[Show abstract][Hide abstract] ABSTRACT: This was a cross-sectional national survey of the elderly population of Saudi Arabia conducted between January 1994 and December 1995. The participants' physical, mental, social, and environmental health status were assessed in a personal interview during which a structured data form was completed by a trained research team. Data on 6,139 elderly participants have been analyzed: 64.2 percent were males mean age: 69.2 +/- 7.8 years which was higher than females 68.0 +/- 7.6 years (P < 0.0001). The widowhood (46.7%) status was also higher than the widowerhood (4.1%) and 9.3 percent of the participants were never married. The proportion of female illiterates (95.8%) was higher than the males (71.4%). The proportion of participants with definite psychopathology was 33.8 percent and this increased with age and higher among females than males. Overall, 18.8 percent were dependent on others for ADL. Other clinical findings included visual impairment (46.1%) and difficulty in hearing (19.9%). However, a sizeable majority (72.2%) enjoyed good health. Only 3.7 percent lived alone. The proportion of the elderly taking part in any recreational exercise was 14.7 percent and only 4.3 percent had any experience of physical therapy. There were no special hospital wards for the elderly patients, and they were treated by general internists. There is a need for a national cost-effective program for the care of the elderly. The present widespread primary health care centers can be upgraded to coordinate the proposed services.
Full-text · Article · Jan 2000 · The International Journal of Aging and Human Development
[Show abstract][Hide abstract] ABSTRACT: The epidemiology of stroke at different geographical locations in the Kingdom of Saudi Arabia has not been adequately investigated.
In this study, clinical types and risk factors of stroke were compared among patients at low-altitude (Riyadh, 620 m) and high-altitude (Al Baha > 2000 m) areas using a case-control study design. One-hundred ninety recently diagnosed cases (109 from Riyadh and 81 from Al Baha) were verified and subjects were interviewed. An equal number of age- and sex-matched controls from the corresponding areas were also interviewed using a specific standard questionnaire.
The frequency of thrombotic stroke at high altitude was 93.4% as compared to 79.3% at low altitude (P < 0.05). The odds ratios (OR) for the different risk factors at high and low altitudes, respectively, were: hypertension 4.4 and 2.1; diabetes mellitus: 2.7 and 1.9; ischemic heart disease (IHD): 2.4 and 1.9; atrial fibrillation: 3.9 and 3.3, and smoking: 2.3 and 2.5. The mean hematocrit values were 45.3% at high altitude and 41.0% for low altitude patients (P < 0.001) and its association with stroke at high altitude remained significant even after adjusting for age, gender and occupation.
The study's finding of an increased frequency of thrombotic stroke at high altitude was explained by increased hematocrit which might have caused this in conjunction with other factors such as hypertension and IHD. Larger studies are recommended for better clarification of interaction between high altitude and other established risk factors not included in this study, such as sickle cell anemia and congenital heart diseases in young patients.
No preview · Article · Jan 1998 · Archives of Medical Research
[Show abstract][Hide abstract] ABSTRACT: The objectives of this Community-based National Epidemiological Household Survey, conducted between 1990-1993, were to estimate the prevalence of overweight and obesity in Saudi Arabia and to examine its association with the socio-demographic characteristics of the adult population. A sample of Saudis 20 years and over was selected using a multistage stratified cluster sampling technique with probability proportionate to size. The selected subjects were requested to visit primary health care centers in their localities. Physicians in these clinics took measurements of heights and weights and collected other relevant data. Obesity was measured by the Body Mass Index, using the Quetelet Index. The results showed the sample of 10,651 subjects of which 50.8% were males, had a mean age of 35.8 years (SD = 14.27 years). The prevalence of overweight was 31.2% (95% confidence interval: 30.3%, 32.1%); 33.1% for males and 29.4% for females. For obesity, the overall prevalence was 22.1%; males 17.8% and females 26.6%. The study design suggested that these estimates could be closer to the true values. The multiple logistic regression analysis showed that age, residential area, region, income, gender, and education are statistically significant predictors of obesity. The prevalence of obesity was higher in females than males, lower in subjects living in rural areas with traditional lifestyles than those in more urbanized environments, and increased with increasing age. The observed prevalence and pattern of overweight and obesity with age and gender is similar to those observed in the Arab community and some Western nations. There is a need for increased physical activity and better nutrition education programs to reduce the extent of obesity and to prevent the serious health consequences, especially, in the middle age group.
