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Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
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Ali R, Loney T, Al-Houqani M, Blair I, Aziz F, Al Dhaheri S, El Barazi I, Soteriades ES, Shah SM. Cigarette smoking and smokeless tobacco use among male south Asian migrants in the United Arab Emirates: a cross-sectional study. BMC Public Health 2020; 20:815. [PMID: 32473627 PMCID: PMC7260757 DOI: 10.1186/s12889-020-08942-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 05/18/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Few data were available on smoking and smokeless tobacco use in South Asian migrants in the United Arab Emirates (UAE). This study aimed to identify the prevalence and correlates of cigarette smoking and smokeless tobacco use in male South Asian migrants in the UAE. METHODS We used a cross-sectional study to recruit a random representative sample of male South Asian migrants, including Indian (n = 433), Pakistani (n = 383) and Bangladeshi (n = 559) nationalities. We used multivariable logistic regression analysis to identify significant correlates of cigarettes smoking and smokeless tobacco use. RESULTS 1375 South Asian migrant adult males participated in the study (response rate 76%) with a mean age of 34 years (SD ± 10). The overall prevalence of cigarette smoking was 28% (95%CI 25-30%) and smokeless tobacco use was 11% (95%CI 10-13%). The prevalence of current cigarette smoking was 21, 23, and 37% among participants from India, Pakistan and Bangladesh, respectively. The prevalence of current smokeless tobacco use was 6, 12, and 16% for Indian, Pakistani, and Bangladeshi participants, respectively. Among study participants, Bangladeshi nationality, hypertension, and alcohol use were significant correlates of current cigarette smoking. Significant correlates of smokeless tobacco use included increased age, less than college level education, alcohol use, and Pakistani or Bangladeshi nationality. CONCLUSIONS Current smoking and smokeless tobacco use in South Asian migrants represent a significant public health burden in the UAE. Effective public health measures are needed to reduce tobacco use in this migrant population.
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Affiliation(s)
- Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mohammed Al-Houqani
- College of Medicine and Health Sciences, Department of Internal Medicine, United Arab Emirates University, Al Aim, United Arab Emirates
| | - Iain Blair
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Faisal Aziz
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
- Department of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
| | - Salma Al Dhaheri
- Health Promotion, Department of Health, Abu Dhabi, United Arab Emirates
| | - Iffat El Barazi
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Elpidoforos S Soteriades
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Harvard T. H Chan School of Public Health, Boston, MA, USA
| | - Syed M Shah
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates.
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan.
- Zayed Centre for Health Sciences, UAE University, Al Ain, United Arab Emirates.
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Abdulla NM, Adam B, Blair I, Oulhaj A. Heavy metal content of herbal health supplement products in Dubai - UAE: a cross-sectional study. Altern Ther Health Med 2019; 19:276. [PMID: 31638965 PMCID: PMC6805626 DOI: 10.1186/s12906-019-2693-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 09/24/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Lead, mercury, cadmium, chromium, and arsenic intoxication have been associated with the use of health supplement (HS) products. The aim of this study is to estimate the concentration of heavy metals in HS products that are on sale in Dubai, United Arab Emirates, premises and to compare estimated daily metal intake with regulatory standards. METHODS Dubai-area premises selling HS products were identified by searching the Dubai Municipality database to identify all pharmacies, para-pharmacies and nutrition and healthcare shops. A total of 859 premises were identified in the Deira and Bur-Dubai areas. Data collection was performed between September 1 and December 12, 2016. During that period, all premises that had been identified within Dubai were visited and samples for laboratory testing were collected. RESULTS A total of 200 HS products were tested for lead, mercury, cadmium, chromium and arsenic. High proportion of samples were found to contain metals less than the limits of the detection (LOD) of the method. It was found that 93% of products contained Arsenic (As) < LOD, 94.5% of lead (Pb) < LOD, 100% of Cadmium (Cd) < LOD, 99% of Mercury (Hg) < LOD and 23.5% of Chromium (Cr) < LOD. Using the single imputation method to account for LOD, estimates for the average daily intake of lead was 0.88 μg compared to the tolerable daily intake (TDI) of 20 μg, daily intake of mercury was 0.09 μg (TDI = 20 μg), daily intake of cadmium was 0.83 μg (TDI = 6 μg) while for arsenic it was 0.92 μg compared to the tolerable daily intake of 10 μg. The average daily intake of chromium was 7.57 μg with no internationally established TDI. Assuming users followed the manufacturers' instructions, daily intake of arsenic, lead and mercury would not exceed TDI for any of the 200 products. However, the daily intake of cadmium exceeded or approximated the TDI for three products. CONCLUSIONS In this study we found low levels of metals in the products that were available for sale in Dubai. With few exceptions, if the products were used according to the suppliers' instructions, average daily intake of heavy metals will be well below the recommended tolerable daily intakes.
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Al Haddad A, Ali N, Elbarazi I, Elabadlah H, Al-Maskari F, Narchi H, Brabon C, Ghazal-Aswad S, AlShalabi FM, Zampelas A, Loney T, Blair I, Ahmed LA. 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. BMJ Open 2019; 9:e030937. [PMID: 31383713 PMCID: PMC6686999 DOI: 10.1136/bmjopen-2019-030937] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
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.
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Affiliation(s)
- Amal Al Haddad
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Haba Elabadlah
- College of Pharmacy, Al Ain University of Science and Technology, Al Ain, United Arab Emirates
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hassib Narchi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Christel Brabon
- Obstetrics and Gynecology Department, Oasis Hospital, Al Ain, United Arab Emirates
| | - Saad Ghazal-Aswad
- Obstetrics and Gynecology Department, Tawam Hospital, Al Ain, United Arab Emirates
| | | | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Abdulla NM, Aziz F, Blair I, Grivna M, Adam B, Loney T. Prevalence of, and factors associated with health supplement use in Dubai, United Arab Emirates: a population-based cross-sectional study. Altern Ther Health Med 2019; 19:172. [PMID: 31299957 PMCID: PMC6624985 DOI: 10.1186/s12906-019-2593-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/04/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Health supplement (HS) products that are available in the Emirate of Dubai (United Arab Emirates; UAE) contain chemicals that may adversely affect human health. This study aimed to investigate the prevalence of, and factors associated with HS consumption, knowledge, related adverse events, and reporting practices of adverse events amongst the general population in Dubai, UAE. METHODS A cross-sectional household telephone survey using a computer-assisted questionnaire was conducted amongst a random representative sample (n = 1203) of the Dubai population that assessed HS use and knowledge. Dependent variables were supplement use and reports of adverse events while independent variables included socio-demographic factors, knowledge, attitudes, and practice. Logistic regression analysis was performed to identify factors independently associated with HS use. RESULTS Among the 1203 participants in this study, 455 (37.8%) reported ever using HS. Amongst ever-users, reasons for use were to improve health (66.1%), for bodybuilding (9.9%), disease prevention (6.8%), and weight management (5.3%). The majority of users purchased their HS from pharmacies (88.4%) or were prescribed HS (46.6%). Vitamins were the most commonly used HS (87.9%) followed by minerals (10.5%) and sports nutrition products (10.5%). Only 2.9% of users experienced an adverse event associated with HS use which all resolved when the HS was discontinued. Only three of those affected reported the incident. Multivariate logistic regression analysis revealed that HS use was independently associated with female gender (adjusted odds ratio [AOR]; 3.26, 95% confidence interval [CI]: 2.26-4.70), higher income (AOR 2.41, 95% CI: 1.20-4.83), being a past-smoker (AOR 2.39, 95% CI: 1.27-4.48), having an allergy (AOR 1.75, 95% CI: 1.14-2.66), more frequent doctor visits (AOR 1.86, 95% CI: 1.02-3.39), taking prescribed medications (AOR 1.47, 95% CI: 1.04-2.06), and knowledge about HS (AOR 3.91, 95% CI: 2.26-6.76). CONCLUSIONS Our study provides the first population-based estimates of HS use and HS-related adverse events in the Gulf region. Adverse events associated with HS are infrequent and this may be due to the well-developed regulatory framework in Dubai and the high level of knowledge amongst consumers who mainly consume vitamins and minerals on the advice of pharmacists or healthcare professionals.
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Al Alkeem F, Loney T, Aziz F, Blair I, Sonnevend Á, Sheek-Hussein M. Prevalence and factors associated with infectious intestinal diseases in Ras Al Khaimah, United Arab Emirates, 2017: A population-based cross-sectional study. Int J Infect Dis 2019; 85:188-194. [PMID: 31202907 DOI: 10.1016/j.ijid.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/26/2019] [Accepted: 06/10/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The United Arab Emirates (UAE) is a rapidly developing high-income country that has experienced significant population growth, urbanization, and improvements in the standard of living since its formation in 1971. Published estimates on the prevalence of infectious intestinal diseases (IID) in the UAE are scarce and exclusively based on hospital data. The aim of this study was to provide the first prevalence estimates of IID in the UAE. METHODS A population-based cross-sectional study design using a telephone-based questionnaire was used to estimate the IID prevalence in the previous 4 weeks in a representative sample of the Ras Al Khaimah (RAK) population from January to September 2017. RESULTS Data were collected from 1254 participants (57.3% male; 25.2% <18 years). The prevalence of IID was 4.2% in the 4 weeks prior to the interview. Multivariate logistic regression analysis identified that being female (odds ratio (OR) 2.4, 95% confidence interval (CI) 1.2-5.1) and having a middle-range monthly household income (approx. USD 4080-<6800: OR 5.42, 95% CI 1.15-25.48; approx. USD 6800-<9530: OR 7.13, 95% CI 1.47-34.57) were positively associated with IID. Age ≥6 years was negatively associated with IID (OR 0.95, 95% CI 0.90-0.99). Forty-nine percent of participants with an IID sought medical care and 20.8% took over-the-counter medication. CONCLUSIONS This study provides the first population-based prevalence estimates of IID in the UAE, which are similar to those reported in China (4%), but lower than those reported in Canada (10%), the Netherlands (7%), and the USA (6%).
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Affiliation(s)
- F Al Alkeem
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666, United Arab Emirates.
| | - T Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, PO Box 505055, Dubai, United Arab Emirates.
| | - F Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666, United Arab Emirates.
| | - I Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666, United Arab Emirates.
| | - Á Sonnevend
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666, United Arab Emirates.
| | - M Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666, United Arab Emirates.
