The study objective was to the assess level of detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in the urban population of Qatar. Antibody testing was performed on ...residual blood specimens for 112,941 individuals (∼10% of Qatar's urban population) attending for routine/other clinical care between May 12 and September 9, 2020. Seropositivity was 13.3% (95% confidence interval CI = 13.1–13.6%) and was independently associated with sex, age, nationality, clinical care encounter type, and testing date. Median optical density (antibody titer) among antibody-positive persons was 27.0 (range = 1.0–150.0), with higher values associated with age, nationality, clinical care encounter type, and testing date. Seropositivity by nationality was positively correlated with the likelihood of having higher antibody titers (Pearson correlation coefficient = 0.85; 95% CI = 0.47–0.96). Less than two in every 10 individuals in Qatar's urban population had detectable antibodies against SARS-CoV-2, suggesting this population is still far from herd immunity and at risk of subsequent infection waves. Higher antibody titer appears to be a biomarker of repeated exposures to the infection.
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•Less than 20% of Qatar's urban population had detectable antibodies for SARS-CoV-2•Qatar's urban population is still at risk of future epidemic waves•Antibody titers varied by age, nationality, and over time•Higher antibody titers appear to be a biomarker of re-exposures to the infection
Health informatics; Public health; Infection control in health technology; Immunology
The burden of heart failure (HF) is high globally, but information on its burden in the Eastern Mediterranean Region (EMR) is limited. This study provides a systematic analysis of the burden and ...underlying causes of HF in the EMR, including at the country level, between 1990 and 2019.
We used the 2019 Global Burden of Disease (GBD) data for estimates of prevalence, years lived with disability (YLDs), and underlying causes of HF in the EMR. Age-standardised prevalence, YLDs, and underlying causes of HF were compared by 5-year age groups (considering 15 years old and more), sex (male and female), and countries.
In contrast with the decreasing trend of HF burden globally, EMR showed an increasing trend. Globally, the HF age-standardised prevalence and YLDs decreased by 7.06% (95% UI: −7.22%, −6.9%) and 6.82% (95% UI: −6.98%, −6.66%) respectively, from 1990 to 2019. The HF age-standardised prevalence and YLDs in the EMR in 2019 were 706.43 (95% UI: 558.22–887.87) and 63.46 (95% UI: 39.82–92.59) per 100,000 persons, representing an increase of 8.07% (95% UI: 7.9%, 8.24%) and 8.79% (95% UI: 8.61%, 8.97%) from 1990, respectively. Amongst EMR countries, the age-standardised prevalence and YLDs were highest in Kuwait, while Pakistan consistently had the lowest HF burden. The dramatic increase of the age-standardised prevalence and YLDs were seen in Oman (28.79%; 95% UI: 28.51%, 29.07% and 29.56%; 95% UI: 29.28%, 29.84%), while Bahrain witnessed a reduction over the period shown (−9.66%; 95% UI: −9.84%, −9.48% and−9.14%; 95% UI: −9.32%, −8.96%). There were significant country-specific differences in trends of HF burden from 1990 to 2019. Males had relatively higher rates than females in all age groups. Among all causes of HF in 2019, ischemic heart disease accounted for the highest age-standardised prevalence and YLDs, followed by hypertensive heart disease.
The burden of HF in the EMR was higher than the global, with increasing age-standardised prevalence and YLDs in countries of the region. A more comprehensive approach is needed to prevent underlying causes and improve medical care to control the burden of HF in the region.
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Background
We investigated the contribution of age, coexisting medical conditions, sex, and vaccination to incidence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and of ...severe, critical, or fatal COVID‐19 in older adults since pandemic onset.
Methods
A national retrospective cohort study was conducted in the population of Qatar aged ≥50 years between February 5, 2020 and June 15, 2023. Adjusted hazard ratios (AHRs) for infection and for severe coronavirus disease 2019 (COVID‐19) outcomes were estimated through Cox regression models.
