Omani Nationals Research Articles

Assessment of vitamin D-related knowledge, attitudes and practices among Sultan Qaboos University students in Oman: a cross-sectional study

BackgroundVitamin D deficiency, a circulating level of 25-hydroxyvitamin D <30 nmol/L, has become an emerging public health issue in recent years. Despite being a sun-rich country, vitamin D deficiency is...

Health system performance assessment and reforms, Oman.

To prioritize key areas of action and investment for the next strategic cycle of national development plans (2026-2031) in Oman, we needed a holistic view of the country's health system and its main deficiencies and inefficiencies. Informed by the World Health Organization framework, our team of seven national health ministry staff and two international experts conducted a rapid health system performance assessment. We used already available data to identify system bottlenecks and their potential root causes, verifying our findings with key informant interviews. Oman's 4.9 million population is relatively young (average age 28years) but ageing, with a mounting burden of chronic diseases. While health-care services are free for Omani nationals, more than 1.5 million expatriates rely on out-of-pocket payments for health-care services. Strengthening primary health care, improving the quality of care, providing financial protection, and ensuring that public and private health-care providers operate within the same legal and procedural framework are recognized as key national priorities. Our assessment highlighted the need to extend health service coverage to the whole population, strengthen private health-care sector governance, improve health education, increase financial investment, and expand the country's capacity for data collection and analysis. The assessment framework allowed us to identify areas where information is lacking and use already available data to analyse multiple health outcomes. As well as identifying issues that need to be addressed during the next policy development cycle, our findings have contributed towards the preparation of a more extensive assessment.

Medical Tourism and Neurological Diseases: Omani Patients' Experience Seeking Treatment Abroad.

There is a dearth of research regarding the motivations and experiences of Omani nationals who travel abroad for medical treatment, especially for neurological diseases. The primary objective was to examine and draw comparisons between Omani adults and children with neurological disorders who pursued medical treatment abroad after being evaluated by local specialists. The study also aimed to gain insights into these patients' motivations and experiences. A related objective was to explore the sociocultural factors and family dynamics that shape the attitudes towards illness and treatment seeking. In this cross-sectional study, Omani patients treated at a major tertiary hospital in Muscat for neurological disorders and subsequently traveled overseas for treatment were identified and administered a structured questionnaire. The participants were 116 Omani nationals (62 children and 54 adults) with neurological disorders, diagnosed predominantly with epilepsy (71.6%) followed by developmental delay, muscular dystrophy, and encephalopathy. Only 19.8% of patients received government sponsorship. The majority (69.8%) followed the recommendations of family members. Most (63.8%) participants reported positive outcomes after treatment abroad, though 4.3% developed complications and 5.2% acquired nosocomial infections. Most (83.6%) participants opined that the treatment they received overseas was comparable to what they would have received in Oman. There were no significant differences between children and adults in most of these aspects. Public awareness should be increased regarding the pros and cons of medical tourism. Patients must be made aware of the advanced treatment facilities available locally. Efforts should be made to enhance patient outcomes and satisfaction by adopting more efficient and patient-friendly processes.

Comparative Study of Antecedent Factors Affecting Entrepreneurial Venture Success among Omani Nationals and Expatriates in Oman

Comparative Study of Antecedent Factors Affecting Entrepreneurial Venture Success among Omani Nationals and Expatriates in Oman

Mycobacterium tuberculosis epidemiology in Oman: whole-genome sequencing uncovers transmission pathways.