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Ismail FY, Gordon-Lipkin E, Huether K, Blair I, Szólics M, Alsaadi T, Aziz F, Suleiman J, Schiess N. Pediatric Multiple Sclerosis in the United Arab Emirates: Characteristics From a Multicenter Study and Global Comparison. J Child Neurol 2018; 33:422-427. [PMID: 29607711 DOI: 10.1177/0883073818759103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We delineate the clinical characteristics, incidence, and prevalence of pediatric-onset multiple sclerosis in Abu Dhabi, United Arab Emirates, from 2010 to 2014. Eighty-two patients (65% female) were identified. Fifty-three (64.6%) were Emiratis (45 from Abu Dhabi and 8 from 5 other emirates) and 29 were expatriates. Mean age of onset was 15.9 years overall, 15.3 years in males and 16.3 years in females. Patients with onset before age 12 years presented with visual symptoms while those with onset after age 12 years presented with a mixture of visual, motor and sensory symptoms. Interferon beta-1a was the most frequently used disease-modifying therapy (48%). In Abu Dhabi Emirati nationals, the age- and sex-adjusted prevalences were 26/100 000 for males and 36/100 000 for females. The total incidence in Emirati nationals from 2010 to 2014 was 2.3/100 000 for ages 10 to 14 years and 7.2/100 000 for ages 15 to 19 years. By comparison with international cohorts, the incidence of pediatric-onset multiple sclerosis in Abu Dhabi is higher whereas gender distribution is similar.
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Affiliation(s)
- Fatima Y Ismail
- 1 Department of Neurology and Developmental Medicine, The Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.,2 Department of Pediatrics, United Arab Emirates University, Al Ain, UAE
| | - Eliza Gordon-Lipkin
- 1 Department of Neurology and Developmental Medicine, The Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | - Iain Blair
- 4 Institute of Public Health United Arab Emirates University, Al Ain, UAE
| | | | - Taoufik Alsaadi
- 6 American Center for Psychiatry and Neurology, Abu Dhabi, UAE
| | - Faisal Aziz
- 4 Institute of Public Health United Arab Emirates University, Al Ain, UAE
| | - Jehan Suleiman
- 2 Department of Pediatrics, United Arab Emirates University, Al Ain, UAE.,7 Division of Neurology, Department of Pediatrics, Tawam Hospital, Al Ain, UAE
| | - Nicoline Schiess
- 8 Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
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Elbarazi I, Devlin NJ, Katsaiti MS, Papadimitropoulos EA, Shah KK, Blair I. The effect of religion on the perception of health states among adults in the United Arab Emirates: a qualitative study. BMJ Open 2017; 7:e016969. [PMID: 28982822 PMCID: PMC5640057 DOI: 10.1136/bmjopen-2017-016969] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/22/2017] [Accepted: 08/03/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Investigate how religion may affect the perception of health states among adults in the United Arab Emirates and the implications for research on self-reported health and quality of life and the use of values in cost-effectiveness analysis. DESIGN Qualitative analysis of short-structured interviews with adult Emiratis carried out by a market research agency.The COREQ criteria have been used where appropriate to guide the reporting of our findings. SETTING Participants were recruited from shopping malls and other public places in the cities of Al Ain and Abu Dhabi. PARTICIPANTS Two hundred adult Emiratis broadly representative of the Emirati population in terms of age and gender. RESULTS Eighty one per cent of participants said that their perception of health states was influenced by their spiritual or religious beliefs. The two overarching themes that seemed to explain or classify these influences were 'fatalism' and 'preservation of life'. Subthemes included powerlessness to change what is preordained by God, fear of disability (particularly diminished mobility) and appreciation of health and life and the requirement to look after one's health. A final theme was that of acceptance, with respondents expressing a willingness to endure suffering and disability with patience in the expectation of rewards in the hereafter. CONCLUSIONS Our results emphasise the need for further work to establish locally relevant value sets for Muslim majority countries in the Middle East and elsewhere for use in health technology assessment decision-making, rather than relying on value sets from other regions.
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Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | | | - Marina-Selini Katsaiti
- Department of Economicsand Finance, College of Business andEconomics, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | | | | | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
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Koornneef E, Robben P, Blair I. Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review. BMC Health Serv Res 2017; 17:672. [PMID: 28931388 PMCID: PMC5607589 DOI: 10.1186/s12913-017-2597-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 09/06/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extensive health system reforms in the past 10 years. The nature, extent and success of these reforms has not recently been comprehensively reviewed. In this paper we review the progress and outcomes of health systems reform in the UAE. METHODS We searched relevant databases and other sources to identify published and unpublished studies and other data available between 01 January 2002 and 31 March 2016. Eligible studies were appraised and data were descriptively and narratively synthesized. RESULTS Seventeen studies were included covering the following themes: the UAE health system, population health, the burden of disease, healthcare financing, healthcare workforce and the impact of reforms. Few, if any, studies prospectively set out to define and measure outcomes. A central part of the reforms has been the introduction of mandatory private health insurance, the development of the private sector and the separation of planning and regulatory responsibilities from provider functions. The review confirmed the commitment of the UAE to build a world class health system but amongst researchers and commentators opinion is divided on whether the reforms have been successful although patient satisfaction with services appears high and there are some positive indications including increasing coverage of hospital accreditation. The UAE has a rapidly growing population with a unique age and sex distribution, there have been notable successes in improving child and maternal mortality and extending life expectancy but there are high levels of chronic diseases. The relevance of the reforms for public health and their impact on the determinants of chronic diseases have been questioned. CONCLUSIONS From the existing research literature it is not possible to conclude whether UAE health system reforms are working. We recommend that research should continue in this area but that research questions should be more clearly defined, focusing whenever possible on outcomes rather than processes.
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Affiliation(s)
- Erik Koornneef
- Institute for Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
- Truven Health Analytics, An IBM Company, Michigan, USA
| | - Paul Robben
- Institute for Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
- Dutch Healthcare Inspectorate, Utrecht, The Netherlands
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
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Novak A, Armstrong N, Caelli T, Blair I. Bayesian Contrast Measures and Clutter Distribution Determinants of Human Target Detection. IEEE Trans Image Process 2017; 26:1115-1126. [PMID: 28026770 DOI: 10.1109/tip.2016.2644269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Human target detection is known to be dependent on a number of components: one, basic electro-optics including image contrast, the target size, pixel resolution, and contrast sensitivity; two, target shape, image type and features, types of clutter; and three, context and task requirements. Here, we consider a Bayesian approach to investigating how these components contribute to target detection. To this end, we develop and compare three different formulations for contrast: mean contrast, perceptual contrast, and a Bayesian-based histogram contrast statistic. Results on past detection data show how the latter contrast measure correlates well with human performance factoring out all other dimensions. As for clutter, our findings show that with large targets, there are effectively no clutter effects. Furthermore, clutter does not have a major effect on detection when it is not contiguous with the target even when it is smaller. However, except for large targets, when the target is contiguous with the clutter, detection clearly decreases as a function of the similarity of target and clutter features-creating type of "clutter camouflage". This Bayesian formulation uses priors based on the contrast histogram statistics derived from all the images, the image context, and implies that human observers have adapted their criteria to fit with the image set, context, and task.
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Shah SM, Ali R, Loney T, Aziz F, ElBarazi I, Al Dhaheri S, Farooqi MH, Blair I. Prevalence of Diabetes among Migrant Women and Duration of Residence in the United Arab Emirates: A Cross Sectional Study. PLoS One 2017; 12:e0169949. [PMID: 28099445 PMCID: PMC5242528 DOI: 10.1371/journal.pone.0169949] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/24/2016] [Indexed: 01/03/2023] Open
Abstract
Background The prevalence rate of type 2 diabetes mellitus (T2DM) is one of the highest in United Arab Emirates (UAE), however data for the expatriate population is limited. This study aimed to identify the prevalence of T2DM amongst migrant women and test the hypothesis that acculturation (measured by years of residency) is associated with an increased risk of T2DM. Methods This was a cross-sectional study and we recruited a representative sample (n = 599, 75% participation rate) of migrant women aged 18 years and over in Al Ain, UAE. The American Diabetes Association criteria were used to diagnose T2DM. An adapted WHO STEPS questionnaire was used to collect socio-demographic, lifestyle and clinical data. Logistic regression analysis was performed to identify correlates of T2DM including length of UAE residence. Results The mean age of participants was 34.1 (± 9.5) years. Of the study participants, based on HbA1C levels, 18.6% (95% CI: 13.9–24.4) had prediabetes and 10.7% (95% CI: 7.2–15.6) had T2DM. Prevalence of prediabetes was 8.5% for Filipinos, 16.7% for Arabs and 30.3% for South Asians. Similarly the prevalence of T2DM was 1.7% for Filipinos, 12.2% for Arabs and 16.7% for South Asians. Significant correlates of overall T2DM (measured and known diabetes) included length of UAE residence for more than 10 years (Adjusted Odds Ratio [AOR] 2.74, 95% CI: 1.21–6.20), age ≥40 years (AOR = 3.48, 95% CI: 1.53–7.87) and South Asian nationality (AOR 2.10, 95% CI: 0.94–4.70). Conclusion Diabetes is a significant public health problem among migrant women in the UAE, particularly for South Asians. Longer length of residence in the UAE is associated with a higher prevalence of diabetes.