Results
Cumulative incidence was 25.01% (95% confidence interval CI: 24.86–25.15%) for infection and 1.59% (95% CI: 1.55–1.64%) for severe, critical, or fatal COVID‐19 after a follow‐up duration of 40.9 months. Risk of infection varied minimally by age and sex but increased significantly with coexisting conditions. Risk of infection was reduced with primary‐series vaccination (AHR: 0.91, 95% CI: 0.90–0.93) and further with first booster vaccination (AHR: 0.75, 95% CI: 0.74–0.77). Risk of severe, critical, or fatal COVID‐19 increased exponentially with age and linearly with coexisting conditions. AHRs for severe, critical, or fatal COVID‐19 were 0.86 (95% CI: 0.7–0.97) for one dose, 0.15 (95% CI: 0.13–0.17) for primary‐series vaccination, and 0.11 (95% CI: 0.08–0.14) for first booster vaccination. Sensitivity analysis restricted to only Qataris yielded similar results.
Conclusion
Incidence of severe COVID‐19 in older adults followed a dynamic pattern shaped by infection incidence, variant severity, and population immunity. Age, sex, and coexisting conditions were strong determinants of infection severity. Vaccine protection against severe outcomes showed a dose–response relationship, highlighting the importance of booster vaccination for older adults.
To date, there is no consensus on the most reliable marker of iron status in patients with chronic kidney disease (CKD). Serum ferritin is used routinely, although it may be a misleading marker for ...iron overload. The success of T2
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MRI in monitoring iron overload in patients with hemoglobinopathies can be beneficial to monitoring patients with CKD.
Introduction
Few studies have reported hepatic and cardiac iron overload in patients with end‐stage renal disease (ESRD), and the current evidence regarding the prevalence is still scarce.
Aim
This ...review aims to estimate the prevalence of hepatic and/or cardiac iron overload quantified by magnetic resonance imaging (MRI) in patients with ESRD who receive hemodialysis (HD), peritoneal dialysis (PD), or have undergone a kidney transplant.
Methods
A systematic review with meta‐analysis was conducted and reported in line with PRISMA (Preferred Reporting Items for Systematic Review and Meta‐Analysis) guidelines. MEDLINE and Embase bibliographic databases were searched using a comprehensive list of controlled vocabulary and keywords to identify relevant studies. All studies reporting the prevalence of hepatic and/or cardiac iron overload quantified by MRI in ESRD patients were considered. The Newcastle‐Ottawa scale was used to assess the methodological quality of included studies. To investigate the heterogeneity between studies, random‐effect meta‐analyses for proportions were used.
Results
The review comprised seven studies that included 339 patients. Using meta‐analysis, the pooled prevalence of severe and mild to moderate hepatic iron overload quantified by MRI was 0.23 95% CI: 0.08–0.43 and 0.52 95% CI: 0.47–0.57, respectively. Only three studies included cardiac iron quantification, and none reported iron overload.
Conclusions
This review has revealed a high prevalence of severe hepatic iron overload in patients with ESRD treated by HD. Further studies with a larger sample size are needed to determine the impact of iron overload on vital organs in patients with ESRD and guide future research in this understudied field. Proper use of iron chelation and continuous monitoring will help in the early detection of unsolicited complications; however, the low renal clearance of most iron chelators limits the options for treating iron excess in patients with ESRD.
Vaccines were developed and deployed to combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to characterize patterns in the protection provided by the ...BNT162b2 and mRNA-1273 mRNA vaccines against a spectrum of SARS-CoV-2 infection symptoms and severities.
A national, matched, test-negative, case-control study was conducted in Qatar between January 1 and December 18, 2021, utilizing a sample of 238,896 PCR-positive tests and 6,533,739 PCR-negative tests. Vaccine effectiveness was estimated against asymptomatic, symptomatic, severe coronavirus disease 2019 (COVID-19), critical COVID-19, and fatal COVID-19 infections. Data sources included Qatar's national databases for COVID-19 laboratory testing, vaccination, hospitalization, and death.
