A second local dengue fever outbreak: A field experience from Muscat Governorate in Oman, 2022

Background

Dengue fever is an infectious disease of global health concern. This study aimed to describe the epidemiology and field experience of a locally transmitted outbreak of dengue fever in Muscat Governorate, Oman from mid-March to mid-April 2022, and the multi-sectoral approach to control the outbreak.

Methods

Data were collected from an electronic e-notification system, active surveillance and contact investigations.

Results

Of 250 suspected and probable cases, 169 were confirmed as dengue fever with DENV-2 serotype. Of these, 108 (63.9%) were male and 94 (55.6%) were Omani. The mean age was 39 years (standard deviation 13 years). Fever was the most common symptom and occurred in 100% of cases. Haemorrhagic manifestations occurred in 10% (n=17) of cases. Hospitalization was required for 93 cases (55.1%). The field investigation included 3444 houses and other suspected sites. Breeding sites for Aedes aegypti were identified in 565 (18.5%) sites visited. Interventions to control the outbreak included environmental and entomological assessment of the affected houses and surrounding areas (400 m radius of each house).

Conclusion

Outbreaks are expected to continue, with the possibility of severe cases due to antibody-dependent enhancement. More data are required to understand the genetics, geographical spread and behaviour of A. aegypti in Oman.

Impact of COVID-19 pandemic on aircraft noise levels, annoyance, and health effects in an urban area in Oman

This study aimed at investigating aircraft noise exposure levels, their annoyance, and potential health effects among communities living within airport catchment areas during the COVID-19 pandemic. Both field measurements and an online survey approach were used to investigate aircraft noise exposure levels, annoyance, and general health effects among residents living near Muscat International Airport (MCT) in Muscat, Oman, amid the COVID-19 period. The study found a drastic decline in aircraft noise levels due to the introduction of COVID-19 intervention measures such as lockdowns, social distancing, and closure of airports. In June 2020, during the COVID-19 pandemic, average daily aircraft noise levels of LAeq (39.9 dB(A)) and Lmax (49.7 dB(A)) was observed compared to the previous year (April-May 2019) of 58.5 and 76.8 dB(A), indicating aircraft noise reductions level of 32% and 35%, respectively. The results of the online social survey among 187 participants showed that most (58.8%) of the respondents did not feel that the level of noise produced by aircraft causes annoyance. During the day, the vast majority of the interviewees did not complain of any annoyance during the morning (45.5%), afternoon (39.6%), and evening (31%) with only < 4% of residents have reported a very high degree of annoyance of during COVID-19 pandemic period. Very few people (17%) did complain of experiencing general health problems while 29% did not know of any potential health effects that could be attributed to aircraft noise exposures. Aircraft noise annoyance complaints among the As-Seeb residents during the pre-COVID-19 pandemic periods were reported to be extremely high reaching about 84% compared to 41% during this current COVID-19 pandemic period. These findings support the need to develop future sustainable noise mitigation policies in order to help reduce noise exposures and improve human health during post-COVID-19 pandemic periods.

Muscat Flavor in Grapevine: A Digital PCR Assay to Track Allelic Variation in VvDXS Gene

The aroma of grapes and derived wines has long been one of the major traits considered in the selection of grapevine varieties through the centuries. In particular, Muscat aromatic grapes have been highly appreciated and widespread since ancient times. Monoterpenes are the key compounds responsible for the Muscat flavor. A major QTL affecting monoterpene level has been found to co-localize with the 1-deoxy-D-xylulose 5-phosphate synthase (VvDXS) gene, encoding for the 1-deoxy-D-xylulose 5-phosphate synthase enzyme involved in the plastidial pathway of terpene biosynthesis. In more detail, a single nucleotide polymorphism (SNP 1822) in the coding region of the gene causes a "gain of function" mutation, which is involved in Muscat flavor. In this work, we have developed a digital PCR-based assay to target allelic variations in the VvDXS gene, SNP1822, with the aim to propose a fast and sensitive analytical tool for targeting Muscat-flavored grapevine genotypes. The assay accurately predicts the genetic structure at 1822 SNP, critical for the development of the aroma in the great majority of Muscats. In the case of grapes in which the aromatic component is due to mutations other than SNP 1822 (e.g., Chasselas Musqué and Chardonnay Muscat), further specific assays can be developed.

Responses to the Pandemic COVID-19 in Primary Health Care in Oman: Muscat Experience

Objectives

As coronavirus disease (COVID-19) was pervading different parts of the world, little has been published regarding responses undertaken within primary health care (PHC) facilities in Arabian Gulf countries. This paper describes such responses from January to mid-April 2020 in PHC, including public health measures in Muscat, Oman.