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Affiliation(s)
- Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Raghib Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Faisal Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat ElBarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - M. Hamed Farooqi
- Dubai Diabetes Center, Dubai Health Authority, Dubai, United Arab Emirates
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- * E-mail:
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Abrahamian FM, Aldape MJ, Aldasoro E, Allen UD, Al-Sum H, Anadkat MJ, Anders K, Angelakis E, Angus BJ, Antoniadou A, Arena F, Arends JE, Arribas JR, Artenstein AW, Atherton JC, Aucott JN, Aw TC, Babcock HM, Bailey R, Bailey TC, Banks AZ, Barillo DJ, Barrette EP, Bauer MP, Bayston R, Beard CB, Beardsley J, Beeching NJ, Bégué RE, Beldi G, Benson CA, Berbari EF, Berenger JM, Berger C, Bernardino JI, Bille J, Billioux AC, Bitnun A, Blair I, Blanche S, Bleck TP, Bleeker-Rovers CP, Bleijenberg G, Bloch KC, Blum J, Blumberg EA, Bonomo RA, Bonten MJ, Bourayou R, Bouza E, Brandt KA, Bretelle F, Brisse S, Britton WJ, Brook I, Brouwer MC, Browne SK, Bryant AE, Bühler S, Bulger EM, Buller RML, Burke LA, Burri C, Butler MW, Calandra T, Calfee DP, Calvo-Cano A, Cameron DW, Carcillo JA, Carson G, Chambers ST, Charrel RN, Nguyen VCV, Chevaliez S, Chiller TM, Christaki E, Chung KK, Clifford DB, Clumeck N, Cohen J, Collinge J, Conlon CP, Conrad C, Cooke FJ, Cope JR, Corey GR, Cross JH, Cunha BA, Cunha CB, D'Journo B, Daikos GL, Daniels JM, Davidson RN, Day NP, De Cock KM, de Silva TI, de Vries HJ, de Wit S, Delaloye J, Denning DW, Dennis DT, Dhanireddy S, Dielubanza EJ, Diemert DJ, Doganay M, Doherty T, Dolecek C, Dondorp AM, Douglas A, Drancourt M, Dubourg G, Dudley MN, Durand G, Eckhardt BJ, Efstratiou A, Ekkelenkamp MB, Eranki A, Erdem H, Escota GV, Evans HL, Eziefula AC, Fenollar F, Fenwick A, Fierer J, Finch RG, Fleckenstein JM, Forstner C, Foschi F, Fournier PE, French MA, Gage KL, Garcia LS, Gascon J, Gastañaduy AS, Gautret P, Geisler WM, Ghanem KG, Giani T, Giannella M, Gilliam BL, Gilliet M, Glaser CA, Glupczynski Y, Gnann JW, Goldstein EJ, Gottstein B, Gouriet F, Gravitt PE, Green MD, Green ST, Groll AH, Gulick RM, Gupta A, Habib G, Harbarth S, Harris M, Hayden FG, Hetem DJ, Hill PC, Hirschel B, Hodowanec AC, Hoffart L, Hoffmann C, Holland SM, Horby PW, Horne DJ, Hraiech S, Hull MW, Huttner A, Ingram RJ, Islam J, Ison MG, James SH, Jenkins C, Jenkins SG, Jensen JS, Johnston C, Jones TB, Jordan SJ, Julian KG, Kato Y, Kauffman CA, Kaye KS, Keane MP, Keeney J, Kelly P, Kent SJ, Kern WV, Keynan Y, Kim AA, Koné-Paut I, Kosmidis C, Kroes AC, Kroon FP, Ksiazek TG, Kuhlmann FM, Kuijper EJ, Kwon JH, Kyei GB, Lacombe K, Lagacé-Wiens P, Lagier JC, Lamagni T, Landraud L, Lanternier F, LaPlante KL, Lawn SD, Lawrence SJ, Leblebicioglu H, Lee N, Leggett JE, Lehours P, Levy PY, Leyh RG, Lillis RA, Limmathurotsakul D, Lin J, Lindquist HA, Lipsky BA, Liscynesky C, Looney D, Lortholary O, Lowy FD, Luft BJ, Mackowiak PA, MacPherson PA, Maghraoui-Slim V, Mallon PW, Mangino JE, Manuel O, Marchetti O, Marks KM, Marr KA, Marrazzo J, Marschall J, Martin DH, Matonti F, Matulewicz RS, Mayer KH, McCulloh RJ, McGready R, Mdodo R, Mead S, Mégraud F, Meintjes G, Metcalf SC, Michaels MG, Migliori GB, Miles MA, Miller A, Mimiaga MJ, Mingeot-Leclercq MP, Misch EA, Mitreva M, Montaner JS, Moore CB, Muñoz P, Muñoz J, Murray CK, Musso D, Mutengo M, Mutizwa MM, Naber KG, Natarajan P, Neme S, Newton PN, Nichols RA, Nicolle LE, Nosten F, Notarangelo LD, Nutman TB, Nyirjesy P, O'Connell PR, Opal SM, Ormerod LP, Osmon DR, Pankert MB, Pantaleo G, Papazian L, Parente DM, Parola P, Parsaei S, Pascual MA, Patel R, Patrozou E, Pawlotsky JM, Peacock SJ, Pechère JC, Pelegrin I, Peters BS, Peters EJ, Petersen JM, Petersen LR, Petraitis V, Pham LL, Picado A, Pilatz A, Pilmis B, Pinazo MJ, Pletz MW, Pogue JM, Polgreen EL, Polgreen PM, Posfay-Barbe KM, Powderly WG, Presti R, Prod'hom G, Puolakkainen M, Quinn TC, Raoult D, Razonable RR, Read RC, Redfield RR, Rentenaar RJ, Reynolds SJ, Ribi C, Richardson MD, Ritter ML, Roch A, Rockstroh JK, Rojek A, Romero JR, Rooijakkers SH, Rosenbluth D, Rosenzweig SD, Rossolini GM, Rubinstein E, Ryan G, Safren SA, Sahasrabuddhe VV, Saikku PA, Sajadi MM, Salvaggio MR, Santos CA, Satlin MJ, Schaeffer AJ, Schimmer C, Schooley RT, Schumacher RF, Sha BE, Shapiro DS, Sheehan G, Shlaes DM, Shoham S, Simmons CP, Simon DW, Simon MS, Simonsen KA, Slack MP, Smith TT, Sobel JD, Souli M, Sridhar S, Steckelberg JM, Stevens DL, Strah H, Sturm AW, Sungkanuparph S, Tabrizi SJ, Tacconelli E, Tan CS, Taplitz RA, Thomas G, Thomas LD, Thuny F, Thwaites G, Tissot F, Tønjum T, Torriani FJ, Toso C, Tulkens PM, Tunkel AR, Turner CE, Ustianowski AP, van Bambeke F, van Crevel R, van de Beek D, van Delden C, van der Eerden MM, van der Meer JW, van der Poll T, van Ingen J, van Putten J, Vaudaux BP, Vermund SH, Viscidi RP, Visvanathan K, Visvesvara GS, von Seidlein L, Wagenlehner FM, Wald A, Walsh TJ, Warhurst DC, Warnock DW, Warrell DA, Warrell MJ, Warris A, Watkins RR, Weatherall DJ, Weber R, Weidner W, White JR, White PJ, Whitehorn J, Whitley RJ, Whitty CJ, Wiersinga WJ, Wilcox MH, Williams TN, Wilson CC, Wilson ME, Wisplinghoff H, Wood R, Wunderink RG, Wyles D, Yang ZT, Yoder JS, Zaidi NA, Zimmer AJ, Zuckerman JN, Zumla A. List of Contributors. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00234-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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El-Hassan O, Sharif A, Al Redha M, Blair I. Tracking the Implementation of Electronic Medical Records in Dubai, United Arab Emirates, Using an Adoption Benchmarking Tool. Stud Health Technol Inform 2017; 245:64-68. [PMID: 29295053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the United Arab Emirates (UAE), health services have developed greatly in the past 40 years. To ensure they continue to meet the needs of the population, innovation and change are required including investment in a strong e-Health infrastructure with a single transferrable electronic patient record. In this paper, using the Emirate of Dubai as a case study, we report on the Middle East Electronic Medical Record Adoption Model (EMRAM). Between 2011-2016, the number of participating hospitals has increased from 23 to 33. Currently, while 20/33 of hospitals are at Stage 2 or less, 10/33 have reached Stage 5. Also Dubai's median EMRAM score in 2016 (2.5) was higher than the scores reported from Australia (2.2), New Zealand (2.3), Malaysia (0.06), the Philippines (0.06) and Thailand (0.5). EMRAM has allowed the tracking of the progress being made by healthcare facilities in Dubai towards upgrading their information technology infrastructure and the introduction of electronic medical records.
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Affiliation(s)
- Osama El-Hassan
- Health Data and Information Analysis Department, Dubai Health Authority, PO Box: 4545 Dubai, UAE
| | - Amer Sharif
- Education Department, Dubai Healthcare City, PO Box 66566 Dubai, United Arab Emirates
| | - Mohammad Al Redha
- Health Data and Information Analysis Department, Dubai Health Authority, PO Box: 4545 Dubai, UAE
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
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Mitchell C, Srinivasan S, Zhan X, Wu M, Reed S, Guthrie K, LaCroix A, Fiedler T, Munch M, Liu C, Hoffman N, Blair I, Newton K, Freeman E, Joffe H, Cohen L, Fredricks D. 1: Associations between serum estrogen, vaginal microbiota and vaginal glycogen in postmenopausal women. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Al Shehhi N, Aziz F, Al Hosani F, Aden B, Blair I. Human brucellosis in the Emirate of Abu Dhabi, United Arab Emirates, 2010-2015. BMC Infect Dis 2016; 16:558. [PMID: 27729014 PMCID: PMC5059989 DOI: 10.1186/s12879-016-1900-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 10/05/2016] [Indexed: 12/14/2022] Open
Abstract
Background Worldwide, human brucellosis remains an important and widespread infection. In the past, there were limited data on the occurrence of human brucellosis in the United Arab Emirates and the reported incidence appeared to be low compared with similar areas. In 2009, a new web-based infectious disease surveillance system was introduced in the Emirate of Abu Dhabi. This paper reports data from this new system on human brucellosis for the 6 years 2010 to 2015. Methods A dataset was extracted for each case of human brucellosis reported to the notification system for the 6 year period January 2010 to December 2015. Annual brucellosis rates by age-group, gender, nationality and, geographical region were calculated and compared. Results A total of 480 cases of brucellosis were reported. The overall crude notification rate was 3 · 3 per 100,000 population but higher rates were seen in certain population subgroups notably expatriate males of working age in the Eastern Region (approximately 10 per 100,000) and UAE nationals of all ages and both genders in Abu Dhabi (between 4 -- 24 per 100,000). Conclusions These findings reflect environmental and behavioral factors linked to occupation and leisure time activities associated with the large number of small non-commercial livestock farms in Abu Dhabi. Controlling human brucellosis in these circumstances will be challenging.
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Affiliation(s)
- Nawal Al Shehhi
- Communicable Disease Control and Prevention Centre, Khasab Hospital, Khasab, Oman
| | - Faisal Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Farida Al Hosani
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Bashir Aden
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates.
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Naseem A, Blair I, Balazs A. 816 Health supplement use and related adverse health events in Dubai: a population-based cross-sectional study. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dhaheri HA, Loney T, Aw TC, Adem A, Adam B, Elias A, Grivna M, Blair I. 772 Gap analysis on pesticides control and occupational health legislation in the united arab emirates. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schiess N, Huether K, Fatafta T, Fitzgerald KC, Calabresi PA, Blair I, Alsaadi T, Szolics M. How global MS prevalence is changing: A retrospective chart review in the United Arab Emirates. Mult Scler Relat Disord 2016; 9:73-9. [PMID: 27645349 DOI: 10.1016/j.msard.2016.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is an autoimmune disorder leading to central nervous system inflammation. Traditionally, reported MS prevalence rates in the Middle East are low. Few studies include age/sex standardization giving an unreliable estimate of regional prevalence. OBJECTIVE to determine the prevalence, incidence and characteristics of MS in Abu Dhabi, United Arab Emirates. METHODS A retrospective chart review was conducted at the four largest hospitals in Abu Dhabi Emirate between 2010 and 2014. Data collected included MS type, age and symptoms at onset, expanded disability status scale, treatment, laboratory findings and family history. RESULTS 510 patients were identified consisting of 318 (62.2%) Emiratis and 192 (37.6%) expatriates. Total crude prevalence rate was 18/100,000 (95% CI: 10-30/100,000). Crude prevalence rate in Emiratis was 57.09 (95% CI:50 to 63/100,000) but increased to 64.44 (95% CI: 57 to 72/100,000) when age standardized. Age-standardized incidence rate in Emiratis was 6.0 MS cases per 100,000 person-years (95% CI: 5.5 to 6.5 cases per 100,000 person-years). CONCLUSION At 64.44/100,000, the Abu Dhabi Emirati population has one of the highest, most reliable prevalence rate on the Arab peninsula. Age/sex standardized prevalence rates, uncommonly reported in the Middle East, should be standard for all prevalence studies.
