- [Show abstract] [Hide abstract] ABSTRACT: To provide community-based information on the prevalence of diabetes, hypertension and heart disease and to highlight their significant correlates. Data were collected in a cross-sectional household survey of 2,487 Kuwaiti nationals aged 50 and over in 2005/2006. A proportionately representative sample of 1,451 respondents from a relatively more urban area (Capital) and 1,036 respondents from a relatively less urban area (Ahmadi) were interviewed. A proxy respondent was used in 5.4% of cases. Among the 2,605 potentially eligible persons approached, 2,487 (95.5%) participated. Doctor-diagnosed prevalences of hypertension, diabetes and heart disease in the two governorates were reported to be 53.4, 50.6 and 17.5%, respectively. If the prevalence in the two governorates is reflective of the nation, a remarkable increase seems to have occurred since 1996. The prevalence of each of the three diseases increased linearly by age among both sexes. Comorbidity of the three diseases increased from 3.6 to 9.4 and to 20.9% among those aged 50-59, 60-69 and > or =70 years, respectively. Logistic regression showed the prevalence of chronic illnesses to be significantly higher among persons who were older, retired, non-Bedouin, less educated, had higher income, were less socially active, were obese and had poorer exercise behavior. The prevalence of diabetes and heart disease was significantly lower among women than men. Judging from data on two governorates, the prevalence of diabetes, hypertension and heart disease is likely to have increased to alarmingly high levels among older Kuwaitis, highlighting the need for focused intervention programs in order to reduce morbidity and increase healthy life years.
- [Show abstract] [Hide abstract] ABSTRACT: We have examined the male-specific phylogeography of the Levant and its surroundings by analyzing Y-chromosomal haplogroup distributions using 5874 samples (885 new) from 23 countries. The diversity within some of these haplogroups was also examined. The Levantine populations showed clustering in SNP and STR analyses when considered against a broad Middle-East and North African background. However, we also found a coastal-inland, east-west pattern of diversity and frequency distribution in several haplogroups within the small region of the Levant. Since estimates of effective population size are similar in the two regions, this strong pattern is likely to have arisen mainly from differential migrations, with different lineages introduced from the east and west.
- [Show abstract] [Hide abstract] ABSTRACT: Oral contraceptive pills (OCPs) are available over-the-counter (OTC) in Kuwait, and constitute a leading method for spacing and limiting children. Data from a nationally representative survey of Kuwaiti women are used to examine OTC use of OCPs. One-fourth of the women initiated use without consulting a doctor, and 50% bought OCPs from the pharmacy. No socioeconomic or demographic differences were found between those who consulted a physician, implying that women of different background have similar accessibility to the physician. Using multivariate analysis, the odds of consulting a physician were found to be significantly lower for women who first bought OCPs directly from the commercial pharmacy. The duration of first time OCP use did not differ according to physician consultation. It is concluded that OTC availability of OCPs has many advantages and prevents unwanted pregnancy. However, there is a need for better packaging and instructions that would enable high-risk women to identify themselves and to use OCPs under physician supervision.
- [Show abstract] [Hide abstract] ABSTRACT: Objective: To document the changes in trends and patterns of contraceptive use from 1984 to 1999 and analyze the sociodemographic correlates of contraceptive use. Methods: A nationally representative household survey of Kuwaiti women of reproductive age was conducted in 1999 and compared with published data from three earlier national surveys, Results: About 52% of Kuwaiti women were currently using some form of contraception and 79% had used it at some time in their life (ever-use), Three fourths were using a modern method of contraception at the time of the survey. Oral contraceptive pills were the leading method, followed by IUCDs, Oral contraceptive use declined from 79 to 45% in the period 1984-1999, Use of withdrawal increased from 2% in 1987 to 11% in 1999, Multivariate analysis indicated that a higher age and parity, a higher level of education of both spouses, urban residence, and a lower desired fertility were associated with higher contraceptive use. Conclusion: Contraception is generally used for spacing children, with the wife being the main user. There is a continuing need to provide services and accurate information about the various methods of contraception. Copyright (C) 2001 S. Karger AG, Basel.
