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PubMed2000

Searching for socioeconomic risk factors in perinatal mortality in Kuwait: a case control study.

The aim of this paper was to investigate whether socioeconomic factors such as parent's education, occupation, and income constitute risk factors in perinatal mortality after controlling for biological variables such as birth weight and length of gestation, and maternal factors such as age, parity and reproductive history. A case-control study covering all perinatal deaths in Kuwait was conducted for one year from 1 October, 1997 to 30 September, 1998. Each case (perinatal death) was matched with a control (live birth). Matching criteria were: father's nationality, place, and date of birth. Information was successfully collected on 463 matched pairs, 274 Kuwaitis and 189 non-Kuwaitis. Only singleton births were included in the analysis. Bivariate analysis showed that several of the socioeconomic variables (e.g. lower education, lower income) increased the risk of a perinatal death. However, none of these variables remained significant in the multivariate analysis in which birth weight and length of gestation emerged as the two major determinants of perinatal deaths among both nationality groups. Among the Kuwaitis, primiparity and high parity, and previous history of miscarriage were also significant risk factors. Among the non-Kuwaitis, none of the socioeconomic factors, or the maternal factors, were significant predictors of perinatal mortality. For Kuwaitis, it appears that the government's policies and programs aimed at reducing social inequalities in the society have been effective in eliminating perinatal mortality differences between socioeconomic groups. Among non-Kuwaitis, the lack of differences is reflective of the fact that this group is relatively homogenous and selective of the more affluent who can bring the family to Kuwait. Both nationality groups benefit from the government's free health services. However, charges for non-Kuwaitis are due to be levied soon which may increase disparities in access to health care.

Birth Weight↗

PubMed2003

Rapid vegetation regeneration in a seriously degraded Rhanterium epapposum community in northern Kuwait after 4 years of protection.

A study was carried out in northern Kuwait to investigate vegetation recovery in sandy depressions in the Sabriya oilfield ('Sabriya-IN'), 4 years after it was completely protected from livestock grazing and other anthropogenic activities which have largely depleted the dwarf shrub vegetation. This vegetation was compared with that in seriously overgrazed depressions outside the oilfield ('Sabriya-OUT'), where negative influences persist, and with a sandy site in central Kuwait which has been protected for over 20 years ('Sulaibiya'). There has been a striking recovery of the dwarf shrub vegetation in Sabriya-IN during the 4 years, with cover values of shrubs as high as at Sulaibiya. Rhanterium epapposum has been the main species to benefit from protection. However, the shrubs have not regenerated from seed, but rather from underground stumps that have probably remained in the soil for decades. Cover values of the annual flora at Sabriya-IN were very similar to those at Sulaibiya, and they were significantly higher than at Sabriya-OUT. However, it appears that some species may have disappeared or become extremely rare at Sabriya-IN when compared with Sulaibiya, as Sabriya-IN and Sabriya-OUT are remarkably similar floristically. Despite the impressive regeneration of the dwarf shrub vegetation at Sabriya-IN, which contradicts the view that vegetation recovery is a slow process in desert ecosystems, it is important to consider what the natural vegetation was in this part of the world. It is suggested that the region was once dominated by an open Acacia woodland, in which perennial grasses comprised most of the ground layer, and that the current dwarf shrub vegetation is a response to decades, if not centuries, of moderate to heavy grazing.

Animals↗

PubMed1978

Cancer of the naso-pharynx in Kuwait.

A clinico-pathological study of 143 cases of malignancy of the naso-pharynx diagnosed and treated at the E.N.T. and Radiotherapy Departments of Al-Sabah Hospital, Kuwait, between the years 1963 to 1974 inclusive is presented. The entire population of Kuwait is served and also a variable but small number of Nomads. During the years of the survey the population has been steadily increasing from about 500,000 in 1963 to about a million in 1974. It is composed of 45 per cent Kuwaitis of pure Arab stock and 55 per cent of immigrant workers, largely of Arabic origin. Cancer of naso-pharynx is the commonest of all head and neck cancers (18.3 per cent) and comprises 4.2 per cent of all malignancies. This is comparable with the 5.1 per cent in the Arab population of North Africa. The sex incidence is 2.2 Kuwaiti males and 0.8 females per 100,000; Non-Kuwaitis 2.0 male and 1.2 female per 100,000, giving an approximate ratio of 2.9 to 1 in both groups. The age distribution shows two peaks in male patients, Kuwaitis and Non-Kuwaitis in the 2nd decade (11.1 per cent) and fifth decade (28.8 per cent). In females, the graph shows a plateau pattern from the 3rd decade onwards. Cervical lymphadenopathy (83 per cent) was the commonest presenting symptom. The commonest histological finding was undifferentiated carcinoma and squamous cell carcinoma (28 per cent each). The hypotheses of the aetiology are reviewed.

