Background: Saudi Arabia is considered the epicentre of MERS-CoV. Since 2012, a total of 1844 cases of MERS-CoV have been reported. A recent cluster, with 8 cases, has been reported in Najran region in the south-western region of the country. This analysis of data from that region on health care workers (HCWs) awareness and attitudes towards the prevention and control of MERS-CoV may be useful when planning health education programmes about this emerging infectious disease. Aims: We aimed to investigate the knowledge and attitude of HCWs toward MERS-CoV in south-western Saudi Arabia. Methods: This cross sectional study was conducted on HCWs in primary health care centres and hospitals at Najran. A questionnaire containing 14 knowledge and 8 attitude items was completed by all 870 participants. Results: Overall, > 80% of HCWs were aware about MERS-CoV etiology, mode of transmission, risk factors, and signs and symptoms. Knowledge scores revealed 51% of participants had sufficient knowledge. Physicians and nurses had significantly better knowledge compared with other HCWs (P = 0.001). Participants who worked at institutions with established infection control programme scored significantly better on knowledge questions (P = 0.001). Concerning attitude, > 70% of HCWs exhibited a positive attitude toward MERS-CoV. Conclusion: the HCWs in Najran region showed a high level of knowledge and positive attitude toward MERS-CoV. There was a noticeable difference in knowledge level between different professions. Periodic educational interventions and professional campaigns are still needed. Any interventions should be directed towards the non-physician and non-nursing professions. Citation: Asaad A; El-Sokkary R; Alzamanan M; El-Shafei M. Knowledge and attitudes towards Middle East respiratory syndrome-coronavirus (MERS-CoV) among health care workers in south-western Saudi Arabia. East Mediterr Health J. 2020;26(4):435-442. https://doi.

Background Coronavirus disease 2019 (COVID-19) was announced in early December 2019. The pandemic situation is declared. This study aimed to evaluate the role of biomarkers in estimating the severity and predicting the prognosis of COVID-19. Results A total of 116 confirmed patients were included in this study. The patients were evaluated clinically. The disease severity was assessed. The measured and calculated laboratory tests were done. The primary outcome is the 30-day mortality. Patients were assigned to the severe (14.7%) and non-severe (85.3%) groups. At IL-6 level of 32.3 pg/mL (the highest Youden’s index = 0.77), IL-6 can differentiate severe from non-severe patients with 82.4% sensitivity and 94.4% specificity. IL-6 can predict the severity [odds ratio of 87.7 (95% CI = 18.9-408.2) (P < 0.0001)]. After adjustment to the significant clinical and laboratory parameters, IL-6 had an adjusted odds ratio of 30.8 (95% CI = 1.1-728.3) (P = 0.046). A high CRP/albumin ratio of > 11.4 was associated with COVID-19 mortality [hazard ratio = 59.9 (95% CI = 7.4–488.3) (P < 0.0001)]. High CRP/albumin ratio had an adjusted hazard ratio of 26.5 (95% CI = 2.6-270.7) after adjustment of age and presence of co-morbidities (P = 0.006). Conclusion IL-6 level could effectively discriminate COVID-19 severity. CRP/albumin ratio was an independent risk factor for 30-day mortality rate in patients with COVID-19. IL-6 and CRP/albumin ratio seem to be valuable biomarkers in evaluating the severity and prognosis of COVID-19, respectively.

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Background Tuberculosis is a communicable disease that is one of the leading cause of death from a single infectious agent (ranking above human immunodeficiency virus/acquired immunodeficiency syndrome). The aim of this work was to study the trend of applying the tuberculosis control program at the ministry of health and population chest hospitals, Sharkia, Egypt. Results This retrospective cross-sectional study was carried out using medical records from the tuberculosis registry at Ministry of Health and Population chest hospitals, Sharkia Governorate. The investigated variables included demographic characteristics, type of tuberculosis infection, and affected organs. All data were coded and statistically analyzed. A total 1404 cases of tuberculosis were notified between 2016 and 2019 with male predominance, where 67.1% were males and 32.9% were females. The highest number of tuberculosis patients was from the reproductive age groups. During the 4-year study period, the highest percentage of cases was new cases and the highest frequency of cases was during 2017 and the lowest frequency was during 2016. There was a decline in the total number of cases in 2018 and 2019 after sharp increase of total cases in 2017: pulmonary tuberculosis cases showed a sharp decline in 2017; however, there was an increase in extrapulmonary tuberculosis cases during 2017 then a slight decrease in 2018 and 2019. Of the pulmonary tuberculosis cases, 83.8% were smear-positive tuberculosis. Conclusions Pulmonary smear-positive and new cases were the most common among the recorded cases of tuberculosis. Productive age groups represented large percentage of the studied cases of tuberculosis. Lymph node and bones were the most common sites of extrapulmonary tuberculosis among reported cases in this study.

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