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Affiliation(s)
- Nicoline Schiess
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States.
| | - Katherine Huether
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States
| | - Taghreed Fatafta
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States
| | - Kathryn C Fitzgerald
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States
| | - Peter A Calabresi
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States
| | - Iain Blair
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States
| | - Taoufik Alsaadi
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States
| | - Miklos Szolics
- Johns Hopkins University, Neurology, 600 N. Wolfe St. Meyer 6-113, Baltimore, MD 21287, United States
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Al-Kuwaiti SJ, Aziz F, Blair I. Frailty in Community-Dwelling Older People in Abu Dhabi, United Arab Emirates: A Cross-Sectional Study. Front Public Health 2015; 3:248. [PMID: 26579508 PMCID: PMC4630498 DOI: 10.3389/fpubh.2015.00248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/19/2015] [Indexed: 11/17/2022] Open
Abstract
Background Frailty describes the aging-associated loss of physiological and psychological reserves, leading to an increased risk of adverse health outcomes. Many developed countries view frailty as a major priority for their health and social care systems. Less is known about frailty in less-developed countries. The purpose of this study was to determine the prevalence of frailty in a sample of community-dwelling older people in the United Arab Emirates (UAE). Methods This was a cross-sectional study of community-dwelling Emirati adults aged 55 years and older (n = 160) in Abu Dhabi, UAE. Data were collected at interview by questionnaire and physical measurements. Frailty was defined according to the criteria of the Fried Frailty Index. The prevalence of frailty and its association with selected independent variables were assessed. Results The overall prevalence of frailty (95% CI) was 47% (39–55). Higher levels of frailty were seen in older age groups, women, those who were non-married, those with recent hospital admission, those with comorbid conditions, those on more than five medications, and those with lower forced expiratory volume and mini-mental state examination score. After adjustment in a multiple logistic regression model, only age and gender were found to be independently associated with frailty. Conclusion A high prevalence of frailty was found among older Emiratis. Given that frailty is associated with adverse health outcomes and can be a means of identifying opportunities for intervention in clinical practice and health policy, further attention and consideration within professional and public health policy circles are needed.
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Affiliation(s)
| | - Faisal Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
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Shah SM, Loney T, Dhaheri SA, Vatanparast H, Elbarazi I, Agarwal M, Blair I, Ali R. Association between acculturation, obesity and cardiovascular risk factors among male South Asian migrants in the United Arab Emirates--a cross-sectional study. BMC Public Health 2015; 15:204. [PMID: 25885030 PMCID: PMC4358865 DOI: 10.1186/s12889-015-1568-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/17/2015] [Indexed: 12/02/2022] Open
Abstract
Background Approximately 65% of the United Arab Emirates (UAE) population are economic migrants from the low- and middle-income countries of South Asia. Emerging evidence suggests that expatriate populations from low or middle-income countries that migrate to high-income countries acculturate their lifestyle with the obesogenic behaviours of the host country. Previous research has focussed on migrant populations in the United States. The objective of this study was to assess the prevalence of obesity and explore the relationship between years of residency (surrogate measure for acculturation) and obesity among South Asian (from India, Pakistan and Bangladesh) male immigrants residing in the UAE. Methods A random sample of 1375 males was recruited from a mandatory residency visa health screening centre in Abu Dhabi (UAE). Employing a cross-sectional design, participants completed an interviewer-led adapted version of the World Health Organisation STEPS questionnaire, and anthropometric and blood pressure measurements were collected. Glycated haemoglobin (HbA1c) was measured in a random sub-sample (n = 100). Logistic regression was used to determine risk factors for being classified as obese, and to assess the relationship between years of residency and adiposity. Results The overall prevalence of body mass index-derived overweight and obesity estimates and waist-to-hip-derived central obesity rates was 615 (44.7%) and 917 (66.7%) males, respectively. Hypertension was present in 419 (30.5%) of the sample and diabetes in 9 (9.0%) of the sub-sample. Living in the UAE for six to 10 years or more than 10 years was independently associated with being classified with central obesity (adjusted odds ratio [AOR] 1.63 95% confidence intervals [CI] 1.13 - 2.35, p < 0.008; AOR 1.95 95% CI 1.26 - 3.01, p < 0.002; respectively) compared to residing in the UAE for one to five years. Conclusions Our study revealed a high prevalence of overweight, central obesity and hypertension amongst a young South Asian male migrant population in the UAE. Study findings suggest a diminished ‘Healthy Migrant Effect’ with increased years of residency possibly due to greater acculturation and a transition in lifestyle behaviours. Health initiatives targeting the maintenance of a healthy body size, coupled with regular assessments of glucose control and blood pressure are urgently required in this population.
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Affiliation(s)
- Syed M Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | | | - Hassan Vatanparast
- School of Public Health, College of Nutrition and Pharmacy, University of Saskatchewan, Saskatchewan, Canada.
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Mukesh Agarwal
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Raghib Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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Papadimitropoulos M, El Barazi I, Blair I, Kalsaiti S, Shah K, Devlin N. Valuing Health in the Uae: An Investigation of the Feasibility and Cultural Appropriateness of Using the TTO and DCE Methods to Generate Health State Values. Value Health 2014; 17:A753. [PMID: 27202737 DOI: 10.1016/j.jval.2014.08.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - I El Barazi
- United Arab Emirates University, Al Ain, United Arab Emirates
| | - I Blair
- United Arab Emirates University, Al Ain, United Arab Emirates
| | - S Kalsaiti
- United Arab Emirates University, Al-Ain, UAE, United Arab Emirates
| | - K Shah
- Office of Health Economics, University of Sheffield, London, UK
| | - N Devlin
- Office of Health Economics, London, UK
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Gamblin J, Maund J, Blair I, Clarke SC. Measles cluster at a university in the United Kingdom. BMC Res Notes 2014; 7:744. [PMID: 25339299 PMCID: PMC4283119 DOI: 10.1186/1756-0500-7-744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 10/13/2014] [Indexed: 11/28/2022] Open
Abstract
Background Measles remains an infection of public health importance. We describe a cluster of measles in a university setting between April and May 2007. Case presentation The outbreak took place over a period of six weeks and involved nine students, eight of whom lived in halls of residence. Due to the potential for significant spread in an institutional setting, a public health investigation was initiated to identify the source of the outbreak. Follow up of cases was undertaken proactively with the university and local general practitioners. Salivary fluid test kits and questionnaires were sent to suspected cases. Seven salivary test kits were returned, but only one questionnaire was returned. Four cases were confirmed as measles. Although seven students had been previously immunised, immunity was only demonstrated in three. Conclusions Public health investigations were hampered by the poor return rate of questionnaire and oral fluid sampling kits despite proactive follow up by public health staff, as well as the break for summer vacation. Nevertheless, our report highlights the public health effort in investigating such outbreaks and the importance of reinforcing immunisation to college and university students.
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Affiliation(s)
| | | | | | - Stuart C Clarke
- Public Health England, Hampshire and Isle of Wight Health Protection Unit, Fareham, Hampshire, UK.
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Hamid S, Al-Ghufli FR, Raeesi HA, Al-Dliufairi KM, Al-Dhaheri NS, Al-Maskari F, Blair I, Shah SM. Women's knowledge, attitude and practice towards menopause and hormone replacement therapy: a facility based study in Al-Ain, United Arab Emirates. J Ayub Med Coll Abbottabad 2014; 26:448-454. [PMID: 25672162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Hormone replacement therapy (HRT) is an effective treatment for menopausal symptoms like vasomotor symptoms, sleep disturbances, mood alteration, depression, urinary tract infection, vaginal atrophy and increased health risks for osteoporosis, cardiovascular diseases and loss of cognitive function. This study was conducted to determine knowledge, attitude and practice toward menopause among women in UAE. METHODS A clinic-based cross-sectional study was carried out among women of age 40 and above. Study subjects were recruited from four Primary Health Care centres in Al Ain city. The participants were administered a questionnaire in Arabic and English, which included 33 items; socio-demographic variables, and questions related to knowledge, attitude and practices regarding menopause and HRT. RESULTS Out of 177 study subjected selected, 150 (85%) completed the survey. Almost half of the participants (51%) had already experienced menopause. A substantial number of women had poor know knowledge about menopause (67%) and HRT (73%). Sixty percent of women had positive attitude towards menopause. Of the fifty three percent of women with symptoms, 35% of them did not use anything to relieve their symptoms. Knowledge about menopause varied significantly (p<0.05) with the level of education and nationality. The association between reported symptoms and attitude towards menopause and HRT was found to be statistically significant. Women with reported symptoms that were bothersome had positive attitude towards HRT uptake. CONCLUSION The study indicated that there is poor knowledge about menopause and HRT among the participants. Level of knowledge was associated with the level of education. There was a positive attitude towards menopause, with women suffering the most from menopausal symptoms showing positive attitude towards HRT.
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Blair I, Grivna M, Sharif AA. The "Arab World" is Not a Useful Concept When Addressing Challenges to Public Health, Public Health Education, and Research in the Middle East. Front Public Health 2014; 2:30. [PMID: 24783189 PMCID: PMC3988371 DOI: 10.3389/fpubh.2014.00030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 03/27/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
| | - Amer Ahmad Sharif
- Education Division, Dubai Healthcare City , Dubai , United Arab Emirates
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Loney T, Aw TC, Handysides DG, Ali R, Blair I, Grivna M, Shah SM, Sheek-Hussein M, El-Sadig M, Sharif AA, El-Obaid Y. An analysis of the health status of the United Arab Emirates: the 'Big 4' public health issues. Glob Health Action 2013; 6:20100. [PMID: 23394856 PMCID: PMC3566378 DOI: 10.3402/gha.v6i0.20100] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 01/08/2013] [Accepted: 01/09/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The United Arab Emirates (UAE) is a rapidly developing country composed of a multinational population with varying educational backgrounds, religious beliefs, and cultural practices, which pose a challenge for population-based public health strategies. A number of public health issues significantly contribute to morbidity and mortality in the UAE. This article summarises the findings of a panel of medical and public health specialists from UAE University and various government health agencies commissioned to report on the health status of the UAE population. METHODS A systematic literature search was conducted to retrieve peer-reviewed articles on health in the UAE, and unpublished data were provided by government health authorities and local hospitals. RESULTS The panel reviewed and evaluated all available evidence to list and rank (1=highest priority) the top four main public health issues: 1) Cardiovascular disease accounted for more than 25% of deaths in 2010; 2) Injury caused 17% of mortality for all age groups in 2010; 3) Cancer accounted for 10% of all deaths in 2010, and the incidence of all cancers is projected to double by 2020; and 4) Respiratory disorders were the second most common non-fatal condition in 2010. CONCLUSION The major public health challenges posed by certain personal (e.g. ethnicity, family history), lifestyle, occupational, and environmental factors associated with the development of chronic disease are not isolated to the UAE; rather, they form part of a global health problem, which requires international collaboration and action. Future research should focus on population-based public health interventions that target the factors associated with the development of various chronic diseases.