Effectiveness of two-dose BNT162b2 vaccination was 75.6% (95% CI: 73.6–77.5) against asymptomatic infection and 76.5% (95% CI: 75.1–77.9) against symptomatic infection. Effectiveness against each of severe, critical, and fatal COVID-19 infections surpassed 90%. Immediately after the second dose, all categories—namely, asymptomatic, symptomatic, severe, critical, and fatal COVID-19—exhibited similarly high effectiveness. However, from 181 to 270 days post-second dose, effectiveness against asymptomatic and symptomatic infections declined to below 40%, while effectiveness against each of severe, critical, and fatal COVID-19 infections remained consistently high. However, estimates against fatal COVID-19 often had wide 95% confidence intervals. Analogous patterns were observed in three-dose BNT162b2 vaccination and two- and three-dose mRNA-1273 vaccination. Sensitivity analyses confirmed the results.
A gradient in vaccine effectiveness exists and is linked to the symptoms and severity of infection, providing higher protection against more symptomatic and severe cases. This gradient intensifies over time as vaccine immunity wanes after the last vaccine dose. These patterns appear consistent irrespective of the vaccine type or whether the vaccination involves the primary series or a booster.
Public health research plays a critical role in strengthening health systems and improving their performance and impact. However, scholarly production in public health coming from the Eastern ...Mediterranean Region (EMR) remains well below the world average and lacks a tangible growth trend over time. During the seventh Eastern Mediterranean Public Health Network Regional Conference, a roundtable session brought together a panel of public health experts representing Global Health Development/Eastern Mediterranean Public Health Network affiliates, universities or academia, and research institutions from the region, where they shared insights on the current situation of public health research; challenges and barriers to research facing the different countries in the EMR and the region in general; and how research agendas, productivity, and quality can be supported through strengthening research capacity in the region. Although the region is diverse in terms of health system capacity and socioeconomic development, several common challenges were identified, including a lack of strategic prioritization to guide health research, insufficient funding, ineffective transfer of knowledge to policy and practice, limited availability of research facilities, and limited national and international research collaboration. Occupied countries and countries in a state of conflict, such as Palestine, face additional barriers, such as personal and social security, lack of control of borders and natural resources, travel and movement restrictions, and confidentiality challenges because of the continuing war conditions and occupation. However, there have been success stories in the EMR regarding research publications and their positive and effective impact on policy and decision-makers. To improve research resilience and public health care in the region, a collaborative approach involving institutions, policymakers, and relevant stakeholders is critical.
Women’s mental health in the perinatal period is understudied worldwide and in Arab countries especially.
This systematic review explores evidence of the association between women’s social resources ...for empowerment in the Arab World and their mental health in the prenatal and postnatal (≤1year postpartum) periods.
Guided by Kabeer’s framework of empowerment, the authors applied a search string in PubMed and Web of Science databases to identify studies in countries of the Arab League (hereafter the Arab World) that address mental health and social resources for women’s empowerment in the perinatal period.
Of 1865 electronically retrieved articles, 23 met the inclusion criteria. Overall, the majority of studies found a positive association between social resources for empowerment and perinatal mental health. Seven studies explored the relationship between familial or general social support and prenatal mental health in Arab women, and found a significant positive association. Sixteen of the 18 studies of women in the postnatal period found that enabling familial, extra-familial, and/or general social support was positively associated with mental health.
This review demonstrates an association between social resources and perinatal mental health, but there is a dearth of research in this area. We call for additional research on Arab women in the perinatal period using context-specific but standardized tools to assess social resources and mental health. Evidence on positive mental health, resilience, and the influence of social resources can guide the improvement of prenatal and postpartum care services.
Adolescents in the 30 μg cohort were matched exactly one-to-one by sex, ten nationality groups, number of coexisting conditions, previous infection status (no previous infection, or previous ...infection with either pre-omicron or omicron viruses, or previous infections with both viruses) to adolescents in the 10 μg cohort, to balance observed confounders between exposure groups. The adjusted hazard ratio comparing infection incidence in the 30 μg cohort with that in the 10 μg cohort was 0·77 (95% CI 0·60–0·98; table). ...a three-fold higher BNT162b2 dose was associated with close to 25% higher protection against infection in infection-naive adolescents of similar age.
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