Maternal and Infant Health in Abu Dhabi: Insights from Key Informant Interviews.
ABSTRACT: Consequent upon rapid development in Abu Dhabi, there has been a rise in chronic disease, the susceptibilities to which are influenced by events occurring in early life. Hence, maternal and infant health are key areas in public health policy. Following a study of maternal and infant health in a cohort of mothers in Abu Dhabi between 2002 and 2004, seven key informant interviews were undertaken to elucidate the study findings through the impressions of Emirati women in positions within the healthcare area-including ministries, hospitals, and universities in Abu Dhabi. Semi-structured interviews were based on five key questions that covered the cultural responsiveness of the maternal health services-breastfeeding, health education, and physical and recreational activity. The responses were analysed using a thematic content technique and indicated that the status of women, cultural beliefs and practices, limited health knowledge, and language differences between the local population, healthcare providers, and health promoting materials were important themes. The study highlighted areas for future research and policy, including the communication gaps between healthcare professionals and women, the influences of advertising and the media on health issues, heath education, and ways to increase women's participation in physical exercise. It is vital to consider non-medical determinants of health alongside biomedical determinants, to help develop culturally appropriate health strategies for this population.
Project description:Middle East respiratory syndrome coronavirus (MERS-CoV) infections sharply increased in the Arabian Peninsula during spring 2014. In Abu Dhabi, United Arab Emirates, these infections occurred primarily among healthcare workers and patients. To identify and describe epidemiologic and clinical characteristics of persons with healthcare-associated infection, we reviewed laboratory-confirmed MERS-CoV cases reported to the Health Authority of Abu Dhabi during January 1, 2013-May 9, 2014. Of 65 case-patients identified with MERS-CoV infection, 27 (42%) had healthcare-associated cases. Epidemiologic and genetic sequencing findings suggest that 3 healthcare clusters of MERS-CoV infection occurred, including 1 that resulted in 20 infected persons in 1 hospital. MERS-CoV in healthcare settings spread predominantly before MERS-CoV infection was diagnosed, underscoring the importance of increasing awareness and infection control measures at first points of entry to healthcare facilities.
Project description:<h4>Objective</h4>This study aimed to elucidate the top five key priorities and barriers to chronic care in the health system of Abu Dhabi, United Arab Emirates (UAE).<h4>Design</h4>A modified Delphi study was performed to reach consensus on priority areas and barriers to the development of the Chronic Care Model in the health system of Abu Dhabi. Individual wireless audience response devices (keypads) linked to a computer were used to reduce 28 priorities and 20 barriers to the top five during three iterative rounds over three consecutive days.<h4>Setting</h4>Chronic care services for patients with diabetes, cardiovascular diseases and cancer, in both private and publicly funded healthcare services in the emirate of Abu Dhabi.<h4>Participants</h4>A purposive sample of 20 health systems' experts were recruited. They were front-line healthcare workers from the public and private sector working in the delivery of care for patients with diabetes, cardiovascular diseases and cancer.<h4>Results</h4>The 'overall organizational leadership in chronic illness care' was ranked as the most important priority to address (26.3%) and 'patient compliance' was ranked as the most important barrier (36.8%) to the development of the Chronic Care Model.<h4>Conclusions</h4>This study has identified the current priorities and barriers to improving chronic care within Abu Dhabi's healthcare system. Our paper addresses the UAE's 2021 Agenda of achieving a world-class healthcare system, and findings may help inform strategic changes required to achieve this mission.
Project description:Both preterm birth and low birth weight (LBW) represent major public health problems worldwide due to their association with the catastrophic effects of morbidity and mortality. Few data exist about such adverse pregnancy outcomes. The current study aimed to investigate the prevalence of and factors associated with preterm birth and LBW among mothers of children under two years in Abu Dhabi, United Arab Emirates. Data were collected in clinical and non-clinical settings across various geographical areas in Abu Dhabi. The data were analyzed using both descriptive and inferential statistics. A total of 1610 mother-child pairs were included in the current study. Preterm birth rate was 102 (6.3%) with a 95% confidence interval [CI] (6.1%, 6.5%) and the LBW rate was 151 (9.4%) with a 95% CI (9.3%, 9.5%). The mean (SD) of gestational age (GA) and birth weight at delivery was 39.1 (1.9) weeks and 3080.3 (518.6) grams, respectively. Factors that were positively associated with preterm birth were Arab mothers, maternal education level below secondary, caesarean section, and LBW. LBW was associated with female children, caesarean section (CS), first child order, and preterm birth. The current study highlighted the need for further interventional research to tackle these public health issues such as reducing the high CS rate and improving maternal education.
Project description:In 2013, Sweihan Healthcare Center, one of several government clinics in Abu Dhabi, catered to 19,349 patients or an average of 52 patients in a day. During the weekdays, close to 80 patients are seen per day, a relatively huge number for a small town clinic. In 2011, the clinic only saw 16,816 patients, which amounts to a 15% increase in two years. Circumstances called for a search for gaps in the system in order to ease the workflow of a steadily increasing patient influx. The focus was mainly on patient identification due to a considerable number of patients having the same name. Data extraction was simplified by the advent of electronic medical records and, as the names of the patients were filtered, one name stood out: "Baby of". The goal of this project was to track the patients using the name "Baby of", and change their names in their respective medical records and thus be able to comply with the International Patient Safety Goals (IPSG) of both Joint Commission International  and the Health Authority of Abu Dhabi .
