A Comparison of Rheumatoid Arthritis Patients in Kuwait with Other Populations: Results from the KRRD Registry | Chapter 07 | Innovations in Medicine and Medical Research Vol. 1

Objective: Data on rheumatoid arthritis (RA) in Kuwait and The Middle East is scarce. Available data from Western countries may not be representative of the region. We describe RA patients in Kuwait and compare them with other RA populations and with Kuwaiti general population.

Methods: Adult RA patients from Kuwait Registry for Rheumatic Diseases (KRRD), the first RA registry in The Middle East, were studied from February 2013 through February 2015. Demographic, clinical and serologic data were compared with other RA populations and with Kuwaiti general population.

Results: 835 patients were enrolled, 62.3% female. Mean age 50.6±12 years and disease duration 6.1±6 years. RA was diagnosed at a mean age of 44.9±12 years. 17.1% had family history of autoimmune rheumatic diseases. 3.1% had rheumatoid nodules. Rheumatoid factor (RF) and anti-citrullinated peptide (ACPA) were detected in 75.6% and 57.8%, respectively. Both were positive in 49% (r=0.287, p=0.001). ANA was positive in 19.1%. Both ACPA and a combination of positive RF and ACPA were more in males (p=0.017, 0.004 respectively), whereas ANA was more in females (p=0.01). One third of male patients were smokers versus 1.9% of females. Smoking was correlated to RF (p=0.009) and ACPA (p=0,002). Difference in ACPA between genders was statistically explained by the predominance of smoking in males. Comorbidities included diabetes mellitus (DM) (20.8%), hypertension (20.2%), hyperlipidemia (10.5%) and coronary artery disease (CAD) (3.1%). 4 cases of cancer were reported.

Conclusion: RA population in Kuwait includes less women than other RA populations but more than Kuwaiti general population. Family history is more common. A higher positive ACPA in males was explained by smoking difference. Hypertension and hyperlipidemia were less reported than in both Kuwaiti general population and other RA populations. CAD was similar to other RA populations. DM was more reported, reflecting its high background prevalence in Kuwait.

Author(s) Details

Dr. Adeeba Al-Herz
Amiri Hospital, Kuwait City, Kuwait.

Adel Al-Awadhi
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.

Khulood Saleh
Farwania Hospital, Farwaniya Governorate, Kuwait

Waleed Al-Kandari
Farwania Hospital, Farwaniya Governorate, Kuwait.

Eman Hasan
Amiri Hospital, Kuwait City, Kuwait.

Aqeel Ghanem
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Fatemah Abutiban
Jahra Hospital, Jahra Governorate, Kuwait.

Ahmad Alenizi
Jahra Hospital, Jahra Governorate, Kuwait.

Mohammed Hussain
Amiri Hospital, Kuwait City, Kuwait.

Yaser Ali
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Ahmad Khadrawy
Farwania Hospital, Farwaniya Governorate, Kuwait.

Ammad Fazal
Farwania Hospital, Farwaniya Governorate, Kuwait.

Khaled Mokaddem
Amiri Hospital, Kuwait City, Kuwait.

Beena Aftab
Jahra Hospital, Jahra Governorate, Kuwait.

Najaf Haider
Jahra Hospital, Jahra Governorate, Kuwait.

Ajaz Zaman
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Ghada Mazloum
Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.

Youssef Bartella
Amiri Hospital, Kuwait City, Kuwait.

Sally Hamed
Amiri Hospital, Kuwait City, Kuwait.

Ahmed Al-Saber
Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland.

View Volume: http://bp.bookpi.org/index.php/bpi/catalog/book/139

Clinical Epidemiology of Chickenpox in Iraq, 2007-2011 | Chapter 04 | Innovations in Medicine and Medical Research Vol. 1

Chickenpox (Varicella zoster) infection is an acute disease caused by varicella zoster virus (VZV). In endemic areas, primary infection tends to occur at a younger age. The World Health Organization (WHO) recommended that routine childhood varicella vaccination should be considered in countries where the disease is a relatively important public health and socioeconomic problem, and where high (85 to 90%) and sustained vaccine coverage can be achieved.

