Emerging Burden of Frail Young and Elderly Persons in Oman: For whom the bell tolls?

Global, regional, and national burden of refraction disorders: findings from the global burden of disease study 2021 and projections to 2050

BACKGROUND

Refraction disorders are the leading cause of visual impairment worldwide. This study investigates the global burden and trends of refraction disorders from 1990 to 2021, with projections extending to 2050.

METHODS

Data on prevalence and disability-adjusted life years (DALYs) for refraction disorders, along with their 95% uncertainty intervals (UIs), were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The study provides a comprehensive analysis of the epidemiology of refraction disorders at global, regional, and national levels. It examines trends from 1990 to 2021 from multiple dimensions, including overall and localized changes. Burden decomposition was performed to assess contributions from population size, age structure, and epidemiological changes. Cross-country inequalities were quantified using standard health equity methods recommended by the World Health Organization. Future changes in the burden of refraction disorders were also projected through 2050.

RESULTS

According to GBD 2021 estimates, there were 159,765,917 prevalent cases (95% UI: 142,526,915-178,698,348) and 6,618,600 DALYs (95% UI: 4,599,082-9,528,676) due to refraction disorders globally in 2021. From 1990 to 2021, prevalence and DALYs rates demonstrated a steady decline, although prevalence numbers, incidence numbers, and rates were consistently higher among females compared to males. Decomposition analysis showed that aging, population growth, and epidemiological changes contributed 36.25%, 76.92%, and - 13.18%, respectively, to changes in the age-standardized prevalence rate (ASR). The concentration index declined from - 0.17 (95% CI: -0.21 to - 0.13) in 1990 to - 0.10 (95% CI: -0.13 to - 0.07) in 2021, indicating a reduction in SDI-related inequalities. By 2050, the ASR for prevalence and DALYs is projected to decline to 1815.27 (95% UI: 534.15-3096.40) and 69.11 (95% UI: 21.45-116.77), respectively.

CONCLUSION

The global burden of refraction disorders decreased significantly from 1990 to 2021 and is expected to decline further by 2050. Females continue to experience a greater burden compared to males. Population growth emerged as the primary driver of changes in the ASR of prevalence and DALYs. While countries with low socio-demographic index (SDI) face a disproportionately high burden, SDI-related inequalities have gradually lessened over time.

Burden of musculoskeletal disorders in the gulf cooperation council countries, 1990-2019: Findings from the global burden of disease study 2019

Objective

The purpose of this study was to investigate the burden of musculoskeletal (MSK) health conditions in Gulf Cooperation Council (GCC) countries based on the Global Burden of Disease (GBD) data.

Methods

The data for GCC countries were obtained from the 2019 GBD study to evaluate the burden of MSK disorders which include the following countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). The main outcome measures were age-standardized prevalence and years of life lived with disability (YLDs) associated with MSK disorders. The burden of MSK disorders attributable to the category of behavioral, metabolic, or environmental/occupational was reported to estimate the risk-attributable fractions of disease.

Results

MSK disorders prevalence ranked fifth in Kuwait, sixth in Bahrain, Oman, Qatar, and UAE, and seventh in Saudi Arabia among all the diseases in 2019. For all GCC countries, MSK disorders were ranked the second leading cause of disability as measured by YLDs for the years 1990 and 2019. The age-standardized prevalence of MSK disorders in 2019 for Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and UAE was 18.56% (95% UI: 17.51–19.66), 19.35% (18.25–20.52), 18.23% (17.14–19.36), 18.93% (17.81–20.06), 19.05% (17.96–20.22), and 18.26% (17.18–19.38), respectively. The age-standardized YLDs per 100,000 individuals of MSK disorders in 2019 for Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and UAE were 1,734 (1,250–2,285), 1,764 (1,272–2,322), 1,710 (1,224–2,256), 1,721 (1,246–2,274), 1,715 (1,230–2,274), and 1,681 (1,207–2,235), respectively. For risk factors, high body mass index (BMI) had the highest contribution to MSK disorders YLDs in most GCC countries (Bahrain, Kuwait, Oman, and Saudi Arabia), followed by the exposure to occupational ergonomic factors which had the highest contribution to MSK disorders YLDs in Qatar and UAE.

