Governorates Of Kuwait Research Articles

Dietary fibre intake in Kuwaiti older adults assessed by validated food frequency questionnaire

Adequate dietary fibre (25-30g/day) is essential in a healthy diet preventing several health problems (1). Age-related changes reduce gut function and increase risk of constipation. A better understanding of fibre in those over 60y is required. This study aimed to measure fibre intake in those over 60y in Kuwait using the Kuwaiti Food Frequency Questionnaire for fibre (KWFFQ-DF) and explore local food sources of fibre and laxative use.Recruitment was conducted Dec 2022 to April 2023 in Geriatric Health Services in Kuwait and geriatric units across the six main governorates in Kuwait. The study was approved by the University of Glasgow Research Ethics Committee (project No. 200220066) and the Medical Research Ethics Committee of the Ministry of Health in Kuwait (project No 9512018)18). The validated KWFFQ-DF assessed intake of total fibre (TDF), soluble fibre (SF) and insoluble fibre and included seven food groups and 134 food items. The last two questions asked if the participant consumed supplementary fibre and if they took laxatives (type and amount). The associations between fibre intake and gender, age and governorate and between TDF and laxative use were assessed by Chi squared test (P < 0.05 considered significant).The study recruited 210 people (61 males and 149 females; 61- 96y (median 66y). BMI ranged from 18 to 68 (median 29). Mean TDF intake was 28.7 g/d (SD 6.6; 13 to 46 g/ day). Most participants (n= 186, 89%) did not use laxatives. Several foods high in fibre were frequently consumed by participants including dates, as a snack with coffee eaten 2-6 times/day at 2.2 g TDF per portion and almonds once a day as a snack with 12 g of TDF. Whole grain toast, eaten 1-2 times daily contributed 4g TDF but with eggs or cheese at breakfast so higher in fat. Other key sources were barley bread, (8g TDF), vegetable soup, 2-4 times a week (4 g/d TDF) and Tabouleh Salad, typically eaten with grilled meat or chicken at 2g/d TDF. There was no significant association between fibre intake and gender (χ2= 1.033; P < 0.597) or governorates (χ2= 14.66; P < 0.145). However, the findings identified a significant association between fibre intake and age of participants (χ2= 10.066; P < 0.039). Moreover, there was a highly significant negative association between the TDF intake and laxative use frequency (χ2= 25.63, P<0.001).In contrast to some populations, fibre intake for people in Kuwait over 60y is within dietary guidelines and laxative use is low. Foods high in fibre in Kuwaiti cuisine can be, however, associated with high calories due to the sugar and fat content and may be associated with high BMI. The consequences of this need to be explored.AcknowledgementsWe would like to express our sincere gratitude to Dr Ali Alqattan and the medical team at the Geriatric Clinic in Mubarak Hospital for their valuable assistance in facilitating the interviews with participants in this research project.

Exposure to household secondhand tobacco smoke and the odds of developing atopic dermatitis among adolescents: A causal mediation analysis.

Exposure to household secondhand tobacco smoke (SHS) among adolescents has been shown to be associated with atopic dermatitis, and affects disproportionality females. However, the mechanisms underlying this link are uncertain. This study sought to identify modifiable factors that mediate the relationship between household SHS exposure and atopic dermatitis among adolescents. During October 2015, a cross-sectional study was conducted using the ISAAC questionnaire for data collection from adolescents enrolled in nine high schools of Hawalli - one of the six governorates of Kuwait. Data were collected on sociodemographic characteristics, self-reported tobacco smoking among adolescents, household SHS exposure (≥1 smokers at home vs none), self-reported asthma and atopic dermatitis. For causal mediation analysis an inverse odds-weighting approach was used. Of 746 participants, 74.8% were Kuwaiti, 50.1% were female, 12.4% were regular daily smokers and 54.1% had household SHS exposure, which was more common among Kuwaiti (79.6%) than non-Kuwaiti (20.4%) adolescents. The prevalences of self-reported asthma and atopic dermatitis were 20.6% and 14.9%, respectively. After adjusting for the pre-exposure covariates (i.e. sex and nativity), household SHS exposure had a significant (p=0.043) total effect, non-significant (p=0.133) natural direct effect, and marginally insignificant (p=0.058) natural indirect effect, which were jointly mediated by asthma status and adolescent's self-reported smoking status, with a proportion of mediated risk to atopic dermatitis of 29.6%. Asthma and self-tobacco smoking among adolescents not only directly affected but also mediated household SHS exposure effect on atopic dermatitis risk. Voluntarily adopting a smoke-free home rule may minimize household SHS exposure, reduce the odds of developing asthma, and deter the initiation of tobacco smoking among adolescents. Such an effort will likely mitigate the atopic dermatitis risk among adolescents in this and other similar settings. If implemented, future studies may contemplate evaluating the impact of such intervention.

