Ahmed Sameer Alnuaimi

Background: Social media use has become highly prevalent among adolescents and has been linked to both positive and negative health outcomes. However, evidence regarding its relationship with mental health and obesity remains inconsistent, and limited data are available from primary care settings in Qatar. This study aimed to describe patterns of social media use and adolescents’ perceptions regarding its effects and to examine associations between active social media engagement, mental health outcomes, and BMI-for-age among adolescents attending Primary Health Care Corporation (PHCC) health centers in Qatar. Methods: A cross-sectional study was conducted between 5th May 2024 to 30th June 2024 among adolescents aged 11–17 years attending six PHCC health centers across Qatar. Participants were recruited using systematic random sampling. Data were collected through structured face-to-face interviews using a questionnaire that assessed sociodemographic characteristics, social media use, frequency of active social media engagement, and participants’ perceptions regarding the effects of social media. Mental health outcomes, including depression, anxiety, and anger, were assessed using PROMIS Emotional Distress scales, while anthropometric measurements were used to calculate BMI-for-age z-scores. Descriptive statistics, bivariate analyses, and multivariable logistic regression models were performed. Results: A total of 429 adolescents participated in the study. Overall, 25.3% of participants were classified as overweight and 21.7% as obese. Moderate-to-severe anxiety, depression, and anger were reported by 16.2%, 11.4%, and 10.3% of participants, respectively. TikTok (56.9%), Snapchat (48.7%), and Instagram (47.3%) were the most frequently used social media platforms. While 58.2% of participants perceived social media as having positive effects on communication and relationships, many also perceived it to contribute to obesity (47.6%), mental health disorders (41.7%), and excessive screen time (58.3%). However, these findings represented participants’ perceptions rather than objectively measured effects. Statistical analyses demonstrated limited evidence of associations between the measured frequency of active social media engagement and BMI-for-age, depression, anxiety, or anger. In multivariable analyses, higher household income was associated with increased odds of moderate-to-severe anxiety; however, the overall regression model was not statistically significant, and the finding should therefore be interpreted cautiously. Conclusions: Adolescents attending primary care services in Qatar reported substantial social media use, notable levels of emotional distress, and a high prevalence of overweight and obesity. Although many participants perceived social media as having adverse effects on health and well-being, statistical analyses provided limited evidence of associations between the measured frequency of active social media engagement and mental health outcomes or BMI-for-age. These findings highlight the importance of distinguishing perceived effects from observed associations and highlight the need for longitudinal studies using more comprehensive measures of social media use to better understand potential relationships with adolescent health outcomes.

Background: The prevalence of type 2 diabetes mellitus (T2DM) is rapidly increasing worldwide, causing serious morbidity and mortality. Proper management and control of T2DM are essential in slowing and reducing complications. Measuring the adequacy of diabetic control, therefore is one of the ways of evaluating the success of health care system and the individuals in addressing disease morbidity and mortality. This study was proposed to assess the extent of uncontrolled T2DM in ambulatory adults managed in the public primary care settings of Qatar over five years. In addition, it aimed to predict the risk of uncontrolled disease based on age, sex, nationality and comorbidity. Methods: A cross sectional review of Electronic Health Records of 84,512 adult individuals with T2DM having at least one HbA1c blood test result per year during the 5 years study period (1st January 2018, to 31st December 2022) was analyzed. The term “inadequately controlled” T2DM was used to define an individual with HbA1c measurements of 7% or higher. Results: The yearly prevalence of inadequately controlled T2DM remained stable at a high rate (53%) during the last three years of observations. Aging increases the probability of having inadequately controlled T2DM, but this was attributed to comorbidities. Adjusting for those comorbidities will show that younger ages are the ones at higher risk of being uncontrolled. Additionally, the study reported that hypertension and dyslipidemia are the most frequently prevalent comorbidities, nevertheless retinopathy, although less frequent, was the most important predictor for inadequately controlled T2DM. Conclusions: The study highlights the significant healthcare challenge posed by T2DM in Qatar due to its high prevalence and associated complications. Males, South Asian ethnic background and Qatari locals have the highest probability of being inadequately controlled. Overall, the study emphasizes the need for targeted interventions to address the challenges of controlling diabetes, particularly among high-risk groups identified in the study