Methods

This is a descriptive study showing the trends of the confirmed positive cases of COVID-19 and the undertaken responses to the evolving epidemiological scenario. These responses were described utilizing the World Health Organizations’ building blocks for health care systems: Leadership and governance, Health workforce, Service delivery, Medical products and technologies, and health information management.

Results

In mid-April 2020, cases of COVID-19 increased to 685 (particularly among non-nationals). As the cases were surging, the PHC responded by executing all guidelines and policies from the national medical and public health response committees and integrating innovative approaches. These included adapting comprehensive and multi-sectoral strategies, partnering with private establishments, and strengthening technology use (in tracking, testing, managing the cases, and data management).

Conclusions

Facilities in the Muscat governorate, with the support from national teams, seemed to continuously scale-up their preparedness and responses to meet the epidemiological expectations in the management of COVID-19.

Influence of beta glucosidases from native yeast on the aroma of Muscat and Tannat wines

It is now well established that β-glucosidases (BGLs) from non-Saccharomyces yeasts are key enzymes that hydrolyze grape-derived aroma precursors enhancing the flavour of wines. This work reports on the specificity for wine glycosides and the impact on wine aroma, of three native yeast β-glucosidases. Volatile compounds were analyzed by gas-chromatography and mass spectroscopy (GC-MS) and wine aroma was studied by sensory analysis. Issatchenkia terricola β-glucosidase stood out from the other β-glucosidases studied. The I. terricola BGL showed remarkable specificity for norisoprenoid aglycones such as: 3-oxo-7, 8-dihydro-alpha-ionol, 3-oxo-α-ionol, vomifoliol. This different specificity was perceived in the sensory tests. The judges described pleasant fruity, sweet, honey and raisin notes in both Tannat and Muscat wines treated with I. terricola BGL. These results are particularly remarkable for Tannat wines, since there are few reports concerning the application of β-glucosidases to enhance its aroma of Tannat, and none with BGLs from native yeasts.

Drawing Links from Transcriptome to Metabolites: The Evolution of Aroma in the Ripening Berry of Moscato Bianco (Vitis vinifera L.)

Monoterpenes confer typical floral notes to "Muscat" grapevine varieties and, to a lesser extent, to other aromatic non-Muscat varieties. Previous studies have led to the identification and functional characterization of some enzymes and genes in this pathway. However, the underlying genetic map is still far from being complete. For example, the specific steps of monoterpene metabolism and its regulation are largely unknown. With the aim of identifying new candidates for the missing links, we applied an integrative functional genomics approach based on the targeted metabolic and genome-wide transcript profiling of Moscato Bianco ripening berries. In particular, gas chromatography-mass spectrometry analysis of free and bound terpenoid compounds was combined with microarray analysis in the skins of berries collected at five developmental stages from pre-veraison to over-ripening. Differentially expressed metabolites and probes were identified in the pairwise comparison between time points by using the early stage as a reference. Metabolic and transcriptomic data were integrated through pairwise correlation and clustering approaches to discover genes linked with particular metabolites or groups of metabolites. These candidate transcripts were further checked for co-localization with quantitative trait loci (QTLs) affecting aromatic compounds. Our findings provide insights into the biological networks of grapevine secondary metabolism, both at the catalytic and regulatory levels. Examples include a nudix hydrolase as component of a terpene synthase-independent pathway for monoterpene biosynthesis, genes potentially involved in monoterpene metabolism (cytochrome P450 hydroxylases, epoxide hydrolases, glucosyltransferases), transport (vesicle-associated proteins, ABCG transporters, glutathione S-transferases, amino acid permeases), and transcriptional control (transcription factors of the ERF, MYB and NAC families, intermediates in light- and circadian cycle-mediated regulation with supporting evidence from the literature and additional regulatory genes with a previously unreported association to monoterpene accumulation).

Volatile composition of Pedro Ximénez and Muscat sweet Sherry wines from sun and chamber dried grapes: a feasible alternative to the traditional sun-drying

Sweet Sherry wines from Pedro Ximénez and Muscat sun and chamber-dried grapes during vintages 2009 and 2010 were aged in American oak wood for 12 months. Their volatile content was periodically analyzed using SBSE-GC-MS. Cluster analysis and principal component analysis demonstrated that the volatile compounds considered can be used to detect grape variety and vintage. Principal component analysis for each grape variety, clearly differentiated aging time and vintage. Drying type was the least significant factor. Sweet wines produced using chamber driers were from Pedro Ximénez and Muscat grapes provides similar in volatile constituents as those produced by traditional process.

