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Epidemiological characteristics of a salmonella outbreak among infants in Qatar, 2017
Purpose: This study was conducted to investigate the epidemiology behind the increased incidence of infant salmonella cases in Qatar during 2017 and identify the possible risk factors. Methods: This was a cross-sectional study using the notification reports of laboratory-confirmed infant salmonella cases received by the Ministry of Public Health during the year 2017. Furthermore complementary phone interviews with the infants’ mothers using a validated questionnaire were conducted. Results: The infant salmonella attack rate was calculated at approximately 3.23 cases per 1000 infants. Among the 89 confirmed infant salmonella cases there were more girls (53%) than boys (47%) with a median age of 8 months. The most common type of salmonella species isolated was group B (50.5%). Among the 59 infant cases whose mothers were interviewed the majority (94.9%) were symptomatic and diarrhea was the main reported symptom (90%) particularly bloody diarrhoea (62%). Regarding their dietary consumption the majority (69.5%) of the infected infants were formula-fed. Moreover the majority reported having no pets at home (91.6%) and were not enrolled in a day care center (93.3%). Conclusion: This study revealed a high incidence of salmonella infection among infants in the State of Qatar which poses a public health concern. Therefore targeted interventions and health awareness programs are required for outbreak prevention detection and control.
Communicating the risk of COVID-19 during sporting events in Qatar: Challenges and opportunities
Background: After a long unprecedented pause sporting events were cautiously resumed in Qatar in September 2020. With the persisting COVID-19 uncertainties characterizing the COVID-19 risks related to sports activities remains to be examined making it difficult to give clear messages 1. This report describes some of the key challenges and opportunities for communicating COVID-19 risks associated with sporting events. Methods: The outbreak investigation report for COVID-19 cases related to the Asian Federation Cup (AFC) Champions League-West hosted in Qatar Sep 14th to Oct 3rd 2020 was interpreted and taken as a case study. Results: The outbreak investigation reports which involved approximately 74 COVID-19 cases is shown in Figure 1 and constituted the main subject to communicate the risks of the infection. The investigation teams were engaged in person-to-person communication reviewing the history of the possible risk exposure and explaining the recommended measures. Clubs’ physicians and delegations besides the local organizing committee seem to have played a pivotal role as a credible source of information to the players and media about the possible case scenarios and the control measures23. The yet unclear mode of transmission may have contributed to the poor risk perception and the compliance with the unfamiliar preventive recommendations23. Conclusion: The profound evolution of the pandemic has already offered a unique opportunity to overcome the ‘lack of attention’ in the communication of communicable diseases. Using the epidemiological findings to communicate COVID-19 risks during sporting events seemed to be beneficial to explain the virus characteristics emphasizing the role of the epidemiological approaches to improve the risk perception and the compliance with the public health advice.
Preparing for infectious disease threats at FIFA sporting events: What Qatar should learn from the available practices?
Background: Qatar is about to host the 2022 FIFA World Cup-WC this can stress the public health system and resources of Qatar as hosting country. Reducing public health risks and ensuring people's safety at The Qatar 2022WC requires thorough planning and coordination. The aim is to obtain a comprehensive insight into the available practices concerning the infectious diseases preparedness and response for major Sporting events and to advise Qatar W.C-2022 health committee accordingly.
Methods: A desk review of WHO literature in public health considerations during mass gatherings was done with particular focus on the Communicable Disease alert and response for mass gatherings.
Results: The literature suggests certain critical factors and preconditions for success that are common to most events as well as strategic organizational and tactical lessons learned that can be applied for Qatar WC 2022 includes Comprehensive risk assessment should be conducted before the event this will allows planners in Qatar to reduce the risk of communicable disease outbreaks associated with WC2022. Plans for risk management and risk communication need to be developed. New surveillance system should be in place for a sufficient length of time prior to the WC and this surveillance need to be divided into three phases Pre-WC surveillance WC-based surveillance and Post-WC surveillance.
Conclusion: The challenge for Qatar is to recognize the possible benefits from the outset of planning for the coming 2022WC and to build a positive and Strategic approach to communicable diseases issues into the earliest stages.
Health and biomedicine in e-Marefa and IMEMR databases: Comparative study of their content and subject analysis
e-Marefa is an Arab electronic database managed by the Knowledge World Company for Digital Content. e-Marefa Database includes the full text of journal articles and other types of publications from the Arab countries. The database covers health and biomedicine in addition to science engineering humanities and social sciences. It includes a total of 250000 records (articles) of which 56494 are in health and biomedicine. The Database was launched in December 2011 and is offered for subscription. IMEMR (Index Medicus for the Eastern Mediterranean Region) is one of the major projects of the Virtual Health Sciences Library (VHSL) of the World Health Organization Regional Office for the Eastern Mediterranean (EMRO). The vast majority of the journals of the IMEMR are neither indexed nor abstracted in international indexing and abstracting services. The Index currently indexes 612 health and biomedical journals and includes 164864 records from the 22 countries of the Region of which 101252 records are from Arab countries. The database was established in 1987 and is offered free of charge. Study sample: A set of 200 articles common between the two data bases was identified retrieved and a database of these was created for analysis. The 200 records were published in 14 journals from countries commonly covered by the two databases. Results: The two databases use international standards and tools for managing bibliographic data and organizing knowledge. They both use the Dublin Core (based on MARC 21 and UNESCO CCF) for metadata the Anglo-American Cataloguing Rules NLM Subject Headings and LC Subject Headings. The IMEMR uses more indexing terms than the e-Marefa. The average number of terms used in IMEMR is 6.31 while it is 2.5 terms per article in e-Marefa. e-Marefa Database does not use the NLM publication types as one of its indexing terms. IMEMR uses post-coordinated terms based on the NLM Subject Headings while e-Mareaf uses pre-coordinated terms from the LC Subject Headings enriched by Arabic local headings. There was high level of compatibility between the two databases as far as using the MeSH terms used as there was minor discrepancy between the two databases in the selection of main subject headings assigned to articles. The study identified the top MeSH terms used by each of the two databases and the common terms used by both. The top five journals contributing to the 200 articles are from Egypt Oman and Qatar. Recommended future actions include urging the e-Marefa Database to increase the number of terms assigned per article and apply a post-coordination indexing and search methodology to allow for more findability and accessibility. IMEMR can benefit from providing multilingual indexing and searching facility. The two databases may collaborate to provide the full bibliographic data and full text in a public-private partnership model. Recommended future research should focus on measuring recall and precision based on the information retrieval systems used by the two databases. The paper includes four annexes of countries covered in the two databases the descriptors/ subject headings used discrepancies in the main headings used and the source journals.