Aim: 1- To describe the epidemiology (occurrence, age, gender and season) of registered clinical cases of chickenpox in Iraq from 2007-2011, 2- To determine the need for the use of chickenpox vaccine in Iraq.

Methods: A retrospective descriptive analysis of surveillance data. Frequency and percentage were used to describe the data. The occurrence per 100,000 of Iraqi population was calculated. Chi square test was used.

Results: There was an obvious rise in the registration of clinical chickenpox cases from 21,798 case in 2007 to 74, 195 case in 2011. This corresponds to an increase in the occurrence rate of clinical chickenpox cases from 73.41/100,000 in 2007 to 222.61/100, 000 in 2011. There were possible outbreaks in 2008 and 2011. The occurrence of chickenpox showed the same seasonal distribution throughout the years 2007-2011, being highest in spring (April, May) season. The highest registered number of chickenpox cases was in provinces of Ninawa, Baghdad/Russafa, Dihok, Baghdad/Karkh, Al-Basrah and As-Sulaymaniyah. There was a sustained preponderance for the males over females with nearly the same percentage over the years. Most of the cases occurred in those of age 5-14 years (65%), only 1% occur in those >45 years with statistical significance p=0.001.

Conclusions: There is a rising trend in the registration of clinical chickenpox cases. Most cases occur in the age group of less than 15 years. Males are slightly higher than females. The highest frequencies were reported in March, April and May. Most of the cases were registered in Baghdad, Ninawa, Dihok and Al-Basrah.

Author(s) Details

Hanan Abdulghafoor Khaleel
Viral Hepatitis Section, CDCC, Public Health Directorate, MOH, Iraq.

Dr. Hassan Muslem Abdulhussein
Public Health Directorate, MOH, Iraq.

View Volume: http://bp.bookpi.org/index.php/bpi/catalog/book/139

Modelling and Prediction of Atherogenic Index of Plasma Against Cardiometabolic Risk | Chapter 01 | Current Trends in Disease and Health Vol. 2

Background and aim: Cardiometabolic risk is a constellation of cardiovascular risk factors which include diabetes, hypertension, obesity and dyslipidaemia. Atherogenic Index of Plasma (AIP) is gaining prominence as a screening tool for dyslipidaemia however, these tools are expensive, time consuming, cumbersome and beyond the reach of an average Nigerian. The purpose of this study was to determine the predictors and modelling of AIP against some cardiometabolic parameters among workers in Owerri, Nigeria. Prediction and modelling of AIP will give cost effective options in the assessment of cardiometabolic risk.

Methods: This was designed as a work-site based cross sectional study carried out on three hundred and sixty one (361) transport workers. The respondents were anthropometrically examined. Blood glucose estimation was determined using glucose oxidase/peroxidase method of Trinder. Lipid indices were determined using Freidewald’s method. Data were facilitated using XLSTAT 2016. Principal component analysis and Logistic probit regression models were employed to determine the degree of relationship and superiority.

Results: AIP was shown to be statistically significant and positively correlated with waist circumference (WC), body mass index (BMI) and systolic blood pressure (SBP) based on the Logistic regression analysis with a Goodness of fit of 69.97%. WC is the most powerful anthropometric tool in predicting cardiometabolic syndrome. AIP was shown to be a principal and dominant predictor of cardiometabolic syndrome.

Conclusions: This study has established that AIP correlates statistically and significantly with WC, BMI and SBP. A set of predictive regression models for AIP was developed for WC, BMI and SBP. AIP as a calculated factor can be used in the clinical setting as a cost-effective diagnostic tool in assessing cardiometabolic risk beyond the routinely done lipid profile especially where others have failed and most importantly in resource-poor setting like Nigeria.

Author(s) Details

Charles C. Onoh
Centre for Occupational Health, Safety and Environment, University of Port Harcourt, Nigeria.

Ify L. Nwaogazie
Centre for Occupational Health, Safety and Environment, University of Port Harcourt, Nigeria.

Ernest I. Achalu
Centre for Occupational Health, Safety and Environment, University of Port Harcourt, Nigeria.