- [Show abstract] [Hide abstract] ABSTRACT: Background: Kuwait has one of the highest consanguinity rates in the world. Our objectives in this study were to assess the frequency and trend in consanguineous marriages, and to identify factors associated with inbreeding. Patients and methods: A representative sample of 482 households from the most developed (the Capital), and the least developed (Jahra), of the five governorates in Kuwait was selected. The study involved only Kuwaiti nationals. A structured questionnaire was administered by previously trained team members through a household face-to-face interview. Results: Data were obtained for 959 current or previous marriages. Frequency of total (first and second cousin) consanguinity was much higher in Jahra governorate (42.1%) than the Capital (22.6%). Over the last decade, the inbreeding has decreased in the Capital but not in Jahra. Bivariate analysis indicated that several socioeconomic and demographic variables were significantly associated with consanguinity. The control of confounding factors by logistic regression showed, however, that Bedouin origin and year of marriage were the only variables significantly related to consanguinity. Conclusion: There is a widening gap between Bedouins and non-Bedouins in the practice of consanguinity in Kuwait.
- [Show abstract] [Hide abstract] ABSTRACT: Background: Kuwait has one of the highest consanguinity rates in the world. Our objectives in this study were to assess the frequency and trend in consanguineous marriages, and to identify factors associated with inbreeding. Patients and Methods: A representative sample of 482 households from the most developed (the Capital), and the least developed (Jahra), of the five governorates in Kuwait was selected. The study involved only Kuwaiti nationals. A structured questionnaire was administered by previously trained team members through a household face-to-face interview. Results: Data were obtained for 959 current or previous marriages. Frequency of total (first and second cousin) consanguinity was much higher in Jahra governorate (42.1) than the Capital (22.6). Over the last decade, the inbreeding has decreased in the Capital but not in Jahra. Bivariate analysis indicated that several socioeconomic and demographic variables were significantly associated with consanguinity. The control of confounding factors by logistic regression showed, however, that Bedouin origin and year of marriage were the only variables significantly related to consanguinity. Conclusion: There is a widening gap between Bedouins and non-Bedouins in the practice of consanguinity in Kuwait.
- [Show abstract] [Hide abstract] ABSTRACT: A structured questionnaire was administered to a random sample of 608 Kuwaiti couples through a household face-to-face interview. Both spouses were non-smokers in more than half (50.8%) of all the couples, and there was a single couple (0.2%) with both spouses currently smoking. Only 0.5% of the wives reported current smoking. The prevalence of smoking was 3.2% among divorced/widowed women from the same households. The difference between the two groups of women remained significant upon controlling for the confounding effect of age. Among the husbands, frequencies of current and ex-smokers were 37% and 11%, respectively. Younger respondents consumed more tobacco and were initiated to smoking at an earlier age. Logistic regression showed that people with one to 11 years of formal education were more likely to be current smokers as compared to the rest of the respondents (adjusted relative risk: 2.07, 95% confidence interval (CI): 1.46-2.93). Reasons for the observed findings have been discussed.
- [Show abstract] [Hide abstract] ABSTRACT: A ‘knowledge and expectation’ survey was conducted among the mothers of asthmatic children attending specialized paediatric clinics in the mostly urbanized areas of Kuwait. The 123 women interviewed generally displayed high levels of knowledge regarding causes, signs and prognosis of asthma. A set of beliefs regarding the possible social and emotional impact of asthma revealed a mostly positive expectation regarding the effect of the disease on affected children. Knowledge scores were higher among the younger, more affluent and better educated mothers. More particularly, scores were higher among women who had had previous personal experience with asthma, and those who had access to information through a physician. Younger, better educated mothers with personal experience of asthma were also more likely to express positive expectations. It is important to assess whether an ‘optimistic bias’ among mothers with previous experience with asthma may lower their vigilance regarding the disease in their children. Physicians should be alerted to that possibility when communicating with mothers of asthmatic children.
- [Show abstract] [Hide abstract] ABSTRACT: In mid-1994, non-Kuwaiti expatriates constituted 61.7% of the total population of Kuwait (1.75 million). Despite this numerical majority, non-Kuwaitis exist as a social minority. Non-Kuwaitis may be grouped into three broad categories along ethnic/nationality lines into Bidoon (without nationality), Arabs, and Asians. The objective of this paper was to compare the relative accessibility of the various groups to health care services in Kuwait. The study is based on data collected as part of a survey of 2184 Emergency Room (ER) users in January-February 1993. All patients attending the hospital ERs between 7:30 am and 9:00 pm were interviewed about their reasons for coming to the ER instead of going to the primary health care (PHC) centres, as required. The major reason given was low accessibility of the PHCs. Compared to Kuwaiti nationals, 92% of whom were registered at the PHC centres, only 62% of the Arabs and 39% of the Asians were registered. Multiple logistic regression of the factors in registration indicated that nationality was the most important reason for lack of registration, with Asians only about one-quarter as likely to be registered as Kuwaitis. Also, people who had been in Kuwait for shorter durations (< 5 years) were less likely to be registered than the Kuwaiti nationals or expatriates who had been here for 10 years or longer. In the absence of registration at the PHC centre, the civil identification card (ID) may be used as a valid means to enter the health system. Among the Arabs and Asians, 22% and 29% did not have a civil ID card. Thus, for many expatriates, the hospital ER, which does not provide the necessary follow-up care is often the only source of health care available.
