Regional Prevalence of Short Stature in Saudi School-Age Children and Adolescents

Objective. To assess the magnitude of regional difference in prevalence of short stature in Saudi children and adolescents. Subjects and Methods. A representative sample from three different regions of the Kingdom of Saudi Arabia (KSA) (North, Southwest, and Center) was used to calculate the prevalence of short stature (standard deviation score less than −2) in children 5 to 17 years of age. Results. There were 9018 children and adolescents from 5 to 17 years of age (3366, 2825, and 2827 in the Northern, Southwestern and Central regions, resp.) and 51% were boys. In both school-age children and adolescents, there was a significantly higher prevalence of short stature in the Southwestern than in the Northern or the Central region (P < 0.0001). Conclusion. The finding of significant regional variation between regions helps in planning priorities for research and preventive measures

Blood pressure standards for Saudi children and adolescents

<b>Background and Objectives: </b> Blood pressure levels may vary in children because of genetic, ethnic and socioeconomic factors. To date, there have been no large national studies in Saudi Arabia on blood pressure in children.Therefore, we sought to establish representative blood pressure reference centiles for Saudi Arabian children and adolescents. <b> Subjects and Methods: </b> We selected a sample of children and adolescents aged from birth to 18 years by multi-stage probability sampling of the Saudi population. The selected sample represented Saudi children from the whole country. Data were collected through a house-to-house survey of all selected households in all 13 regions in the country. Data were analyzed to study the distribution pattern of systolic (SBP) and diastolic blood pressure (DBP) and to develop reference values. The 90th percentile of SBP and DBP values for each age were compared with values from a Turkish and an American study. <b> Results: </b> A total of 16 226 Saudi children and adolescents from birth to 18 years were studied. Blood pressure rose steadily with age in both boys and girls. The average annual increase in SBP was 1.66 mm Hg for boys and 1.44 mm Hg for girls. The average annual increase in DBP was 0.83 mm Hg for boys and 0.77 mm Hg for girls. DBP rose sharply in boys at the age of 18 years. Values for the 90th percentile of both SBP and DBP varied in Saudi children from their Turkish and American counterparts for all age groups. <b> Conclusion: </b> Blood pressure values in this study differed from those from other studies in developing coun--tries and in the United States, indicating that comparison across studies is difficult and from that every popula--tion should use their own normal standards to define measured blood pressure levels in children

The LMS and Z scale growth reference for Saudi school-age children and adolescents

Background/Aim: To establish L, M, and S parameters and z score reference for the assessment of nutrition and growth of Saudi school-age children and adolescents. Subjects and Methods: Data from the original cross-sectional study were reanalyzed. The L, M, and S parameters and z scores were calculated for weight, height and body mass index for school-age children and adolescents. Results: A total of 19,299 subjects from 5 to 18 years of age were included. All were Saudi nationals and 9,827 (50.9%) were boys. The L M S parameters and z scores for weight for age, height for age, and BMI for age for boys and girls are presented in detailed tables across the age of commonly used z scores (+3, +2, +1, 0, -1, -2, -3). Graphs corresponding to the same parameters (weight, height, and BMI) showing the main z scores across all ages from 5 to 18 years are illustrated. Conclusion: This report provides the first reference for nutritional status and growth of Saudi school-age children and adolescents. This tool is essential for more accurate assessment of growth and nutrition in various clinical conditions and research

Regional disparity in prevalence of malnutrition in Saudi children

Objectives: To evaluate the regional difference in the prevalence of malnutrition in Saudi children. Methods: Data for this study were collected over 2 years (2004 and 2005). A cross-sectional representative sample of the Saudi population of healthy children below 5 years of age was used to calculate the prevalence of malnutrition. The study was carried out in the College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. Body measurements of the weight, length, and height were performed according to standard recommendations. Standard deviation scores were determined using the Lambda, Mu, and Sigma (LMS) statistical methodology. The 1978 NCHS/WHO growth reference was used for the calculation of prevalence of underweight, wasting, and stunting defined as the proportion of children whose weight for age, weight for height, and height for age was below minus standard deviation (-2 SD) for Northern, Southwestern, and Central regions of the Kingdom of Saudi Arabia. Chisquare test was used to assess the difference in prevalence between regions, and a p<0.05 was considered significant. Results: The sample size of children <5 years of age in Central region was 5067, Southwestern 2285, and Northern 2933. The prevalence of underweight was 4%, 19.7% and 5.5%, that of wasting was 6.5%, 16.7% and 6.5% and of stunting was 6.4%, 13.2% and 6.4% in the Central, Southwestern, and Northern regions indicating a significantly-higher prevalence in Southwestern compared to other regions (p<0.001). Conclusions: This report revealed a high prevalence of significant nutritional indicators in the Southwestern regions than in other regions. This finding indicates that this region should be given priority for further studies to identify causes, and to design health promotion programs

Long-term outcome of the difficult nephrotic syndrome in children

To determine the long-term outcome of nephrotic syndrome (NS) in children, we studied 48 patients with the NS aged seven months to 12 years at onset and followed for a long period (3-9 years). Consanguinity was positive in 31.2%. Patients′ history of atopy was present in 25%, while family history of allergy was present in 18 (37.5%) patients. Renal impairment at initial presentation was observed in 12.5% of the patients. Among 32 biopsied patients, 11 (34.3%) had focal segmental glomerulosclerosis and eight (25%) revealed mesangial IgM nephropathy. Outcome at two years of presentation showed 41.6% patients as frequent relapsers, 39.5% as steroid dependent and18.7% as steroid resistant. Forty-three patients were available for follow-up after ten years of presentation, 22 (51%) patients had complete remission, 15 (34.8%) were steroid dependent, two (4.6%) developed chronic renal failure and two (4.6%) died. Two patients (4.6%) developed insulin-dependent diabetes mellitus, two (4.6%) had cataract and one (2.3%) had documented peritonitis. In conclusion, the high incidence of steroid-dependent, frequent relapses and steroid resistance in children can be explained by different factors, including consanguinity, atopy and severe presentation at onset of disease. We suggest longer initial treatment at onset for this group of patients. The low incidence of infection in this group needs to be addressed in future studies