Temporal trends of hemoglobin among pregnant women: The Mutaba'ah study

BACKGROUND

Low hemoglobin (Hb) level is a leading cause of many adverse pregnancy outcomes. Patterns of changes in Hb levels during pregnancy are not well understood.

AIM

This study estimated Hb levels, described its changing patterns across gestational trimesters, and identified factors associated with these changes among pregnant women.

MATERIALS AND METHODS

Data from the ongoing maternal and child health cohort study-The Mutaba'ah Study, was used (N = 1,120). KML machine learning algorithm was applied to identify three distinct cluster trajectories of Hb levels between the first and the third trimesters. Descriptive statistics were used to profile the study participants. Multinomial multivariable logistic regression was employed to identify factors associated with change patterns in Hb levels.

RESULTS

The three identified clusters-A, B and C-had, respectively, median Hb levels (g/L) of 123, 118, and 104 in the first trimester and 119, 100, and 108 in the third trimester. Cluster 'A' maintained average normal Hb levels in both trimesters. Cluster 'B', on average, experienced a decrease in Hb levels below the normal range during the third trimester. Cluster 'C' showed increased Hb levels in the third trimester but remained, on average, below the normal range in both trimesters. Pregnant women with higher gravida, diabetes mellitus (type 1 or 2), nulliparity or lower level of education were more likely to be in cluster 'B' than the normal cluster 'A'. Pregnant women who reported using iron supplements before pregnancy or those with low levels of education. were more likely to be in cluster 'C' than the normal cluster 'A'.

CONCLUSION

The majority of pregnant women experienced low Hb levels during pregnancy. Changes in Hb levels during pregnancy were associated with parity, gravida, use of iron before pregnancy, and the presence of diabetes mellitus (type 1 or 2).

Happiness and associated factors amongst pregnant women in the United Arab Emirates: The Mutaba'ah Study

OBJECTIVE

Prenatal happiness and life satisfaction research are often over-shadowed by other pregnancy and birth outcomes. This analysis investigated the level of, and factors associated with happiness amongst pregnant women in the United Arab Emirates.

METHODS

Baseline cross-sectional data was analyzed from the Mutaba'ah Study, a large population-based prospective cohort study in the UAE. This analysis included all expectant mothers who completed the baseline self-administered questionnaire about sociodemographic and pregnancy-related information between May 2017 and July 2021. Happiness was assessed on a 10-point scale (1 = very unhappy; 10 = very happy). Regression models were used to evaluate the association between various factors and happiness.

RESULTS

Overall, 9,350 pregnant women were included, and the majority (60.9%) reported a happiness score of ≥8 (median). Higher levels of social support, planned pregnancies and primi-gravidity were independently associated with higher odds of being happier; adjusted odds ratio (aOR (95% CI): 2.02 (1.71-2.38), 1.34 (1.22-1.47), and 1.41 (1.23-1.60), respectively. Women anxious about childbirth had lower odds of being happier (aOR: 0.58 (0.52-0.64).

CONCLUSION

Self-reported happiness levels were high among pregnant women in the UAE. Health services enhancing social support and promoting well-being during pregnancy and childbirth may ensure continued happiness during pregnancy in the UAE.

The prevalence and correlates of depression among patients with chronic diseases in the United Arab Emirates

BACKGROUND

Chronic diseases constitute a major public health problem in the United Arab Emirates (UAE) and are the leading cause of mortality and morbidity. Chronic diseases have been found to be associated with an increased prevalence of depression and depressive symptoms. Depression can have detrimental effect on the prognosis of the disease and quality of life in patients.

AIMS AND OBJECTIVES

This study aimed to estimate the prevalence and correlates of depression in a sample of patients suffering from chronic disease in Al-Ain city, UAE.

MATERIALS AND METHODS

A cross-sectional survey based study was conducted with 417 participants recruited from seven primary health care centers of Al-Ain city. Men and women aged 18 years and above suffering from chronic disease filled the Patient Health Questionnaire (PHQ-9). Univariate and multivariable logistic regressions were performed on the collected data to investigate correlates of different factors with depression. Data was analyzed using SPSS (version 26). The study was approved by Ambulatory Healthcare Services (AHS) Human Ethics Research Committee.

