Statistical Analysis of Rainfall Patterns in Jeddah City, KSA: Future Impacts

Recently, the Kingdom of Saudi Arabia (KSA) has been facing significant changes in rainstorm patterns (rainstorm intensities, frequencies, distributions) causing many flash flood events. The city of Jeddah is located in a coastal plain area, in the middle of the western side of the KSA, which represents a clear case of changing rainstorm patterns. Jeddah has been hit by many rainstorm events, which increased dramatically since 2009 (e.g., one in 2009, one in 2011, one in 2015, and another one happened in 2017). However, in 2018 about six rainstorms occurred. Two major flash flood events occurred in the city in November 2009 and in January 2011. There were significant impacts of these two events causing severe flooding. During these events, 113 persons were announced dead (in the 2009 event), and infrastructures and properties were damaged (roads and highways, more than 10,000 homes and 17,000 vehicles). In addition to that, dam failure occurred in the 2011 event. This situation gives clear evidence in changing the climate system that could cause more storms in the future across the KSA. Generally, Jeddah city has a lack of short-duration data in rainfall stations. In addition to that, there are a limited number of studies that have been done in determining rainstorm patterns. Consequently, the approach of the current study will focus on understanding and determining rainstorm patterns in the period between 2011 and 2017 depending on some digital rainfall stations that have been installed recently in Jeddah city. Rainstorm pattern and the method of distribution are the most crucial factors affecting peak flow and volume calculations. Our findings showed that there are two pattern types for the rainstorms in Jeddah city. Finally, a comparison with SCS-type II distribution was carried out

A Flood Risk Management Program of Wadi Baysh Dam on the Downstream Area: An Integration of Hydrologic and Hydraulic Models, Jizan Region, KSA

For public safety, especially for people who dwell in the valley that is located downstream of a dam site, as well as the protection of economic and environmental resources, risk management programs are urgently required all over the world. Despite the high safety standards of dams because of improved engineering and excellent construction in recent times, a zero-risk guarantee is not possible, and accidents can happen, triggered by natural hazards, human actions, or just because the dam is aging. In addition to that is the impact of potential climate change, which may not have been taken into account in the original design. A flood risk management program, which is essential for protecting downstream dam areas, is required. Part of this program is to prepare an inundation map to simulate the impact of dam failure on the downstream areas. The Baysh dam has crucial importance both to protect the downstream areas against flooding, to provide drinking water to cities in the surrounding areas, and to use the excess water for irrigation of the agricultural areas located downstream of the dam. Recently, the Kingdom of Saudi Arabia (KSA) was affected by extraordinary rainstorm events causing many problems in many different areas. One of these events happened along the basin of the Baysh dam, which raised the alarm to the decision makers and to the public to take suitable action before dam failure occurs. The current study deals with a flood risk analysis of Wadi Baysh using an integration of hydrologic and hydraulic models. A detailed field investigation of the dam site and the downstream areas down to the Red Sea coast has been undertaken. Three scenarios were applied to check the dam and the reservoir functionality; the first scenario at 100-and 200-year return period rainfall events, the second scenario according to the Probable Maximum Precipitation (PMP), and the third scenario if the dam fails. Our findings indicated that the Baysh dam and reservoir at 100-and 200-year rainfall events are adequate, however, at the PMP the water will spill out from the spillway at ~8900 m3/s causing flooding to the downstream areas; thus, a well-designed channel along the downstream wadi portion up to the Red Sea coast is required. However, at dam failure, the inundation model indicated that a vast area of the section downstream of the dam will be utterly devastated, causing a significant loss of lives and destruction of urban areas and agricultural lands. Eventually, an effective warning system and flood hazard management system are imperative

Knowledge and attitudes toward COVID-19 vaccination in Sudan: A cross-sectional study

Background: Vaccines are an essential part of public health interventions to mitigate the devastating health and non-health impacts of COVID-19 pandemic. Despite the fact that Sudan launched the COVID-19 vaccination program in March 2021, only 10% of the population received their two primary doses of vaccines by the end of May 2022. This delayed uptake of vaccines obviously warrants investigation. Therefore, we have conducted this study to evaluate the knowledge, attitude and acceptance of the general population in Sudan toward COVID-19 vaccines. Methodology: A descriptive cross-sectional community-based study. The data were collected using an electronic questionnaire from 403 individuals living in Khartoum, Sudan. The data were processed using the Statistical Package for Social Sciences (SPSS), and data analysis was performed using appropriate tests. Results: 51% of the participants were found to have sufficient knowledge about the COVID-19 vaccine, and the knowledge level is higher among those educated beyond the secondary school and those who were employed. Among those unvaccinated, only 47% of the participants expressed their intention to take the vaccine when offered to them. The major reason for not trusting the vaccine is safety concerns expressed by 65.5% of the unvaccinated. Conclusion: Higher education levels and employment were associated with an increase in sufficient knowledge about the vaccine in around half of the participants. However, most of participants had not taken the vaccine at the time of the study, and the trust in vaccines is not high. Effective interventions by the health authorities are needed to address these issues in order to accelerate the COVID-19 vaccination program in Sudan

