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PubMed2006

Characterisation of non-multiresistant methicillin-resistant Staphylococcus aureus (including EMRSA-15) in Kuwait Hospitals.

This study characterised non-multiresistant methicillin-resistant Staphylococcus aureus (nmMRSA) isolates from Kuwait hospitals to ascertain whether they were community-acquired MRSA (CA-MRSA). Forty-two nmMRSA isolates obtained between July 2001 and October 2003 were analysed by staphylococcal cassette chromosome mec (SCCmec) typing, bacteriophage typing, production of Panton-Valentine leukocidin (PVL), urease and staphylococcal enterotoxins A, B, C and D, TSST-1, and by pulsed-field gel electrophoresis (PFGE). Forty-one isolates were SCCmec type IV, and one isolate was SCCmec type III. The isolates belonged to six PFGE patterns, with two types, A and D, distributed in six and four hospitals, respectively. Most (n = 26; 61.9%) isolates produced urease. These isolates were mainly from wound and skin infections, showed low-level methicillin resistance (MIC 8-48 mg/L), and nine carried genes for PVL. These characteristics, together with their carriage of the type-IV SCCmec, identified the isolates as CA-MRSA. Ten of the 16 urease-negative isolates produced staphylococal enterotoxin C; 12 reacted weakly with phage 75, and were resistant to clindamycin and/or erythromycin, which are characteristics of EMRSA-15. Thus, this study identified the co-existence of two types of nmMRSA, i.e., CA-MRSA and EMRSA-15, in Kuwait hospitals.

Anti-Bacterial Agents↗

PubMed1996

Eclampsia in Kuwait 1981-1993.

The aim of this study is to investigate the maternal and fetal outcome and the risk factors for developing eclampsia in Kuwait. The study includes all patients with eclampsia observed at the Maternity Hospital, Kuwait during the period from 1981 to 1993. It revealed that the risk factors predisposing to eclampsia were primiparity, a maternal age below 30 years, multiple pregnancy and the presence of preeclampsia. The pregnancy outcome in terms of the stillbirth rate, neonatal death rate and low birth-weight babies was significantly higher in mothers with eclampsia than in noneclamptic mothers. The operative delivery and maternal mortality rates were also significantly higher in these patients.

Birth Weight↗

PubMed2005

Prevalence of viral markers among first-time Arab blood donors in Kuwait.

BACKGROUND: The aim of this study was to assess the effect of blood donation modes on the prevalence of viral markers among Arab first-time blood donors in Kuwait. STUDY DESIGN AND METHODS: Donor ethnic background was classified as Kuwaiti nationals and non-Kuwaiti Arabs. A total of 26,874 donors were screened in 2002 for the following viral markers: hepatitis C virus antibody (anti-HCV), hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc), human immunodeficiency virus-1 and -2 antibody (anti-HIV-1 and -2), HIV p24, and human T lymphotropic virus-I and -II antibody (anti-HTLVI/II). All samples positive for the presence of anti-HBc were tested for anti-HBs. Among these donors, 12,798 were first-time donors of which 74 percent were replacement and 26 percent were volunteers. RESULTS: The prevalence of HCV among replacement donors was significantly higher than the volunteer group. The difference between the two modes of blood donations, however, was not significant for HBsAg. The prevalence of anti-HCV among Kuwaiti national and non-Kuwaiti Arab first-time donors was 0.8 and 5.4 percent, respectively, whereas the prevalence of HBsAg was 1.1 and 3.5 percent, respectively, with the difference being significant at a p level of <0.0001. The difference observed for prevalence of anti-HBc among Kuwaiti national and non-Kuwaiti Arab donors (17 and 33.3%, respectively) was significant (p < 0.0001). Among first-time donors, 13.7 percent were positive for the presence of anti-HBs, indicating that 13.7 percent of the total Arab donor population might have had a previous infection and possible immunity to hepatitis B virus (HBV). CONCLUSION: A high prevalence of HBV and HCV was found among non-Kuwaiti Arab donors. The prevalence of anti-HCV was only significantly higher among replacement versus volunteer first-time donors. Therefore, there is a need to develop a strategic plan that incorporates the diverse background of the blood donors living in Kuwait.

Adult↗

PubMed2002

Hantavirus-specific antibodies in rodents and humans living in Kuwait.