Social Media as a Health-related Information Source about the Coronavirus among a Sample of Kuwaiti Youth

Due to the rapid dissemination of COVID-19, the public community has begun following social media as a main source of health-related information daily due to the grave, life-threatening implications on patients’ health. The current study aims to (1) detect socio-demographic differences, knowledge of COVID-19 symptoms and general health, and social media trust among youth; (2) determine the degree of using social media and traditional media among youth; and (3) examine the relationship between using social media to track COVID-19 news (symptoms, general health knowledge, and social media trust) and the degree of using social media. This is a cross-sectional study conducted among 663 Kuwaiti youth from all governorates in Kuwait. A self-administrated questionnaire consisted of demographic information and variables related to using social and traditional media to receive information about COVID-19. Findings detect that females and older youth participants show higher COVID-19 general health knowledge and more trust in social media. Males reported highest in following Satellite TV channels, and Instagram as sources of health information. The youngest age group reported a greater use of social media in general. The primary social media platform for following the news is Twitter, with Kuwait TV being the main source of traditional media.
 Keywords: Social Media; Health Information; Coronavirus; Youth; Kuwait.
 

Frequency and visual outcomes of herpes simplex keratitis in a Kuwaiti tertiary referral center.

Herpes simplex virus (HSV), a cause of many ocular pathologies, may affect the corneal epithelium, stroma, or endothelium, with the epithelium as the most frequently affected location. We aimed to determine the frequency and visual outcomes of HSV keratitis over a 1-year period at Farwaniya Hospital, Kuwait. This prospective observational case series included patients diagnosed with HSV keratitis who presented to the outpatient or eye casualty department between September 2022 and September 2023. Full history, demographic profile, detailed ocular and slit-lamp examinations, and visual acuity assessments were recorded prior to and after treatment. Baseline corneal sensation was assessed in the four corneal quadrants using the cotton wisp test. Of the 227 patients who presented with infectious keratitis, 72 (31.7%) were diagnosed with HSV keratitis. The mean (SD) age was 45.86 (16.06) years, and 48 (66.7%) patients were male. The subtypes of HSV keratitis were endotheliitis in 27 (37.5%) patients, dendritic ulcer in 22 (30.6%), stromal keratitis with ulceration in 9 (12.5%) and without ulceration in 8 (11.1%), and geographic ulcer in 6 (8.3%). The mean baseline best-corrected distance visual acuity (BCDVA) differed significantly between the HSV keratitis subtypes (P < 0.001). Most patients (n = 70, 97.2%) had unilateral eye involvement, were treated within 1 - 2 weeks, and demonstrated improved BCDVA. Despite the improvement in BCDVA in all HSV keratitis subtypes, a significant difference in the median BCDVA remained after treatment (P < 0.001). Pairwise comparisons revealed a significantly better BCDVA after treatment in eyes with dendritic epithelial ulcers than in eyes with HSV stromal keratitis with ulceration (P = 0.003) or geographic epithelial ulcers (P = 0.005). After treatment, corneal haze and neovascularization were detected in 54 (75.0%) and 24 (33.3%) patients, respectively. We detected a substantial frequency of HSV keratitis in one of the governorates of Kuwait, with endotheliitis as the most common manifestation. Timely standard treatment interventions based on valid guidelines resulted in BCDVA improvement in all subtypes of HSV keratitis in our series, indicating the importance of early treatment. However, the BCDVA in eyes with dendritic epithelial ulcers remained substantially better than that in eyes with geographic epithelial ulcers or HSV stromal keratitis with ulceration, signifying the effect of the initial HSV keratitis subtype on visual outcomes. To our knowledge, this is the first study to highlight the frequency of HSV keratitis in a Kuwaiti hospital, and larger-scale research in this region is needed to further understand and manage the condition.

Does the severity of untreated dental caries of preschool children influence the oral health-related quality of life?

