact of psoriasis on quality of life in Kuwait.

BACKGROUND: Psoriasis can seriously affect the quality of life (QOL) of patients and has a strong impact on social relations, psychological status and daily activities. OBJECTIVE: The aim of this study was to describe the impact of different grades of severity in psoriasis on QOL in patients in Kuwait. PATIENTS/METHODS: We used the Dermatology Quality Of Life scale (DQOLS) developed by Morgan and then validated for use in Kuwait to study a sample of 330 out-patients with psoriasis. RESULTS: Overall, physical activities were affected in greater than 50% of cases. This figure increased significantly with increased severity of psoriasis. Also, social relationships were disrupted in more than half of the patients but with no significant difference between different grades of severity. All psychological feeling items were affected by psoriasis to variable degrees. However, significant differences related to the severity of psoriasis were detected: feeling embarrassed, feeling short tempered, feeling depressed, and feeling a lack of hope. One third of cases declared their sexual activities were affected by psoriasis. CONCLUSION: Data provided should improve the physicians' awareness of the importance of patients' QOL and enhance psychological evaluation of the psoriatic patient which will promote his/her positive outcome and compliance with treatment.

Adult↗

PubMed1997

Prevalence of allergic sensitization to inhalant allergens among blood donors in Kuwait--a desert country.

Kuwait is a desert country where the prevailing high temperatures, low humidity, and scant vegetation suggest a low prevalence of allergy. We evaluated the prevalence of atopic sensitization (presence of allergen-specific IgE) among young adult blood donors by screening a total of 505 subjects (male: female ratio 1.6) with mean age of 28.4 years (range 18-50 years). The Pharmacia CAP-Phadiatop test, which detects serum IgE specific to most common airborne allergens, was used. Some of the specific sensitizing allergens were also identified by the related CAP-RAST method. Sensitization was detected in 223 of the 505 subjects (44.2%) screened. Kuwaiti nationals had a significantly higher prevalence rate (50.2%) than non-Kuwaitis (34.2%) (chi 2 = 8.6, P < 0.003). The highest prevalence rate was found among male Kuwaitis (53.8%). The prevalence of current or previous allergic disease (subject-reported) was 20.6%. Bermuda grass, house-dust mite (Dermatophagoides pteronyssinus), and Chenopodium album were the most prevalent sensitizing allergens, with frequencies of 53.6%, 52.7%, and 50.9%, respectively, among the sensitized subjects (corresponding to 23.7%, 23.3%, and 22.5%, respectively) for the entire population. Sensitization increased with age, but only among the expatriates, younger Kuwaitis being as frequently sensitized as the older ones. Polysensitization was found to be common. Of the 109 CAP-RAST-positive subjects, 71 (65.1%) were sensitized to more than one allergen, and 30 of these (42.3%) were sensitized to four or more allergens. These results show that atopy is highly prevalent among young adults in Kuwait, and the higher prevalence rate among nationals than expatriates suggests the involvement of genetic or local environmental factors. The results also confirm that mite and plant pollens may be major sensitizing allergens even in a desert environment.

Adolescent↗

PubMed1989

Distribution of keratinophilic fungi in desert soil of Kuwait.

Forty soil samples from different desert localities in Kuwait were surveyed for keratinophilic and geophilic dermatophytic fungi. Sixteen species classified in 9 genera were recovered on wool baits. Chrysosporium species were the most common fungi: Chr. tropicum (60%), Chr. pannicola (32.5%), Chr. queenslandicum (27.5%), Chr. keratinophilum (25%), Chr. indicum (20%) and the Chrysosporium anamorph of Arthroderma cuniculi. The second dominant genus was Malbranchea (27%) represented by two species; followed by Myceliophthora (10%). A number of cleistothecial keratinophilic species were also reported in restricted areas. Ctenomyces serratus Eidam and its Myceliophthora anamorph were new records to Kuwait. The frequency and distribution of these fungi have been discussed in relation to ecological conditions of desert soils.

Chrysosporium↗

PubMed2005

Vitamin D status of mothers and their neonates in Kuwait.

BACKGROUND: There has been a resurgence of nutritional rickets in children in many developing countries and some of the developed countries. Children between 6 and 18 months old are commonly affected. In order to find out the association between vitamin D and rickets we studied the vitamin D status of the neonates and their mothers in Kuwait. METHODS: Two hundred and fourteen full-term pregnant mothers and their neonates were selected from two hospitals in Kuwait. All mothers had normal vaginal delivery. On the day of delivery 2.5 mL of maternal blood and 2.5 mL of cord blood samples were withdrawn. Serum 25-hydroxyvitamin D (25OHD) was determined in duplicate by radioimmunoassay using an Incstar kit. Quality control analyses were done using several between and within run experiments. RESULTS: A total of 128 mother-neonate pairs were selected from the Al-Adan hospital and 86 from the Maternity Hospital. The mean age and parity of the mothers were similar in both hospitals. The mean (+/- SD) 25OHD levels of the mothers and the neonates in the Adan hospital were 13.3 (6.5) ng/mL and 8.2 (6.5) ng/mL, respectively. The corresponding values in the Maternity Hospital were 17.6 (12.4) and 8.1 (7.3) ng/mL for the mothers and the neonate, respectively. Serum 25OHD of the mothers and their newborn infants were highly correlated (r = 0.790, P < 0.001). CONCLUSIONS: Results demonstrate that 40% of the mothers and 60% of the neonates are vitamin D deficient on the day of delivery. The vitamin D of the mothers and neonates are highly correlated (r = 0.790, P < 0.001).

Adult↗