RESULTS

The majority 62.41% (n = 254) of the sample were females, 57.97% (n = 240) aged above 55 years and with a median (Q25, Q75) duration of chronic disease of 8 (4, 15) years. The prevalence of depression was 21.1% (95% CI: 17.5%-25.3%). With severe depression was in 1.7% and mild-moderate in 34.7% of the participants. Depression severity was statistically significantly associated with increasing age (p = 0.006), low level of education (p<0.001), presence of asthma (p = 0.007) and heart disease (p = 0.013). Unadjusted logistic regression reported that presence of depression was significantly associated with female gender (cOR = 1.8, [95% CI; 1.1-3.1], p = 0.025), and presence of chronic kidney disease (cOR = 4.9, [95% CI; 1.3-20.2], p = 0.020) and heart disease (cOR = 2.9, [95% CI; 1.6-5.4], p = 0.001) longer duration of disease in years (cOR = 1.04, [95% CI; 1.01-1.07], p = 0.003). However, in the adjusted logistic regression analysis, participants with heart disease (aOR = 2.8, [95% CI; 1.4-5.5], p = 0.004), and with longer duration of disease (aOR = 1.04, [1.01-1.07], p = 0.014) remained significantly associated statistically with higher chance of having depression.

CONCLUSION

The prevalence of depression was quite high and the study highlights for health care professionals and policy makers, the importance of mental health support as part of a comprehensive management plan for patients with chronic diseases. A multidisciplinary comprehensive program will improve the long-term outcomes of these patients. Patients with chronic diseases may need more support and counseling at primary health care levels.

Prevalence of chronic diseases among United Arab Emirates University students: cross-sectional study

Background

Chronic disease burden is increasing globally. In Arab Gulf Countries, the burden has increased exponentially over the past five decades due to rapid economic growth and urbanization. In the United Arab Emirates (UAE), chronic diseases are the leading cause of mortality and economic burden, hence, there is need to explore their patterns for targeted interventions. Studies among university students in Europe and the United States show chronic diseases prevalence ranging from 16.5% to 30.0%, respectively. To our knowledge, this is the first study in the Gulf region to assess multiple chronic diseases among university students. Our study describes the prevalence and patterns of multiple chronic diseases among UAE University (UAEU) students.

Methods

We conducted a descriptive cross-sectional study among UAEU students ≥18years from July to October 2021. Online questionnaire was used to collect data. Self-reported chronic diseases were described and compared between male and female students using chi-square and t tests. Other students’ characteristics were also explored. All analyses were conducted using STATA statistical software.

Results

902 students participated in the study with mean age of 21.9±5.2yrs. 79.8% were females. 80.7% were undergraduates. The prevalence of self-reported chronic diseases was 23.0%. Obesity, Diabetes and Asthma/Allergies were the commonest (12.5%, 4.2% & 3.2%, respectively). 34.8% of the students were either overweight or obese. Overall chronic disease prevalence was similar between males and females [27.5% vs 21.8%, 0.104] though it was significantly higher among postgraduates, students who are older, married and have family history of diabetes. 4.7% of the students reported 2 or more chronic diseases.

Conclusions

Our study showed that more than 1 in 5 of the students reported at least one chronic disease. This shows the need for proactive chronic disease screening and prevention programs to meet the health needs of the students.

Key messages

• Prevalence of chronic diseases (Diabetes, Prediabetes, Obesity, Hypertension, Asthma/Allergies, Lipid disorders, Thyroid disorders, GI disorders, and CVDs) was high among the university students.

• Universities should commit to researching students’ health and creating targeted health policies and interventions, as chronic diseases have direct and indirect negative impact on students’ education.