View Books: http://bp.bookpi.org/index.php/bpi/catalog/book/91

Neglected Tropical Diseases (NTDs): Case Study on Gastrointestinal Parasites and Morbidity Indicators in Some Rural Villages of the South Region of Cameroon | Chapter 06 | Current Trends in Disease and Health Vol. 1

Background: Parasitic diseases in tropical regions are important cause of morbidity and mortality. Some groups of infection that sufficient attention has not been attributed to by donors and planners worldwide still exist presently. These infections include schistosomiasis, soil transmited helminthes (STHs), amibiasis etc. Intestinal parasitic infections still constitute major public health threats in many parts of Cameroon. To improve on the different control measures and their effectiveness, continuous surveys are necessary to update epidemiological data.

Aim: This study aim to evaluate the transmission level of intestinal parasitosis and morbidity indicators link to infections in inhabitants of Lolodorf Health district in south Cameroon. Informations from such studies will permit to build concrete recommendations for the National control program for these infections.

Methodology: A total of 423 participants were recruited for the study. Stool samples were collected and examined microscopically for the search of helminthes eggs and protozoan cysts using Kato Katz and concentration formol-ether techniques respectively. Anemia was evaluated by measuring heamoglobin level using the spectrophotometic technic with a hemoglobinometer URIT-12 while malnutrition was determined by taking anthropometric parameters.

Results: Out of 423 participants examined, 321 (75.9%) were infected with Ascaris lumbricoides (30.3%), Trichuris trichiura (64.5%), Hookworms (12.5%), E. histolytica/ E. dispar (9.9%) and E. coli (34.0%). Among infected individuals, 117 (36.4%) had single infections, while 204 (63.6%) had multiple infections. Multiple infections were significantly high (P= 0.0001) compared to single infections.  E. histolytica/ E. dispar infection was significantly more prevalent in females than in males (P=0.01), same as in participants of 3-5 years for Hookworms (P= 0.02), 3-5 years and 11-15 years for E. coli (P= 0.04). T. trichura infections occurred more frequently as single infection (P= 0.0001). Interactions between T. trichiura+ E. coli led to a significant increase of E. coli prevalence (P= 0.001). Significant high egg load was observed for T. trichiura (P= 0.00001) and in people between 3-5 years infected by T. trichiura (P=0.0001) and hookworms (P=0.0001). Low infection intensity was significantly more observed compared to moderate and high infection intensities (P= 0.0001) for A. lumbricoides, T. trichiura, and Hookworm. T. trichiura density increases significantly when it interacts with A. lumbricoides + Hookworms, A. lumbricoides + E. coli, Hookworms + E. coli, E. histolytica/ E. dispar + E. coli, A. lumbricoides + Hookworms + E. coli and A. lumbricoides + E. histolytica/ E. dispar + E. coli (P< 0.05).Anemia and malnutrition were the morbidity indicators evaluated. Participants were severely anemic (46.2%) with probable chronic malnutrition (36.7%). Moderate anemia was significantly more observed in infected participants (49.7%: P<0.0001), same for participants of 11-15 years for the two indicators (P<0.0001).

Conclusion: This study has demonstrated that the Ngovayang health area in the health district of Lolodorf is highly endemic for intestinal parasites with high level of anemia and malnutrition observed in individuals, constitutes an area with high risk of transmission. This implies that, the protocol of mass drug administration recommended by MINSANTE might not be adequate to reduce the endemicity level and morbidity caused by these parasites.  Also, recommendations for control measures should be done while taking into consideration the impact of morbidity indicators in infected population.

Author(s) Details

Dr. Nkengazong Lucia
Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaounde, P.O.Box 13033, Cameroon & Laboratory of Parasitology and Ecology, Faculty of Science, University of Yaounde I, P.O.Box 812, Cameroon.

Ngo Ngue Thérèse Nadyne
Faculty of Science, University of Ngaoundere, P.O.Box 454, Cameroon.

Professor Nukenine, Elias Nchiwan
Faculty of Science, University of Ngaoundere, P.O.Box 454, Cameroon.

Ngué Monique
Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaounde, P.O.Box 13033, Cameroon.

Prof. Moyou-Somo Roger
Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaounde, P.O.Box 13033, Cameroon.

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View Volume: https://doi.org/10.9734/bpi/ctdah/v1