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, with a growing burden in the Eastern Mediterranean Region. Despite high pre

Background: Health literacy (HL) has increasingly been recognized as a key factor influencing health outcomes and performance of health systems. Evidence suggests enhancing HL can improve access to care, self-management, and overall health outcomes. Despite Qatar’s well-established primary health care system, the country faces a high prevalence of non-communicable diseases. This study aimed to develop a health literacy framework tailored for primary health care service users (PHCSUs) in Qatar. Methods: A mixed methods study design which included a quantitative and qualitative component was employed. The quantitative component consisted of administering a validated Health Literacy Questionnaire (HLQ) to establish HL levels in PHCSUs. The qualitative component included interviews with PHCSUs and focus group discussion (FGD) with PHCC health care providers (HCPs). They were designed to identify preferred HL channels and gain an in-depth understanding of barriers and facilitators pertaining to HL strategies. The findings from the HLQ survey, HCP FGD and PHCSUs interviews along with strategies identified from literature were triangulated to develop a HL framework utilising the Socioecological Model structure as a foundation. Results: A total of 3124 HLQ survey responses were received. 26 HCPs and 16 PHCSUs participated in the FGD and interviews respectively. The study found HL in PHCSUs was influenced by expectations of HL, tailoring of messages, existing chronic conditions, language barriers, peer support, duration of clinical consultations, access to preventive services, regulation of health information sources, societal and cultural factors and community outreach. Conclusions: The study proposes a HL framework with HL determinants nested within the SEM in its entirety. It provides comprehensive view of HL and the many factors that influence it. The HL framework acknowledges the role of individuals and organizations, as well as the strong influence of overarching societal and cultural factors. This information can be utilized to devise interventions to improve HL through effective and innovative learning strategies. Implementation of these evidence-informed interventions and future research in this area can enhance patient centered care and improve the health outcomes.

Background: Conducting clinical reviews is integral to the continuous process of enhancing healthcare quality by identifying specific areas or aspects within medical services and clinical practices. These reviews involve measuring a clinical outcome or process against established evidence-based standards, aiming to spotlight discrepancies between current practice and these benchmarks to facilitate improvements in care quality. Notably, clinical reviews rely on the exceptional skill of the driving force, underscored by key elements: the clinical expertise of participants, result confidentiality, and an objective strongly linked to the professional ‘quality’. The worldwide prevalence of type 2 diabetes mellitus (T2DM) is on the rise, especially in economically developing nations. Current research conducted in Qatar indicates a significant prevalence of diabetes mellitus within the adult population, alongside a considerable proportion of pre-diabetes cases that are likely to elevate the incidence of diabetes mellitus in the coming years. This information underscores the critical need for effective diabetes management at the primary care level, particularly for individuals with pre-diabetes. A comprehensive systematic assessment and intervention are essential to enhance diabetes care. Methods: The proposed research will adopt a quasi-experimental design, which includes a baseline cross-sectional situational analysis conducted across 31 Primary Health Care Centers (PHCCs) prior to the intervention. The study will focus on patients aged 18 and older who have been diagnosed with Type 2 Diabetes Mellitus (T2DM), encompassing both newly diagnosed individuals and those in follow-up care, while excluding pregnant patients. A random sampling method will be utilized to ensure a representative sample size of 450 patients from the last three months of diabetes consultations. Following the identification of gaps in the situational analysis, an intervention will be implemented, after which a post-intervention cross-sectional study will be carried out using the same sample as the baseline to evaluate changes in the measured parameters. Additionally, a cohort study will be performed through a telephonic survey of a random sample of 60 patients, both before and after the intervention, to assess changes from the patients’ perspective. Discussion: A comprehensive assessment and intervention are essential to evaluate the quality of diabetes care delivered at primary health centers. The ICAE-DM CARE study aims to provide an effective situational analysis, which will include the identification of gaps and the underlying causes of these gaps in the DM care using suitable quality improvement tools. The study will also showcase appropriate intervention strategies to improve practice. Furthermore, the implications of this process will be thoroughly examined. This study design will closely reflect a practical understanding of healthcare quality management in diabetes care, which can be applied in similar settings.