AimTo assess the impact of untreated dental caries and its severity on the oral health-related quality of life (OHRQoL) of Kuwaiti preschool children and their caregivers.MethodsParticipants were 4- and 5-year-old kindergarten children attending preselected public schools from one of the Governorates in Kuwait. Early childhood caries (ECC) was evaluated by clinical examinations and presented using decayed, missed, filled teeth/surface (dmft/dmfs). The clinical consequences of untreated dental caries were assessed using the pufa (pulp, ulcers, fistula, abscess) index for primary teeth. A structured questionnaire obtained demographic information of children and their caregivers. OHRQoL was assessed using the Arabic version of Early Childhood Oral Health Impact Scale (A-ECOHIS).ResultsAmong the 334 participants, 171 were kindergarten level-1 (KG1), and 163 were level-2 (KG2). The overall prevalence of dental caries was 78.9% for KG1 children and 67.4% for KG2 children. Decayed teeth were the main component for both dmft (84%) and dmfs (68%). The total mean (SD) pufa score was 0.54 (1.5), and about 19.2% of participants had at least one tooth with pufa > 0. A total of 207 A-ECOHIS were completed. Both family and child impact scores were significantly higher for children with a dmft score of 1 or more (p < 0.001) or with one or more pufa (p < 0.001). Child impact section scores were significantly higher with the increasing degrees of untreated caries (dt) (p = 0.004).ConclusionThe severity of untreated dental caries and caries experience had a negative impact on the OHRQoL of Kuwaiti preschool children and their families. Using the pufa index had provided additional information about the effect of the caries severity on the OHRQoL than assessing the caries experience alone.

Kuwait Parents’ Attitudes toward Inclusive Education for Students with Intellectual Disabilities in General Education

This study investigated the attitudes (i.e., beliefs, feelings, and behavioral intentions) of Kuwaiti parents about providing students with intellectual disabilities (ID) an inclusive education in general education classrooms. One hundred seventy-seven parents from the six governorates in Kuwait participated in this study. The researchers utilized a survey method to examine the parents’ attitudes with a concentration on eight demographic attributes: gender, age, level of education, knowledge about people with ID, having a child with a disability, contact with a person with ID, having school-age children, and the governorate where they live. The results indicated that parents who had contact with or had children with ID held the most positive attitudes toward providing students with disabilities an inclusive education in general education. The findings of the study provide a comprehensive view of the importance of the inclusion of people with disabilities in attitude. In this study, we identified predictor factors that affect the attitudes of parents and implications.

Perceptions of Oral Health and Quality of Life among Parents in Kuwait.

To determine the self-perceived oral health and general health as well as the oral health-related quality of life (OHRQoL) among parents in Kuwait. This cross-sectional study was conducted among parents visiting the School Oral Health Programme (SOHP) clinics in all the governorates in Kuwait. Being a parent and able to read and understand the Arabic language was the inclusion criterion. A convenience sample of parents (n = 2357) were enrolled in this study, which was conducted using a self-administered questionnaire in Arabic. The questionnaire included previously validated questions and also questions designed for this study. The parents completed and returned the questionnaire while waiting for their children in the waiting area of the SOHP clinic. The mean age of the parents was 38.3 ± 7.3 years. The majority (75.2%) of the participants perceived their oral health 'excellent', 'very good' or 'good' and 76.4% also rated their general health as 'excellent', 'very good' or 'good'. Overall, higher levels of perceived oral health were reported more frequently by younger participants, females, Kuwaitis, and those who had higher levels of education (p < 0.001). Most of the participants (72.3%) were satisfied with their oral health, (91.0%) enjoyed eating their food and (79.0%) liked their smile. Perceived difficulty in chewing food was stated by only 21.0%, and very few (5.0%) had speech difficulties. Almost half (45.0%) mentioned that they had never had any dental and/or gum problems that affected their daily activities during the past 6 months, nor did such problems influence their social activities. Nearly two-thirds (61.0%) stated that they never had any difficulty in conversation, and half (49.0%) did not report any disturbance in their sleep. Cronbach's alpha (0.89) showed a high degree of internal consistency between different OHRQoL responses. Most of the parents were satisfied with their oral health, which had an impact on their quality of life.