Tuberculosis (TB) originating from expatriates that hail from high TB-burden countries is hypothesized to play a role in continued TB transmission in Oman. Here, we used whole-genome sequencing (WGS) to assess national TB transmission dynamics. The annual incidence per 100,000 population per year was calculated for nationals and expatriates. A convenience sample of Mycobacterium tuberculosis (MTB) isolates from 2018 to 2019 was sequenced and analyzed with publicly available TB sequences from Bangladesh, Tanzania, the Philippines, India, and Pakistan. Relatedness was assessed by generating core-genome single nucleotide polymorphism (SNP) distances. The incidence of TB was five cases per 100,000 persons in 2018 and seven cases per 100,000 persons in 2020 (R2 = 0.34, P = 0.60). Incidence among nationals was 3.9 per 100,000 persons in 2018 and 3.5 per 100,000 persons in 2020 (R2 = 0.20, P = 0.70), and incidence among expatriates was 7.2 per 100,000 persons in 2018 and 12.7 per 100,000 persons in 2020 (R2 = 0.74, P = 0.34). Sixty-eight local MTB isolates were sequenced and analyzed with 393 global isolates. Isolates belonged to nine distinct spoligotypes. Two isolates, originating from an expatriate and an Omani national, were grouped into a WGS-based cluster (SNP distance < 12), which was corroborated by an epidemiological investigation. Relatedness of local and global isolates (SNP distance < 100) was also seen. The relatedness between MTB strains in Oman and those in expatriate countries of origin can aid inform TB control policy. Our results provide evidence that WGS can complement epidemiological analysis to achieve the End TB strategy goal in Oman. IMPORTANCE Tuberculosis (TB) incidence in Oman remains above national program control targets. TB transmission originating from expatriates from high TB-burden countries has been hypothesized to play a role. We used whole-genome sequencing (WGS) to assess TB transmission dynamics between expatriates and Omani nationals to inform TB control efforts. Available Mycobacterium tuberculosis isolates from 2018 to 2019 underwent WGS and analysis with publicly available TB sequences from Bangladesh, the Philippines, India, and Pakistan to assess for genetic relatedness. Our analysis revealed evidence of previously unrecognized transmission between an expatriate and an Omani national, which was corroborated by epidemiological investigation. Analysis of local and global isolates revealed evidence of distant relatedness between local and global isolates. Our results provide evidence that WGS can complement classic public health surveillance to inform targeted interventions to achieve the End TB strategy goal in Oman.

HR PRACTICES AND THEIR EFFECTIVENESS DURING THE POST-OMANIZATION PHASE: A CRITICAL REVIEW

Omanization is a strategy applied by the Sultanate of Oman since 1988 with an aim to replace expatriate workers with Omani nationals. The Omani government has set goals to increase the percentage of employed Omani nationals compared with foreigners (expatriates) through Omanization as a routine Human Resource (HR) practice. This strategy was introduced because of the increasing number of expatriates that indirectly resulted in reduced job opportunities for Omani nationals. It is expected that this strategy would allow Omani nationals to get jobs and consequently needed training and development programs. This research work is focusing on Omanization and its likely impact on HR practices in Oman. As it was not feasible to collect data from both the public and private sectors, this research, therefore, aims to analyze the perceptions of private sector employees on Omanization. This research is expected to highlight likely changes in the HR practices applied and their effectiveness in Oman. It will be worthwhile identifying how employees from the private sector foresee this strategy, and whether the Omanization initiative can actually improve the quality of work and enhance HR output to reach a higher level of productivity. It is assumed that Omanization could have a significant impact on HR practices, so it was decided to conduct interviews and focus group discussions with some of the private sector employees to gain a richer insight. Findings from this research indicate that there is a gap between the labor market and the education system. It is evident that fresh graduates lack the necessary skills and training for taking over the positions. Furthermore, there is a lack of training and development programs for the employees. This research is highlighting some recommendations too for the progress toward Omanization.

Oman: Recent Developments in the Protection of the Rights of Migrant Workers and of Women

Abstract This survey is a review listing some key legislative and executive measures of the government of Oman in the year 2021–2022, which have relevance to mainly the rights of the migrant workers. Further, and in less detail, this survey also refers to some of the developments pertinent to the rights of women living in Oman. However, more generally these rights are less relevant to women who are not Omani nationals. Oman is a member country of the Gulf Cooperation Council (GCC). The GCC comprises six states in the Arab-Gulf region: Oman, Bahrain, the United Arab Emirates (UAE), Kuwait, Qatar and Saudi Arabia. These oil-producing states have a significant proportion of foreign workforce in the population. Foreign workers work mostly in the private sector and are also residents in the host countries. At 46.5 per cent, Oman has a relatively lower proportion of migrants in its population among the GCC members (UN DESA, 2020). Therefore, a broader spectrum of governments’ measures relating to the issues like labour, entry and residence, and ownership of property or business touch the lives of the foreign/migrant workers or expatriates in the Gulf country. Governments’ initiatives targeting domestic workers are relevant also for women because they comprise the majority in this group. The survey notes that most of the governmental activity in Oman in the past year largely concern new laws or amendments of the existing legislation and regulations linked to labour and residency matters. Some of the more relevant ones that the survey has selected here confirms this. It also marks the period post the pandemic, which had posed considerable economic challenge for the government. Hence, as also some neighbouring Gulf countries, Oman has shown a balance of measures. On the one hand, to revive its economic dynamism and competitiveness by facilitating more ease and benefits to attract and retain foreign labour and investment in the country. On the other hand, with measures such as increased nationalization effort and support expressly favouring the national workforce to boost their more active participation in the labour market. The new labour law declared by the Omani government and its signing of the Maritime Labour Convention are a few notable highlights. The survey has essentially drawn on the government’s documents and announcements as available in English or translated text, in addition to information in the press and other relevant sources.