Objectives During the COVID-19 epidemic, due to the high risk associated with travel and group gatherings, the Ministry of Public Health in Qatar introduced home delivery of pharmaceutical services. This study aims to investigate the satisfaction and preferences of patients who used the new home delivery services provided by health centres (HCs). Study design A cross-sectional study was conducted using an exploratory questionnaire to assess patients’ preferences for pharmaceutical delivery services. Settings Primary care. Participants A convenient sample of 604 adults who used the pharmaceutical delivery services was recruited. The study tool measured satisfaction with a set of 11 service evaluation criteria on a Likert scale of 5 grades. The score ranged between 1 for highly dissatisfied and 5 for highly satisfied. A quantitative summary satisfaction score was calculated by summing the satisfaction rating for home delivery on the 11 service evaluation criteria. The final score was adjusted to a maximum of 100 for ease of understanding. Results Results showed that 45.5% of participants were highly satisfied with the overall quality of the home delivery service. Furthermore, 58.9% were willing to recommend the service to others, while only 30.9% considered the delivery cost to be reasonable. Among the factors associated with satisfaction was nationality, where Qatari nationals had a significantly higher mean satisfaction score (89%) compared with expatriates (79.5%). Outcome The satisfaction score exhibited a significant positive trend with age and educational level. Factors such as gender, the time required to access the HCs, frequency of requesting pharmacy service and income categories did not show a significant difference in the satisfaction score. Conclusion The home delivery service is a promising addition to primary care. It may play a crucial role in enhancing accessibility for the beneficiaries reducing unnecessary visits to HCs in the future.

Background: Tobacco dependence is a chronic disease that often requires repeated interventions and multiple attempts to quit. Cigarette smoking is the leading preventable cause of mortality. Globally, an estimated 1.3 billion people smoke. In Qatar, Smoking cessation services (SCSs) are provided free of charge to citizens and at a minimal cost to non-citizens. This study aimed to measure the effectiveness of the smoking cessation program adopted by the Primary Health Care Corporation (PHCC) of Qatar. This was achieved through calculating the percentage of smoking cessation service users (survival probabilities) who maintained the non-smoking status after selected follow up periods. Moreover, the study highlighted the possible association of selected explanatory variables with smoking cessation survival probabilities. Methods: In this historical cohort study 490 participants were recruited by simple random sampling who attended the smoking cessation clinics (SCCs) in PHCC prior to 30/06/2021. The participants were contacted by phone and invited to participate in the study. The participants who agreed to participate in the study were interviewed utilizing a structured questionnaire. Results: Initially 311 (63.5%) of the participants quitted smoking after receiving SCSs. There were statistically significant differences between quitting smoking and the nationality and the educational level of participants (p ≤ 0.001 and 0.02 respectively). About one fourth (23.3%) of individuals who initially quitted smoking relapsed and resumed smoking as early as 6 months after completing their SCC visits. This relapse rate increased to 38.7, 47.2 and 51.1% after 12, 24 and 36 months respectively. Less than a half (45.8%) maintained the non-smoking status after 42 months from their initially quitting. Conclusion and recommendations: The findings of the study substantiate the effectiveness of SCSs designed within PHCC both in short- and long-term basis. Younger individuals, smokers with Arab ethnicity, smokers falling within high income and education groups were identified as high-risk groups and need highest focus. The accessibility to the service among the local population can be increased by upscaling the advertisement of the existing services.