Determinants of Affective Organisational Commitment and the Mediating Role of Job Satisfaction among English Teachers in Kuwait

The notion of affective organisation commitment is devaluing and needs fresh evidence for its contemporary understanding. This paper aimsto explain the organisational commitment in terms of its key determinants such as person-job fit, work conditions, work-life balance and with the with important mediating role of the job satisfaction. A total of 900 survey questionnaires were sent to a sample schools related to six governorates of Kuwait; 548 responded, giving a response rate of 61%. SmartPLS 3 software and SPSS were used to perform structural equation modelling for testing hypotheses and doing the mediation analysis. The findings suggest that organisational commitment is primarily determined by the person-job fit, work conditions, and total experience whereas job satisfaction is found having a moderating relationship in between. There is, however, no considerable evidence to support the teachers nationality and work-life balance have any direct relationship with the affective organisational commitment. These findings reveal fresh evidence from the english teachers community in Kuwaiti government schools and thus inform local government human resource policies and its global theorization. The findings related work-life balance required more research as in the recent times work-life balance has disturb and therefore our findings contradicts the established literature in this regard. Keywords: Organisational Commitment, Job Satisfaction, Job-person fit, work conditions, and experience DOI: 10.7176/JEP/13-15-11 Publication date: May 31 st 2022

Prevalence of Giardiasis and Entamoeba Species in Two of the Six Governorates of Kuwait

Intestinal parasitic infections are a global concern owing to elevated rates of morbidity and mortality in many parts of the world. Increased rates of intestinal parasitic infections are observed in developing and low-income countries. In Kuwait, many expatriates and foreigners hail from endemic countries, thus increasing the rate and risk factor of infection. This retrospective study is aimed at assessing the prevalence of Giardia lamblia and Entamoeba sp. in stool samples handled by two of Kuwait's general hospitals during the period from January 2018 to July 2019: Mubarak Al Kabeer (serving Hawalli governorate population) and Aladan hospitals (serving Mubarak Al Kabeer governorate population) serving 27% of total Kuwait population with Kuwaitis making up only 32%. A total of 9,653 samples were tested for consistency and the availability of any parasitic particles using visual, direct wet mount, and concentration method. Statistical analysis was implemented using SPSS statistical program, at p < 0.05. Of all the 9,653 tested stool samples, 74 were positive for G. lamblia or Entamoeba sp. This represented a mere 1% rate of infection and showed no significant correlation to the prevalence of intestinal parasite infections in Kuwait. On the other hand, comparing the rate of infection in different seasons revealed an increased rate of infection during spring compared to other seasons (p = 0.03). Findings revealed low rates of intestinal parasitic infection within the two governorates of Kuwait representing no statistical significance to the distribution of the investigated parasites in Kuwait. This may be attributed to improved living conditions and healthcare. Elevated infection rates in spring in relation to other seasons raised the importance of increasing public awareness during camping season for maintaining proper personal hygiene and waste management to contain and decrease the rate on infection.

Bromate concentrations and pH values in bottled drinking water in Kuwait.

The study objectives were to assess bromate concentrations in bottled drinking water sold at retail in Kuwait and assess pH values relationship to bromate concentrations. A cross-sectional study was conducted in 2019 where 120 bottled water samples were collected from supermarkets across six governorates in Kuwait. Samples represented local brands that used distilled or mineral water as well as imported brands that used mineral water only. The samples were analyzed for bromate concentrations and pH values. The overall mean bromate concentration was 4.02µg/L (95% CI: 3.35-4.69) with concentration of 4.45µg/L in locally distilled water significantly (P < 0.05) higher than that in imported mineral water samples (i.e., 1.34µg/L). The overall bromate percent positive was 41.7% (n = 120) with 35.8% in locally distilled samples, significantly higher than that in imported mineral samples (5.8%). None of the local mineral bottled water samples had detectable bromate. Bromate concentrations in our samples were within the international allowable limits of less than 10µg bromate/L (except for one local distilled sample that contained 14.9µg bromate/L). The mean pH value was 7.39 (95% CI: 7.33-7.45). There was no significant relationship between pH values and bromate concentrations in our samples. Our findings proved that local and imported bottled water sold at retail in Kuwait was bromate safe.