Knowledge, Attitudes and Practices Regarding Traditional and Complimentary Medicine in Oman.

This study aimed to assess the knowledge, attitudes and practices regarding traditional medicine (TM) in Oman and examine the factors that necessitate its use. This cross-sectional, questionnaire-based study was conducted among the general population from November 2019 and March 2020. All Omani nationals above the age of 18 were eligible to be enrolled. The questionnaire consisted of questions on the knowledge, attitudes and use regarding traditional medicine in Oman. A total of 598 responses to the questionnaire were received (response rate: 85.4%), of which 552 were deemed complete. Most responses were received from males (62.5%) and the sample had a mean age of 33.6 ± 7.7 years. A majority of the respondents (90%) were aware of the different types of TM in Oman; a high percentage (81.5%) felt that it was effective. Most (67.8%) had tried at least one method of TM use. Individuals who were older had tried TM compared to those who had not (34.5 ± 7.8 years versus 31.8 ± 7.2 years; P <0.001); in addition, more males than females (72.2% versus 27.8%; P <0.001) and those with full-time employment than those without had tried TM (84.2% versus 14.2%; P <0.001). Herbal medications (65.8%) and traditional massage (60.4%) were the most common forms of TM practice. Among females, herbal medications (69.2%) and massage (63.5%) are most often used; among males, cupping (65.2%) followed by herbal medications (64.4%) and massage (59.3%) were used more often. Notably, back pain (74.3%) was the most common condition for which TM was reportedly used, with only a small percentage (8.3%) reporting any concomitant side-effects. There is widespread use of TM among Oman's urban population. An improved understanding of their benefits will facilitate their incorporation into modern health care services.

Determinants of Consumers’ Decision to Switch to Islamic Banking System: A Case Study of Oman

Islamic banking is becoming a major alternative to conventional banking in many parts of the world, including the Gulf region. Although one of the prevalent reasons includes religious inclination, the variety of products added by Islamic banks contributes to customers switching from conventional to Islamic banking. This study analyses the factors responsible for customers’ decision to switch to Islamic banking in Oman through a questionnaire survey from Omani nationals in Muscat, Salalah, and Sohar. The data analysis tool included Structural Equation Modelling (SEM) analysis using SPSS and AMOS software. Some of the variables incorporated in the study include physical quality, outcome quality, interaction quality, customer satisfaction, trust, price, religion, and social prestige, which are the dependent variables. The independent variable includes the decision to switch. These variables have been incorporated to evaluate their impact on customers’ decision-making to switch from conventional to Islamic banking. The results indicate that interaction quality significantly influences the switching decision, whereas physical environment and outcome quality could not influence the decision. Moreover, customer satisfaction and trust positively affect the decision. Religion significantly influences switching decisions, while the price and social prestige have no association with it. The findings suggest that religion is a strong determinant and positively impacts switching decisions. Additionally, the people of Oman consider the quality of service, customer service, and trust before switching decisions.

PS-P07-2: KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING TRADITIONAL MEDICINE AMONG PATIENTS WITH HYPERTENSION IN OMAN