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Affiliation(s)
- Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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Taha NF, Sharif AA, Blair I. Financing health care in the United Arab Emirates. World Hosp Health Serv 2013; 49:33-39. [PMID: 24228347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Newcomers to the United Arab Emirates (UAE) health care system often enquire about the way in which UAE health services are financed particularly when funding issues affect eligibility for treatment. The UAE ranks alongside many western counties on measures of life expectancy and child mortality but because of the unique population structure spends less of its national income on health. In the past as a wealthy country the UAE had no difficulty ensuring universal access to a comprehensive range of services but the health needs of the UAE population are becoming more complex and like many countries the UAE health system is facing the twin challenges of quality and cost. To meet these challenges new models of health care financing are being introduced. In this brief article we will describe the evolution of UAE health financing, its current state and likely future developments.
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Blair I, Sharif A. Health and health systems performance in the United Arab Emirates. World Hosp Health Serv 2013; 49:12-17. [PMID: 24683809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the early 2000s, the United Arab Emirates (UAE) had good levels of health and its health system was ranked twenty-seventh in the world by the World Health Organization. Since that time, to further improve the situation and to address cost and quality challenges, the UAE has embarked on an ambitious programme of health system reform. These reforms have focused on the introduction of private health insurance and encouraging the growth of private health provision. In these areas there have been impressive achievements but while it is too early to say whether these reforms are succeeding some anxieties are emerging. These include the rising cost of services with no obvious improvement in outcomes, a growth in hospital provision that may not best meet the needs of the population, rising levels of chronic disease risk factors and an insuffcient focus on public health services, public health leadership, health work-force planning and research.
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Gamblin J, Jefferies JM, Harris S, Ahmad N, Marsh P, Faust SN, Fraser S, Moore M, Roderick P, Blair I, Clarke SC. Nasal self-swabbing for estimating the prevalence of Staphylococcus aureus in the community. J Med Microbiol 2012; 62:437-440. [PMID: 23222858 DOI: 10.1099/jmm.0.051854-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Staphylococcus aureus remains a significant cause of morbidity and mortality and, therefore, a burden on healthcare systems. Our aim was to estimate the current rate of nasal S. aureus carriage in the general population and to determine the feasibility of nasal self-swabbing as a means of detection. Two thousand people (1200 adults and 800 children) from a single NHS general practice in Southampton, UK, were randomly selected from a general practice age sex register, stratified by age and sex, and invited to undertake nasal self-swabbing in their own home. Overall, 362 (32.5%) swabs from adults and 168 (22%) from children were returned. Responses were greater for adults and those of increased age, female gender and decreasing socio-economic deprivation. The overall estimated practice carriage rate of S. aureus directly standardized for age sex was 28% [95% confidence interval (CI) 26.1-30.2%]. Carriage of meticillin-susceptible S. aureus was 27% (95% CI 26.1-30.2%), whilst that of meticillin-resistant S. aureus was 1.9% (95% CI 0.7-3.1%). Although nasal self-swabbing rates were relatively low, they are comparable to other studies and may allow large population-based carriage studies to be undertaken at relatively low cost. Importantly, this study updates prevalence data for S. aureus carriage in the community.
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Affiliation(s)
- Jenny Gamblin
- Health Protection Agency, Hampshire and Isle of Wight Health Protection Unit, Unit 8, Fulcrum 2, Solent Way, Whiteley, Hampshire PO15 7FN, UK
| | - Johanna M Jefferies
- Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK
| | - Scott Harris
- Academic Unit of Primary and Population Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK
| | - Nusreen Ahmad
- HPA Public Health Laboratory, Southampton Laboratory Level B, South Pathology Block, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK
| | - Peter Marsh
- HPA Public Health Laboratory, Southampton Laboratory Level B, South Pathology Block, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK
| | - Saul N Faust
- NIHR Respiratory Biomedical Research Unit, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.,NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.,Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK
| | - Simon Fraser
- Grove Medical Practice, Shirley Health Centre, Grove Road, Southampton SO15 3UA, UK
| | - Michael Moore
- Academic Unit of Primary and Population Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK
| | - Paul Roderick
- Academic Unit of Primary and Population Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK
| | - Iain Blair
- Institute of Public Health, College of Medicine & Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates
| | - Stuart C Clarke
- NIHR Respiratory Biomedical Research Unit, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.,HPA Public Health Laboratory, Southampton Laboratory Level B, South Pathology Block, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.,Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK
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Blair I, Sharif AA. Population structure and the burden of disease in the United Arab Emirates. J Epidemiol Glob Health 2012; 2:61-71. [PMID: 23856422 PMCID: PMC7320375 DOI: 10.1016/j.jegh.2012.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 02/17/2012] [Accepted: 04/05/2012] [Indexed: 11/15/2022] Open
Abstract
To carry out their duties more effectively, health care professionals in the UAE often ask about the population structure and the main causes of mortality and morbidity in the country. This paper summarizes what is known about these topics drawing on secondary data sources that are available in the public domain, including census data, population estimates, births and deaths, proportionate mortality, age-standardized mortality rates and disability adjusted life-years. There are inconsistencies and flaws in some of this data which this paper will highlight and attempt to explain. Since 2005, the UAE population has grown substantially owing to high natural growth and high net inward migration and is currently estimated to be about 8.2 million. In 2008, injuries, heart disease, neoplasms and cerebrovascular disease accounted for 57% of deaths, and this is well known. Less is reported about the risk of death, disease, injury and disability. The population of the UAE is diverse, and there are variations in mortality and morbidity risk by age-group, sex and nationality. The authors recommend improvements in the timeliness, completeness and consistency of data. They conclude that better data will encourage more analysis which will generate health intelligence leading to health improvement for the UAE population.
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Affiliation(s)
- Iain Blair
- Department of Community Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates.
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Sonnevend Á, Blair I, Alkaabi M, Jumaa P, Al Haj M, Ghazawi A, Akawi N, Jouhar FS, Hamadeh MB, Pál T. Change in meticillin-resistant Staphylococcus aureus clones at a tertiary care hospital in the United Arab Emirates over a 5-year period. J Clin Pathol 2011; 65:178-82. [PMID: 22039280 DOI: 10.1136/jclinpath-2011-200436] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS Meticillin-resistant Staphylococcus aureus (MRSA) strains isolated in Tawam Hospital, a tertiary care hospital in the United Arab Emirates, were examined in order to understand the reasons for a doubling of its incidence between 2003 and 2008 while maintaining the same infection control measures. METHODS All consecutive non-duplicate clinically relevant MRSA isolates recovered between January and December 2003 and between May and October 2008 were studied. The antibiotic susceptibility, pulsed field gel electrophoresis, toxin gene, staphylococcal cassette chromosome mec (SCCmec), spa, agr and multilocus sequence types of the strains were tested. RESULTS In 2003, typical healthcare-associated (HA-MRSA) genotypes (ST239-MRSA-III, ST22-MRSA-IV and ST5-MRSA-II) represented the majority (61.5%) of the isolates. By 2008 this pattern had changed and clonal types considered as community-associated (CA) MRSA comprised 73.1% of the strains with ST80-MRSA-IV, ST5-MRSA-IV and ST1-MRSA with non-typable SCCmec types being the most frequent. However, further epidemiological investigations showed that only one-third of the CA-MRSA infections were actually acquired in the community, indicating that CA-MRSA clones have entered and spread within the hospital. CONCLUSIONS The emergence of CA-MRSA clones with subsequent entry to and spread within the hospital has contributed to the increasing incidence of MRSA observed in Tawam Hospital and probably also in other hospitals in the UAE.
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Affiliation(s)
- Ágnes Sonnevend
- Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Aw TC, Zoubeidi T, Al-Maskari F, Blair I. Challenges and strategies for quantitative and qualitative field research in the United Arab Emirates. Asian Pac J Cancer Prev 2011; 12:1641-1645. [PMID: 22126513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Clinical and public health research depends on factors including national systems, socio-cultural influences, and access to organisations and individuals. As a 'new' country, the United Arab Emirates (UAE) has yet to develop strong support for population research. However, there is interest in research. The challenges for quantitative and qualitative research include the varied composition and mobility of the UAE population, with limited health records and disease registries. Long-term follow-up of patients, and tracing foreign workers who may only be in the UAE for a few years, are two major obstacles for longitudinal studies. There can also be a reluctance shown by parts of the population to participate in studies, especially those that require responding to what is perceived as sensitive questions. Successful execution of population research in the UAE requires an understanding of socio-cultural aspects of the study population, and good communication between researchers and participants.
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Affiliation(s)
- Tar-Ching Aw
- Department of Community Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates.
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Sharif AA, Blair I. The role of the hospital in the changing landscape of UAE health care: a focus on Dubai. World Hosp Health Serv 2011; 47:11-13. [PMID: 22235721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In the UAF, health services have developed greatly in the past 40 years and there have been enormous improvements in population health. The hospital sector is growing strongly with private sector investment. However the current and future health needs of the population are complex and may not be properly served by the continued expansion of hospital capacity. In this paper, using the Emirate of Dubai as a case study, we examine the changes that have taken place in health services and attempt to predict their optimum configuration and capacity in the future taking into account population structure and growth and levels of morbidity and service use.