Economic Anxiety and the Performance of SMEs during COVID-19: A Cross-National Study in Kuwait

The focal aim of the project was to assess the economic anxiety (EA) and the performance of small and medium enterprises (SMEs) during partial and full lockdowns in Kuwait. The challenges facing the SMEs during COVID-19 and the potential solutions were also explored. The call for this vital investigation was due to the global economic fallout and the shocking drop within the marketplace caused by the COVID-19 pandemic. A descriptive approach was used for online survey design to collect datasets from 147 SMEs spanning all governorates of Kuwait in the period between March and June 2021. It included sociodemographic data, economic anxiety perception, potential challenges and solutions to SMEs, and SMEs’ performance. The data analysis using SPSS 25 showed that 78.2% of the SMEs were affected directly by the COVID-19 pandemic, and about 83% were affected negatively by the COVID-19 pandemic. In comparison, only 12.2% experienced a positive impact, mainly medical, technology, social media, food supplies, and delivery or logistics industries. With great concerns of SMEs for all dimensions related to economic anxiety (with an average of around 3.95), the greatest concerns were the financial and cash flow, followed by labor shortage (an average between 4.51 and 5.00). The results also showed that most of the performance indicators for the SMEs were low (with an average of less than or equal to 2.5), and more than 66% of them worked fewer hours during the pandemic; the number of operating hours was dropped dramatically. More than 74% of the SMEs used technology in more than 20% of their activities, representing an increase in using technologies of about 44%, and about 25.2% used social networks in more than 80% of their activities. The performance of SMEs is also found to be significantly and positively correlated with the economic anxiety levels, with a correlation coefficient of 0.186. The findings revealed significant and crucial outcomes for policymaking, decision-makers, and governmental agencies to build recovery plans and proper actions needed to manage the consequences caused by the disaster against the economic and other developments within the context of SMEs. Overall, there is a clear need to find ways and customize operations to adapt to the new work modes that require social distancing, online operations, and site management. In addition, new alternative modes of SMEs work follow to compensate for the lower working hours from the office and increased online working from home.

An architectural analytical study of contemporary minaret design in Kuwait

The minaret is considered the symbol of Islam and a prominent feature in Muslim communities. In Kuwait, almost every mosque, regardless of its size, includes one or more minarets. Minaret architecture has attracted considerable attention, both scholarly and from the public. Previous studies about mosque and minaret architecture have been restricted to architectural styles. The principal objective of this paper was to investigate the minaret's validity as an essential feature in contemporary mosque architecture by analyzing several aspects of minaret’s architecture such as its function, number, prominence, placement of minaret to the mosque, minaret's main components, and minaret's decoration. Based on ten selected case studies representing the six governorates of Kuwait, the study attempts to understand further essential elements of minaret and the extent to which architects can redesign/transform the minaret without risking its symbolic and historic value. The findings indicate that the minaret continues to play an important role and is considered a significant element in contemporary Kuwaiti mosque architecture. The minaret's prominence within mosque design is dependent on its number, location, size, articulation, and decoration’s subtlety. Furthermore, while the square plan is most common in minaret's base, the octagonal shaft plan is the most common in contemporary minarets. This research provides a timely and necessary study of minaret design that contributes to contemporary Mosque architecture, directing architects, designers, and mosque's patrons.

Evaluation of Universal Design Compliance: With Emphasis on the Main Entrance of Selected Mosques in Kuwaiti Governorates

Accessibility characteristics that enable everyone to successfully use public facilities and settings are critical for establishing a sustainable and strong community. Unfortunately, studies show that in reality, numerous public facilities, services, and physical infrastructure in many places are still inaccessible in various ways to people with disabilities. As a result, many countries, including Kuwait, have enacted laws intended to integrate people with disabilities into the mainstream of social, political, and economic life (PADA, n.d.). This study evaluates the main entrances of six main mosques, one in each of the six governorates in Kuwait, to gauge the level of compliance with Universal Design principles.Research objectives: The chief objective of this study is to provide decision-makers in Kuwait with a set of recommendations for complying with Universal Design principles. The main entrances to all mosques in Kuwait should be accessible for all their users, without discriminating against those with physical disabilities, so that more people can participate in their community’s daily social activities. This paper will also provide the Ministry of Awqaf and Islamic Affairs with a body of knowledge about the condition of mosque designs, and main entrances in particular, that could assist designers and decision makers to improve mosque accessibility. The study promotes increased access within public buildings in general and mosques in particular.

Correlates of food intake and mealtime behaviors among Kuwaiti adolescents.