Background and Aims: The aim of the study was to assess the knowledge, attitudes and practices with regards to use of traditional medicine(TM) among patients with hypertension in Oman and to assess the characteristics that favor its use Methods: This was a cross sectional questionnaire-based study. All Omani nationals above the age of 18, who were diagnosed with hypertension were eligible to be enrolled. The questionnaire consisted of questions regarding the knowledge, attitudes and use of TM practices. Results: There were 121 (out of 150) responses to the questionnaire (response rate of 69.3%) of which 104 (mean age 44_11.6 years; 92 or 88.5% male) were complete and used for analysis. Majority of the respondents (90.4%) are aware of the different types of TM. A high percentage (90.4%) feel that it is effective. 74(71.2%) had tried at least one method, though only 29(27.9%) had tried it specifically for hypertension. There was no difference between age, genders, occupation or educational status. between those who had tried or not, though there was a trend towards those who had tried some form of TM to being non significantly older (45.61 + 11.9 years vs 41.4 + 10.2 years, p = 0.09), Cupping (58.6%) and herbal medications (49.1%) were the most common form of TM that was practiced. Backpain (47.4%)and headaches(44.2%) were the main reason for using TM among these patients. For reducing blood pressure, the main forms of TM used were herbal medications(82.8%), branding(78.2%) and cupping (75.9%). Most of the patients (90.4%)felt that these practices were effective. Around half of patients 43(41.3%) said that they had used these practices alongside modern medicine. Only 7.7% said that they had any side effect, and 63(60.6%) said that they would use it again. However, only 18(17.3%) said that they would encourage others to use it. Of those who had not used any TM practice, majority (90%) felt that they did not know enough about it to use it while only 12% said that they did not believe in its efficacy. 90% of them also said that they would like to try it in the future. Conclusion: There is widespread use of TM practices among the hypertensive patients in Oman. Better understanding of their benefits will help incorporate them into modern health care services.

Determinants of Sustainable Capital Budgeting Practice: A Structural Equation Modelling Approach

Across the globe, capital budgeting – the planning process of appraising an organisation‟s long term investments for funding – plays a pivotal role in economic growth by providing the platform for mobilising long-term funds for economic development. Capital budgeting practice refers to the aggregate tools/techniques for strategic investment decisions under risk and uncertainty conditions (Desai, 2019; Hillier et al., 2021). It involves a large cash outlay, expecting a future stream of benefits/income/return. Existing research suggests that financial and non-financial considerations influence managers‟ choices of CBTs across nations (Batri &amp; Verma, 2017). One of the significant concerns of Oman‟s Ninth five-year development plan 2016-2020 is its focus on achieving a private sector-driven economy enabled by public-private partnership (PPP) projects and related growth strategies that will drive non-hydrocarbon and more excellent employment opportunities for the Omani nationals. To this end, the manufacturing sector is at the centre of Oman‟s Top 7 Sectors comprising other critical industries, including Construction, Wholesale and Retail Trade, Agriculture and Forestry, Real Estate and Business Activities, Private households with Employed Persons, and Hotels &amp; Restaurants (MoCI, 2014). However, there has been very little academic research on capital budgeting with a focus on the manufacturing industry of Oman. Keywords: Advanced capital budgeting techniques (ACBTs), Confirmatory factor analysis (CFA), Oman, Real options valuation (ROV), Structural equation modelling (SEM).

The Political Economy of Skill Formation in a Rentier State: The Case of Oman

Context: Against a backdrop of dwindling oil resources and increasing unemployment rates, the government of Oman has set out to diversify its industry and establish a knowledge-based economy. In this context, forming a highly-skilled Omani workforce is considered to be of crucial importance. Yet, the national TVET system suffers from low social status, poor quality, and limited labour market connectivity. This paper offers an analysis of Oman's TVET system in the socio-economic and cultural context of a rentier state. Approach: We draw on the political economy of skills and socio-cultural approaches that understand TVET systems and the broader skills regimes in which they are embedded as part and expression of particular patterns of the social organisation of work. This helps to locate TVET systems' strengths and weaknesses in the context of their underlying social relations instead of considering them as mere dysfunctionalities at the systemic level. This paper draws on an unpublished study on TVET for industrialisation commissioned by an Omani line ministry in cooperation with an international organisation. For this study, the authors carried out a literature review, undertook two field trips to Oman in 2018 and 2019 and conducted forty semi-structured interviews with stakeholders from government, private companies, business associations, and TVET and higher education institutions. Findings: Our analysis highlights how skill formation in Oman is shaped by the socio-economic and cultural context of the Omani rentier state. First, the availability of cheap expatriate labour and Omanis' traditional preference for public sector jobs culminate in poor incentives for employing Omani nationals in the private sector. Second, reluctant employer attitudes towards national skill formation deepen quality issues in the TVET system, especially with regard to work-based training. This reinforces negative perceptions of the local workforce, which in turn contribute to biased employment patterns. Both social processes mutually reinforce each other, eventually preventing the emergence of strong national skill formation dynamics. Conclusions: While immediate structural change appears challenging, it is evident that reforms of the TVET system alone will not lead to its sustainable improvement. More research into how skill formation relates to Oman's specific socio-economic structures, how employment dynamics relate to educational credentials and how cultural traditions shape educational and work practices is needed.