- [Show abstract] [Hide abstract] ABSTRACT: Utilization of the emergency rooms (ERs) in Kuwait has increased considerably during the last decade. Such an increase is a concern for health planners because of the burden on ER services, lack of continuous service provided by the ER and the higher cost of such services. Based on a study of 2011 patients attending the medical ERs in the six government hospitals in early 1993, the predictors of non-urgent utilization were analyzed. Patients were asked about their reasons for visiting the ER rather than the primary health care (PHC) centre. Both patients and doctors were asked to rate the urgency of the visit. According to the doctors' judgement, 61% of the visits were for non-urgent problems that did not require emergency care, while 23% of the patients viewed their visits to be non-urgent. Multiple logistic regression analysis indicated that perceived urgency of the visit was the most important predictor of a non-urgent visit to the ER, after controlling for several predisposing and enabling factors. Patients who perceived their visit to the ER to be non-urgent were about four times more likely to visit the ER for a non-urgent condition as judged by the doctor. The level of education had a significant, positive effect on non-urgent utilization among both Kuwaiti nationals and expatriates. Several factors may explain the above finding. Employment of educated persons in the hospital was one route through which education facilitated ER use. It is also likely that educated persons had more influential contacts or wasta in the hospital. Also, the less educated might have delayed seeking care while the educated consulted for non-urgent reasons as soon as they noticed the symptoms. Like education, the level of non-urgent utilization was higher among Kuwaiti nationals with higher incomes. Thus, a higher social class seems to facilitate ER use for non-urgent reasons. Among the non-Kuwaitis, lack of registration at the PHC centre was a significant reason for non-urgent use of the ER. It is recommended that hurdles in the utilization of PHC facilities should be removed. Registration of non-Kuwaitis at the PHC must be improved, and referrals to the PHC back from the ER should be instituted to ensure the necessary follow-up care.
- [Show abstract] [Hide abstract] ABSTRACT: The Arab, Muslim, oil-rich nation of Kuwait has achieved unusually high levels of knowledge and use of contraception for a developing, high fertility country. Almost all women know of contraceptive pills without prompting, and 57-86% report having ever used a method (usually the oral pill or IUD) in recent studies. Based on a survey of six randomly selected clinics the present study compares the knowledge and use levels of two major ethnic groups--the Beduins and non-Beduins. It also analyses preference for various contraceptive methods and probable reasons for this. While Census or Survey data do not provide information about the size of ethnic groups analyzed in this paper, it is estimated that at least one-third of the population of Kuwait is Beduin. There is a significant difference between the levels of knowledge and use of contraception between the Beduin and non-Beduin women; current use being 42% and 65%, respectively. The differentials between the two groups are particularly marked among women of lower socioeconomic status, and tend to reduce notably once variables such as education and income are controlled. Within the subgroup of non-Beduins, socioeconomic differences in contraceptive use have virtually disappeared; the illiterate and relatively less affluent women are as likely to use a contraceptive method as the university educated, and richer women. However, among the Beduins, the usually expected differences by socioeconomic characteristics still persist. The oral pill is the best known and most commonly used method. Male sterilization is the least known and not practiced at all.(ABSTRACT TRUNCATED AT 250 WORDS)
- [Show abstract] [Hide abstract] ABSTRACT: This paper analyzes whether patients visiting the Medical Emergency Rooms (ERs) perceive their general health to have deteriorated, improved or stayed the same one year before the Iraqi occupation and one year after the liberation. The paper also examines the impact of such perceptions on the utilization of an ER. Data were collected by means of a survey of the ER attendees in Kuwait’s six general hospitals during January and February 1993. Sixty percent of the respondents perceived their health to have been better one year before the invasion, about 30% perceived no change, while 10% said their health had improved one year after the liberation. A significantly larger percentage of women and wealthier people perceived a deterioration. Regarding ER utilization, 56% reported at least one visit before and after the occupation. The average number of visits was 9.68 before the invasion and 10.09 after the liberation. Perception of health was not significantly associated with the number of visits.Copyright © 1994 S. Karger AG, Basel
Kuwait, Muhafazat al `Asimah, Kuwait
- • Department of Community Medicine and Behavioral Sciences
- • Faculty of Medicine