Eating meals with the family improves the food choices of adolescents. Studies conducted on Kuwaiti adolescents have reported suboptimal dietary intake; however, it is unclear what meal-related behaviors and family dynamics influence dietary choices in young Kuwaiti adolescents.This study explored the food intake and meal-related behaviors of young adolescents in relation to their mother's educational level, parental employment, and family size and to identify meal-related behaviors associated with poor dietary choices. A cross-sectional survey was conducted using a modified and validated version of the International Health Behavior in School Children questionnaire recruiting 774 adolescents aged 14-16 years from all six governorates of Kuwait. A higher level of the mother's education was associated with higher odds of eating fruits and breakfast. A stay-at-home mother was associated with higher odds of consuming milk and home-made desserts. Larger family size was associated with higher odds of eating fruits, and a higher frequency of family meals was associated with higher odds of consuming vegetables and whole grain bread. All unhealthy snacks, including sweets, potato chips, french fries, home-made desserts, and sugar-sweetened beverages, were associated with higher odds of watching TV during mealtime. A higher level of mother's education level, large family size, and family meals encouraged consuming fruits, vegetables, whole grain bread, milk, and breakfast, but consuming empty calorie snacks is very common. Family involvement in developing healthy meal-related behaviors is imperative for shaping healthy eating habits of adolescents.

Prevalence of lead toxicity in adolescents in Kuwait

BackgroundElevated blood lead level (EBLL) is a public health problem in both developing and industrialized countries. Being a petrochemical-based economy, lead (Pb) levels are expected to be high in Kuwait, but systematic data on population exposure are lacking. This study aimed at determining the prevalence of EBLL in adolescents in Kuwait.MethodsAdolescents (N = 1385; age range 11–16 years) were cross-sectionally selected from public middle schools from all Governorates of Kuwait, utilizing multistage cluster random sampling. Pb in whole blood was analyzed by inductively coupled plasma mass spectrometry. Distribution of blood Pb levels (BLL) among Governorates and sexes were compared by non-parametric tests and the prevalence of EBLL (defined as BLL above the CDC reference level of ≥5 μg/dL) was estimated by χ2 test. Binary logistic regression was used for assessing the association between EBLL and Governorate.ResultsMedian (IQR) BLL was 5.1(3.6–7.1) μg/dL [4.9 (3.8–6.5) μg/dL in males and 5.4 (3.3–7.6) μg/dL in females; p = 0.001]. In the overall sample, 51% had BLL ≥5 μg/dL; 13% had ≥10 μg/dL and 3% > 20 μg/dL. Prevalence of EBLL was 47% in males and 56% in females (p < 0.001). EBLLs were clustered in Al-Asima, Al-Ahmadi (in both sexes); Al-Jahra (in males) and Mubarak Al-Kabeer (in females) Governorates.ConclusionsEBLL is a significant public health problem in adolescents in Kuwait. Urgent public health intervention is required in areas with EBLL, and the sources of exposure need to be identified for prevention.

Association of blood lead level with vitamin D binding protein, total and free 25-hydroxyvitamin D levels in middle-school children.

A negative association between blood Pb level (BPbL) and vitamin D metabolites in occupationally exposed populations has been reported, but data from the general population are scarce. Furthermore, the association between BPbL and vitamin D binding protein (DBP) and free 25-hydroxyvitamin D (25(OH)D) has not been reported. We investigated the association of BPbL with DBP, total and free 25(OH)D in healthy adolescents (n 1347; age range 11-16 years) cross-sectionally selected from all Governorates of Kuwait, utilising multi-stage cluster random sampling. Pb in whole blood was analysed by inductively coupled plasma MS, and DBP with ELISA. Plasma 25(OH)D was analysed by LC-MS/MS, and free 25(OH)D was calculated utilising the levels and binding affinities of DBP and albumin for 25(OH)D. DBP was positively associated with BPbL (β = 0·81; 95 % CI 0·14, 0·22; P < 0·001). A negative association between BPbL and total 25(OH)D was non-significant (P = 0·24) when BPbL was used as a continuous variable but was significant when used as quartiles (P = 0·02). The negative association between BPbL and free 25(OH)D was significant whether BPbL was used as continuous, as quartiles or as cut-off point of <5 µg/dl (0·24 µmol/l). In multinomiallogistic regression, the odds of vitamin D insufficiency and deficiency were more than two-fold higher in the upper quartiles of BPbL compared with the lowest quartile. The negative correlation of BPbL with free 25(OH)D was more robust than its correlation with total 25(OH)D. Future studies must consider the levels of DBP when assessing the association between Pb and vitamin D metabolites.