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Use of geological and geomorphological parameters in potential suitability assessment for urban planning development at Wadi Al-Asla basin, Jeddah, Kingdom of Saudi Arabia

During the planning of urban environment, usually economic and social parameters are taken into consideration. As a result, urban planning areas are susceptible and vulnerable to different types of natural disasters, which cause extensive damages to these areas. In the current study, for the protection of the urban environment, a unique approach of urban planning and sustainable development is proposed. The study area is the Wadi Al-Aska basin (East of Jeddah City), Saudi Arabia. Before the suitability analysis, urban development in the Jeddah area from 1973 to 2009 was applied. In the current study, an integrated evaluation of the suitable areas for urban development is proposed by using geological, geomorphological, and geographical characteristics of the study area as well as flash flood hazard factor. The used parameters were correlated by using the analytical hierarchical process (AHP) method and incorporated into a geographic information system (GIS) in order to produce the corresponding suitability maps. The study area is classified into five categories including very high, high, moderate, low, and very low suitability for urban development. These can be attributed mainly to the fact that in the majority of cases, only geographical, social, and economical factors were used for urban development, whereas in the current study, geomorphological, geographical, geological, and natural hazards parameters were quantified and taken into account

A Flood Risk Management Program of Wadi Baysh Dam on the Downstream Area: An Integration of Hydrologic and Hydraulic Models, Jizan Region, KSA

For public safety, especially for people who dwell in the valley that is located downstream of a dam site, as well as the protection of economic and environmental resources, risk management programs are urgently required all over the world. Despite the high safety standards of dams because of improved engineering and excellent construction in recent times, a zero-risk guarantee is not possible, and accidents can happen, triggered by natural hazards, human actions, or just because the dam is aging. In addition to that is the impact of potential climate change, which may not have been taken into account in the original design. A flood risk management program, which is essential for protecting downstream dam areas, is required. Part of this program is to prepare an inundation map to simulate the impact of dam failure on the downstream areas. The Baysh dam has crucial importance both to protect the downstream areas against flooding, to provide drinking water to cities in the surrounding areas, and to use the excess water for irrigation of the agricultural areas located downstream of the dam. Recently, the Kingdom of Saudi Arabia (KSA) was affected by extraordinary rainstorm events causing many problems in many different areas. One of these events happened along the basin of the Baysh dam, which raised the alarm to the decision makers and to the public to take suitable action before dam failure occurs. The current study deals with a flood risk analysis of Wadi Baysh using an integration of hydrologic and hydraulic models. A detailed field investigation of the dam site and the downstream areas down to the Red Sea coast has been undertaken. Three scenarios were applied to check the dam and the reservoir functionality; the first scenario at 100- and 200-year return period rainfall events, the second scenario according to the Probable Maximum Precipitation (PMP), and the third scenario if the dam fails. Our findings indicated that the Baysh dam and reservoir at 100- and 200-year rainfall events are adequate, however, at the PMP the water will spill out from the spillway at ~8900 m3/s causing flooding to the downstream areas; thus, a well-designed channel along the downstream wadi portion up to the Red Sea coast is required. However, at dam failure, the inundation model indicated that a vast area of the section downstream of the dam will be utterly devastated, causing a significant loss of lives and destruction of urban areas and agricultural lands. Eventually, an effective warning system and flood hazard management system are imperative

Mobile wireless sensor networks applied to the survey of water infrastructures

The paper reports our last advances in the realization of mobile wireless sensor networks (WSNs), able to reveal unknown tracks and leakages within underground pipelines used to distribute water. This WSN technology is based on a concept recently proposed by the authors, which makes use of mobile acoustic sensors able to flow within a pipe, transported by the fluid, and equipped with a wireless interface that reports the acquired information to the surface. The paper starts from the early and simplified realization that has been already presented to demonstrate the feasibility of the concept and describes the realization of advanced prototypes, using wireless modules that work in different frequency ranges with specifically designed antennas with the auxiliary possibility to track the position of the device. Ad-hoc solutions have been identified for the construction of the microwave front-end, allowing an improved stability despite the mobility and the rotations. Battery life, compared to application requirements, have been investigated and optimized. Moreover, the technology has been adapted to different operational contexts, making use of different choices of the Physical Layers and various transmission protocol optimizations. At last, results are presented and discusse