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Blair I. Children's environmental health. Ibnosina Journal of Medicine and Biomedical Sciences 2010. [DOI: 10.4103/1947-489x.210997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Iain Blair
- Department of Community Medicine, Faculty of Medicine & Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates
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Khan G, Rizvi TA, Blair I, Adrian TE. Risk of blood-borne infections in barber shops. J Infect Public Health 2010; 3:88-9. [PMID: 20701897 DOI: 10.1016/j.jiph.2010.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 03/07/2010] [Accepted: 03/12/2010] [Indexed: 10/19/2022] Open
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Alangaden GJ, Aldape MJ, Allardet-Servent J, Allen UD, Ammerlaan HS, Angelakis E, Artenstein A, Asboe D, Asiedu KB, Atherton JC, Aw TC, Baid-Agrawal S, Bailey R, Bandel C, Barie PS, Barillo DJ, Bart PA, Bayston R, Beard CB, Beeching NJ, Bégué RE, Benhamou Y, Benson CA, Berbari EF, Berendt AR, Bhatta MP, Bille J, Bitnun A, Black FT, Blair I, Blanche S, Bleck TP, Bleeker-Rovers CP, Bleijenberg G, Bloch KC, Bonten MJ, Boucher CA, Bourayou R, Bouza ES, Bowie WR, Brause BD, Brisse S, Britton W, Brook I, Brown DW, Brun-Buisson C, Brust JC, Bryant AE, Bryskier A, Buller RML, Bush K, Calandra T, Cameron DW, Caraël M, Carr MJ, Casas I, Chambers ST, Chiller KG, Chiller TM, Chiodini PL, Chopra I, Chu AC, Chung KK, Clark BM, Clumeck N, Cockerell CJ, Cohen J, Collinge J, Conlon CP, Corey GR, Cross A, Cross JH, Currier J, Curtis CM, Dallabetta G, Davidson RN, Davies J, Day J, Day NP, De Gascun CF, de Wit S, Delmont J, Dennis DT, Diemert DJ, Doganay M, Doherty T, Dolecek C, Donati SY, Dondorp AM, Doudier B, Drancourt M, Drekonja DM, Drew RH, Duker JS, Dummer JS, Edwards CN, Ekkelenkamp MB, Enright MC, Epstein PR, Erard V, Eziefula AC, Feinberg MB, Fenollar F, Fenwick A, Fernandez L, Fierer J, Finch RG, Flexner CW, Fluit AC, Ford-Jones EL, Fournier PE, Fraser V, French MA, Friedland JS, Fritz JM, Furuya EY, Gage KL, Garcia LS, Gastañaduy AS, Ghanem KG, Giannella M, Glaser CA, Glesby MJ, Glover S, Glupczynski Y, Gnann JW, Goddard AF, Goldstein EJ, González IJ, Gorbach SL, Gottstein B, Gowda R, Grabenstein JD, Grange JM, Green MD, Green ST, Greenblatt DT, Greenwood B, Gregson AL, Groll AH, Gupta AK, Gwee KA, Hall W, Hammer SM, Handa S, Hanfelt-Goade D, Harari A, Harris M, Hartman BJ, Hay RJ, Henderson DK, Hensley LE, Herbert L, Hill DR, Hills TJ, Hinze JD, Hirsch HH, Hirschel B, Hoepelman AI, Holland SM, Horgan MM, Howe R, Hughes JM, Hull MW, Inderlied CB, Ison MG, Jenks PJ, Johnson JR, Jones T, Kanno M, Kauffman C, Kelly P, Kendler JS, Keynan Y, Khan AS, Kho GT, Kinghorn GR, Klapper PE, Kluytmans JAJW, Kok M, Koné-Paut I, Krieger JN, Kroes AC, Kroon FP, Kubin CJ, La Rosa AM, Lalani T, Lalloo DG, Lambert H, Landraud L, Lawn SD, Pharm PL, Leone M, Levi I, Levitt AM, Lindquist HDA, Lloyd G, Looney DJ, Lowy FD, Luft BJ, Lynn WA, Macielag MJ, Mackowiak PA, MacPherson PA, Maghraoui-Slim V, Main J, Mallet V, Mangino JE, Manuel O, Marchetti O, Marks K, Marr KA, Martin C, Martín-Rabadán P, Martinez AJ, Mascini EM, Mayer KH, McCormick JB, McGready R, McKendrick MW, Mead S, Mégraud F, Meheus AZ, Meintjes G, Michaels MG, Miles M, Miller A, Mimiaga MJ, Mingeot-Leclercq MP, Mitchell TG, Moise PA, Montaner J, Moore CB, Moreillon P, Morgan-Capner P, Montessori V, Moss P, Muñoz P, Naber KG, Nakhla S, Narain JP, Nathwani D, Newton P, Nguyen C, Nicolle LE, Niederman MS, Noel GJ, Norrby SR, Nosten F, Notarangelo LD, Nyirjesy P, O'Connell PR, Odorico JS, Ong EL, Opal SM, Ormerod LP, Osmon DR, Ottesen EA, Palacios G, Pantaleo G, Papazian L, Parola P, Pascual MA, Patrozou E, Paya C, Peacock SJ, Pechère JC, Perkins MD, Peters B, Pfyffer GE, Pham PA, Piot P, Placko-Parola G, Pol S, Posfay-Barbe KM, Powderly WG, Pozniak A, Prod'hom G, Quinn TC, Rahn DW, Rana AI, Raoult D, Raz R, Razonable R, Read RC, Reynolds SJ, Richardson MD, Robinson CC, Rooijakkers SH, Rosenbluth D, Rosenzweig SD, Rovery C, Rubin RH, Rubinovitch B, Rubins KH, Rubinstein E, Ryan G, Ryder S, Safren S, Sahasrabuddhe VV, Saikku PA, Sakoulas G, Salazar JC, Salvaggio MR, Schaffer K, Schmitz FJ, Schooley RT, Schumacher RF, Scrimgeour EM, Seddon J, Seifert H, Serjeant GR, Sha BE, Shah KV, Shapiro DS, Sheehan G, Shoham S, Simmons CP, Simonsen KA, Singh N, Slack MP, Sobel JD, Sopirala MM, Spacek LA, Sriskandan S, Stanley SL, Steckelberg JM, Stephenson I, Stevens DL, Straus WL, Sturm W, Summerbell RC, Susa JS, Tabrizi SJ, Tack MA, Taplitz R, Tebas P, Temmerman M, Thijsen SF, Thomas LD, Thomson G, Thwaites GE, Tirelli U, Tolkoff-Rubin NE, Tønjum T, Torriani FJ, Townsend GC, Masó GT, Tulkens PM, Tunkel AR, Vaccher E, Vallet-Pichard A, Van Bambeke F, van de Beek D, van der Meer JW, van Loon AM, van Putten J, Vaudaux BP, Vermund SH, Verstraelen H, Verweij P, Viscidi RP, Visvanathan K, Visvesvara GS, von Seidlein L, Wagenlehner FM, Wahl-Jensen V, Walsh TJ, Warhurst DC, Warnock DW, Warrell DA, Warrell MJ, Warris A, Weber R, Weidner W, Weston VC, Whimbey E, Whitby M, White PJ, Whitty CJ, Willems RJ, Williams E, Wilson C, Wilson ME, Winn RE, Winthrop KL, Wiselka MJ, Wisplinghoff H, Wolfe CR, Wood R, Wright N, Yankaskas JR, Zaidi NA, Zenilman JM, Zhang Y, Zuckerman AJ, Zuckerman JN, Zumla A. Contributors. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Stirling J, Griffith M, Blair I, Cormican M, Dooley JSG, Goldsmith CE, Glover SG, Loughrey A, Lowery CJ, Matsuda M, McClurg R, McCorry K, McDowell D, McMahon A, Cherie Millar B, Nagano Y, Rao JR, Rooney PJ, Smyth M, Snelling WJ, Xu J, Moore JE. Prevalence of gastrointestinal bacterial pathogens in a population of zoo animals. Zoonoses Public Health 2008; 55:166-72. [PMID: 18331520 DOI: 10.1111/j.1863-2378.2007.01099.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Faecal prevalence of gastrointestinal bacterial pathogens, including Campylobacter, Escherichia coli O157:H7, Salmonella, Shigella, Yersinia, as well as Arcobacter, were examined in 317 faecal specimens from 44 animal species in Belfast Zoological Gardens, during July-September 2006. Thermophilic campylobacters including Campylobacter jejuni, Campylobacter coli and Campylobacter lari, were the most frequently isolated pathogens, where members of this genus were isolated from 11 animal species (11 of 44; 25%). Yersinia spp. were isolated from seven animal species (seven of 44; 15.9%) and included, Yersinia enterocolitica (five of seven isolates; 71.4%) and one isolate each of Yersinia frederiksenii and Yersinia kristensenii. Only one isolate of Salmonella was obtained throughout the entire study, which was an isolate of Salmonella dublin (O 1,9,12: H g, p), originating from tiger faeces after enrichment. None of the animal species found in public contact areas of the zoo were positive for any gastrointestinal bacterial pathogens. Also, water from the lake in the centre of the grounds, was examined for the same bacterial pathogens and was found to contain C. jejuni. This study is the first report on the isolation of a number of important bacterial pathogens from a variety of novel host species, C. jejuni from the red kangaroo (Macropus rufus), C. lari from a maned wolf (Chrysocyon brachyurus), Y. kristensenii from a vicugna (Vicugna vicugna) and Y. enterocolitica from a maned wolf and red panda (Ailurus fulgens). In conclusion, this study demonstrated that the faeces of animals in public contact areas of the zoo were not positive for the bacterial gastrointestinal pathogens examined. This is reassuring for the public health of visitors, particularly children, who enjoy this educational and recreational resource.
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Affiliation(s)
- J Stirling
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast BT9 7AD, Northern Ireland
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Duffy G, Sheridan J, McDowell D, Blair I, Harrington D. The use of Alcalase 2·5L in the acridine orange direct count technique for the rapid enumeration of bacteria in beef mince. Lett Appl Microbiol 2008. [DOI: 10.1111/j.1472-765x.1991.tb00607.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bodley-Tickell AT, Mossop H, Rehman Y, Natin D, Blair I. Enhanced surveillance of HIV infection in the West Midlands. Commun Dis Public Health 2004; 7:315-8. [PMID: 15779797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The West Midlands Regional HIV Surveillance Project was set up in 1991 in response to a need for enhanced surveillance of HIV at a local level for service planning. The system showed that accurate and timely data could be collected whilst ensuring patient confidentiality. We present some of the data obtained from the system. HIV diagnoses continue to increase year on year, with certain population subgroups, including men who have sex with men and black Africans, disproportionately affected.
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Affiliation(s)
- A T Bodley-Tickell
- Health Protection Agency, Regional Surveillance Unit, 2nd Floor, Lincoln House, Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS
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Blair I, Bodley-Tickell AT, Bhaduri S, White DJ, Smith G, Shirley J, Mossop H, Natin D, Ross JDC. Surveillance of sexually transmitted infections in the West Midlands using anonymised individual patient datasets from genitourinary medicine clinics. Commun Dis Public Health 2004; 7:112-9. [PMID: 15259411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Sexually transmitted infections (STIs) declined in the UK during the 1980s and early 1990s but have increased substantially since 1995. Within the overall increase there are important differences in the epidemiology of these infections. The current, aggregate system of STI data collection in the UK provides limited demographic information and is unable to fully explain these differences. More useful information can be obtained using an enhanced surveillance system that collects disaggregate, anonymised, individual patient data including ethnic group and truncated postcode of residence. Such a system has been set up in the West Midlands NHS region. The methodology of the project is described here along with the findings to date. These findings confirm that the burden of STIs disproportionately affects young persons, men who have sex with men, black ethnic minority groups and those living in urban areas. Identifying the groups at greatest risk in this way enables interventions to be more usefully targeted.