Hantaviruses are found in widely scattered areas of the world and are transmitted by inhalation of virus-contaminated aerosols of rodent excreta. The present study was undertaken in Kuwait to investigate the serological evidence for hantavirus infection in rodents and humans. Sera were collected from 283 wild rodents and 183 human subjects (46 Kuwaitis and 137 non-Kuwaitis). The rodent sera were investigated for the presence of antibodies against the Seoul and Puumala strains of the hantaviruses by enzyme-linked immunosorbent assay and immunofluorescence technique using the virus-infected Vero E6 cells. The findings showed the presence of anti-hantavirus antibodies in seven out of the 283 (2.8%) rodents. Antibodies against the Seoul strain were present in six (2.1%) and against the Puumala strain in three (1%) rodents. Further, it was observed that three out of 84 (3.6%) of the Rattus norvegicus and four out of 174 (2.3%) Mus musculus had anti-hantavirus antibodies. Two rodents belonging to species Mus musculus had antibodies against both strains of the hantaviruses. Out of 183 human sera, 13 (7%) were positive for hantavirus antibodies. Among the Kuwaitis 5/46 (11%) and among the non-Kuwaitis 8/137 (6%) were positive for the hantavirus antibodies. Antibodies to both Puumala and Hantaan strains were detected in Kuwaitis as well as in non-Kuwaitis. Although no human case of hantavirus illness has yet been reported in Kuwait, the serological evidence of infection suggests a constant vigil.

Adult↗

PubMed1989

The serotype distribution of Campylobacter in patients with diarrhoea in Kuwait.

Fifty one strains of Campylobacter jejuni/coli isolated from patients with diarrhoea, at the Amiri Hospital, Hawally, Kuwait were classified on the basis of the heatstable-HS-antigens and the heat-labile-HL-antigens, by using 20 and 23 hyperimmune antisera for the two methods, respectively. The ages of the patient ranged from 3 months to 60 years, and 72.6% of the strains were from children less than 4 years. With the number of antisera used 78.4% of the HS antigens and 96.1% of the HL antigens could be identified. About half of the strains had one of five HS antigens (4, 8, 13, 5 or 25) and 70.5% of the strains had one of five HL antigens (1, 36, 2, 6, or 21). The study shows that the most common HS and HL antigens among Campylobacter strains from Kuwait also are the most frequent antigens of strains from other parts of the world. A limited number of antisera are sufficient to identify the majority of the strains.

Adolescent↗

PubMed1981

Some behavioural and psychological aspects of alcohol and drug dependence in Kuwait Psychiatric Hospital.

Seventy Kuwait alcohol and drug-dependent inpatients at Kuwait Psychiatric Hospital were compared with a matched group of 40 abstinent inpatients on a surgical ward in a general hospital in order to find out the drugs abused, pattern of consumption, the effect of prohibition and sanctions, motives, personality type, social complications, religious attitudes and family history. The majority abused alcohol (62%) followed by hypnotics. The reason most frequently stated for starting consumption was to relieve boredom (39%). Gamma type drinking was prominent at an early stage. The addicts showed a greater proportion of abnormal personalities. Prohibition and sanction had little effect but led to a shift to more toxic substances. The most common legal involvement was driving offenses. Compared with the control group there was higher marital instability and a higher incidence of alcohol and/or drug addicts in the families of the experimental group, and they were also less religious. The role of cultural and religious factors is discussed in detail.

Adult↗

PubMed2005

Self-reported oral health, oral hygiene habits, and dental attendance of pregnant women in Kuwait.

OBJECTIVES: The aim of this study was to describe self-reported oral health, oral hygiene habits, and frequency of visits to a dentist among pregnant women in Kuwait. MATERIAL AND METHODS: A cross-sectional study with an anonymous structured questionnaire was distributed among 650 pregnant women during May-June 2003, when they were admitted to the maternity ward at the largest government maternity hospital in Kuwait City. The response rate was 93% (n=603). RESULTS: Every fourth respondent was in her first pregnancy, while 36% already had three or more children. Every fifth woman felt that her oral health was poor, and one-third of the women believed that they had periodontal problems currently. About two-thirds of the women were brushing more than once a day and almost all (94%) at least once a day. Over the previous 6 months, 40% had experienced dental pain. Half of the women had visited a dentist during pregnancy, mostly for dental pain. Most of the women had received no instructions concerning oral health care during their pregnancy. CONCLUSIONS: A large proportion of the pregnant women in this study had oral health problems; however, half of the women had not seen a dentist during their pregnancy.