Adolescent↗

PubMed2000

The prevalence and clonal diversity of penicillin-resistant Streptococcus pneumoniae in Kuwait.

Penicillin-resistant Streptococcus pneumoniae (PRSP) is widespread all over the world, including countries previously free of PRSP. This study was undertaken to determine the prevalence, the common serotypes and the clonality of PRSP isolated over a period of 1 year, from various clinical samples from three major hospitals in Kuwait. Strains were identified by standard methods and their antibiotic susceptibility was determined by the agar dilution method. The clonality of the isolates was determined by repetitive extragenic palindromic sequence polymerase chain reaction (REP-PCR) genomic profiling and pulsed field gel electrophoresis (PFGE). Serotyping was done by Quellung reaction using specific antisera. We found that 55% of the S. pnuemoniae were resistant to penicillin (46% and 9% exhibited intermediate and full resistance, respectively). Nearly 41% were resistant to sulfamethoxazole-trimethoprim, 9% to cefotaxime and ceftriaxone, 15% to amoxycillin-clavulanate, 17% to cefuroxime, 77 % to cefaclor, and 14% to clindamycin. The commonest serotypes among the PRSPs were 6A, 6B, 14, 19F, 23F and nontypable. PFGE and REP-PCR patterns showed a large diversity of genetic clones of the PRSP. Serotypes 6B, 14, 19F and 23F were more clonally related than the others. Our data showed that the prevalence of PRSP was high, the serotypes were diversified and different genetic clones make up the population of circulating PRSP in Kuwait.

DNA, Bacterial↗

PubMed1997

Nocardia asteroides in the soil of Kuwait.

A pilot study was undertaken to determine the occurrence and distribution of pathogenic nocardiae in Kuwaiti soil. A total of 102 soil samples collected from two localities were investigated by the paraffin bait technique. Nocardia asteroides was the only species isolated from 42 (41%) soil samples. None of the isolates fulfilled the criteria required for identification of N. farcinica or N. nova. Thirty one (73.8%) isolates showed equivalent growth at 45 degrees C and 35 degrees C, 17 (40.4%) isolates utilized acetamide for carbon and nitrogen requirements and 3 (7.1%) isolates showed delayed arylsulphatase activity. Only a solitary isolate was resistant to cefamandole. Soil samples originating from the Kuwait University Campus, Shuwaikh, which were rich in humus/organic matter, were more productive for N. asteroides (67%) than the samples which were devoid of it but were mixed with crude oil (39%). Sand samples that lacked organic matter and crude oil samples were least productive of N. asteroides. These preliminary findings do not suggest that massive oil contamination of soil in the Ahmadi oil field area during the Gulf war promoted the natural occurrence of N. asteroides. However, isolation of N. asteroides in as many as 41% of the soil sample is a significant observation warranting further epidemiologic studies including its possible role in the operation desert storm sickness syndrome. This is the first report on the natural occurrence of N. asteroides in Kuwait.

Fuel Oils↗

PubMed2001

Trace metal toxicity to phytoplankton of Kuwait coastal waters.

Trace metal concentrations in phytoplankton were determined in seven locations (Stations I-VII) of the Kuwait Coast, known for significant industrial and recreational activities. Trace metal concentrations in phytoplankton (20-200 microns size) occurred in the sequence of Zn > Pb > Cu > Ni at Stations I-III and VII, and Zn > Cu > Ni > Pb at Stations IV-VI. Station III showed higher concentrations of all the analyzed metals than at other stations. Toxicity tests to phytoplankton revealed a significant decrease in the rate of oxygen with increasing concentrations of trace metals. Further, such comparisons to station wise observations between the rate of oxygen evolution and trace metal levels revealed the nature of trace metal pollution in each station off the Kuwait coast.

Environmental Monitoring↗

PubMed2002

Measurements of 210Pb concentrations in airborne in Kuwait.