Knowledge and practice of foot self-care among patients with diabetes attending primary healthcare centres in Kuwait: A cross-sectional study

BackgroundDiabetes mellitus is a major public health issue and is the main cause of morbidity and mortality worldwide. At the time of diagnosis, many patients with type 2 diabetes (T2D) have one or two risk factors for diabetic foot diseases, such as diabetic peripheral neuropathy (DPN) and diabetic foot ulcers (DFUs). Patients can overcome such complications through good knowledge and practice of foot self-care. This study aims to evaluate the knowledge and practice of foot care among patients with diabetes mellitus attending primary healthcare centres (PHCs) in Kuwait and to identify those at risk for developing DPN. MethodsA cross-sectional study was conducted using a pre-tested self-administered questionnaire. The questionnaire included questions on demographic characteristics and patients’ knowledge and practices of foot care. Adult patients (aged 21 and above) with a diagnosis of diabetes mellitus for at least 1 year were randomly selected from PHCs located in the five governorates of Kuwait. Data were analysed using SPSS, version 26. ResultsA total of 357 patients participated in this study, giving a response rate of 87.3%. The overall mean knowledge score of foot care was 12.7 ± 2.7 (equals 81.3%). Most patients (n = 283, 79.3%) showed good knowledge. In comparison, less than one-third of patients (n = 110, 30.8%) practiced good foot care. The overall mean score of patients’ practices was 55.7 ± 9.2 (equals 64.0%). Approximately 17.4% of the patients had a higher risk of developing DPN. University students had lower odds of having good knowledge about foot care [OR: 0.19 (95%CI: 0.04–0.86)]. On the other hand, patients who reported having diabetes for a long duration (10 years and above) [OR: 1.88 (95%CI: 1.11–3.18)] and patients who did not have any other comorbidities [OR: 0.49 (95%CI: 0.26–0.90)] had higher odds of having good foot care knowledge. Patients who were on oral hypoglycaemic agents (OHAs) only had lower odds [OR: 0.63 (95%CI: 0.39–1.00)] of practicing good foot care. Patients who reported having diabetes for a duration between 5 to less than 10 years [OR: 1.75 (95%CI: 1.06–2.90)] and those who are on a diet only [OR: 1.76 (95%CI: 1.06–2.94)] had higher odds of practicing good foot care. Patients who were using combination therapy with OHAs and insulin had a higher risk [OR: 2.67 (95%CI: 1.11–6.41)] of developing DPN. On the other hand, patients who reported that they did not have a previous history of foot ulcer had a lower risk of developing DPN [OR: 0.21 (95%CI: 0.09–0.47)]. ConclusionThe knowledge of patients with diabetes regarding foot care is rated as good, while their self-practice is considered satisfactory. To improve the foot care knowledge and self-care practice of patients, healthcare providers (HCPs) need to support patients through educational programmes and appropriate training.

Primary Headache Disorder Among School Students in Kuwait.

Background: Primary headaches are remarkably prevalent worldwide and are increasingly reported among children. However, the exact trend in this age group, particularly in the Gulf region, remains largely unknown.Aims and Objectives: To examine the prevalence of primary headache disorders among primary and middle school students in Kuwait.Methods: We conducted a cross-sectional study that included Kuwaiti primary and middle school children and adolescents of both genders in randomly selected schools located in two governorates in Kuwait in the 2018/2019 academic year. Prevalence and attributable burden of headaches, definite and probable migraines, definite and probable tension-type headaches, chronic headaches (≥15 days/month), and probable medication-overuse headaches were assessed using the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) questionnaire for children and adolescents.Results: Of 1,485 questionnaires that were distributed, 1,089 students completed the questionnaire with a respondent rate of 73.4%. The study population consisted of 420 boys (38.56%) and 669 girls (61.43%) students with a mean age of 11.5 ± 2.11 years. The 1-year prevalence of primary headache disorders was 42.78%, with more middle schoolers reporting headaches than primary schoolers (50.37 vs. 30.48%; p < 0.02). The mean age of students with primary headaches was 11.98 ± 2.03 years in both genders. When stratified according to diagnostic criteria, migraine headaches were the most frequently reported (20.75%), followed by tension type headaches (18.8%), chronic headaches (2.75%), and probable medication-overuse headaches (0.46%). Primary headaches were significantly higher in girls compared to boys among middle schoolers (66.46 vs. 38.49%; p < 0.001); however, no significant difference between genders was noted among primary school students (33.12 vs. 22.33%; p < 0.118).Conclusion: Primary headaches are remarkably common in Kuwaiti school students, with migraine headaches being the most frequently reported type. Age and female gender may play a role in the development of primary headaches. These findings necessitate the direction of health services and research efforts toward this age group and warrant the need for further epidemiological studies.