Adolescent↗

PubMedDate not supplied

Malocclusions and traumatic injuries in disabled schoolchildren and adolescents in Kuwait.

The present study was carried out to determine the prevalence of malocclusion and traumatic injuries in disabled children and adolescents attending the special-needs schools in Kuwait. Included in the study were 818 children (438 males and 380 females), in the age groups of 3-20 years, who have visual impairment, hearing impairment, physical handicaps, or developmental disorders. The mean age of participants was 11.9 years. The survey was carried out according to the methods of WHO. The prevalence of severe malocclusion was 23.6%, and that of slight malocclusion was 37.0%. Children with Down syndrome (OR = 2.3; 95% CI = 1.51-3.52), those of increasing age (OR = 1.1; 95% CI = 1.01-1.10), and males (OR = 1.5; 95% CI = 1.05-2.07) had higher risk for the occurrence of severe malocclusion. Less than one-fifth of the subjects (16.9%) had traumatized anterior teeth. Severe malocclusion (OR = 1.8; 95% CI = 1.17-2.77) and increasing age (OR = 1.2; 95% CI = 1.13-1.26) were significant risk factors for the occurrence of traumatic injuries. We concluded that malocclusion and traumatic injuries are more prevalent among these subjects with disabilities than among the healthy population in Kuwait.

Adolescent↗

PubMed2004

Oral health in Kuwait.

This paper reviews oral health in Kuwait, based on all the surveys conducted in the country. In the global perspective, the prevalence of dental caries in Kuwait is high and there is no indication of a decrease, contrary to that observed in most industrialised countries. The periodontal diseases are common, affecting the majority of the population. Oral health promotion needs to be strengthened and a defined strategy should be developed and implemented for the improvement of the quality of life of individuals. Children and disadvantaged groups of the population should be given the priority when focusing on national oral health care efforts.

Adolescent↗

PubMed2004

Community based schoolchildren's oral health programmes, Kuwait 1985--1998.

AIM: To describe the development of children's oral health programmes in Kuwait and present selected results and expected outcomes based on specific markers. To provide a basis for choosing best outcomes to develop public health policy and implement future programmes. METHOD: Assessment of the health, structural, cost and benefit changes in the oral health sector that resulted from policy decisions and implementation through different approaches in the period 1986--1998. RESULTS: Analysis has provided a basis for selection of appropriate methodologies to be implemented in the country. CONCLUSIONS: The regional programme consisting of full immediate prevention coverage with fluoride lozenges, periodic fluoride rinses, multi-operator care teams, flexible and moveable equipment appears to have provided the best potential within the Kuwait context during this period.

Child↗

PubMed2001

Calcium pyrophosphatase dihydrate (CPPD) crystal deposition disease in a teaching hospital in Kuwait.

OBJECTIVE: A Medline electronic search showed a paucity of reports on calcium pyrophosphate dihydrate crystal deposition disease (CPPD-CDD) from the Gulf region. To date only a single case report has been published from this region. Therefore, this study aimed, firstly, at finding out the prevalence of chondrocalcinosis in adult Arabs in Kuwait presenting with knee arthritis and, secondly, at carrying out an observational study of CPPD-CDD among Arabs in Kuwait. METHODS: For the study of the prevalence of chondrocalcinosis 100 consecutive adult patients presenting with knee arthritis were radiologically examined. For the observational study the clinical, laboratory, and radiological findings were analysed in patients with CPPD-CDD seen over a period of five years. RESULTS: This study showed the presence of chondrocalcinosis in two (2%) of the 100 adult Kuwaiti and other Middle-Eastern Arab patients (70 men, 30 women, median age 50 (range 45-80)) who presented to the rheumatology clinic for the evaluation of knee pain. When the younger age of the group (only three patients aged >70) is taken into account the figure was comparable with that reported from Western countries. Over a period of five years a total of 2726 new patients were evaluated at the rheumatology clinic of this institution. A diagnosis of crystal arthritis was made in 85 patients (3%). Fourteen of these 85 (that is, 16.5%, but 0.5% of the total cases) were diagnosed with definite (eight patients) or probable (six patients) CPPD-CDD. Different clinical presentations, including that of acute monarthritis (that is, pseudogout), premature generalised osteoarthritis, and polyarticular rheumatoid-like presentations, were seen in different patients. Overlap with true gout, with the additional presence of monosodium urate crystals in the joint aspirate, was seen in two patients. CONCLUSION: The present report shows that CPPD-CDD may not be uncommon among Arabs in the Gulf region. A high degree of clinical awareness and routine examination of joint aspirates with careful analysis for crystals may make it a more common diagnosis in this part of the world. In this regard it is interesting to note that cases and case series including familial cases have been reported from North Africa, especially Tunisia, indicating that the disease has been well described in Arabs of other geographical regions.