SARS-CoV2 a new emerging Corona Virus Disease in humans, which called for containment measures by many countries. The current paper aims to discuss the impact of two different sampling methodologies when executing a drive through COVID-19 survey on the quality of estimated disease burden measures. Secondary data analysis of a pilot cross-sectional survey targeting Qatar's primary health care registered population was done. Two groups with different sampling methods were compared for estimating COVID-19 point prevalence using molecular testing for nasopharyngeal swabs. The first group is a stratified random sample non-proportional to size (N = 260). A total of 16 population strata based on age group, gender, and nationality were sampled. The second group is the Open invitation group (N = 841). The results showed that the two groups were obviously and significantly different in age and nationality. Besides, reporting of COVID-19 symptoms was more frequent in the open invitation group (28.2%) than the random sample (16.2%). The open invitation group overestimated the symptomatic COVID-19 prevalence rate by more than four times, while it overestimated the asymptomatic COVID-19 cases by a small margin. The overall prevalence rate of active COVID-19 cases in the open invitation sample (13.3%) was almost double that of the random sample (6.9%). Furthermore, using population sampling weights reduced the prevalence rate to 0.8%. The lesson learned here is that it is wise to consider the magnitude of bias introduced in a surveillance system when relying on convenient sampling approaches in response to time constraints.

To support the deployment of serology assays for population screening during the COVID-19 pandemic, we compared the performance of three fully automated SARS-CoV-2 IgG assays: Mindray CL-900i^® (target: spike [S] and nucleocapsid [N]), BioMérieux VIDAS^®3 (target: receptor-binding domain [RBD]) and Diasorin LIAISON^®XL (target: S1 and S2 subunits). A total of 111 SARS-CoV-2 RT-PCR- positive samples collected at ≥ 21 days post symptom onset, and 127 pre-pandemic control samples were included. Diagnostic performance was assessed in correlation to RT-PCR and a surrogate virus-neutralizing test (sVNT). Moreover, cross-reactivity with other viral antibodies was investigated. Compared to RT-PCR, LIAISON^®XL showed the highest overall specificity (100%), followed by VIDAS^®3 (98.4%) and CL-900i^® (95.3%). The highest sensitivity was demonstrated by CL-900i^® (90.1%), followed by VIDAS^®3 (88.3%) and LIAISON^®XL (85.6%). The sensitivity of all assays was higher in symptomatic patients (91.1–98.2%) compared to asymptomatic patients (78.4–80.4%). In correlation to sVNT, all assays showed excellent sensitivities (92.2–96.1%). In addition, VIDAS^®3 demonstrated the best correlation (r = 0.75) with the sVNT. The present study provides insights on the performance of three fully automated assays, which could help diagnostic laboratories in the choice of a particular assay according to the intended use.

Childhood asthma is a growing clinical problem and a burden on the health care system due to repetitive visits to children’s emergency departments and frequent hospital admissions where it is poorly controlled. Due to lack of reliable baseline information on its prevalence among children in Qatar and the extent of their utilization of primary health care services, we sought to analyse electronic medical records data for children aged 5–12 years. Our primary objective was to establish point prevalence over the period 2016–2017. Furthermore, we wanted to assess the frequency and pattern of use of the primary care services including any demographic and seasonal variations, the types of clinical encounter and treatment received. A cross sectional study on 54,704 clinical encounters of electronic health records for children aged 5 to 12 years in which a diagnosis of Asthma was tagged during a two years period. The prevalence rate of Asthma out of total registered clients in the specified pediatric age group (196,557) is 6.1%. The rate was highest (10.2%) in youngest age group (5–6 years old) and lowest (4.1%) in teenagers (10–12 years old). An obvious peak of clinical encounters of Asthma cases was observed in Oct and Nov. The work load in PHCC clinics for Asthma clinical encounters is increased by more than 50% compared to the average monthly count of 4556.Moreover, the rate was higher in males (7.6%) compared to females (4.6%). The most frequently prescribed medication group was antihistamine (57.8%) followed by adrenergic bronchodilators (33.9%). Asthma constitutes an important part (8.5%) of the total primary care clinic work load among children aged 5–12 years in Qatar. A guideline need to encourage physician to use preventive Asthma strategies including steroid medications to provide continuity of care for Asthma cases.