Project description:BACKGROUND:Optimal complementary feeding (CF) promotes health and supports growth and development in children. While suboptimal feeding practices are reported for many countries, very limited information exists about such practices in the United Arab Emirates (UAE). The present study describes CF practices in Abu Dhabi, UAE, and evaluates them using the United Nations Children's Fund (UNICEF) Programming Guide: Infant and Young Child Feeding. METHODS:In this cross-sectional study, participating mothers of children below the age of two reported on their children's CF introduction and practices via a structured questionnaire. The study received ethical approval (ZU17_006_F) from Zayed University. RESULTS:Out of 1822 participating mothers, 938 had initiated complementary feeding for their children, who had a mean age of 7.1?±?5.9?months. Three quarters of the children (72.2%) were introduced to CF in a timely manner between the ages of 6 and 9?months. A majority (71.4%) consumed ?4 food groups, i.e. the recommended minimum diet diversity. In total, less than half (47.3%) of the children met the requirements for minimum meal frequency, with the non-breastfed, 6-23?month old children being the least compliant (21.9%) (p?<?0.001). Many children were fed with sugar-containing snack items. Overall, 36.2% of the children aged ?6?months had a minimum acceptable diet. CONCLUSION:The gap between the suboptimal CF practices and the recommendations may be attributable to poor knowledge about feeding practices rather than food availability problems. Effective intervention programs can facilitate improvements in the feeding practices to better support a healthy upbringing among Abu Dhabi infants and toddlers.
Project description:In January 2013, several months after Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia, Abu Dhabi, United Arab Emirates, began surveillance for MERS-CoV. We analyzed medical chart and laboratory data collected by the Health Authority-Abu Dhabi during January 2013-May 2014. Using real-time reverse transcription PCR, we tested respiratory tract samples for MERS-CoV and identified 65 case-patients. Of these patients, 23 (35%) were asymptomatic at the time of testing, and 4 (6%) showed positive test results for >3 weeks (1 had severe symptoms and 3 had mild symptoms). We also identified 6 clusters of MERS-CoV cases. This report highlights the potential for virus shedding by mildly ill and asymptomatic case-patients. These findings will be useful for MERS-CoV management and infection prevention strategies.
Project description:<h4>Background</h4>The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond. This study assessed breastfeeding knowledge, attitudes, and practices among women residing on the island of Abu Dhabi and identified associated factors.<h4>Methods</h4>We conducted a cross-sectional study using a self-administered questionnaire among mothers visiting primary healthcare clinics in Abu Dhabi between November 2014 and 2015. Participants were women aged at least 18 years who had at least one child aged 2 years or younger at the time of the study. Breastfeeding knowledge, attitudes, and practices were assessed on the basis of experience with last child. Selected questions were used to develop a scaled scoring system to categorize these aspects as good, fair, or poor. Exclusive breastfeeding is defined as the act of feeding infants only breast milk since birth, without providing water, formula, or other liquid supplements.<h4>Results</h4>The participants were 344 women. Exclusive breastfeeding for 6 months was reported by only 46 (16.9%, 95% CI 0.10, 0.17, <i>n</i>?=?272). 79 (28.7%, <i>n</i>?=?275) of the participants were breastfeeding and planning to continue after the child was ?24 months. Multivariate logistic regression analysis revealed that the following factors were associated with exclusive breastfeeding: mothers with female children (adjusted OR [AOR] 2.42; 95% CI 1.18, 4.97) and better breastfeeding knowledge scores (AOR 1.25; 95% CI 1.04, 1.50). The following factors were associated with less likelihood of exclusively breastfeeding: working mothers (AOR 0.29; 95% CI 0.12, 0.72), living with relatives (AOR 0.21; 95% CI 0.05, 0.81), no past exclusive breastfeeding experience (AOR 0.23; 95% CI 0.09, 0.58) and being offered readymade liquid formula in hospital (AOR 0.33; 95% CI 0.15, 0.72). The most common reason for stopping breastfeeding was insufficient breast milk production (68/89, 76%), and the most common work related reason was inadequate maternity leave (24/89, 15%).<h4>Conclusion</h4>Although breastfeeding knowledge was generally good, breastfeeding practice was still suboptimal. Modifiable factors found to predict exclusive breastfeeding included breastfeeding knowledge and mothers' employment status.