The prevalence of Schmorl's nodes in osteoporotic vs normal patients: a Middle Eastern population study.

This study aims to identify the prevalence of Schmorl's nodes (SNs) in a cohort of Omani nationals, and also to determine any relation between osteoporosis and Schmorl's nodes. This retrospective observational study was conducted on Omani nationals. One thousand three hundred and forty-eight DEXA scan patients were included. Of these, 545 patients had complete X-rays and MRI scans that would help determine the SN status. The X-rays and sagittal, coronal, and axial T2-weighted MR images were used to identify the presence and exact location of the Schmorl nodes by one orthopedic trainee and confirmed by the senior author. The correlation of each parameter with the presence of SN was analyzed by the independent-samples T test and one-way ANOVA. The overall prevalence of SN in this population sample appeared to be 41.1%. Over 88% of the SN-positive cases were either osteopenic or frankly osteoporotic by the WHO definition. Vast majority of SNs (87.1%) occurred in the lumbar spine and were central in location and mostly solitary. Statistical analysis of the data revealed significant correlation between osteopenia or osteoporosis and the presence of SNs. The prevalence of SN in the sample of Omanis studied was 41.1% and was most frequently seen in older men in the lumbar spine. It is strongly associated with osteoporosis/osteopenia (88.4%) and frequently presents as solitary central lesions.

The magnitude and effect of work-life imbalance on cognition and affective range among the non-western population: A study from Muscat.

The temporal relationship between work-life balance/imbalance, occupational burnout, and poor mental health outcomes have been widely explored. Little has been forthcoming on cognitive functioning among those with work-life imbalance. This study aimed to explore the rate of work-life imbalance and the variation in neuropsychological functioning. The relationship between affective ranges (anxiety and depressive symptoms) and work-life balance was also explored. The target population in this study are Omani nationals who were referred for psychometric evaluation. The study employs neuropsychology measures tapping into attention and concentration, learning and remembering, processing speed, and executive functioning. Subjective measures of cognitive decline and affective ranges were also explored. A total of 168 subjects (75.3% of the responders) were considered to be at a work-life imbalance. Multivariate analysis showed that demographic and neuropsychological variables were significant risk factors for work-life imbalance including age and the presence of anxiety disorder. Furthermore, participants indicating work-life imbalance were more likely to report cognitive decline on indices of attention, concentration, learning, and remembering. This study reveals that individuals with work-life imbalance might dent the integrity of cognition including attention and concentration, learning and remembering, executive functioning, and endorsed case-ness for anxiety.

The Prevalence and Sociodemographic Correlates of Social Anxiety Disorder: A Focused National Survey

Background Social Anxiety Disorder (SAD) is among the most common anxiety disorders worldwide with data largely emerging from the Euro-American and Pacific Rim populations. In contrast, there is a dearth of studies among the populations of Arabian Gulf countries including Oman. This study has two interrelated aims: (i) to explore the prevalence of SAD among Omani adults, and (ii) to tease out the links between socio-demographic factors and SAD in Oman. Methods A cross-sectional study via an online survey was conducted among 1019 adult Omani nationals residing in Oman. The presence of SAD was assessed using the Arabic version of the Liebowitz Social Anxiety Scale (LSAS). Results Nearly half the participants (45.9%, n = 468) exhibited “caseness” for SAD as defined by LSAS. In the multivariate logistic analysis, participants below 40 years of age were 1.6 times (OR = 1.568, p = .026) more likely to have caseness for SAD than those who were 40 and older. Women were 1.3 times (OR = 1.348, p = .038) more likely to exhibit caseness for SAD than men. Participants who had secondary or undergraduate education were respectively 1.5 times (OR = 1.45, p = .014) and 2.5 times (OR = 2.509, p < .001) to have caseness for SAD than those who were graduates. Conclusion The present data suggest that 45.9% of the participants reached the cut-off for caseness in LSAS, which is high compared to reports from other populations. The present accrued frequency is discussed within the context of the accrued response rate, socio-cultural factors as well as the tendency for self-reported measures to “produce” spurious results is also highlighted which, in turn, calls for studies that adopt more inclusive survey methods.

