Recent Increase in HIV cases in Oman

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Clinical and molecular epidemiology of Crimean-Congo hemorrhagic fever in Oman

BackgroundCrimean-Congo hemorrhagic fever (CCHF) is a serious disease with a high fatality rate reported in many countries. The first case of CCHF in Oman was detected in 1995 and serosurveys have suggested widespread infection of humans and livestock throughout the country.MethodologyCases of CCHF reported to the Ministry of Health (MoH) of Oman between 1995 and 2017 were retrospectively reviewed. Diagnosis was confirmed by serology and/or molecular tests in Oman. Stored RNA from recent cases was studied by sequencing the complete open reading frame (ORF) of the viral S segment at Public Health England, enabling phylogenetic comparisons to be made with other S segments of strains obtained from the region.FindingsOf 88 cases of CCHF, 4 were sporadic in 1995 and 1996, then none were detected until 2011. From 2011-2017, incidence has steadily increased and 19 (23.8%) of 80 cases clustered around Eid Al Adha. The median (range) age was 33 (15-68) years and 79 (90%) were male. The major risk for infection was contact with animals and/or butchering in 73/88 (83%) and only one case was related to tick bites alone. Severe cases were over-represented: 64 (72.7%) had a platelet count ConclusionsCCHF is well-established throughout Oman, with a single strain of virus present for at least 20 years. Most patients are men involved in animal husbandry and butchery. The high mortality suggests that there is substantial under-diagnosis of milder cases. Preventive measures have been introduced to reduce risks of transmission to animal handlers and butchers and to maintain safety in healthcare settings

Human rabies importation to the Middle East: An emerging threat?

International audienc

Effective vaccine management and Oman’s healthcare system’s challenge to maintain high global standards

The prevention of infection through vaccination has been among the most successful public health interventions. Nearly 2.5 million deaths per year globally are saved by immunization against vaccine-preventable disease (VPD) (WHO, 2013) [1]. Oman has experienced a sharp decline in VPDs over the last 40 years due to the introduction of new vaccines and the maintenance of high vaccination coverage of over 99%.The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the effective vaccine management (EVM) framework to assist countries to gauge the performance of their immunization supply chains. Oman underwent the assessment in 2016 and scored the best score to date. This report looks at the process of EVM and the challenges for the Oman healthcare system to maintain high global standards. Keywords: Vaccine, Immunization, Effective, Management, Oma

A survey of thrombosis experts evaluating practices and opinions regarding venous thromboprophylaxis in patients post major abdominal surgery

Abstract Background Patients undergoing major abdominal surgery are at high risk for developing venous thromboembolism in the post-operative period. Current evidence-based guidelines recommend routine pharmacological venous thromboembolism prophylaxis in patient at moderate to high risk post major abdominal surgery. However, the type of agent, dose and duration of thromboprophylaxis remain unclear. We sought to survey current clinical practice and assess for potential clinical equipoise regarding pharmacological thromboprophylaxis post major abdominal surgery. Methods An electronic survey targeting thrombosis expert members of Thrombosis Canada was conducted. Results The total response rate was 52.3% (45/86). All thrombosis experts recommended pharmacological thromboprophylaxis for high risk patients post major abdominal surgery. Over 68% of the thrombosis experts recommended thromboprophylaxis during hospitalization only. The majority of the participants recommended using LMWH (85.9%) over UFH (10.1%). Approximately a third of the surveyed thrombosis experts estimated the incidence of overall VTE at 7 to 10 days post-operatively in patients who do not receive thromboprophylaxis post major abdominal surgery to be between 4 and 6%. A total of 55.3% of the thrombosis experts estimated the incidence of PE to be between 0.5 and 1.0% for the same patient population. The risk of major bleeding episode was estimated to be between 0.5 and 1% in patients receiving 7 to 10 days of pharmacological thromboprophylaxis in the post-operative period by a majority of the thrombosis experts (68.4%). However, approximately 80% of thrombosis experts believed that there is still some clinical equipoise around the use of thromboprophylaxis post discharge (up to 7 to 10 days) in high risk adult patients post major abdominal surgery. Conclusions Thrombosis experts recommend LMWH prophylaxis post major abdominal surgery. There is still, however, significant clinical equipoise regarding the duration of thromboprophylaxis (hospitalization only vs. total to 7–10 days). The result of the survey might not be generalizable to non-academic centers and to other countries