Metabolite profiling elucidates communalities and differences in the polyphenol biosynthetic pathways of red and white Muscat genotypes

The chemical composition of grape berries is varietal dependent and influenced by the environment and viticulture practices. In Muscat grapes, phenolic compounds play a significant role in the organoleptic property of the wine. In the present study, we investigated the chemical diversity of berries in a Muscat collection. Metabolite profiling was performed on 18 Moscato bianco clones and 43 different red and white grape varieties of Muscat using ultra-performance liquid chromatography-quadrupole time of flight-mass spectrometry (UPLC-QTOF-MS/MS) coupled with SNP genotyping. Principle component analysis and hierarchical clustering showed a separation of the genotypes into six main groups, three red and three white. Anthocyanins mainly explained the variance between the different groups. Additionally, within the white varieties mainly flavonols and flavanols contributed to the chemical diversity identified. A genotype-specific rootstock effect was identified when separately analyzing the skin of the clones, and it was attributed mainly to resveratrol, quercetin 3-O-galactoside, citrate and malate. The metabolite profile of the varieties investigated reveals the chemical diversity existing among different groups of Muscat genotypes. The distribution pattern of metabolites among the groups dictates the abundance of precursors and intermediate metabolite classes, which contribute to the organoleptic properties of Muscat berries.

Clinical Features and Outcome of 65 Laboratory Confirmed Cases of H1N1 in Muscat, Sultanate of Oman

OBJECTIVES

Responding to Pandemic Influenza A (H1N1) virus alert in 2009, Ministry of Health (MoH), Sultanate Of Oman arranged task force to deal with the emergency. MOH published articles in newspapers, prepared guidelines and hospitals were assigned to admit patients of H1N1. All the patients suspected of H1N1 were admitted and isolated as per the guidelines. This report describes clinical features and outcomes of 65 laboratory confirmed cases of H1N1 in Muscat, Sultanate of Oman.

METHODS

From July to October 2009, 101 cases suspected of suffering from Pandemic Influenza A (H1N1) virus were admitted and isolated in Al Nahdha Hospital in Muscat. All the patients on admission were tested for H1N1, by real time reverse transcriptase polymerase chain reaction (RT-PCR). Immediately on admission, all of them were treated with Oseltamivir and antibiotics.

RESULTS

Of the 65 confirmed cases of H1N1, 53.84% were males. Age of patients varied from 14 to 60 years, while 53.7% were aged between 31 to 55 years. Results showed that 70.8% had underlying co-morbidity; among which diabetes mellitus and respiratory illness were common. The most common presenting symptoms were fever (95%) and cough (94%). Also, 20% of the patients had leucopenia and 10.8% leucocytosis. Deranged LFT was observed in 26 (42.6%) of cases while 14 (21.5%) had hypokalemia. One patient (0.01%) with underlying severe co-morbidity died. Two patients (3.1%) had ARDS (Acute Respiratory Distress Syndrome); both recovered. Radiological infiltration was documented in 84.6% of cases, with lower zone involvement as the common finding. Hospital stay was between 1 to 12 days, 49.2% of patients were discharged within 3 days.

CONCLUSION

Mainly adult population was affected during this epidemic. H1N1 infection can lead to severe illness. Incidence of H1N1 was higher in patients with underlying co-morbidity. Timely intervention and administration of Oseltamivir may need to be modified.

Clients' satisfaction with primary health care in muscat

BACKGROUND

To measure clients' satisfaction with primary health care in the capital of Oman, Muscat, and also to identify the factors affecting their satisfaction.

METHODS

Through a cross-sectional study in health centers, 400 participants during the period from November 2009 to February 2010 were interviewed about their satisfaction degree with the primary health care services and setting. Four urban primary health care clinics from Muscat were selected randomly. Six domains of satisfaction including accessibility to services, continuity of care, humaneness of staff, comprehensiveness of care, provision of health education, and effectiveness of services were calculated from selected variables. The mean score of each area were calculated and then divided by the number of items in each area. Finally satisfaction areas were ranked based on recent criteria.

RESULTS

Mean age was 29.5 years (SD = 9.37) for male and 26.01 years (SD = 7.12) for female participants. All the areas were suitable and only continuity of care had negative score. The ranked areas of satisfaction were as humanness of staff, effectiveness of services, access to services, provision of health educational materials, comprehensiveness of care, continuity of care.

CONCLUSIONS

Primary health care were accepted as a suitable strategy for providing health care among clients of urban health centers of Muscat. It can be recommended to other countries to use this as a choice for health care provision.