Project description:BACKGROUND:In developing medical research, particularly in regions where medical research is largely unfamiliar, it is important to understand public perceptions and attitudes towards medical research. In preparation for starting the first cohort study in the United Arab Emirates, the Abu Dhabi Cohort Study (ADCS), we sought to understand how we could improve the quality of the research process for participants and increase public trust and awareness of research. METHODS:We conducted six focus groups (FG), consisting of Emirati men and women aged above 18 years to resemble the target population for the ADCS. Sampling was purposive and convenient. Data collection was an iterative process until saturation was reached with no new themes identified. Text from each FG was analyzed separately by identifying emerging issues and organizing related concepts into categories or themes. A coding tree was developed, consisting of the main concepts, themes, subthemes and corresponding quotes. Both themes and main ideas were identified using inductive analysis. RESULTS:Forty-two participants enrolled at 3 academic centers (New York University Abu Dhabi, UAE University, Zayed University) and the Abu Dhabi blood bank. Focus group participants described lack of awareness of research as a challenge to participation in clinical research studies. Altruism, personal relevance of the research, and the use of role models were commonly identified motivators. Participants were generally satisfied with the informed consent process for the ADCS, but would be disappointed if not provided test results or study outcomes. Fear of a breach in confidentiality was a frequently expressed concern. CONCLUSIONS:Participants join research studies for varied, complex reasons, notably altruism and personal relevance. Based on these insights, we propose specific actions to enhance participant recruitment, retention and satisfaction in the ADCS. We identified opportunities to improve the research experience through improved study materials and communication to participants and the broader community.
Project description:BACKGROUND:Traffic collision fatality rates per mile travelled have declined in Abu Dhabi similar to many developed countries. Nevertheless, the rate is still significantly higher than the average of countries with similar GDP and socio-demographic indicators. The literature on the subject in the UAE is limited especially in the area of studying drivers behaviour. This study aims to find determinants of risky driving behaviours that precipitate having a road traffic collision (RTC) in the United Arab Emirates (UAE). METHODS:A cross-sectional, survey-based study was employed. Participants were 327 active drivers who were attending Abu Dhabi Ambulatory Health Care Services clinics. They were provided with a questionnaire consisting of demography, lifestyle history, medical history, driving history, and an RTC history. They were also given a driving behaviour questionnaire, a distracted driving survey, depression screening and anxiety screening. RESULTS:Novice drivers (less than 25?years old) were 42% of the sample and 79% were less than 35?years. Those who reported a history of an RTC constituted 39.8% of the sample; nearly half (47.1%) did not wear a seatbelt during the collision. High scores in the driving behaviour questionnaire and high distraction scores were evident in the sample. Most distraction-prone individuals were young (90.5% were less than 36?years old). High scores in the driving behaviour questionnaire were also associated with high distraction scores (p?<?0.001). Respondents with high depression risk were more likely to be involved in the RTC. With each one-point increase in the driver's distraction score, the likelihood of a car crash being reported increased by 4.9%. CONCLUSION:Drivers in the UAE engage in risky behaviours and they are highly distracted. Some behaviours that contribute to severe and even fatal injuries in RTCs include failing to wear a seatbelt and being distracted. Younger people were more likely distracted, while older drivers were more likely to have higher depression scores. Depression is suggested as a determinant factor in risky driving. These findings are informative to other countries of similar socioeconomic status to the UAE and to researchers in this field in general.
Project description:<h4>Background</h4>The United Arab Emirates is experiencing increasing rates of type 2 diabetes (T2D) and its complications. As soluble levels of the receptor for advanced glycation end products, (sRAGE), and endogenous secretory RAGE (esRAGE), the latter an alternatively spliced form of <i>AGER</i> (the gene encoding RAGE), have been reported to be associated with T2D and its complications, we tested for potential relationships between these factors and T2D status in Emirati subjects.<h4>Methods</h4>In a case-control study, we recruited Emirati subjects with T2D and controls from the Sheikh Khalifa Medical City in Abu Dhabi. Anthropomorphic characteristics, levels of plasma sRAGE and esRAGE, and routine chemistry variables were measured.<h4>Results</h4>Two hundred and sixteen T2D subjects and 215 control subjects (mean age, 57.4?±?12.1 <i>vs.</i> 50.7?±?15.4?years; <i>P</i>?<?0.0001, respectively) were enrolled. Univariate analyses showed that levels of sRAGE were significantly lower in the T2D <i>vs.</i> control subjects (1033.9?±?545.3 <i>vs.</i> 1169.2?±?664.1?pg/ml, respectively; <i>P</i>?=?0.02). Multivariate analyses adjusting for age, sex, systolic blood pressure, pulse, body mass index, Waist/Hip circumference ratio, fasting blood glucose, HDL, LDL, insulin, triglycerides, Vitamin D and urea levels revealed that the difference in sRAGE levels between T2D and control subjects remained statistically-significant, <i>P</i>?=?0.03, but not after including estimated glomerular filtration rate in the model, <i>P</i>?=?0.14. There were no significant differences in levels of esRAGE. Levels of plasma insulin were significantly higher in the control <i>vs.</i> the T2D subjects (133.6?±?149.9 <i>vs.</i> 107.6?±?93.3?pg/L. respectively; <i>P</i>?=?0.01, after adjustment for age and sex).<h4>Conclusion/discussion</h4>Levels of sRAGE, but not esRAGE, were associated with T2D status in Abu Dhabi, but not after correction for eGFR. Elevated levels of plasma insulin in both control and T2D subjects suggests the presence of metabolic dysfunction, even in subjects without diabetes.