Full-text · Article · Jul 1997 · Journal of Community Health
[Show abstract][Hide abstract] ABSTRACT: Following transsternal thymectomy, up to 50% of patients may require postoperative ventilation. The aim of this study was to identify the variables most useful in predicting the myasthenic patient who needs postoperative mechanical ventilation.
We applied multivariate discriminant analysis to preoperative physical, historical, laboratory and intraoperative data of 51 myasthenic patients who underwent transcervical-transsternal thymectomy to select those variables most useful in predicting the postoperative need for mechanical ventilation. The receiver operating characteristic (ROC) curve was also used to describe the discrimination abilities and to explore the trade-offs between sensitivity and specificity of the model.
Discriminant analysis identified seven risk factors that correlated with the need for postoperative ventilation: FVC, FEF25-75%, MEF50% and their percentages of the predicted values, as well as, sex. The model correctly predicted the actual ventilatory outcome in 88.2% of patients. The area under the ROC curve verified that our model correctly predicted the actual ventilatory outcome with a probability of 88.2%.
This model can be used for predicting the need for postoperative mechanical ventilation in myasthenia gravis patients.
Full-text · Article · Nov 1996 · Canadian Journal of Anaesthesia
[Show abstract][Hide abstract] ABSTRACT: To determine the prevalence of overweight and obesity among male school children in Saudi Arabia and provide a growth chart for males 6-18 y old.
Three stage stratified cluster sampling procedure.
The study population was 9061 male school children, attending public schools in Saudi Arabia. Their ages ranged from 6-18 y and covered all the 12 grade levels of school. Children with evidence of chronic or acute diseases were excluded from the study.
Structured questionnaire, including: location of school, socio-demographic characteristics and age of the student. Anthropometric measurements of weight and height was done for all the study sample. Growth charts were designed through fitting the polynomial regression model of degree three. The percentage of body mass index (BMI) of expected BMI at the 50th percentile for each age group was computed. The 50th percentile of The National Center for Health Statistics/Center for Disease Control reference population was used as the expected standard population values for defining childhood overweight and obesity.
The overall prevalence of overweight was 11.7% and obesity 15.8%. There was a statistically significant variation in the regional distribution of overweight and obesity (P < 0.01). The highest prevalence (18.0%) was recorded in Riyadh, capital of Saudi Arabia, and the lowest was in Sabea (11.1%) located in the Southern region.
These findings of a high prevalence of childhood obesity when compared with the NCHS/CDC calls for an early health education program on the appropriate choice of diets for growth, health and longevity. However, because of the possible ethnic differences between the Saudi and American populations, the growth charts presented could serve as a better reference for future comparisons.
No preview · Article · Nov 1996 · International Journal of Obesity
[Show abstract][Hide abstract] ABSTRACT: PurposeFollowing transsternal thymectomy, up to 50% of patients may require postoperative ventilation. The aim of this study was
to identify the variables most useful in predicting the myasthenic patient who needs postoperative mechanical ventilation.
MethodsWe applied multivariate discriminant analysis to preoperative physical, historical, laboratory and intraoperative data of
51 myasthenic patients who underwent transcervical-transsternal thymectomy to select those variables most useful in predicting
the postoperative need for mechanical ventilation. The receiver operating characteristic (ROC) curve was also used to describe
the discrimination abilities and to explore the trade-offs between sensitivity and specificity of the model.
ResultsDiscriminant analysis identified seven risk factors that correlated with the need for postoperative ventilation: FVC, FEF25–75%, MEF50% and their percentages of the predicted values, as well as, sex. The model correctly predicted the actual ventilatory outcome
in 88.2% of patients. The area under the ROC curve verified that our model correctly predicted the actual ventilatory outcome
with a probability of 88.2%.
ConclusionsThis model can be used for predicting the need for postoperative mechanical ventilation in myasthenia gravis patients.
ObjectifAprès une thymectomie transternale, jusqu’à 50% des patients peuvent avoir besoin de ventilation postopératoire. L’objectif
de cette étude était d’identifier les variables les plus utiles pour prédire le besoin de ventilation mécanique postopératoire
chez le myasthénique.