The concentrations of 210Pb in the atmosphere of Kuwait City have been monitored over a period of five years (January 1994 to December 1998) using cellulose air filters for analysis with liquid scintillation counting forgross beta. Results show that the distribution of daily averaged 210Pb concentrations varied from 0.002 to 2.53 mBqm(-3) with an average of 0.896 mBqm(-3) and a geometric mean of 0.687 mBqm(-3). The study suggests that the existence of 210Pb in air in Kuwait originates mainly from re-circulated fraction of 210Pb which was already deposited on ground surface, not from direct decay of radon. The long-term trend pattern for the five years shows a seasonal variation with maximum concentrations occurring in the autumn season.

Air Pollutants↗

PubMed2002

The prevalence and pattern of congenital anomalies of the urinary tract detected by intravenous urography in Kuwait.

We conducted a prospective population-based study in Kuwait to determine the prevalence and pattern of previously undiagnosed congenital anomalies of urinary tract in patients undergoing intravenous urography (IVU) and to examine the demographic factors associated with these anomalies. The study included 2398 consecutive patients undergoing IVU, for various indications, in all the six public hospitals in Kuwait, during the period 1 June 1999-30 September 2000. Patients were also interviewed to obtain selected demographic information. Multiple logistic regression was used to identify factors associated with the anomalies. The average age (+/- SD) of the patients (1623 males, 775 females) was 39.2 +/- 15.1 years. A total of 335 anomalies (12.1% in males, 17.9% in females; p < 0.001) were detected in 300 (12.5%) patients (10.9% males, 15.9% females; p < 0.01). About half (47.2%) of the anomalies involved the kidney, 28.4% renal pelvis, 22.4% ureters, and 2.1% bladder. Multiple regression analysis showed that age < 20 years (odds ratio (OR) = 12.5; 95% confidence interval (95% CI): 7.0-22.3) female gender (OR = 1.5; 95% CI: 1.2-2.0) Kuwaiti nationality (OR = 1.7; 95% CI: 1.2-2.3) and family history of congenital malformation (OR = 3.8; 95% CI: 2.2-6.6) were independently associated with the anomalies of the urinary tract. Overall, 42% of the patients reported a consanguineous marriage between their parents. The frequency of anomalies was higher in individuals who had consanguineous parents (13.8 vs. 11.6%; OR = 1.2) but this positive association did not reach statistical significance. Considering the relatively high prevalence of previously undiagnosed congenital anomalies of the urinary tract, it is important to establish clinical guidelines for early detection and management of these conditions to decrease the associated morbidity and mortality.

Adult↗

PubMed2003

HHV-6 DNAaemia in patients with multiple sclerosis in Kuwait.

OBJECTIVE: To study the presence of active human herpesvirus type-6 (HHV-6) infection indicated by the presence of HHV-6 DNA in serum (DNAaemia) in patients suffering from multiple sclerosis (MS) in Kuwait. MATERIAL AND METHODS: Sera from 24 patients with MS (18 relapsing-remitting, six secondary progressive disease), control sera from 13 patients suffering from other neurological diseases and sera from 20 healthy volunteers were examined for the presence of HHV-6 DNA by nested polymerase chain reaction (PCR) test. RESULTS: None of the MS patients, nor patient controls were positive for HHV-6 DNAaemia while, one of the normal healthy controls was positive for HHV-6 DNAaemia. CONCLUSION: HHV-6 DNAaemia, indicating active HHV-6 infection could not be demonstrated in a sample of Kuwaiti patients suffering from active clinically definite MS. There is no evidence to incriminate this virus in the pathogenesis of MS in Kuwait.

Adult↗

PubMed2000

Risk factors for nutritional rickets among children in Kuwait.