Tobacco Use and Exposure to Environmental Tobacco Smoke amongst Pregnant Women in the United Arab Emirates: The Mutaba'ah Study

Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This study investigated the prevalence of, and factors associated with, tobacco use and exposure to environmental tobacco smoke (ETS) amongst pregnant women in the UAE. Baseline cross-sectional data were analysed from the Mutaba’ah Study. Expectant mothers completed a self-administered questionnaire collecting sociodemographic information, maternal tobacco use, and ETS exposure during antenatal visits at three hospitals in Al Ain (UAE; May 2017–February 2021). Amongst 8586 women included in the study, self-reported tobacco use during pregnancy was low (0.7%), paternal tobacco use was high (37.9%), and a third (34.8%) of expectant mothers were exposed to ETS (28.0% at home only). Pregnant women who were employed (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.19–1.52), with childbirth anxiety (aOR 1.21, 95% CI 1.08–1.36), and with an increased number of adults living in the same household (aOR 1.02 95% CI 1.01–1.03) were independently more likely to be exposed to ETS. Pregnant women with higher education levels (aOR 0.84, 95% CI 0.75–0.94) and higher gravidity (aOR 0.95, 95% CI 0.92–0.99) were less likely to be exposed to ETS. Public health efforts targeting smoking cessation amongst husbands and promoting smoke-free homes are warranted to help reduce prenatal ETS exposure in the UAE.

Effects of Diabetes Prevention Education Program for Overweight and Obese Subjects with a Family History of Type 2 Diabetes Mellitus: A Pilot Study from the United Arab Emirates

Objectives

The association of obesity and family history of type 2 diabetes mellitus (T2DM) provides an opportunity for risk stratification and prevention, as these two conditions are the most well-known risk factors for T2DM. We aimed to test the feasibility and effects of a diabetes mellitus prevention education program designed for overweight and obese Emirati people with at least one parent with T2DM.

Methods

We conducted a pilot study using a pre-post design without a control arm at the Diabetes Center at Tawam Hospital in Al Ain, UAE. Overweight and obese subjects with at least one parent with T2DM were invited to participate. Three study assessments were conducted at baseline, three months, and six months including a questionnaire, anthropometry, and laboratory assessments. Interventions included three individualized or family-engaged counseling sessions based on the DiAlert protocol. The study outcomes included awareness of risks and prevention opportunities to T2DM, behavior changes in nutrition and exercise, decreased waist-circumference, and clinical/metabolic/inflammatory markers. Pre-post changes were analyzed using repeated-measures analysis of variance.

Results

One hundred twenty-two overweight or obese individuals were approached. Forty-four individuals met the eligibility criteria, and 32 individuals (35.0±9.0 years; 75.0% female) completed the study. At six months, there were significant improvements in the glycated hemoglobin levels (p = 0.007), high-density lipoprotein (p < 0.049), serum creatinine (p < 0.025), estimated glomerular filtration rate (p = 0.009), and adiponectin levels (p < 0.024). Sixteen of 32 participants had ≥ 2 cm reduction in waist circumference. They demonstrated notable physical and laboratory improvements in moderate-vigorous activity, average activity counts per day, tumor necrosis factor-alpha, and interleukin-6 total cholesterol, triglyceride, and low-density lipoprotein.

Conclusions

Offering family-oriented diabetes education to people at risk for T2DM is well received and has favorable effects on relevant risk factors. Better testing with large-scale randomized controlled studies is needed, and implementing similar educational programs for the Emirati population seems warranted.

Stakeholders' Interest and Attitudes toward Genomic Medicine and Pharmacogenomics Implementation in the United Arab Emirates: A Qualitative Study

BACKGROUND AND AIM

Mapping the power, interest, and stance of stakeholders is a cornerstone for genomic medicine implementation. In this study, we aimed at mapping the power/interest of various stakeholders in United Arab Emirates (UAE) and exploring their attitudes toward pressing health genomics aspects. The overarching aim of this study is to facilitate the construction of a road map for the full implementation of genomic medicine and pharmacogenomics in the UAE with potential applicability to many healthcare systems around the world.

METHODS

A qualitative approach using in-depth interview was employed. Heterogeneous stakeholders were identified by experts in the field. The analysis of the data was a hybrid of deductive and inductive approach using NVivo software for coding and analysis.

RESULTS

13 interviews were conducted. Following mapping the Mendelow's matrix, we categorized the stakeholders in UAE to promoter, latent, defender, and apathetic. Most of the interviewed stakeholders emphasized the clinical demand for genomic medicine in UAE. However, many of them were less inclined to articulate the need for pharmacogenomics at the moment. The majority of stakeholders in UAE were in favor of building infrastructure for better genetic services in the country. Stakeholder from an insurance sector had contradicting stance about the cost-effectiveness of genomic medicine; the majority were concerned with the legal and ethical aspects of genomic medicine and had an opposing stance on direct-to-consumer kits.

CONCLUSIONS

Implementing the Mendelow's model will allow the systematic strategy for implementing genomic medicine in UAE. This can be achieved by engaging the key players (promoters and defenders) as well as engaging and satisfying the latent stakeholder.

Association between duration of residence and prevalence of type 2 diabetes among male South Asian expatriate workers in the United Arab Emirates: a cross-sectional study

Expatriates account for about 80% of the total population in the United Arab Emirates (UAE). This study aimed to evaluate the hypothesis that prevalence of type 2 diabetes in male South Asian expatriates increases with increased length of residence in the UAE.

DESIGN, SETTINGS AND PARTICIPANTS

This cross-sectional study recruited a representative sample (n=1375) of male South Asian expatriates aged ≥18 years in Al Ain, UAE. Sociodemographic, anthropometric and lifestyle data were obtained using a pilot-tested adapted version of the WHO STEPS instrument.

MAIN OUTCOME MEASURES

Duration of residence was used as a marker for acculturation. Type 2 diabetes was defined as a self-reported physician diagnosis of diabetes or a glycosylated haemoglobin blood level ≥6.5%.

RESULTS

Mean (±SD) age of participants was 34.0±9.9 years. Overall, the prevalence of type 2 diabetes was 8.3% (95% CI 6.8% to 9.8%). Diabetes prevalence was positively associated with longer duration of residence in the UAE, 2.7%, <5 years; 8.2%, 5-10 years; and 18.8%, >10 years. After adjusting for age, nationality, and income and age, expatriates were more likely to develop diabetes if residing in the UAE for 5-10 years (OR=2.18; 95% CI 1.02 to 4.67) or >10 years (OR=3.23; 95% CI 1.52 to 6.85) compared with those residing for <5 years.

CONCLUSIONS

After controlling for potential confounding factors, longer duration of residence was significantly associated with a higher prevalence of type 2 diabetes in male South Asian expatriate workers in the UAE.

Impact of Recurrent Miscarriage on Maternal Outcomes in Subsequent Pregnancy: The Mutaba'ah Study

Purpose

To estimate the prevalence of recurrent miscarriage (RM) and investigate the association between RM and adverse maternal outcomes in subsequent pregnancies.

Participants and Methods

This is an interim analysis of a prospective study of 1737 pregnant women with gravidity of two or more prior to the current pregnancy. These women joined the Mutaba’ah Study between May 2017 and April 2019 and were followed up until they delivered. Hospital medical records were used to extract data on past pregnancy history and the progress and outcomes of the current pregnancy, such as gestational diabetes, preeclampsia, mode of delivery, preterm delivery, and complications at birth.

Results

Amongst pregnant women with at least two previous pregnancies (n=1737), there were 234 (13.5%) women with a history of two or more consecutive miscarriages. Women with RM were slightly older, more parous, and more likely to have had previous infertility treatment (all p-values <0.05). Women with a history of RM had independently significant increased odds of cesarean section (adjusted odds ratio (aOR) 1.81, 95% CI 1.24–2.65) and preterm (<37 weeks, aOR: 2.52, 95% CI 1.56–4.08) or very preterm delivery (<32 weeks, aOR: 7.02 95% CI 2.41–20.46) in subsequent pregnancies than women who did not have a history of RM.

Conclusion

Women with a history of RM were twice as likely to undergo cesarean section and seven times more likely to deliver prior to 32 weeks of gestation than women without a history of RM. The study findings support the need for early pregnancy monitoring or assessment units to ensure better follow-up and customized care for at-risk pregnant women with a history of RM.

Antenatal Care Initiation Among Pregnant Women in the United Arab Emirates: The Mutaba'ah Study

Introduction: Antenatal care (ANC) provides monitoring and regular follow-up of maternal and fetal health during pregnancy. Women with appropriate ANC tend to have better delivery and birth outcomes. This study describes the patterns of ANC utilization and factors associated with appropriate ANC initiation in the United Arab Emirates (UAE) for the first time. Methods: Baseline cross-sectional data from pregnant women who participated in the Mutaba'ah-Mother and Child Health Study between May 2017 and January 2019 was analyzed. Participants were recruited during ANC visits and completed a self-administered questionnaire that collected socio-demographic and pregnancy-related information and assessed whether it was their first ANC appointment. Regression models assessed the relationship between socio-demographic and pregnancy-related variables and "appropriate" (≤ 4 months' gestation) vs. "late" ANC initiation (>4 months' gestation). Results: At recruitment, 841 participants reported that it was their first ANC visit and half (50.2%) of these women were late initiating their ANC. Mothers who were more educated, had previous infertility treatment or previous miscarriages were all more likely to achieve appropriate ANC initiation [adjusted odds ratio (aOR): 1.66, 95% confidence interval (CI): 1.05-2.62; aOR: 3.68, 95% CI: 1.50-9.04; aOR: 1.80, 95% CI: 1.16-2.79, respectively]. Women worrying about childbirth were less likely to achieve appropriate ANC initiation (aOR: 0.54, 95% CI: 0.34-0.85). Conclusion: Half of pregnant women in this study did not achieve the global consensus guidelines on appropriate ANC initiation. Interventions among less educated women and those with previous pregnancy complications and childbirth anxiety are recommended to ensure appropriate ANC initiation.

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

BACKGROUND

We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia.

METHODS

We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a random-effects model.

RESULTS

Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I2 = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I2 = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes.

CONCLUSIONS

Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017068910.

Mutaba'ah-Mother and Child Health Study: protocol for a prospective cohort study investigating the maternal and early life determinants of infant, child, adolescent and maternal health in the United Arab Emirates

INTRODUCTION

Early life exposures, particularly environmental and parental lifestyle factors, have a major influence on children's health and development. Due to increasing interest in the early life developmental origins of diseases, many birth cohorts have been established. These studies constitute a repository of data which researchers use over many years to investigate emerging research questions. However, no such databank or cohort study is available in the United Arab Emirates (UAE). This project aims to establish a prospective mother and child cohort study in Al Ain (Abu Dhabi, UAE) to investigate the maternal and early life determinants of infant, child, adolescent and maternal health of the Emirati population.

METHODS AND ANALYSIS

During the period 2017-2021, this study aims to recruit 10 000 pregnancies at approximately 12 weeks of gestation from hospitals and clinics in Al Ain city. For each mother/newborn pair, an initial dataset will be collected including anthropometric, physiological and biochemical measurements, medical interventions, circumstances of pregnancy, delivery details and neonatal and perinatal growth and health using a combination of questionnaires, interviews and medical record extractions. Baseline data will act as the starting point from which the children will be followed up and re-surveyed at intervals throughout their life course until the age of 16 years, to explore how familial, socioeconomic and lifestyle factors interact with genetic and environmental factors to influence health outcomes and achievements later in life.

ETHICS AND DISSEMINATION

Ethical approval has been granted by the United Arab Emirates University Human Research Ethics Committee and the ethical committees of the participating institutions. Results will be widely disseminated via peer-reviewed manuscripts, conference presentations, media outlets and reports to relevant authorities.

Genomic Medicine Without Borders: Which Strategies Should Developing Countries Employ to Invest in Precision Medicine? A New "Fast-Second Winner" Strategy

Genomic medicine has greatly matured in terms of its technical capabilities, but the diffusion of genomic innovations worldwide faces significant barriers beyond mere access to technology. New global development strategies are sorely needed for biotechnologies such as genomics and their applications toward precision medicine without borders. Moreover, diffusion of genomic medicine globally cannot adhere to a "one-size-fits-all-countries" development strategy, in the same way that drug treatments should be customized. This begs a timely, difficult but crucial question: How should developing countries, and the resource-limited regions of developed countries, invest in genomic medicine? Although a full-scale investment in infrastructure from discovery to the translational implementation of genomic science is ideal, this may not always be feasible in all countries at all times. A simple "transplantation of genomics" from developed to developing countries is unlikely to be feasible. Nor should developing countries be seen as simple recipients and beneficiaries of genomic medicine developed elsewhere because important advances in genomic medicine have materialized in developing countries as well. There are several noteworthy examples of genomic medicine success stories involving resource-limited settings that are contextualized and described in this global genomic medicine innovation analysis. In addition, we outline here a new long-term development strategy for global genomic medicine in a way that recognizes the individual country's pressing public health priorities and disease burdens. We term this approach the "Fast-Second Winner" model of innovation that supports innovation commencing not only "upstream" of discovery science but also "mid-stream," building on emerging highly promising biomarker and diagnostic candidates from the global science discovery pipeline, based on the unique needs of each country. A mid-stream entry into innovation can enhance collective learning from other innovators' mistakes upstream in discovery science and boost the probability of success for translation and implementation when resources are limited. This à la carte model of global innovation and development strategy offers multiple entry points into the global genomics innovation ecosystem for developing countries, whether or not extensive and expensive discovery infrastructures are already in place. Ultimately, broadening our thinking beyond the linear model of innovation will help us to enable the vision and practice of genomics without borders in both developed and resource-limited settings.

Maternal and birth cohort studies in the Gulf Cooperation Council countries: protocol for a systematic review and narrative evaluation

INTRODUCTION

Cohort studies have revealed that genetic, socioeconomic, communicable and non-communicable diseases, and environmental exposures during pregnancy may influence the mother and her pregnancy, birth delivery and her offspring. Numerous studies have been conducted in the Gulf Cooperation Council (GCC) countries to examine maternal and birth health. The objectives of this protocol for a systematic review are to systematically review and characterise the exposures and outcomes that have been examined in the mother and birth cohort studies in the GCC region, and to summarise the strength of association between key maternal exposures during pregnancy (ie, body mass index) and different health-related outcomes (ie, mode of birth delivery). The review will then synthesise and characterise the consequent health implications and will serve as a platform to help identify areas that are overlooked, point out limitations of studies and provide recommendations for future cohort studies.

METHODS AND ANALYSIS

Medline, Embase, Cochrane Library and Web of Science electronic databases will be comprehensively searched. Two reviewers will independently screen each study for eligibility, and where discrepancies arise they will be discussed and resolved; otherwise a third reviewer will be consulted. The two reviewers will also independently extract data into a predefined Excel spreadsheet. The included studies will be categorised on the basis of whether the participant is a mother, infant or mother-infant dyad. Outcome variables will be divided along two distinctions: mother or infant. Exposure variables will be divided into six domains: psychosocial, biological, environmental, medical/medical services, maternal/reproductive and perinatal/child. Studies are expected to be of heterogeneous nature; therefore, quantitative syntheses might be limited.

ETHICS AND DISSEMINATION

There is no primary data collection; therefore, ethical review is not necessary. The findings of this review will be disseminated in a peer-reviewed journal and presented at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42017068910.

Screening strategy for type 2 diabetes in the United Arab Emirates

The prevalence of type 2 diabetes mellitus (DM) among Emirati nationals is one of the highest in the world. The recently released United Arab Emirates National DM guidelines call for screening all adults aged 30 years and more. The authors explored the need for such a modification of current American Diabetes Association (ADA) guidelines. They also considered the prevalence rates for undiagnosed DM based on oral glucose tolerance test (OGTT) versus glycohemoglobin (HbA( 1c)) >or= 6.5% in a population-based sample of 296 adult Emirati participants. In the low-risk ADA category, defined by age <45 years and BMI <25, only 1 of 68 (1.5%) participants was diagnosed with DM. The overall rate of DM based on HbA(1c) was lower than that based on OGTT (10.1% versus 14.2%; P < .05). The authors conclude that the ADA guidelines are adequate for screening in this high-risk population. They also find high discordance between HbA(1c) and OGTT.