MéthodesL’analyse discriminante multifactorielle a été appliquée à l’examen physique préopératoire, à l’anamnèse, au laboratoire et
aux données peropératoires de 51 myasthéniques qui ont subi une thymectomie transcervicotransternale dans le but de choisir
les variables les plus utiles pour prédire le besoin postopératoire de ventilation mécanique. La courbe ROC (receiver operating
characteristic) a aussi été utilisée pour décrire les capacités de discrimination et pour explorer les échanges entre la sensibilité
et la spécificité du modèle.
RésultatsL’analyse discriminante a identifié sept facteurs de risque qui corrélaient avec le besoin de ventilation postopératoire:
CVF, FEF25–75%, FEM50% et leur pourcentage des valeurs prédites, ainsi que le sexe. Le modèle a prédit le résultat ventilatoire actuel chez 88,2%
des patients. La surface sous la courbe a prédit correctement le résultat ventilatoire actuel avec un probabilité de 88,2%.
ConclusionOn peut utiliser ce modèle pour prédire le besoin de ventilation mécanique postopératoire chez des patients souffrant de myasthénie
Full-text · Article · Oct 1996 · Canadian Journal of Anaesthesia
[Show abstract][Hide abstract] ABSTRACT: We aimed to validate the Eating Disorders Inventory (EDI) in Arabic.
Subjects were chosen randomly from female school students. Only healthy Saudi students were included. They were asked to fill the EDI and undergo a semi-structured interview by a psychiatrist who was unaware of the EDI scores. Of 146 students approached 12 did not meet our criteria and were excluded; 16 other students were excluded for incomplete responses.
The difference between the two diagnostic methods in the proportion of caseness was statistically significantly (P < 0.0001). The scores on Perfectionism, Maturity Fears and Interoceptive Awareness were significantly higher in the Saudi students compared with Canadians (P < 0.05).
The EDI-DT subscale has a sensitivity of 100% and a specificity of 85%. Despite its low positive predictive value of 5%, it may be useful for screening large non-clinical groups for eating disorders.
No preview · Article · May 1996 · The British Journal of Psychiatry
[Show abstract][Hide abstract] ABSTRACT: The objectives of this study were to examine the distribution and effects of sex and urbanization on cord serum lipids, and to determine the cut-off point for calculating prevalence of hypercholesterolaemia in neonates in Saudi Arabia. The study sample was 200 full-term newborns at four different hospitals selected on a quota basis from the urban and rural areas of Saudi Arabia. Total cholesterol, triglyceride and high density lipoprotein (HDL) were the serum lipids assayed. The results showed that the serum total cholesterol and HDL concentration were significantly higher in urban than in rural areas. However, there was no significant sex differential in the lipids. The cut-off points for the calculation of prevalence of hypercholesterolaemia were 1.79 mmol/l in rural areas and 2.56 mmol/l in urban areas. The study also showed that the 95th percentiles of the three lipid parameters were lower than those reported from other countries, e.g. Australia and Finland. This study provides the distributional form of total cholesterol, HDL cholesterol and triglyceride in cord blood, and may serve as a pilot for a large-scale study which incorporates the prevalence of familial hypercholesterolaemia in Saudi Arabia.
No preview · Article · Apr 1996 · Annals of Tropical Paediatrics International Child Health
[Show abstract][Hide abstract] ABSTRACT: To determine the prevalence and determinants of cigarette smoking among intermediate (junior secondary) schoolboys in Riyadh, Saudi Arabia.
A sample of 1382 students (ages 12-19 years) in 45 classes randomly selected from 15 schools, using a two-stage stratified cluster sampling scheme.
Students in the selected classes were requested to complete an anonymous questionnaire, under the supervision of trained interviewers. Univariate and multivariate statistical analyses of potential risk factors were performed.
Intermediate schools in Riyadh, Saudi Arabia.
Association between current smoking and socio-demographic variables, history of smoking, age of smoking initiation, smoking behaviour among family members, knowledge of the harmful effects of smoking, and whether smoking is allowed in the presence of relatives and acquaintances.
The prevalence of current smokers was 13.2% overall, ranging from 3.2% in those 12-13 years old to 31.1% in those aged 18-19. Some of the variables (nationality, father's education, and smoking allowed in the presence of parents or teachers) found to be associated with current smoking in a univariate analysis were no longer significantly associated with smoking in the multivariate analysis. By multivariate analysis, knowledge of the harmful effects of smoking, age, smoking allowed in the presence of friends or brothers, and previous smoking were statistically significant determinants of current smoking.