Conclusion

There was an increase in both age-standardized prevalence of MSK disorders and YLDs between 1990 and 2019 that was observed for all GCC countries. Some risk factors such as higher BMI and exposure to occupational ergonomic factors were highly associated with YLDs due to MSK disorders. The results of this study provide guidance for the potential nature of preventative and management programs to optimize the individual's health.

The Effect of Body Mass Index on Pulmonary Related Debility Rehabilitation

BACKGROUND

Obesity is a known factor for the development of abnormal respiratory physiology. However, several studies have found that obesity does not hinder functional recovery in patients hospitalized for postacute care following a stroke or cardiovascular event. This study was designed to determine the effect of overweight and obesity on patients with acute pulmonary disease, hospitalized in an inpatient rehabilitation facility (IRF).

OBJECTIVE

To investigate the impact of body mass index (BMI) on indices of function, specifically, the functional independence measure (FIM) among patients with pulmonary related debility admitted to a rehabilitation hospital.

DESIGN

Retrospective cohort study.

SETTING

Pulmonary unit in an acute freestanding rehabilitation hospital.

PATIENTS

All patients admitted to an IRF with a diagnosis of pulmonary related debility over a 6-year period.

METHODS

The data used in the study included the patient height and weight (measured on admission) and FIM (scored on admission and discharge).

MAIN OUTCOME MEASURES

The primary study outcome measure was the change in FIM per day by the patients' BMI category.

RESULTS

For the 381 patients admitted during the observation period, BMI was compared with FIM score changes per day (FIM efficiency). After adjusting for age and sex, the FIM efficiency only slightly differed by BMI, failing to reach statistical significance. However, age did significantly influence the outcome (P = .05).

CONCLUSION

This study demonstrates that among a large group of patients with a pulmonary related debility, there was no statistically significant correlation between BMI and FIM efficiency. The overweight patients were similar in progression to those who were underweight, normal weight, and obese. However, this study found that increased age adversely affected the outcome of rehabilitation.

LEVEL OF EVIDENCE

III.

Therapeutic drug monitoring-guided dosing of busulfan differs from weight-based dosing in hematopoietic stem cell transplant patients

Busulfan (Bu)-based preparative regimens in hematopoietic stem cell transplantation are commonly used. Previous studies have shown that Bu at a fixed dose of 3.2mg/kg/day (FBD) given intravenously decreases variability in drug pharmacokinetics and this decreases the dependency on therapeutic drug monitoring (TDM) of Bu. We compared the Bu dose given using TDM with the FBD of 3.2mg/kg/day. Seventy-three patients with acute leukemia, myelodysplasia, chronic myeloid leukemia, thalassemia major, and sickle cell disease were included. The mean age at transplant was 15years (range 2-55years) with 57% adults. Indication for transplantation was leukemia/myelodysplastic syndrome in 46% of the patients, while the remaining 54% were transplanted for inherited blood disorders. We found that the median FBD was lower than the median TDM dose by 39mg/day with a statistically significant difference (p<0.001) even after adjusting for the weight (median total FBD of 349mg, median TDM dose of 494mg, p<0.0001). Age and underlying condition (malignant vs. nonmalignant) were the main factors affecting Bu clearance (p<0.001 and p<0.07, respectively). TDM remains an important tool for the appropriate dosing of Bu in preparative regimens of hematopoietic stem cell transplantation, especially in populations with genetic admixture.

Trauma care in Oman: A call for action

Many Arab countries have undergone the epidemiologic transition of diseases with increasing economic development and a proportionately decreasing prevalence of communicable diseases. With this transition, injuries have emerged as a major cause of mortality and morbidity in the Gulf Cooperation Council countries in addition to diseases of affluence. Injuries are the number one cause of years of life lost and disability-adjusted life-years in the Sultanate of Oman. The burden of injuries, which affects mostly young Omani males, has a unique geographic distribution that is in contrast to the trauma care capabilities of the country. The concentration of health care resources in the northern part of the country makes it difficult for the majority of Omanis who live elsewhere to access high-quality and time-sensitive care. A broader multisectorial national injury prevention strategy should be evidence based and must strengthen human resources, service delivery, and information systems to improve care of the injured and loss of life. This paper provides a unique overview of the Omani health system with the goal of examining its trauma care capabilities and injury control policies.

Prevalence and characteristics of road traffic injuries among young drivers in Oman, 2009-2011

OBJECTIVES

Studies from different parts of the world have indicated that the impact of road traffic incidents disproportionally affects young adults. Few known studies have been forthcoming from Arabian Gulf countries. Within Oman, a high proportion of the population is under the age of 20. Coupled with the drastic increase in motorization in recent years, there is a need to understand the state of road safety among young people in Oman. The current research aimed to explore the prevalence and characteristics of road traffic injuries among young drivers aged 17-25 years.

METHODS

Crash data from 2009 to 2011 were extracted from the Directorate General of Traffic, Royal Oman Police (ROP) database in Oman. The data were analyzed to explore the impact of road crashes on young people (17-25 years), the characteristics of young driver crashes, and how these differ from older drivers and to identify key predictors of fatalities in young driver crashes.

RESULTS

Overall, young people were overrepresented in injuries and fatalities within the sample time period. Though it is true that many young people in crashes were driving at the time, it was also evident that young people were often victims in a crash caused by someone else. Thus, to reduce the impact of road crashes on young people, there is a need to generally address road safety within Oman. When young drivers were involved in crashes they were predominantly male. The types of crashes these drivers have can be broadly attributed to risk taking and inexperience. Speeding and nighttime driving were the key risk factors for fatalities.

CONCLUSION

The results highlight the need to address young driver safety in Oman. From these findings, the introduction of a graduated driver licensing system with nighttime driving restrictions could significantly improve young driver safety.

Characterization of depression among patients at urban primary healthcare centers in Oman

AIM

The aim of this study was to estimate the prevalence and predictors of depression among Oman adult population attending primary healthcare clinics (PHCs) in Muscat Governorate in 2011.

METHODOLOGY

A cross-sectional study was conducted on 2005 participants attending 27 different PHCs in Muscat Governorate during 2011. A Patient Health Questionnaire (PHQ-9), together with a socio-demographic and relevant clinical data questionnaire was administered.

RESULTS

Of the 2005 participants, 61.8% were women and 42.1% were of 25-50 age group. Of the total, 44.4% were employed, of whom 51% were government employees. The prevalence of depression among them was 8.1%. The adjusted odds ratios generated by logistic regression models indicated that depression was significantly associated with age greater than 50 years old (OR = 2.23; 95% CI 1.07, 4.22; P = 0.04), female (OR = 1.34; 95% CI 1.12, 3.82; P = 0.03), married (OR = 1.91; 95% CI 1.11, 3.30; P = 0.02), graduated or attended higher education (OR = 1.40; 95% CI 1.03, 2.66; P = 0.04), working in the private sector if employed (OR = 1.72; 95% CI 1.08, 2.75; P = 0.02), and having chronic illness such as diabetes mellitus, hypertension, asthma, heart, thyroid, and renal diseases (OR = 1.82; 95% CI 1.03, 3.51; P = 0.01).

CONCLUSION

The rate of depression appears to be in the lower range compared to rate reported from elsewhere. Some socio-cultural factors that may contribute to the present findings are discussed.

Underlying Factors Behind the Low Prevalence of Autism Spectrum Disorders in Oman: Sociocultural perspective

Epidemiological surveys from various countries indicate an increased prevalence of autism spectrum disorders (ASD), leading researchers to debate whether there are now 'more affected' or 'more detected'. The epidemiology of ASD in developing countries, such as Oman, has generally indicated a lower prevalence compared to developed countries in the West. In Oman, the prevalence is low; however, this article highlights some of the factors that could contribute to the appearance of a low ASD rate: cross-cultural variations in the presentation of distress; a lack of reliable biological markers for diagnosing ASD, and a lack of health services for children with ASD, thus limiting the number of participants in epidemiological surveys. While the defining features of ASD have yet to be established, pilot studies in Oman indicate a substantial number of children with these disorders. Therefore, it is important that these discrepancies be addressed and the need for appropriate services for this patient population in Oman be highlighted.

The magnitude and impact of bullying among school pupils in Muscat, Oman: a cross-sectional study

Research about bullying among school pupils in the Arab/Muslim population is scarce. This study evaluates the characteristics of bullying and its impact among school pupils in Oman via cross-sectional survey among eighth grade school pupils (n = 1,229) during the academic year 2006-2007. The participants were selected using stratified random selection among 6 administrative divisions of one the governorates in the country. Data were collected using self-completed structured questionnaires. This study found similar percentages of males and females (76%) have experienced one form of bullying, and the majority of the incidents (80%) occurred in the vicinity of the school. In almost half of the cases, the bullying was initiated by a student of the same age or older than the victim. The most common type of bullying encountered in this study was verbal (47.7%), followed by misuse (45.9%), physical (43.9%), and, finally, social isolation/exclusion (22.5%). Although the failure of an academic year was uncommon among victims of bullying, the number of pupils who missed 4-6 and ≥ 7 school days was higher among bullied pupils. If this study will withstand further research, educational initiatives are needed to mitigate the rate of bullying in Oman.

Patient safety culture assessment in oman

OBJECTIVE

To illustrate the patient safety culture in Oman as gleaned via 12 indices of patient safety culture derived from the Hospital Survey on Patient Safety Culture (HSPSC) and to compare the average positive response rates in patient safety culture between Oman and the USA, Taiwan, and Lebanon.

METHODS

This was a cross-sectional research study employed to gauge the performance of HSPSC safety indices among health workers representing five secondary and tertiary care hospitals in the northern region of Oman. The participants (n=398) represented different professional designations of hospital staff. Analyses were performed using univariate statistics.

RESULTS

The overall average positive response rate for the 12 patient safety culture dimensions of the HSPSC survey in Oman was 58%. The indices from HSPSC that were endorsed the highest included 'organizational learning and continuous improvement' while conversely, 'non-punitive response to errors' was ranked the least. There were no significant differences in average positive response rates between Oman and the United States (58% vs. 61%; p=0.666), Taiwan (58% vs. 64%; p=0.386), and Lebanon (58% vs. 61%; p=0.666).

CONCLUSION

This study provides the first empirical study on patient safety culture in Oman which is similar to those rates reported elsewhere. It highlights the specific strengths and weaknesses which may stem from the specific milieu prevailing in Oman.

Variation in socio-economic burden for caring of children with autism spectrum disorder in Oman: caregiver perspectives

A cross-sectional study was conducted to investigate whether caregiver's variations in socioeconomic status (SES) has direct bearing on challenges of nurturing children with autism spectrum disorder (ASD) in Oman. A cadre of caregivers (n = 150) from two types of SES (low-income and middle-high income) were compared based on four domains: (1) accessing and perception of remedial services, (2) utilization and perception of psychiatric services, (3) constraints for being a caregiver of children with ASD and (4) financial expenses of taking care of children with ASD. There is little indication that any particular SES fare well on these domains. Factors to mitigate such predicaments are therefore imperative in order to improve quality of life for caregivers among children with ASD.