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Affiliation(s)
- I Blair
- Health Protection Agency, West Bromwich
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Olowokure B, Spencer NJ, Hawker JI, Blair I, Smith RL. Invasive Haemophilus influenzae disease: an ecological study of sociodemographic risk factors before and after the introduction of Hib conjugate vaccine. Eur J Epidemiol 2003; 18:363-7. [PMID: 12803378 DOI: 10.1023/a:1023606501705] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study examines the impact of H. influenzae type b (Hib) conjugate vaccine on sociodemographic risk factors for invasive H. influenzae disease in the 2 years before and immediately after the introduction of Hib conjugate vaccine. An ecological study design was used and cases were identified using active surveillance employing several surveillance systems. The study population comprised all children aged < 5 years resident in the West Midlands, an English health region, with laboratory confirmed invasive disease 2 years before (1990-1992) and 2 years after (1992-1994) the introduction of Hib conjugate vaccine. Selected sociodemographic variables derived from the UK census were obtained for all census enumeration districts in the region. Each variable was then ranked and divided into six categories. Linear associations between disease rates and sociodemographic variables were examined. Overall, there was a significant reduction in the incidence of invasive H. influenzae disease. In the pre-conjugate vaccine era there were trends of decreasing disease incidence with increasing child population density (p = 0.012) and total population density (p = 0.0023). In the post-conjugate vaccine period, total population density (p = 0.0275) remained significant and a trend of increasing disease incidence with increasing population mobility (p = 0.0012) was seen. Although Hib conjugate vaccine has resulted in a dramatic reduction in disease incidence changes in sociodemographic risk factors were identified in the post-conjugate vaccine period, particularly population mobility. Our results may have implications for current and future vaccine strategies.
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Affiliation(s)
- Babatunde Olowokure
- Section of Child Health, School of Postgraduate Medicine, University of Warwick, Coventry, UK.
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Olowokure B, Spencer NJ, Hawker JI, Blair I. Immunization with Haemophilus influenzae (Hib) conjugate vaccine following discharge from hospital. Infection 2003; 31:324-6. [PMID: 14556057 DOI: 10.1007/s15010-003-3189-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2002] [Accepted: 05/22/2003] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study was undertaken to ascertain Haemophilus influenzae type b (Hib) conjugate vaccination status following discharge from hospital and to determine the time taken to vaccinate with Hib conjugate vaccine following hospital discharge of unvaccinated children. MATERIALS AND METHODS Population-based cross-sectional survey involving children aged 3-59 months admitted to a hospital with laboratory confirmed invasive H. influenzae disease. RESULTS Of 51 eligible children, 42 (82%) had not received Hib conjugate vaccine prior to admission. No children were immunized prior to discharge. Vaccination following discharge took an average of 110 days (range 3-441 days). More than one quarter (28%) remained unvaccinated following discharge. If these children had been immunized, immunization coverage among this group of children would have increased significantly from 73% to 98% (p = 0.0017). CONCLUSION In the immediate post-Hib conjugate vaccine period, delayed immunization after discharge was identified. This reduces the individual and community benefits of immunization.
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Affiliation(s)
- B Olowokure
- Public Health Laboratory Service Communicable Disease Surveillance Centre, 2nd Floor Lincoln House, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
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Olowokure B, Spencer NJ, Hawker JI, Blair I, Smith RL. Changing socioeconomic risk factors for invasive H. influenzae disease after the introduction of conjugate vaccine. J Infect 2003; 46:46-8. [PMID: 12504608 DOI: 10.1053/jinf.2002.1069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To determine socioeconomic risk factors for invasive Haemophilus influenzae (HI) disease before and after the introduction of HI type b (Hib) conjugate vaccine in the West Midlands, UK. METHODS Study population consisted of children aged <5 years with laboratory confirmed invasive disease. Linear associations between disease rates and socioeconomic variables were examined 2-years before and 2-years after the introduction of conjugate vaccine. RESULTS Pre-vaccine there were no trends in disease incidence. Post-vaccine there was an absolute reduction in disease incidence and significant disease differentials between affluent and deprived populations were identified for non-owner-occupancy (P=0.032) and car access (P=0.049). CONCLUSIONS Our results suggest that changes in socioeconomic risk factor for invasive HI occurred after the introduction of conjugate vaccine. This may have implications for future immunisation strategies.
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Affiliation(s)
- B Olowokure
- Section of Child Health, School of Postgraduate Medicine, University of Warwick, Coventry CV4 7AL, UK.
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Beckwith ALJ, Blair I, Phillipou G. Preferential cis cyclization of 6-hepten-2-yl and related radicals. Example of orbital symmetry control. J Am Chem Soc 2002. [DOI: 10.1021/ja00812a066] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Olowokure B, Spencer NJ, Hawker JI, Blair I. Ethnic differences in invasive Haemophilus influenzae disease in the West Midlands region of England, UK. Eur J Clin Microbiol Infect Dis 2002; 21:65-6. [PMID: 11913507 DOI: 10.1007/s10096-001-0646-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- B Olowokure
- Department of Public Health, South Staffordshire Health Authority, Stafford, England, UK.
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Shickle D, Carlisle J, Fryers P, Wallace S, Suckling R, Cork M, Bowns I, Beyleveld D, McDonagh A, Sandvik L, Mowinckel P, Abdelnoor M, Erikssen G, Erikssen J, White R, Altmann DR, Nanchahal K, Oliver S, Donovan JL, Peters TJ, Frankel S, Hamdy FC, Neal DE, Whincup PH, Gilg J, Papacosta O, Miller GJ, Alberti KGMM, Cook D, Lawlor DA, Ebrahim S, Smith GD, Lampe F, Morris R, Whincup P, Walker M, Ebrahim S, Shaper A, Brunner E, Shipley M, Hemingway H, Juneja M, Page M, Stansfeld S, Kumari M, Walker B, Andrew R, Seckl J, Papadopoulos A, Checkley S, Marmot M, Wood D, Sheehan J, Reilly M, Twomey H, Collins M, Daly A, Loningsigh S, Dolan E, Smith GD, Ben-Shlomo Y, Perry I, Moher M, Yudkkin P, Wright L, Turner R, Fuller A, Schofield T, Mant D, Feder G, Lilford RJ, Dobbie F, Warren R, Braunholtz D, Boaden R, Nolte E, Scholz R, Shkolnikov V, McKee M, Neilson S, Gilthorpe MS, Wilson RC, Jenkinson C, Coulter A, Bruster S, Richards N, Chandola T, Cromwell DA, Griffiths DA, Campbell MJ, Mollison J, McIntosh E, Grimshaw J, Thomas R, Rovers MM, Straatman H, Zielhuis GA, Hemminki E, Hove SL, Veerus P, Hakama M, Tuimala R, Rahu M, Ukoumunne OC, Gulliford MC, Shepstone L, Spencer N, Araya R, Rojas G, Fritsch RE, Acuna J, Lewis G, Ajdacic-Gross V, Bopp M, Eich D, Rossler W, Gutzwiller F, Corcoran P, Brennan A, Reilly M, Perry IJ, Middleton N, Whitley E, Frankel S, Dorling D, Gunnell D, Stanistreet D, Paine K, Scherf C, Morison L, Walraven G, O'Cathain A, Sampson F, Nicholl J, Munro J, Chapple A, Ziebland S, McPherson A, Herxheimer A, Shepperd S, Miller R, Brindle L, Donovan JL, Peters TJ, Quine S, O'Reilly M, Cahill M, Perry IJ, Maconochie N, Doyle P, Prior S, Ego A, Subtil D, Cosson M, Legoueff F, Houfflin-Debarge V, Querleu D, Rasmussen F, Smith GD, Sterne JAC, Tynelius P, Leon DA, Doyle P, Roman E, Maconochie N, Smith P, Beral V, Macfarlane A, Shoham-Vardi I, Winer N, Weitzman D, Levcovich A, Lahelma E, Kivela K, Roos E, Tuominen T, Dahl E, Diderichsen F, Elstad J, Lissau I, Lundberg O, Rahkonen O, Rasmussen NK, Yngwe MA, Gilmore AB, McKee M, Rose R, Salmond C, Crampton P, Tobias M, Li L, Manor O, Power C, Bruster S, Coulter A, Jenkinson C, Osler M, Prescott E, Gronbak M, Andersen AN, Due P, Engholm G, Drury N, Bruce J, Poobalan AS, Smith WCS, Jeffrey RR, Chambers WA, Mueller JE, Doring A, Stieber J, Thorand B, Lowel H, Chen R, Tunstall-Pedoe H, Redpath A, Macintyre K, Stewart S, Chalmers JWT, Boyd AJ, Finlayson A, Pell JP, McMurray JJV, Capewell S, Chalmers JWT, Macintyre K, Stewart S, Boyd AJ, Finlayson A, Pell JP, Redpath, McMurray JJV, Capewell S, Critchley J, Capewell S, Stefoski-Mikeljevic J, Johnston C, Cartman M, Sainsbury R, Forman D, Haward R, Morris E, Haward R, Forman D, Cartman M, Johnston C, Moebus S, Lehmann N, Goodacre S, Calvert N, Montgomery AA, Fahey T, Ben-Shlomo Y, Harding J, Anderson W, Florin D, Gillam S, Ely M, Nath U, Ben-Shlomo Y, Thomson RG, Morris HR, Wood NW, Lees AJ, Burn DJ, West RR, Fielder HM, Palmer SR, Dunstan F, Fone D, Higgs G, Senior M, Moss N, Campbell R, Pound P, Pope C, Britten N, Pill R, Morgan M, Donovan J, Rottingen JA, Garnett GP, Jagger C, Robine JM, Clarke M, Tobiasz-Adamczyk B, Szafraniec K, Lall R, Campbell MJ, Walter SJ, McGrother C, Donaldson M, Dallosso H, Dineen BP, Bourne RR, Ali SM, Huq DMN, Johnson GJ, Stang A, Jockel KH, Karvonen S, Vikat A, Rimpela M, Borras