Genitourinary Symptoms Associated with Chlamydia trachomatis and Neisseria gonorrhoeae Infections in a Tertiary Care Hospital in Oman

Objectives: This study aimed to determine the pattern of clinical presentations associated with Chlamydia trachomatis and Neisseria gonorrhoeae infections. Methods: A retrospective cohort study was conducted between 2015 and 2020 and included patients attending Sultan Qaboos University Hospital, Muscat, Oman, who were tested for these infections using nucleic acid amplification. Results: A total of 408 women and 89 men were included. A total of 11 infections were identified in women (n = 11, 2.7%) and 14 in men (n = 14, 15.7%). Chlamydia accounted for almost all infections in women (n = 10, 90.9%), commonly presenting with lower abdominal pain or abnormal vaginal bleeding. In men, urethral discharge/dysuria syndrome was the most common presentation and chlamydia was identified in eight men and gonorrhoea in six; a majority of all infections were seen in patients ≤35 years old. Conclusion: The relative prevalence of two common sexually transmitted infections (STIs) among patients with genitourinary symptoms at a tertiary referral hospital have been described. The pattern of their presentations will inform the design of prospective studies to improve surveillance and guide public health policy in Oman. This study highlights the need for a multi-sectoral approach involving all providers to enable comprehensive STI surveillance. Keywords: Sexually Transmitted Diseases; Chlamydia trachomatis; Neisseria gonorrhoeae; Oman

The Spectrum of Bacille Calmette–Guérin Diseases in Children—A Decade of Data from Neonatal Vaccination Settings

In this paper, we present a multicentre record-based descriptive study used to estimate the incidence and characterize the spectrum of confirmed bacille Calmette–Guérin (BCG) vaccine-related disease among children in Oman. This study included all children (age ≤ 14 years) who had culture and/or polymerase chain reaction (PCR)-confirmed BCG disease from January 2006 to December 2018, as identified from Central Public Health Laboratory data and International Classification of Diseases coding of an electronic patient information system. In total, 88 children confirmed to have BCG disease were included in the study, making an average incidence of 9.2 cases per 100,000 vaccinated neonates. The males comprised 65.9%, Omanis 93.2%, and the median age of presentation was 4 months in children with BCG disease. The most common type of disease was BCG abscesses (72.4%). Children with immunodeficiency and those presenting within 6 months were found to have a more severe and disseminated disease. In total, 28 children had immunodeficiency. The age of presentation and type of BCG disease was significantly associated with immunodeficiency status. The majority of cases required therapy (both medical and surgical) and recovered well. The incidence of laboratory-confirmed BCG vaccine-related disease was low in Oman supporting continuing the use of the BCG vaccination practice at birth

Epidemiological Characteristics of Pandemic Coronavirus Disease (COVID-19) in Oman

Objectives: The aim of the current study was to describe COVID-19’s epidemiological characteristics in Oman during the initial stages of the outbreak and compare findings with other countries’ reports. Methods: Data were drawn from a descriptive, records-based review of reported cases of COVID-19 collected through the national COVID-19 Surveillance System from February to April 2020. Results: A total of 2,443 confirmed cases were reported during the study period. The overall first-time testing rate for this period was 851.7 per 100,000, the positivity rate was 53.1 (confidence intervals [CI]: 51.0–55.2) and the death rate was 0.32 (CI: 0.20–0.54) per 100,000 population, respectively. The overall national positive ratio was 5.7% and ranged from 2.2–7.1% across various governorates. Muscat Governorate had the highest positive ratio (12.5%). People in the 51–60 year old age group (RR = 1.97), males (RR = 1.24), non-Omanis (RR = 2.33) and those living in Muscat (RR = 2.14) emerged as categories with significant demographic risk for COVID-19 cases when compared to the national average. The mean age was 35.6 ± 13.4. Asymptomatic cases accounted for nearly 16%. Conclusion: The overall rate of COVID-19 cases and deaths were low in Oman compared to the rest of the world during the study period. Keywords: Coronavirus; COVID-19; SARS-CoV2; Epidemiology; Pandemic; Oman