Prevalence of risk factors of non-communicable diseases in the Sultanate of Oman: STEPS survey 2017.

BackgroundNon-communicable diseases (NCD) represent a major public health issue and currently cause 185.75 deaths per 100,000 population in Oman. Hence, there is a need for comprehensive, up-to-date and internationally comparable data on NCD risk factors in order to evaluate the effectiveness of ongoing public health policies and to develop further NCD prevention and control interventions. The aim of the study was to provide evidence-based, up-to-date, extensive, and reliable baseline data on the behavioural and biological risk factors of NCDs in the Sultanate of Oman.MethodsA cross‐sectional, prospective, observational community‐based survey designed to be nationally representative of the Sultanate of Oman was conducted based on the WHO STEPwise approach to Surveillance (STEPS). Multi-stage stratified random sampling according to geographical distribution selected a total of 9053 households (Omani nationals and non-Omani residents). Cluster sampling was used to randomly select equal clusters from each governorate. 823 households were randomly selected from the list of all households in all selected clusters from each governorate and one eligible adult selected from each household randomly accounting for 6582 consenting participants. The survey used demographic and behavioural information questionnaires along with physical and biochemical measurements among adults aged 18 years and above.ResultsThe prevalence of behavioural risk factors such as tobacco use was 9%, alcohol consumption was 2%, insufficient fruit or vegetable intake was 61%, and insufficient physical activity was 39%. The prevalence of biological risk factors such as overweight and obesity was 66%, raised blood pressure was 33%, raised blood glucose was 16%, and raised blood cholesterol was 36%. The prevalence of multiple risk factors was also determined and 95% of the population were found to have more than one risk factor. Three or more risk factors were found among 33% of population aged 18 years and above and 45% of the population aged 45 years and above.ConclusionA high prevalence of various NCD risk factors was found which needs to be addressed through health promotion, education, and policy. The findings are important to support the formulation and implementation of NCD-related policies and action plans that improve health status and prevent mortality due to NCDs in Oman.

Epidemiological Characteristics of 69,382 COVID-19 Patients in Oman

ObjectivesTo describe the epidemiological characteristics of the first 69,382 patients with COVID-19 infection in Oman.MethodsA retrospective case series study of patients diagnosed with SARS-CoV-2 infection in Oman from 24 February to 23 July 2020. The data were obtained from the National surveillance COVID-19 network.ResultsThe overall mean age of patients was 34 (± 14) years, 74% (n = 51,391) were males, 40,859 (59%) were Omani citizens, and 28,523 (41%) were foreign-born individuals. The most common symptoms at presentation were fever 50% (n = 34,600), cough 46% (n = 32,062), sore throat 46% (n = 31,953) and shortness of breath (SOB) 35% (n = 24,567). Overall, 8,960 (12.9%) patients required hospitalization with 1189 (13.3%) individuals requiring admission to the intensive care unit (ICU) and mechanical ventilation (MV). Patients hospitalized with COVID-19 infection were mostly Omani nationals and males between 30 and 39 years old (p < 0.001). The mortality rate was 7.7 per 100,000 population (n = 359) with rates of 9.4 (n = 278) and 4.8 (n = 81) deaths per 100,000 population in Omani nationals and foreign-born individuals, respectively. Females hospitalized with COVID-19 had a mean age of 64 (± 18) years versus a mean age of 55 (± 17) years in males. Mean age of patients with COVID-19-related mortality was 58 (± 18) years with significant differences in mean age between females and males 64 (± 18) versus 55 (± 17) years, respectively.ConclusionsYoung Omani males accounted for the highest incidence of COVID-19 infection and hospitalization, while mortality rates were higher among males and the older age (> 50 years). Identifying the epidemiological characteristics and outcomes of COVID-19-infected patients is essential for developing targeted intervention strategies and preparing for the resurgence of anticipated second and third waves of this pandemic.