Adult↗

PubMed1984

Patterns of chronic liver disease in Kuwait with special reference to localisation of hepatitis B surface antigen.

Two hundred and fifty six consecutive liver biopsy specimens (without secondary malignancy) collected over five years were reviewed to characterise the pattern of liver diseases encountered in the Kuwait region. A relatively high proportion of chronic active hepatitis (19%) and cirrhosis (40%) was found. Localisation of HBsAg was carried out by the histochemical orcein method and the immunohistological peroxidase-antiperoxidase (PAP) procedure. The PAP technique was superior to orcein both in quality and quantity in addition to its specificity. Three immunohistological staining patterns were observed: diffuse pancytoplasmic , partial perinuclear, and peripheral cytoplasmic. The positivity rate of HBsAg in chronic hepatitis was 29% and 27%, in all cases of cirrhosis. The results of immunohistology and serology of HBsAg were compared in 52 patients in whom both tests were carried out; almost one third of chronic active liver diseases were positive by both methods. Our data clearly show the sensitivity of immunohistology and its value in detecting HBsAg, especially in retrospective studies where serology is not always available. Additionally, the data show that hepatitis B infection is often associated with the development of chronic liver disease in Kuwait.

Chronic Disease↗

PubMed1986

Multiple sclerosis in Kuwait: clinical and epidemiological study.

Eighty-nine cases of multiple sclerosis (70 Arabs) are reported from Kuwait. The prevalence is estimated to be 8.33 per 100,000 (age and sex adjusted to USA population). Kuwait thus emerges to be in the medium risk zone. No differences were found in the age of onset, clinical pattern and disability from the disease found in Europeans and North Americans.

Adolescent↗

PubMedDate not supplied

Glucose-6-phosphate dehydrogenase deficiency in Kuwait, Syria, Egypt, Iran, Jordan and Lebanon.

A total of 3,501 male subjects from six Arab countries living in Kuwait were investigated for quantitative and phenotypic distribution of red cell glucose-6-phosphate dehydrogenase (G6PD). The ethnic origins of those investigated were Kuwait, Egypt, Iran, Syria, Lebanon and Jordan. The distribution of G6PD deficiency among the different ethnic groups varied widely, ranging from 1.00% for Egyptians to 11.55% for Iranians. The activity of the normal enzyme was remarkably similar, with values ranging from 6.1 +/- 0.8 to 6.5 +/- 1.1 IU/g Hb. A low frequency of the Gd(A) allele was found in two ethnic groups, Egyptians (0.019) and Iranians (0.014). Gd(A-) was present at the very low frequency of 0.006 in another two ethnic groups, Kuwaitis and Jordanians.

Adolescent↗

PubMedDate not supplied

Hospital-acquired Clostridium difficile infection amongst ICU and burn patients in Kuwait.

OBJECTIVES: To prospectively study the prevalence of nosocomially acquired Clostridium difficile, a major cause of diarrhoea in hospitalized patients, in the intensive care units (ICUs) and burn unit (BUs) of three teaching hospitals in Kuwait. METHODS: During a 1-year prospective study, stool/rectal swabs were obtained from 344 patients admitted into the ICUs of Mubarak Hospital (ICU-1), the Kuwait Cancer Control Centre (ICU-2), and the BU of Ibn Sina Hospital. The presence of C. difficile and/or its toxin was detected by serially culturing the specimens on differential, selective and enriched media and the use of TOX-A/B test, on admission and at subsequent 1-weekly interval until discharge. RESULTS: Out of the 344 patients admitted into these units, over a study period of 1 year, only 263 (77%) were evaluable. All of them had negative stool culture/toxin on admission. Overall, 25 (9.5%) of these 263 patients acquired C. difficile during their hospitalization. Thirteen (7%) of 187 patients acquired C. difficile in ICU-1, 9 (36%) of 25 on ICU-2 and 3 (5.9%) of 51 patients in BU. Eight (32%) developed diarrhoea attributable only to C. difficile and/or toxin, and the remaining 17 (68%) were asymptomatic: none had pseudomembranous colitis. The diarrhoea in these patients was associated with antibiotic use, the main trigger-antibiotics being the third-generation cephalosporins. Acquisition occurred within 4-53 days of admission, with the majority occurring in the first 15 days. CONCLUSION: Overall, the prevalence of hospital-acquired C. difficile infection/colonization was less than 10%. The use of third-generation cephalosporins was high and was related to the development of diarrhoea. Once acquired, diarrhoea developed in about one third of C. difficile-positive cases, an indication that C. difficile infection/colonization endemic in the hospital ICUs studied is usually transmitted among the hospitalized patients.