JM, Schiaffino A, Fernandez E, Borrell C, Garcia M, Salto E, Jefferis B, Power C, Graham H, Manor O, Yudkin P, Hey K, Roberts S, Welch S, Johnstone E, Murphy M, Griffiths S, Jones L, Walton R, Rasul F, Stansfeld SA, Hart CL, Gillis C, Smith GD, Marks D, Lambert H, Thorogood M, Neil H, Humphries S, Wonderling D, Surman G, Newdick H, Johnson A, Pharoah P, Glinianaia SV, Wright C, Rankin J, Basso O, Christensen K, Olsen J, Love A, Cheung WY, Williams J, Jackson S, Maddocks A, Hutchings H, Gissler M, Pakkanen M, Olausson PO, Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG, Aveyard P, Markham WA, Sherratt E, Bullock A, Macarthur C, Cheng KK, Daniels H, Murphy S, Egger M, Grimsley M, Green G, Read C, Redgrave P, Suokas A, McCulloch A, Zagozdzon P, Zaborski L, Cardano M, Costa G, Demaria M, Gnavi R, Spadea T, Vannoni F, Batty D, Leon DA, Rahi J, Morton S, Leon D, Stavola BDE, Gunnell D, Fouskakis D, Rasmussen F, Tynelius P, Harrison G, Spadea T, Faggiano F, Armaroli P, Maina L, Costa G, Ellison GTH, Travis R, Phillips M, Dedman D, Upton M, McCarthy A, Elwood P, Davies D, Shlomo YB, Smith GD, Berrington A, Cramer DW, Kuper H, Harlow BL, Titus-Ernstoff L, McLeod A, Stockton D, Brown H, Leyland AH, Liratsopulos G, West CR, Williams EMI, Abrams K, Sharp L, Little J, Brockton N, Cotton SC, Haites NE, Cassidy J, Kamali A, Kinsman J, Kintu P, Quigley M, Carpenter L, Kengeya-Kayondo J, Whitworth. JAG, Porter K, Noah N, Rawson H, Crampin A, Smith WCS, Group CMSOBOTMS, Jahn A, Kudzala A, Kitundu H, Lyamuya E, Razum O, Thomas SL, Wheeler JG, Hall AJ, Moore L, Dennehy A, Shemilt I, Belderson P, Brandon M, Harvey I, Moffatt P, Mugford M, Norris N, O'Brien M, Reading R, Robinson J, Schofield G, Shepstone L, Thoburn J, Cliffe S, Leiva A, Tookey P, Hamers F, Nicoll A, Critchley J, Capewell S, Ness AR, Hughes J, Elwood PC, Whitley E, Smith GD, Burr ML, Chase D, Roderick P, Cooper K, Davies R, Raftery J, Martikainen P, Kauppinen TM, Valkonen T, Somerville M, Barton A, Foy C, Basham M, Thomson H, Petticrew M, Morrison D, Chandola T, Biddulph J, McCarthy M, Gallivan S, Utley M, Kinra S, Black ME, Murphy M, Hey K, Jones L, Brzezinski ZJ, Mazur J, Mierzejewska E, Evans JG, Clarke R, Sherliker P, Birks J, Wrieden WL, Connaghan JP, Tunstall-Pedoe H, Silva IDS, Mangtani P, McCormack V, Bhakta D, Sevak L, McMichael AJ, Sauvaget C, Nagano J, Ogilvie D, Raffle AE, Alden B, Brett M, Babb PJ, Quinn M, Banks E, Beral V, Bull D, Reeves G, Leung GM, Lam TH, Thach TQ, Hedley AJ, Roderick P, Davies R, Crabbe D, Patel P, Raftery J, Bhandari P, Pearce R, Thomas MC, Walker M, Lennon LT, Thomson AG, Lampe FC, Shaper AG, Whincup PH, Fallon UB, Ben-Shlomo Y, Laurence KM, Lancashire RJ, Pharoah POD, Nevin NC, Smith GD, Fear NT, Roman E, Ansell P, Bull D, Nilsen TIL, Vatten LJ, Lane JA, Harvey RF, Murray LJ, Harvey IM, Donovan JL, Egger M, Wright CM, Parker L, Lamont D, Craft AW, Hallqvist J, Lundberg M, Diderichsen F, Boniface DR, McNeilly E, Bromen K, Pohlabeln H, Ahrens W, Jahn I, Jockel KH, Darby S, Doll R, Whitley E, Key T, Silcocks P, Linos D, Markaki I, Ntalles K, Riza E, Linos A, Memon A, Darif M, AL-Saleh K, Suresh A, de Vries CS, Bromley SE, Williams TJ, Farmer RDT, Ruiz M, Nieto A, Boshuizen HC, Nagelkerke NJD, Schellekens JFP, Peeters MF, Den Boer JW, Van Vliet JA, Neppelenbroek SE, Spaendonck MAECV, Mazloomzadeh S, Woodman CBJ, Collins S, Winter H, Bailey A, Young LS, Rosenbauer J, Herzig P, Giani G, Olowokure B, Spencer NJ, Hawker JI, Blair I, Smith R, Olowokure B, White J, Rush M, Hawker JI, Ramsay M, Watkins J, Mayor S, Matthews I, Crilly M, Bundred P, Prosser H, Walley T, Walker ZAK, Oakley L, Townsend JL, Donovan C, Smith H, Bell J, Hurst Z, Marshall S, Wild S, Whyman C, Barter M, Wishart K, Macleod C, Marinko K, Malmstrom M, Johansson SE, Sundquist J, Crampton P, Salmond C, Tobias M, Lumley J, Small R, Brown S, Watson L, Gunn J, Hawe P, Shiell A, Langer M, Steiner G, Tiefenthaler M, Adamek S, Ronsmans C, Khlat M, Waterstone M, Bewley S, Wolfe C, Hooper R, Moore L, Campbell R, Whelan A, Winter H, Macarthur C, Bick D, Lancashire R, Knowles H, Henderson C, Belfield C, Gee H, Biggerstaff D, Lilford R, Olsen J, the EuroMap Group, Spencer EA, Davey GK, Appleby PN, Key TJ., Breeze E, Leon D, Clarke R, Fletcher A, Boniface DR, McNeilly E, Lam TH, Ho SY, Hedley AJ, Mak KH, Canoy D, Khaw KT, Thorogood M, Appleby PN, Mann JI, Key TJ, Bobak M, Pikhart H, Martikainen P, Rose R, Marmot M, Rooney CIF, Cook L, Uren Z, Watson MC, Bond CM, Grimshaw JM, Mollison J, Ludbrook A, Poobalan AS, Bruce J, King PM, Krukowksi ZH, Smith WCS, Chambers WA, Seagroatt V, Goldacre M, Purcell B, Majeed A, Mayor S, Watkins J, Matthews I, Morris RW, Whincup PH, Emberson J, Lampe FC, Walker M, Wannamethee G, Shaper AG, Ebrahim S, May M, McCarron P, Frankel S, Smith GD, Yarnell J, Ebrahim S, May M, McCarron P, Shlomo YB, Stansfeld S, Gallacher J, Smith GD, Taylor FC, Rees K, Ebrahim S, Angelini GD, Ascione R, Muller-Nordhorn J, Binting S, Kulig M, Voller H, Willich SN, Group FTPS, Whincup PH, Emberson J, Papacosta O, Walker M, Lennon L, Thomson A, Sturdy PM, Anderson HR, Butland BK, Bland JM, Victor CR, Wilman C, Gupta R, Anderson HR, Mindell J, Joffe M, Nikiforov B, Pattenden S, Armstrong B, Hedley AJ, Wong CM, Thach TQ, Chau P, Lam TH, Anderson HR, Whitley E, Darby S, Deo H, Doll R, Raleigh VS, Logie J, Macrae K, Lawrenson R, Villegas R, Nielson S, O'Halloran DJ, Perry IJ, Gallacher JEJ, Elwood PC, Yarnell JWG, Shlomo YB, Pickering J, Evans JMM, Morris AD, Sedgwick JEC, Pearce AJ, Gulliford MC, Walker M, Thomson A, Whincup P, Lyons RA, Jones S, Richmond P, McCarthy J, Fone D, Lester N, Johansen A, Saunders J, Palmer SR, Barnes I, Banks E, Beral V, Jones GT, Watson KD, Taylor S, Papageorgiou AC, Silman AJ, Symmons DPM, Macfarlane GJ, Pope D, Hunt I, Birrell F, Silman A, Macfarlane G, Thorpe L, Thomas K, Fitter M, Brazier J, Macpherson H, Campbell M, Nicholl J, Morgan A, Roman M, Allison T, Symmons D, Urwin M, Brammah T, Roxby M, Williams G, Primatesta P, Falaschetti E, Poulter NR, Knibb R, Armstrong SJ, Chilvers CED, Logan RFA, Woods KL, Bhavnani V, Clarke A, Dowie J, Kennedy A, Pell I, Goldacre MJ, Kurina L, Seagroatt V, Yeates D, Watson E, Clements A, Yudkin P, Rose P, Bukach C, Mackay J, Lucassen A, Austoker J, Guillemin M, Brown W, Tell GS, Nurk E, Vollset SE, Nygard O, Refsum H, Ueland PM, Villegas R, Nielson S, Creagh D, Hinchion R, Perry IJ, Allen NE, Key TJ, Vatten LJ, Odegard RA, Nilsen ST, Austgulen R, Harding AH, Khaw KT, Wareham NJ, Riza E, Silva IDS, De Stavola B, Bradlow HL, Sepkovic DW, Linos D, Linos A. Society for Social Medicine and the International Epidemiological Association European Group. Abstracts of oral presentations. Br J Soc Med 2001. [DOI: 10.1136/jech.55.suppl_1.a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
A prevalence survey of nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage was undertaken on a random sample of adults (aged over 16) resident in the community in Birmingham, UK during 1998. Microbiological samples were taken from the anterior nares at the subjects' general practice or in their home. Information about risk factors for the acquisition of MRSA was obtained via a self-completed questionnaire. A 58% response rate (280/483) was achieved. The prevalence of nasal MRSA colonization was 1.5% [4/274, 95% confidence interval (CI) 0.03-2.9%]. Twenty-three per cent (63/274) of subjects were nasal carriers of S. aureus. Six per cent (4/63) of S. aureus isolates were MRSA and 2 of the 4 MRSA carriers reported previous contact with health facilities. The prevalence of MRSA colonization in the general adult population in Birmingham appears to be low.
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Affiliation(s)
- L Abudu
- Public Health Department, Worcestershire Health Authority, Worcester
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Olowokure B, Hawker J, Blair I, Spencer N. Decrease in effectiveness of routine surveillance of Haemophilus influenzae disease after introduction of conjugate vaccine: comparison of routine reporting with active surveillance system. BMJ 2000; 321:731-2. [PMID: 10999903 PMCID: PMC27486 DOI: 10.1136/bmj.321.7263.731] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- B Olowokure
- Section of Child Health, School of Postgraduate Medicine, University of Warwick, Coventry CV4 7AL.
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Cook SA, Blair I, Tyers M. Outbreak of tuberculosis associated with a church. Commun Dis Public Health 2000; 3:181-3. [PMID: 11014031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Investigation of an outbreak of tuberculosis (TB) in a West Midlands health district in 1999 revealed spread in an extended family network and to church contacts. Within the family four cases of smear positive TB, four cases of smear negative infection, and 14 cases requiring chemoprophylaxis were identified. One of the infectious cases visited a local church on two occasions, which resulted in a further 16 cases of infection including one case of tuberculous meningitis. DNA fingerprinting of isolates from five culture positive cases indicated that the same strain of Mycobacterium tuberculosis was responsible. This outbreak is a reminder that while outbreaks of TB usually arise within households or family networks, where close contact over extended periods provides more opportunity for exposure, community outbreaks of TB can occur after only causal contact.
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Affiliation(s)
- S A Cook
- Birmingham Public Health Laboratory
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