AIM: To assess the risk factors for nutritional rickets among children in Kuwait. METHODS: One hundred and three children with rickets and 102 control children matched for age and socioethnic characteristics were recruited over a 2 year period (January 1995 to January 1997) in Al-Adan Hospital in Kuwait. Diagnosis was made on clinical, radiologic and biochemical parameters. A specially designed questionnaire was administered by one of the investigators to both mothers of patients and mothers of control subjects to assess the role of social, nutritional and other related factors in the pathogenesis of nutritional rickets. Biochemical investigations included estimation of hemoglobin, serum calcium, serum phosphorus, serum alkaline phosphatase and serum 25-hydroxy vitamin D. RESULTS: The mean birthweights of rickets patients and control subjects were 3.20 +/- 0.46 and 3.19 +/- 0.45 kg, respectively. At the time of diagnosis, bodyweights of the patients and controls were 9.36 +/- 1.50 and 10.15 +/- 2.10 kg, respectively. Heights at the time of diagnosis were 73.58 and 77.24 cm for the patients and the controls, respectively. Mean hemoglobin, serum calcium and serum phosphate were significantly lower in the patients compared with the controls. Alkaline phosphatase was higher among the patients (P < 0.0001). The mean serum 25-hydroxy vitamin D level of the patients was 26.5 nmol/L, compared with 83.5 nmol/L in the controls. The mean age of starting semisolid feeds for the patients was 8.12 months, compared with 5.7 months in the controls. The nutritional quality of semisolid feeds was adequate among 71.6% of the controls as opposed to 13.6% of the patients. CONCLUSION: Nutritional rickets is a multifactorial condition. However, several factors seem to make important contributions. Among these, lack of exposure to sunlight, prolonged breast feeding without supplementation and inadequate weaning practices are important. Maternal education is important as it can influence all of the above factors.

Breast Feeding↗

PubMed2006

Consumption of sugar products and associated life- and school-satisfaction and self-esteem factors among schoolchildren in Kuwait.

OBJECTIVE: The objective of this study was to assess how frequently schoolchildren report consuming sweets, soft drinks, and cakes, and whether life- and school-satisfaction and self-esteem factors are associated with the consumption of these sugar products. MATERIAL AND METHODS: A total of 2,312 schoolchildren between the ages of 11 and 13 years from the government schools in Kuwait completed an anonymous structured questionnaire during 2002 and 2003. A representative sample of children from all six governorates of the country was drawn into the study. The questionnaire of the Health Behaviour in School-Aged Children (HBSC) survey was translated from English to Arabic and was used after modification to suit Kuwaitis. The chi-square test and logistic regression model were used in the analysis. RESULTS: A large proportion of children reported consuming sweets (42%), soft drinks (43%), and cakes (31%) several times a day. Almost every fourth child reported consuming all these sugar products more than once a day. All life-satisfaction and self-esteem variables and almost all school-satisfaction variables seemed to associate with more-than-once-a-day consumption of sugar products. When all the associated variables were analyzed together using the logistic regression model, the life- and school-satisfaction and self-esteem factors seemed to have a stronger association with frequent sugar consumption than did gender, grade, or nationality. CONCLUSIONS: Consumption of sugar products was common among schoolchildren in Kuwait, and both positive and negative life-satisfaction and self-esteem factors were associated.

Adolescent↗

PubMed1983

The epidemiology of cutaneous leishmaniasis in Kuwait.

Studies in Kuwait have suggested that sandflies feed on man and domestic animals, but not on rodents in different habitats. Of 1129 feral and wild rodents, none showed evidence of leishmanial infection nor did their incidental lesions resemble those produced by inoculating a human strain. Five out of 30 patients with lesions of cutaneous leishmaniasis claimed they had never been outside the country, but the validity of these claims is questioned. Cutaneous leishmaniasis in Kuwait is essentially an imported disease, with no substantial evidence that it is yet endemic.

Adolescent↗

PubMed2001

Aflatoxin M1 contamination in commercial samples of milk and dairy products in Kuwait.

As part of the programme on monitoring of environmental contaminants in food stuff in Kuwait, 54 samples of fresh full cream and skimmed milk, powdered milk, yoghurt, and infant formula were analysed for aflatoxin M1 (AFM1) by HPLC following sample clean up using immuno-affinity columns. Of samples, 28% were contaminated with AFM1 with 6% being above the maximum permissible limit of 0.2 microgl(-1). Three fresh cow milk samples collected from a private local producer showed the highest level of 0.21 microg l(-1) AFM1. There was no contamination with AFM1 in powdered milk and infant formulas. These results show the necessity of a survey involving a larger number of milk and its products and suggest that presently the contamination of milk and milk products with AFM1 does not appear to be a serious health problem in Kuwait. Nevertheless, a continuous surveillance programme may be warranted to monitor regularly the occurrence of aflatoxins in the animal feeds responsible for current limited contamination and to note rapidly and worsening in the situation that may depend on market changes or on unfavourable climatic developments.

Aflatoxin M1↗

PubMed2006

Estimates of dietary exposure of children to artificial food colours in Kuwait.

To assess the intake of artificial food colour additives by 5-14-year-old children in the State of Kuwait, a 24-h dietary recall was conducted twice on 3141 male and female Kuwaiti and non-Kuwaiti children from 58 schools. The determination of colour additives in 344 foods items consumed was performed using high-performance liquid chromatography with diode array detector. A comparison with the Food and Agriculture Organization and World Health Organization acceptable daily intakes (ADIs) was undertaken to evaluate the potential risk associated with the consumption of artificial colour additives by children in Kuwait. The results indicated that out of nine permitted colours, four exceeded their ADIs by factors of 2-8: tartrazine, sunset yellow, carmoisine and allura red. Further, follow-up studies to provide insight into potential adverse health effects associated with the high intakes of these artificial colour additives on the test population are warranted.

Adolescent↗

PubMed1981

Acute rheumatic fever during childhood in Kuwait: the mild nature of the initial attack.

A prospective clinical study is reported of the initial attack of acute rheumatic fever in 210 children seen in Kuwait over a period of four years. The main presenting feature was pain in the joints, caused by arthritis in 79% of our patients and by arthralgia in 15%. Five per cent presented with chorea alone and 1% with congestive heart failure alone. Carditis was detected in 46.2%, cardiomegaly in 10%, pericarditis in 1.4% and congestive heart failure in 4.8%. The incidence of chorea was 7.6%, of erythema marginatum 1% and of subcutaneous nodules 0.5%. The mortality rate was 0.5%. Data from this study reflect the mild nature of acute rheumatic fever in Kuwait, in contrast to the aggressive nature of the disease described from neighbouring and developing countries.

Acute Disease↗

PubMed1989

Vitamin-D-deficiency rickets in Kuwait: the prevalence of a preventable disease.

Two hundred and fifty children with clinical, biochemical and radiological evidence of vitamin-D-deficiency rickets were studied over a period of 5 years. Their ages ranged from 1 month to 2 years. Breastfed infants formed 63% of total cases. Intramuscular therapy with vitamin D in a dose of 600,000 IU, deep intramuscular, proved to be safe and effective. In contrast, oral vitamin D did not provide such satisfactory results, presumably owing to poor patient/parental compliance. This report reveals that vitamin-D-deficieny rickets is common in Kuwait in spite of abundant sunlight all through the year because children are wrapped up and kept indoors. Insufficient intake of vitamin D is another important factor in the pathogenesis of vitamin-D-deficiency rickets in Kuwait.

Child, Preschool↗

PubMedDate not supplied

Post-war changes in the outcome of pregnancy in Maternity Hospital, Kuwait.

To analyse the pre- and post-Gulf War changes in the outcome of pregnancy and to explore the possible causes that could have affected these changes, a retrospective analysis of medical records of patients delivering in Maternity Hospital Kuwait (MHK) was carried out for the period 1987-89 (pre-Gulf-War) and 1992 (post-Gulf War). The records of 1991 were used when adequate information was available. The normal z test was used to assess the significance between two proportions. There is a significant rise in abortion, low birth weight babies, triplet pregnancies, and major congenital anomalies in the post-war period. The still-birth rate, early neonatal mortality rate and perinatal mortality rate significantly increased in the immediate post-war period in 1991, but decreased to levels below the pre-war period in 1992. It should be investigated whether these changes are secondary to the changes in the population structure; the effects of war in terms of deterioration of health care services; environmental pollution caused by oil well fires, oil spills; or the psychological trauma, anxiety and stress caused by the Iraqi invasion of Kuwait.

Female↗

PubMedDate not supplied

Post-invasion change in the trend of complications and outcome of pregnancy in Maternity Hospital Kuwait from 1981 to 1995.

To assess the trend in the complications and outcome of pregnancy in Maternity Hospital, Kuwait, a retrospective analysis of yearly hospital statistics books and labour ward records of patients delivering in Maternity Hospital Kuwait was carried out for the period 1981 to 1995. In the post-invasion period there is a significant rise in: primiparity; mothers aged 35 years or older; Kuwaiti mothers; and in multiple pregnancy. The incidence of pregnancy-induced hypertension, pre-eclampsia, and hysterectomy for postpartum haemorrhage also increased. There was a significant increase in spontaneous abortions and low birth weight babies. The incidence of hydatidiform mole has significantly decreased. Still birth rate shows a decreasing trend in the study period. The significant change in the age and parity of the mothers delivering in the post-invasion period might partly explain the above changes. However, the effect of environmental pollution, social and psychological stress, and anxiety due to war may have also contributed to an increase in the complications and adverse outcomes of pregnancy.

Adolescent↗