How MERS-CoV Helped Overcome Communication Barriers in Qatar
Background
As a conventional type of communication health education usually face several barriers that make its outcome fall short. Among many lack of interest distraction and rejection are well documented barriers to engaging audience in a communication process leading to behavioral change. Despite the novel corona virus which was responsible for the Middle East Respiratory Syndrome (MERS-CoV) created public concerns it on the other hand paved the road to effective health education via raising receivers’ attention. With the aim to highlight the context and factors attributed to educate the public during epidemics this study documented how the outbreak of MERS-CoV offered valuable opportunities to communicate critical educational messages on the recommended preventive behaviors and practices.
Methods
In this retrospective study we documented the timeline of MERS-CoV key events in Qatar along with the disseminated health education messages that were captured by the print media during the period Sep 2012 through Nov 2013.
Results
The media documented that one of the first two reported cases worldwide was a Qatari national. A significant turn of the public's risk perception about MERS-CoV took place when studies documented that camels are thought to play critical role in the virus transmission to humans. Six months after the identification of the first case this relationship was confirmed when it was declared that the MERS-CoV was isolated from camels in Qatar provided that raising camels is a social norm and an embedded cultural practice in the country and across the region. Nevertheless MERS-CoV cases and deaths continued to be reported.
Out of 153 news stories reported on MERS-CoV 12 major developments either reporting confirmed cases or deaths were identified in Qatar. Two Press conferences sixteen press releases and two interviews were counted all from competent authorities. As the novel virus captured the media attention all aspects of the new virus were extensively reported ranging from the basic information about the virus traits the clinical signs and symptoms treatment outcome of cases to the ongoing researches epidemiological findings of the most vulnerable persons the zoonotic nature of the disease and the recommended course of action. The public pressing demand for updates and information drove the media interest to arrange talk shows and interviews with the high health officials to give firsthand accounts about the virus and the prevention and control efforts.
While fresh MERS-CoV cases were reported from The Kingdom of Saudi Arabia fears were growing that Hajj season may allow for a large scale spread of the virus. The publicized health education messages at that time called upon the most-at-risk group to postpone going to Hajj and Umrah be assessed for medical fitness get vaccinated against seasonal flu and avoid the crowded and badly ventilated areas. This group involved elderly and patients with chronic illnesses or impaired immunity. Afterwards frequent hand washing and drinking pasteurized camel milk or consuming well-cooked camel meat was advised along with minimizing close contact with symptomatic persons.
Discussion
The timeline of MERS-CoV events along with the communication activities in response to them gave a strong indication about the correlation between the media interest and public concern of a particular subject in hand and the opportunities created by this momentum to communicate key information and recommended course of action by the competent authorities to satisfy the public's needs on the other hand.
Three main factors influenced how MERS-CoV was perceived in Qatar: its unfamiliarity the epidemiological link to camels and the way media had portrayed it. Like any other exotic risk MERS-CoV's acknowledged unfamiliarity even to health officials seduced the media to fill the uncertainty vacuum by persistently focusing on the similarities with the deadly SARS epidemic that erupted in 2002 thereby allowing for scary scenarios to seed in the public's imagination. It was then announced that a kind of relationship had been established between the infected persons and camels before a Qatari scientific team declared that the life MERS CoV was isolated from an infected camel. The immediate result of this perceived risk was heightened public attention and interest. However the repeatedly announced symptoms of suspected cases allowed for better identification and induced voluntary reporting of cases to healthcare facilities.
Substantial proportion of the communication process usually devoted to achieve the preparatory steps of seizing the audiences’ attention besides making sure that the content matters to them. Whereas the public need for information was being satisfied through news releases and press conferences health education messages constituted a prime ingredient of the communication content.
Despite of the denial and stigma linked to the unfamiliar disease the communicated health messages had a tangible influence on giving the target audience the information necessary to take decisions on the personal and community level. According to records of the medical Hajj committee response to the pre-travel medical assessment and vaccination was remarkable. Patients complied with the isolation requirements. Nevertheless Information Education and Communication (IEC) materials were not prepared prior to the press conferences indicating missed opportunities.
After all no significant rejection to the recommended course of action was identified.
Study limitations
As this study was based on reviewing the content of print media other types of mass media were excluded. Moreover it was important to determine the extent to which the target communities relied on official press releases and press conferences to gain information related to MERS-CoV.
Conclusion
Couple of factors contributed to the successful engaging of the target communities to adopt the recommended course of action: the perceived risk of the novel virus which made the public highly attentive the timing of the health education messages that usually coincided with the critical disease developments and the assignment of credible well-known resource officials from the competent authorities. As the public uptake of behaviors recommended by trusted authorities tends to be very high during epidemics efforts should be made on designing health education messages to be injected within media products like press conferences and press releases during early preparedness phases.