Background: Candida auris (C. auris) is an emerging healthcare-associated pathogen resulting in significant morbidity and mortality. The aim of this study is to report data from the national C. auris surveillance system for 2019 and conduct a survival analysis of the reported cohort. Methods: a retrospective analysis was conducted for all C. auris cases reported nationally to the Oman Antimicrobial Surveillance System (OMASS) in 2019, and isolates were sent to the Central Public Health Laboratories (CPHL). Clinical and demographic data were obtained through the E-Surveillance reporting system and the Electronic System (NEHR Al-Shifa) at CPHL. Statistical analysis was done using Kaplan–Meier analysis and Cox proportional hazard models. Results: One hundred and twenty-nine isolates of C. auris were grown from 108 inpatients; 87% were isolated from clinical samples, of which blood was the most common (38.9%). Forty (37%) were ≥65 years of age, 72 (66.7%) were males, and 85 (78.7%) were Omani nationals. Of the total isolates, 43.5% were considered as colonization; 56.5% were considered infection, of which 61.8% of them were candidemia. At least one risk factor was present in 98.1% of patients. The mean time from admission to infection was 1.7 months (SD = 2.8), and the mean length of hospital stay was 3.5 months (SD = 4). Totals of 94.8% and 96.1% of the isolates were non-susceptible to fluconazole and amphotericin, respectively. The variables found to be significantly associated with longer survival post C. auris diagnosis (p < 0.05) were age < 65 years, absence of comorbidities, length of stay < 3 months, colonization, and absence of candidemia. The infection fatality rate was 52.5%. Conclusion: Including C. auris in an ongoing antimicrobial surveillance program provides important data for the comprehensive management of this growing public health threat. The current study shows health care outbreaks of C. auris are ongoing, with 52.5% infection fatality, although our isolates remained sensitive to Echinocandins in vitro.

Objective To assess SARS-COV-2 seroprevalence in Oman and longitudinal changes in antibody levels over time within the first 11 months of the COVID-19 pandemic. Methods This nationwide cross-sectional study was conducted as a four-cycle serosurvey using a multistage stratified sampling method from July–November 2020. A questionnaire was used and included demographics, history of acute respiratory infection and list of symptoms, COVID-19 contact, previous diagnosis or admission, travel history, and risk factors. Results In total, 17,457 participants were surveyed. Thirty percent were female, and 66.3% Omani. There was significant increase in seroprevalence throughout the study cycles, starting from [5.5 (4.8–6.2)] for the first cycle and ending with [22 (19.6–24.6)] for the forth cycle. There was no difference in seroprevalence between genders, but significant differences between age groups. There was a transition of seroprevalence from being higher in non-Omanis in cycle one, [9.1 (7.6–10.9)] to Omanis [3.2 (2.6–3.9)] to being higher in Omanis [24.3 (21.0–27.9)] to non-Omanis [16.8 (14.9–18.9)] in cycle four. There was remarkable variation in seroprevalence of COVID-19 according to governorate. Close contacts of people with COVID-19 had a 96% higher risk of having the disease, (adjusted odds ratio [AOR]=1.96, 95% confidence interval [CI] 1.64–2.34); laborers have 58% higher risk of infection compared to office workers (AOR=1.58, 95% CI; 1.04–2.35). Conclusion The study showed a wide variation of SARS-CoV-2 dissemination between governorates in Oman, with higher seroprevalence estimates in migrants in the first two cycles. Prevalence estimates remain low and are insufficient to provide herd immunity.

To determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare workers (HCWs) based on risk of exposure to COVID-19 patients. Method: This was a SARS-CoV-2 seroprevalence cross-sectional study in risk-stratified HCWs randomly selected from three main district hospitals in Oman. Results: 1078 HCWs were included, with an overall SARS-CoV-2 seroprevalence of 21%. The seropositivity rates in low-, variable-, and high-risk groups were 29%, 18%, and 17%, respectively (p-value < 0.001). The study found higher positivity in males (crude odds ratio [COR] 1.71, 95% confidence interval [CI] 1.28-2.3), and workers residing in high-prevalence areas (COR 2.09, 95% CI 1.42-3.07). Compared with doctors, workers from supporting services, administration staff, and nurses were more likely to test positive for SARS-CoV-2 antibodies (COR 9.81, 2.37,; 2.08 95% CI 1.14-3.81). The overall rate of previously undetected infection was 12%, with higher values in low-risk HCWs. High district prevalence was a driving factor for seropositivity in the low-risk group (adjusted odds ratio [AOR] 2.36, 95% CI 1.0-5.59). Conclusion: Low-risk supporting services workers can drive SARS-CoV-2 transmission in hospitals. More attention and innovation within this area will enhance the safety of health care during epidemics/ pandemics.

Despite the apparent challenges inflicted by COVID-19 globally, the pandemic provided an opportunity to utilize and expand existing public health capacities for a more adaptive and resilient system during and after each wave of the disease. This paper provides a narrative review of Oman's public health response to the COVID-19 pandemic from January 2020 to July 2021, and the challenges it faced for a more rapid and efficient response. The review demonstrates that the three main pillars influencing the direction of the pandemic and aiding the control are Oman's unified governmental leadership, the move to expand the capacity of the health care system at all levels, and community partnership in all stages of the response including the COVID-19 vaccination campaign. The opportunities identified during response stages in the harmonization of the multisectoral response, streamlining communication channels, addressing vulnerable communities (dormitories, residences at border regions), and providing professional technical leadership provide an excellent precursor for expediting the transformation of Oman's health care system to one with a multisectoral holistic approach. Some of the major challenges faced are the shortage of the public health cadre, lack of a fully integrated digital platform for surveillance, and the scarcity of experts in risk communication and community engagement. A future health system where the center for diseases surveillance and control acts as a nucleus for multisectoral expertise and leadership, which includes community representatives, is crucial to attain optimum health. The destruction inflicted by this prolong COVID-19 pandemic at all levels of human life had valued the importance of investing on preventive and preparedness strategies.

Background: Non-pharmaceutical interventions (NPIs), particularly mobility restrictions, are mainstay measures for the COVID-19 pandemic worldwide. We evaluated the effects of Oman’s mobility restriction strategies to highlight their efficacy in controlling the pandemic. Methods: Accessible national data of daily admissions and deaths were collected from 1 April 2020 to 22 May 2021. Google Community Mobility Report (CMR) data were downloaded for the same period. Among six CMR categories, three were used and reduced to one index—the community mobility index (CMI). We used a generalised linear model with a negative binomial distribution combined with a non-linear distributed lag model to investigate the short-term effects of CMI on the number of admitted PCR-confirmed COVID-19 cases and deaths, controlling for public holidays, day of the week, and Eid/Ramadan days. Results: We demonstrated the feasibility of using CMRs in the evaluation and monitoring of different NPIs, particularly those related to movement restriction. The best movement restriction strategy was a curfew from 7 p.m. to 5 a.m. (level 3 of CMI = 8), which had a total reduction of 35% (95% confidence interval (CI); 25–44%) in new COVID-19 admissions in the following two weeks, and a fatality reduction in the following four weeks by 52% (95% CI; 11–75%). Conclusion: Evening lockdown significantly affected the course of the pandemic in Oman which lines up with similar studies throughout the world.