An audit of surgical site infections among Omani travelers to India for spinal surgery

IntroductionMany Omani nationals travel to India for Spine surgery. Surgical site infection (SSI) rates in these patients is considered more than normal. The indications for surgery are also deemed liberal. Objective: To determine whether SSI rates are more in medical tourists. Materials & MethodsDesign: The submission is a retrospective observational study done at a tertiary care referral hospital in Oman. The participants were a cohort of 125 patients who had travelled to India for spine surgery between January 2013 and December 2015. Their data was retrieved from the hospital information system. They were evaluated for satisfaction, residual complaints, surgical site infection and putative indications for surgery. The primary outcome measure was surgical site infection. The SSI rates were compared to a group of patients treated in-house during the same period. ResultsAll the surgeries done were in the private sector. Fifty-four of the 80 cases were advised surgery locally as well, while 26 were advised against intervention. There were 15 cases of SSI, 10 of them needing re-operation. Four patients had neurological deterioration with 2 wrong level surgeries. Discussion & Conclusions:The rate of SSI in medical tourism patients was 12% compared to the 2.7% native cases. There was a 78% chance of improvement when the surgery was locally approved and 74% chance of worsening when not approved.

Prevalence and risk factors of diabetes in a large community-based study in the Sultanate of Oman: STEPS survey 2017

BackgroundType 2 diabetes in the Gulf Cooperation Council countries, including Oman, is currently the fastest growing health crisis and is a significant cause of premature mortality and disability. There is currently insufficient up-to-date information available on prevalence of type 2 diabetes. This study aimed to assess the latest prevalence of type 2 diabetes mellitus and its associated demographic, behavioural, and clinical risk factors.MethodsUsing the WHO STEPwise approach to chronic disease surveillance, a nationally representative population-based survey was conducted from January to April 2017 of adults aged 18 years and above. A multi-stage, stratified, geographically clustered random sampling surveyed 9053 households including Omani nationals and non-Omani residents. Univariate and multiple logistic regression analysis was performed to determine the predictors of diabetes.ResultsOverall prevalence of diabetes among the population was 15.7% (95% CI: 14.0–17.5%) whereas prevalence of prediabetes was 11.8% (95% CI: 11.4–12.2%). Age, educational level, raised blood pressure, family history of diabetes, abnormal waist-to-hip ratio, and hypertriglyceridemia were found to be significantly associated with diabetes mellitus. Of the cases of diabetes mellitus, 17% were newly diagnosed and 13.2% were on medication and had an uncontrolled glucose level while 55.5% were not taking medication (although diagnosed) and had an uncontrolled blood glucose level.ConclusionsThe present study provides reliable information regarding the high prevalence of diabetes mellitus among the adult population in Oman with urgent attention needed to address this significant burden on the health system. The high proportion of uncontrolled cases warrants further research, awareness programmes, and community interventions.

Characteristics, Risk Factors, and Survival Analysis of Candida auris Cases: Results of One-Year National Surveillance Data from Oman.

Background: Candida auris (C. auris) is an emerging healthcare-associated pathogen resulting in significant morbidity and mortality. The aim of this study is to report data from the national C. auris surveillance system for 2019 and conduct a survival analysis of the reported cohort. Methods: a retrospective analysis was conducted for all C. auris cases reported nationally to the Oman Antimicrobial Surveillance System (OMASS) in 2019, and isolates were sent to the Central Public Health Laboratories (CPHL). Clinical and demographic data were obtained through the E-Surveillance reporting system and the Electronic System (NEHR Al-Shifa) at CPHL. Statistical analysis was done using Kaplan–Meier analysis and Cox proportional hazard models. Results: One hundred and twenty-nine isolates of C. auris were grown from 108 inpatients; 87% were isolated from clinical samples, of which blood was the most common (38.9%). Forty (37%) were ≥65 years of age, 72 (66.7%) were males, and 85 (78.7%) were Omani nationals. Of the total isolates, 43.5% were considered as colonization; 56.5% were considered infection, of which 61.8% of them were candidemia. At least one risk factor was present in 98.1% of patients. The mean time from admission to infection was 1.7 months (SD = 2.8), and the mean length of hospital stay was 3.5 months (SD = 4). Totals of 94.8% and 96.1% of the isolates were non-susceptible to fluconazole and amphotericin, respectively. The variables found to be significantly associated with longer survival post C. auris diagnosis (p < 0.05) were age < 65 years, absence of comorbidities, length of stay < 3 months, colonization, and absence of candidemia. The infection fatality rate was 52.5%. Conclusion: Including C. auris in an ongoing antimicrobial surveillance program provides important data for the comprehensive management of this growing public health threat. The current study shows health care outbreaks of C. auris are ongoing, with 52.5% infection fatality, although our isolates remained sensitive to Echinocandins in vitro.