Adolescent↗

PubMedDate not supplied

Hemoglobin electrophoresis and hemoglobinopathies in Kuwait.

OBJECTIVES: To analyze the results of hemoglobin electrophoresis (HE) in the routine laboratory of a tertiary hospital in Kuwait and to review the common types of hemoglobinopathies prevalent in the country. METHODS: This was a prospective study of HE performed on 2,386 samples in Mubarak Al-Kabeer Hospital, which serves more than 30% of the population of Kuwait, from June 1997 to May 1998. RESULTS: Of the 2,386 HE tests, only 561 (23.5%) had abnormal hemoglobin genotypes. The most commonly identified hemoglobinopathies were beta-thalassemia minor (14%), sickle cell trait (6%), sickle cell anemia (0.9%), S beta zero thal (0.8%) and S beta + thal (0.8%). Two rare hemoglobin variants, Hb DPunjab and Hb E, were encountered. CONCLUSION: HE yielded only 23.5% abnormal results, thus indicating the need to streamline requests for the test. The test should be limited to patients with hematological and clinical features suggestive of hemoglobinopathies or to individuals with a positive family history.

Electrophoresis↗

PubMed2002

Oral health in Kuwait before the Gulf War.

OBJECTIVE: The aim of this oral health survey was to determine the oral health status and oral health behavior in the whole population in Kuwait. This survey was part of the Kuwait Health Survey, which was conducted by the Ministry of Public Health. The original data were destroyed during the Gulf War (1990/1991), but the aim of this report is to publish the main findings concerning oral health and related factors. METHODOLOGY: The data were collected between April 1984 and April 1985. The sample consisted of 3,358 households and 26,530 individuals. The survey consisted of interviews and clinical examinations (> 12-year-olds). WHO (1977) criteria were used for examinations. RESULTS: Females were more often brushing their teeth at least once a day than males and non-Kuwaitis slightly more often than Kuwaitis. Over one third (39%) had visited a dentist during the previous 12 months. The proportion of subjects with soft deposit was 66%, calculus 45%, intensive gingivitis 46% and advanced periodontitis 18%. The caries experience was prevalent (52%) in primary dentition (< 8-year-olds) and in permanent dentition, highest (95%) among the 60- to 64-year-olds. CONCLUSION: Preventive programs for periodontal diseases and for dental caries are urgently needed. The coverage of curative care of both diseases also needs to be improved. Health behavior improvement should be targeted by oral health promotion activities.

Adolescent↗

PubMedDate not supplied

Patient characteristics and practice patterns in the treatment of acute myocardial infarction in Kuwait: a pilot study.

OBJECTIVES: To determine the characteristics, management and outcomes of patients with acute myocardial infarction (AMI) admitted to the general hospitals and to assess the feasibility of establishing a registry for AMI in Kuwait. SUBJECTS AND METHODS: We prospectively included 111 consecutive patients (94 males and 17 females, mean age 55 years) admitted to the coronary care units of the five participating hospitals during May 2000. The subjects all had a final diagnosis of AMI. A structured data collection form that included biochemical measurements was filled out for each patient. RESULTS: The prevalence of hypercholesterolemia, diabetes, hypertension and current smoking was 46, 45, 30 and 49%, respectively. Fifty-four of 57 patients who were eligible for thrombolytic therapy received treatment. The median time from symptom onset to thrombolytic therapy was 180 min. At discharge 93% were prescribed aspirin, 81% beta-blockers, 40% angiotensin-converting enzyme inhibitors, and 32% lipid-lowering drugs. The in-hospital mortality was 10%. CONCLUSIONS: The incidence of smoking, diabetes and hypercholesterolemia is high among our patients. Thrombolytic therapy is used regularly but insufficiently early. Based on this pilot study, it is feasible to establish an AMI registry in Kuwait.

Adrenergic beta-Antagonists↗