The medical and biochemical knowledge of health care professionals regarding the management of MERS-CoV: lessons from 2019 pilgrimage season in Al-Madinah, Saudi Arabia: A cross-sectional study

Background: Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic was a serious healthcare concern not responding to conventional anti-viral therapies between 2012 and 2017 with high fatality rates. Saudi Arabia is still among the best world examples in combating both MERS-CoV and COVID-19 pandemics. Objectives: Investigating the medical and biochemical knowledge of healthcare professionals in Al-Madinah, Saudi Arabia on preventive, diagnostic and therapeutic measures against MERS-CoV epidemic. Subjects and methods: In 2019, this cross-sectional study included 416 healthcare personnel of which 402 participants answered the questions with a response rate of 96.7%. Specialties of participants were medical students (1.4%), physicians (64.4%), nurses (23.6%) and others (10.7%). Results: The vast majority of the investigated healthcare personnel gave the right answers. 96.7% of the participants answered that washing hands using water helps prevent MERS-CoV. 90.8% of the participants answered that wearing a clean non-sterile long-sleeved gown and gloves does helps prevent MERS-CoV infection. 94.7% of participants answered that using alcohol-based hand rub helps prevent MERS-CoV infection. 92.03% of the participants thought that wearing protective equipment does help preventing MERS-CoV infection. 86.1% answered that there is no vaccine available against MERS-CoV infection and 86.1% answered that taking vaccines is suitable for preventing MERS-CoV infection. 90.04% of the participants answered that MERS-CoV patients should be diagnosed using PCR and 84.3% thought that the highest levels of anti-CoV antibodies are in abattoir workers while 87.8% thought that isolation of suspected cases helps preventing MERS-CoV infection. Conclusion: The investigated healthcare workers had a satisfactory knowledge on the preventive and therapeutic measures and biochemical knowledge against MERS-CoV epidemic at mass gatherings as pilgrimage season

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially