Prevalence and factors associated with infectious intestinal diseases in Ras Al Khaimah, United Arab Emirates, 2017: A population-based cross-sectional study

BACKGROUND

The United Arab Emirates (UAE) is a rapidly developing high-income country that has experienced significant population growth, urbanization, and improvements in the standard of living since its formation in 1971. Published estimates on the prevalence of infectious intestinal diseases (IID) in the UAE are scarce and exclusively based on hospital data. The aim of this study was to provide the first prevalence estimates of IID in the UAE.

METHODS

A population-based cross-sectional study design using a telephone-based questionnaire was used to estimate the IID prevalence in the previous 4 weeks in a representative sample of the Ras Al Khaimah (RAK) population from January to September 2017.

RESULTS

Data were collected from 1254 participants (57.3% male; 25.2% <18 years). The prevalence of IID was 4.2% in the 4 weeks prior to the interview. Multivariate logistic regression analysis identified that being female (odds ratio (OR) 2.4, 95% confidence interval (CI) 1.2-5.1) and having a middle-range monthly household income (approx. USD 4080-<6800: OR 5.42, 95% CI 1.15-25.48; approx. USD 6800-<9530: OR 7.13, 95% CI 1.47-34.57) were positively associated with IID. Age ≥6 years was negatively associated with IID (OR 0.95, 95% CI 0.90-0.99). Forty-nine percent of participants with an IID sought medical care and 20.8% took over-the-counter medication.

CONCLUSIONS

This study provides the first population-based prevalence estimates of IID in the UAE, which are similar to those reported in China (4%), but lower than those reported in Canada (10%), the Netherlands (7%), and the USA (6%).

VIM-4 carbapenemase-producing Enterobacter cloacae in the United Arab Emirates

Screening 34 carbapenem non-susceptible Enterobacteriaceae recovered in Abu Dhabi hospitals identified an Enterobacter cloacae strain carrying bla(VIM-4) , bla(CMY-4) and bla(CTX-M-15) . It was isolated from the urine of an Egyptian patient repeatedly hospitalized and treated with broad-spectrum antibiotics, including carbapenems, in the United Arab Emirates. The bla(VIM-4) coding class I integron, highly similar to In416, was carried on a 175-kilobase non-conjugative incA/C type plasmid also hybridizing with the bla(CMY-4) probe. This is the first detailed report on the isolation of a Verona integron-encoded metallo-β-lactamase (VIM) -producing enteric bacterium in the Arabian Peninsula with characteristics suggestive of spreading from the Mediterranean region.