Current health education activities against smoking should be continued and extended to the young population to further reduce the prevalence of smoking and its health consequences. Religious antipathy toward smoking should be emphasised in any local anti-smoking campaigns.
[Show abstract][Hide abstract] ABSTRACT: Objective; To examine the views and attitudes of a sample of outpatients on the proposed appointment system at the Primary Health Care Clinics (PHCC) of King Khalid University Hospital. Setting: The Primary Health Care Clinics of the King Khalid University Hospital (KKUH). Design: A systematic sample of every tenth patient attending the PHCC over a period of three weeks between May and June 1994 was selected. The sample members completed questionnaires containing demographic data and information regarding views and opinions of the intended move to an appointment system. Subjects: Male and female outpatients over 12 years old attending the PHCC of KKUH. Results: The median waiting time was one hour with a mean of 1.33 hours SD(0.882). The waiting time was significantly higher in females than males and significantly different among the occupational groups. There was no statistical significant association between dissatisfaction with waiting times and decisions to seek alternative health providers. Ninety-six percent of the respondents (267) believed the appointment system would be more valuable than the present "walk-in" system for various reasons discussed in the text. Conclusions: Patients showed dissatisfaction with the present system of outpatient admission to the clinic. However, this dissatisfaction did not influence them to seek other health providers thus indicating their confidence in the quality of care at the PHCC of King Khalid University Hospital. They perceived several benefits of the intended appointment system. A post survey to assess the new appointment system is recommended after a trial period of six months.
No preview · Article · Jan 1996 · Saudi medical journal
[Show abstract][Hide abstract] ABSTRACT: A case-control study was conducted in Saudi Arabia, where the same strain of BCG has been used and surveys had shown that up to 88% of vaccinated children remain tuberculin negative. Active cases were obtained by surveying the seven tuberculosis centers in 1 yr. Control subjects were obtained from a nationwide survey of normal individuals. Vaccination in both groups was ascertained by history and BCG scar. Relative risk of contracting active tuberculosis in the vaccinated versus unvaccinated and protection was calculated. Protection was as follows: age group 5 to 14 yr, 82% (55 to 93%); age group 15 to 24 yr, 67% (55 to 77%); and age group 25 to 34 yr, 20% (-6 to 37%). We document the uninterrupted record of protection by BCG administered in the neonatal period and discuss the significance of vaccination timing. We concur with other studies that protection lapsed after about 20 yr. More importantly, this is the first large study that documents a lack of tuberculin sensitivity despite protection. This challenges the view that sensitization is essential for protection and supports the "two-pathway" theory that BCG vaccination could trigger either protective (Lister type) or antagonistic (tuberculin or Koch type) reactions and that the most protective vaccines would have little tuberculin-sensitizing effect because the two pathways are competitive.
No preview · Article · Dec 1995 · American Journal of Respiratory and Critical Care Medicine
[Show abstract][Hide abstract] ABSTRACT: This study was carried out to identify possible factors influencing the growth pattern of Saudi children in the first 2 years
of life. The body length and weight of 400 healthy babies attending the well-baby care clinic of King Khalid University Hospital,
Riyadh, Saudi Arabia, were measured at various determined ages in a cross-sectional study design. Nutritional indicators were
calculated and the proportions with low height-for-age, low weight-for-height and low weight-for-age were compared with the
reference population. The results showed a prevalence of 2 per cent of wasted children and 18 per cent of children with stunted
growth. A univariate and multivariate analysis of personal and nutritional variables with the standard nutritional indicators
identified age, sex, bottle feeding, and type of solid foods as significant risk factors for stunted growth. Stunting increases
with age and males have poorer growth pattern than females. Genetic factors and poor feeding practices of the children are
suggested reasons for the observed faltering growth between 6 and 24 months of age. A public health education programme for
good nutrition is highly recommended
No preview · Article · Sep 1994 · Journal of Tropical Pediatrics
[Show abstract][Hide abstract] ABSTRACT: The study examines the meaning of waiting time in an outpatient department. Attention is payed to the activities of the patients and companions during the waiting time, the potential for health education programmes during the waiting time and the form such a health education programme should take. The setting was the King Khalid University Hospital Outpatient Department, Riyadh, Saudi Arabia. The study sample was selected by a systematic random sample approach of one in every 10 patients or companions visiting the clinic in a period of 2 weeks. The results showed an average waiting time of 148 min with a standard deviation of 11 min. Patients currently engage in reading, sleeping or talking during long waiting time. However, they showed a preference for health education programmes for specific diseases such as heart disease, diabetes mellitus and bowel diseases during the waiting time. Leaflets were favoured to be the most preferred mode for disseminating such information. A sizeable proportion of patients also wanted religious programmes included. We conclude that education programmes for preferred specific health topics at outpatient clinic services would be of potential benefit to patients' overall health.
No preview · Article · May 1994 · Patient Education and Counseling
[Show abstract][Hide abstract] ABSTRACT: A study sample of 880 women attending the primary health care center in the Al-Baha region of Saudi Arabia was interviewed on their attitudes towards antenatal care services in the primary care setting. Some 91.3% of the women expressed positive views about obtaining the antenatal care in these centers. The major factor influencing their choice was the geographic location of primary health centers which are near to their residence and therefore more convenient for them to patronize. Other factors were the easier access to staff in primary care centers, especially mid-wives and female doctors. There was a significant relationship of age, parity and education with their current antenatal and delivery practices. The women also recommended less than ten antenatal visits before delivery. These findings are relevant to any policy regarding maternity services in the country.
No preview · Article · May 1994 · Journal of Community Health
[Show abstract][Hide abstract] ABSTRACT: In a study of 32 unrelated Arab patients with juvenile myoclonic epilepsy (JME), we compared the frequencies of human leukocyte antigen (HLA) class I and II alleles with those of unrelated healthy controls. A significant difference between the phenotypic frequencies in JME patients and controls was observed for DRW13, the split of DRW6 (37.5 vs 11% of controls). The strength of association as measured by the relative risk was 4.85 for this antigen (p = 0.002). The possible association of JME with HLA-DRW6 recently reported in Caucasians was confirmed in this study. This finding speaks for the homogeneity of the disease among Arabic and Caucasian JME patients. The existence of this association is evidence of a locus in the HLA region that influences expression of JME.
En un estudio de 32 enfermos árabes no relacionados entre si que padecían epilepsia mioclónica juvenil (JME) se ha comparado la frecuencia de los HLA Clase I y Il con los enfermos sanos controles también sin relación familiar entre sí. Se ha observado una diferencia significativa de las frecuencias fenotípicas entre los pacientes con JME y los controles para DRW13, la excisión de DRW6 (37.4% por sus 11% en controles). La potencia de la asociación medida por el riesgo relativo fue de 4.85 para este antigeno (p < 0.002). La posible asociación de la JME con HLA-DRW6, recientemente publicada en sujetos caucasianos ha sido confirmada en este estudio. Este hallazgo habla en favor de la homogeneidad de la enfermedad entre pacientes con JME árabes y caucasianos. La existencia de esta asociación es una evidencia a favor del locus en la región del HLA que influencia la expresión de la JME.
In einer Untersuchung von 32 nicht verwandten arabischen Patienten mit juveniler myoklonischer Epilepsie (JME) verglichen wir die Häufigkeiten der Allele der HLA-Klassen I und ü mit nicht verwandten gesunden Kontrollen. Es wurde ein signifikanter Unterschied der phaenotypischen Häufigkeiten bei JME-Patienten für DRW13, dem Bruchstück von DRW6, gefunden (37.5% gegenüber 11% bei Kontrollen). Die Stärke der Assoziation, gemessen als relatives Risiko, betrug 4.85 für dieses Antigen (p 0.002). Die mögliche Assoziation von JME mit HLADRW6, wie kärzlich bei Kaukasiern berichtet, wurde in dieser Studie bestätigt. Der Befund spricht für die Homogenität der Erkrankung bei arabischen und kaukasischen JME-Patienten. Das Auftreten dieser Assoziation ist ein Hinwis auf den Ort der HLA-Region, der die Expression von JME beeinflusst.
[Show abstract][Hide abstract] ABSTRACT: Information on the morbidity pattern of patients seen at a primary care clinic is sparse or not available for most countries in the Middle East including Saudi Arabia. A prospective study of all new patients at the primary care clinic of King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia was therefore carried out over a period of one year (1991G to 1992G). An analysis of the morbidity pattern of 9,441 new patients seen over this period is hereby reported. There is a male prepondence overall and more than 70% of the patients were below 40 years of age. III-defined illnesses, diseases of the skin, genitourinary, digestive, musculoskeletal and respiratory diseases accounted for more than 70% of the patients. About one-third of the patients, mainly those with diseases of the skin and genitourinary systems, were referred for specialist care. It is conceivable that the commonly observed pattern of diseases in this study may change over a period of time either due to the interventions adopted by the primary care clinics or as part of social development or as a cumulative effect of both. The primary physician has to be aware of such a change by periodically analyzing the available morbidity pattern.