Prevalence of food allergy among children in Al-Ain city, United Arab Emirates

BACKGROUND

Food allergy (FA) in children is an important health problem. However, the prevalence of FA in the United Arab Emirates (UAE) has not yet been determined. This cross-sectional study was carried out to assess the prevalence of FA among school children aged 6-9 years in Al-Ain city, UAE.

METHODS

We used multistage random sampling in order to get a sample of 397 school children whose parents completed a self-administered questionnaire designed to assess the presence or absence of physician diagnosis of FA and other allergic diseases.

RESULTS

The study showed that the prevalence of physician-diagnosed FA in children was 8% (95% CI 5.4-10.8%). Eggs, fruits and fish were the main allergies reported. FA was independently related to a family history of FA, to a small sibship size and to a personal history of other atopic diseases.

CONCLUSIONS

The prevalence of FA in Al-Ain city was 8%. A history of FA in first-degree family members and a small sibship size were associated with a higher risk of FA in children. FA was related to a personal history of other atopic diseases.

Prevalence and correlates of conduct disorder among inmates of juvenile detention centres, United Arab Emirates

The prevalence of conduct disorder was assessed in 77 young people in 4 juvenile detention centres in the United Arab Emirates (UAE). The prevalence of conduct disorder was 24.7%, and recidivism, as indicated by repeat admissions to the centres, was found to be associated with conduct disorder. Having a diagnosis of conduct disorder was associated with a lower educational and occupational level of the father, as well as living with a single parent or relatives. Among UAE nationals, conduct disorder was also associated with having a mother who was a non-UAE national.

Prevalence of diabetes mellitus and its complications in a population-based sample in Al Ain, United Arab Emirates

AIMS

To determine the prevalence of diabetes mellitus (DM) and its complications in the adult population of the United Arab Emirates (UAE) and assess the degree of metabolic control in subjects with diagnosed DM.

METHODS

A random sample of houses of Emirati citizens living in Al Ain, UAE was surveyed. Fasting blood glucose was determined by glucose meter and an oral glucose tolerance test (OGTT) was conducted if blood sugar was <7 mmol/l. DM was defined according to the WHO criteria. Pre-diabetes status was based on fasting venous blood glucose concentration of 5.6-6.9 mmol/l or 2h post-OGTT venous blood glucose level of 7.8-11.0 mmol/l.

RESULTS

There were 2455 adults (>18) living in the 452 surveyed houses of which 10.2% reported having the diagnosis of DM. A total of 373 men and non-pregnant women underwent testing, and after adjustment for factors affecting participation probability the prevalence of diagnosed DM, undiagnosed DM and pre-diabetes was 10.5, 6.6 and 20.2%, respectively. Age-standardized rates for DM (diagnosed and undiagnosed) and pre-diabetes among 30-64 years old were 29.0 and 24.2%, respectively. Logistic regression analysis showed that only age and body mass index (BMI) were significantly independently related to undiagnosed DM. In patients with diagnosed DM, the prevalence rates for retinopathy, neuropathy, nephropathy, peripheral vascular disease and coronary heart disease were 54.2, 34.7, 40.8, 11.1 and 10.5%, respectively. A significant proportion of subjects with undiagnosed DM and pre-diabetes also had micro- and macro-vascular complications. The proportion of subjects with diagnosed DM who achieved internationally recognized targets for HbA1c (<7%), LDL-C (<2.6 mmol/l) and blood pressure (<130/80 mmHg) was 33.3, 30.8 and 42.1%, respectively.

CONCLUSION

This study confirms the previously reported high prevalence of DM in the UAE. Diabetic complications were highly prevalent among subjects with diagnosed and undiagnosed DM. Metabolic control was suboptimal in most subjects with diagnosed DM. Greater efforts are urgently needed to screen early and effectively treat DM in the UAE in order to prevent long-term complications.