PDB26 Cost and Utilization Patterns of Diabetes Treatment in Kuwait

Kuwait has high prevalence of type 1 and type 2 diabetes (18%), with great impact on healthcare services. The aim of this study is to explore the utilization patterns and costs of diabetes treatment and its complications in Kuwait. This study was a cross-sectional study. Patients were recruited from the six governorates of Kuwait from both primary and secondary care. Patients with diabetes aged 18 to 80 years old were included. Drug utilization data was collected for the year 2018. A generalized linear model with log transformation and normal distribution was performed to explore whether patients with complications and comorbidities will have higher drug costs after adjustments for confounders (gender, age group, facility type). The study included 1182 patients from across Kuwait. The mean age was 56.3 (+/- 13.1) years. Most patients were females (65.3%) and most had type-2 diabetes (89.5%). The most common comorbidity was dyslipidemia (64.0%). Neuropathy was the most prevalent complication (19.7%). Majority of patients (81.0%) were on oral anti-diabetics, and 45.7% were on insulin’s, while 27.0% of patients were on oral anti-diabetics plus insulin. The most frequently used oral drug was metformin (70.5%), and most frequently used insulin was insulin glargine (33.7%). Patients were on chronic medications other than anti-diabetics, the most frequently used were lipid-lowering drugs (61.3%). The cost of drugs was 23.6% higher for patients with at least one comorbidity compared to none ([95% CI]= 2.8% - 48.5%, p-value=0.0245) and 29.1% higher for patients with at least one complication compared to none ([95% CI]= 13.8% - 46.6%, p-value<0.001). In year 2018, diabetes treatment and its complications costed the country 18% of its total drug budget. Diabetes drug therapy has a high burden on the healthcare system. Patients with comorbidites and complications have higher drug costs.

Impact of Puberty in Girls on Prevalence of Primary Headache Disorder Among Female Schoolchildren in Kuwait.

Background: The prevalence of primary headaches in the pediatric population is shaped by many factors, of which pubertal status may possibly play a substantial role. Epidemiological studies in the pediatric population in the gulf region remain scarce.Aims and objectives: To examine the impact of puberty on the prevalence of primary headache disorders among female schoolchildren in Kuwait.Methods: We conducted a cross-sectional study that included Kuwaiti primary and middle schoolgirls in randomly selected schools located in two governorates in Kuwait during the academic year 2018/2019. Prevalence of headache was assessed using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire for children and adolescents. Female students were asked about their menarchal status and whether they attained menarche before or after experiencing headaches.Results: The questionnaire was completed by 669 girls with a mean age of 11.44 ± 2.14 years. The 1-year prevalence of migraine headache disorder among girls was 23.62%, and the lifetime prevalence of any headache was 84.9%, whereas the 1-year prevalence of primary headache disorders was 47.98%. The mean age of girls with headaches was 11.44 ± 2.14 years. With respect to diagnostic criteria, migraine headache was the most frequently reported (23.62%), followed by tension-type headaches (20.93%), chronic headaches (2.99%), and probable medication-overuse headaches (0.45%). Postpubertal females were at significantly higher risk of having primary headaches compared to their prepubertal counterparts (64.26 vs. 34%; p < 0.0001). All types of primary headaches were more significantly prevalent among postpubertal girls compared to those who are prepubertal.Conclusion: Migraine headache is commonly reported among Kuwaiti schoolgirls. Postpubertal females are at higher risk of developing primary headaches compared to prepubertal females. Pubertal transition and female sex hormones may play a significant role in the pathophysiology of headaches, migraines in particular, and further research is therefore needed to investigate the underlying mechanisms.