No preview · Article · Feb 1994 · Annals of Saudi medicine
[Show abstract][Hide abstract] ABSTRACT: The sickness absence records of workers at the King Khalid University Hospital over a period of two years (1990-1991) were analysed to identify the category of workers at high risks. The records of each staff who went on 'sick-off' are available at the Employee Health Clinic of the hospital. There were 861 workers with sickness absence records during the period of study and 86% are expatriates on contract. The prevalence of sickness absence is higher among contract workers than non-contract workers about 16% and 9% respectively. The sex ratio was 1:2 in favour of females among contract employees but 1.2:1 in the male's favour for the Saudis. The observed sex differential in the rate of sickness absence in each occupational group is statistically significant (P < 0.01). Females have more spells of sickness than males and the duration of sickness absence is significantly higher in females. However, the average spell of sickness which is generally low is not different between contract and non-contract workers although slightly higher in the former. There was no significant occupational effect on the spells and duration of sickness absence. Respiratory infections and diseases of the digestive and musculoskeletal systems are the major diseases causing sickness absence. The implications of these findings are discussed in the paper. But for a good monitoring of sickness absence records, a health record surveillance card for each employee is recommended.
No preview · Article · Feb 1994 · Journal of the Royal Society of Health
[Show abstract][Hide abstract] ABSTRACT: This study compares the growth patterns of Saudi Arabian pre-school children aged 0-5 years to a reference population of American children documented by the National Center for Health Statistics/Centers for Disease Control (NCHS/CDC). The anthropometric data of weight, height and age were collected in a cross-sectional study of Saudi Arabian children in Riyadh, the capital of Saudi Arabia. The sample selection was accomplished by a 3-stage stratified random procedure, basing the stratification on location and a socio-economic index. A total of 3,795 children comprising 55.2% males and 44.8% females had complete basic anthropometric measurements among other variables. Analyses were effected by using the WorHealth Organization/Centers for Disease Control (WHO/CDC) standard software programme for calculating nutritional indicators. 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 (78.1%) have normal or slightly above normal nutritional status. A small proportion of the children (1.4%) were below -2.0 SD scores of the reference population for weight for height and for age. Overall, Saudi Arabian children are slightly shorter and thinner than their American counterparts. An important finding in weight for height was that nearly 20% of the children were below -2 SD scores of the reference population median. However, due to the very high per capita income, and the fact that food and other essential items are subsidised by the government, the deficits from this reference population may be attributed to inadequate health education nutrition programmes, genetic and other social factors including reproductive behaviour, rather than malnutrition.
No preview · Article · Nov 1993 · Journal of the Royal Society of Health
[Show abstract][Hide abstract] ABSTRACT: In the first nationwide community-based survey of the epidemiology of tuberculosis in Saudi Arabia, 7721 subjects were screened in the 5 provinces (using an equal proportional allocation formula) for 2 parameters: (1) prevalence of positive Mantoux test in non BCG vaccinated subjects; (2) prevalence of bacillary cases on sputum culture. The prevalence of positive Mantoux reaction in children aged 5-14 years was 6% +/- 1.8; higher in urban areas (10%), and lower in rural areas (2%), thus classifying Saudi Arabia among the middle prevalence countries. These relatively good results (by Third World standards) could reflect the rise of the standard of living and wide availability of free treatment for active cases with a lowered risk of infection in the community. This view is supported by the fact that in our survey, only one subject grew Mycobacterium tuberculosis in the sputum. However, there were foci of high prevalence of Mantoux reaction in the urban communities in the Western province (20% +/- 8.7 urban; 1% +/- 1.9 rural). The problem may be caused by the fact that the province receives every year over a million pilgrims, some of whom are known to settle illegally and escape the usual screening for tuberculosis imposed on foreign labourers. In conclusion, even in the absence of an enforceable national programme for the eradication of tuberculosis, the economic standard and wide availability of free treatment for active cases has resulted in relatively low rates of prevalence of tuberculin sensitivity in children. The foci of high prevalence in the Western Province require special screening arrangements.
No preview · Article · Sep 1993 · Tubercle and Lung Disease