Global vaccine action plan lessons learned I: Recommendations for the next decade.

The Global Vaccine Action Plan 2011-2020 (GVAP) was developed to realize the ambitions of the Decade of Vaccines - that all individuals and communities enjoy lives free from vaccine-preventable diseases. It included a comprehensive monitoring and evaluation/accountability framework to assess progress towards global targets with recommendations for corrective actions. While many of the GVAP targets are very unlikely to be met by the end of 2020, substantial progress has nevertheless been made, establishing a strong foundation for a successor global immunization strategy, the Immunization Agenda 2030 (IA2030).

How Labor Laws Can Transform Health Systems: The Case of Saudi Arabia.

-In 1999, the Kingdom of Saudi Arabia enacted a law that compels private employers to cover non-Saudi employees with health insurance. In the 16 years that followed, the health sector in the Kingdom has seen a dramatic shift in how services are provided and paid for, and the change continues at an accelerated speed. Based on interviews with 12 large private sector providers in Riyadh, Jeddah, and Khobar, we found that a labor law enacted in 1999 led to rapid expansion of the insured population, both expatriates and Saudis, which led to a drastic change in how hospitals and other facilities are paid, and considerable more consistency in revenue stream.

Meningococcal serogroup C serum and salivary antibody responses to meningococcal quadrivalent conjugate vaccine in Saudi Arabian adolescents previously vaccinated with bivalent and quadrivalent meningococcal polysaccharide vaccine.

Following repeated polysaccharide vaccination, reduced immune responses have been reported, but there are limited data on the mucosal response of meningococcal polysaccharide vaccine (PSV) or meningococcal conjugate vaccination. Saudi Arabian adolescents (aged 16-19 years) who had previously been vaccinated with ≥1 dose of bivalent meningococcal polysaccharide vaccine and 1 dose of quadrivalent meningococcal polysaccharide (MPSV4) were enrolled in a controlled, randomised, and modified observer-blind study (collectively termed the PSV-exposed group). The PSV-exposed group was randomised to receive either quadrivalent meningococcal conjugate vaccine (MCV4) (PSV-exposed/MCV4 group) or MPSV4 (PSV-exposed/MPSV4 group), and a PSV-naïve group received MCV4.

Safety and immunogenicity of a meningococcal quadrivalent conjugate vaccine in five- to eight-year-old Saudi Arabian children previously vaccinated with two doses of a meningococcal quadrivalent polysaccharide vaccine.

Saudi Arabian children respond poorly to 2 doses of meningococcal quadrivalent polysaccharide vaccine (MPSV4) when given before 2 years of age. This study examined whether such children were able to respond to 1 dose of quadrivalent meningococcal diphtheria toxoid conjugate vaccine (MCV4) when they were older. Saudi Arabian children 5 to 8 years of age who had previously been vaccinated with 2 doses of MPSV4 when they were under 2 years of age (termed the prior-MPSV4 group) were enrolled in a controlled, open-label, multicenter study.

Immunogenicity and safety of a meningococcal quadrivalent conjugate vaccine in Saudi Arabian adolescents previously vaccinated with one dose of bivalent and quadrivalent meningococcal polysaccharide vaccines: a phase III, controlled, randomized, and modified blind-observer study.

Reduced immune responses to repeated polysaccharide vaccination have been previously reported, but there are limited immunogenicity data on the use of meningococcal polysaccharide vaccine (PSV) followed by meningococcal conjugate vaccine. Saudi Arabian adolescents (aged 16 to 19 years) who had previously been vaccinated with ≥1 dose of bivalent meningococcal polysaccharide vaccine and 1 dose of quadrivalent meningococcal polysaccharide (MPSV4) were enrolled in a controlled, randomized, and modified observer-blind study (collectively termed the PSV-exposed group). The PSV-exposed group was randomized to receive either quadrivalent meningococcal conjugate vaccine (MCV4) (n = 145 PSV-exposed/MCV4 group) or MPSV4 (n = 142 PSV-exposed/MPSV4 group), and a PSV-naïve group received MCV4 (n = 163).

Smoking in Saudi Arabia and its relation to coronary artery disease.

Objectives: The health hazards related to smoking are well known. Smoking is a recognized risk factor for coronary artery disease (CAD). Despite rejection of smoking by the Saudi community, we are still seeing smokers in our population.

Changing patterns of hepatitis A prevalence within the Saudi population over the last 18 years.

Aim: To determine the seroprevalence of Hepatitis A (HAV) amongst Saudi children and compare it with previously reported prevalence data from the same population.

Methods: A total of 1357 students were randomly selected between the ages of 16 and 18 years (689 males and 668 females) from three different regions of Saudi Arabia (Madinah, Al-Qaseem, and Aseer) and tested for anti-HAV-IgG.

Results: The overall prevalence of anti-HAV-IgG among the study population was 18.

Hyperlipidemia in Saudi Arabia.

Objective: To determine the prevalence of hyperlipidemia among Saudis of both genders in rural and urban communities.

Methods: Selected Saudis in the age group of 30-70 years were studied over a 5-year period between 1995 and 2000 in Saudi Arabia. Data were obtained from history, physical examination, and analysis of fasting plasma lipids.

Factors affecting child mortality in Saudi Arabia.

Objective: To estimate levels and trends, gender differentials, effect of modes of living, regional differentials, and the effect of parental educational on infant and child mortality.

Methods: A nationwide stratified random sample was used to estimate levels, trends and differentials of infant and child mortality in Saudi Arabia. The study was executed during the period February 2006 to June 2006 and covered all the 20 health regions of Saudi Arabia.

Diphtheria, pertussis, and tetanus serosurvey in Saudi children.

Objective: To evaluate immune protection against vaccine-preventable diseases targeted by the Expanded Program of Immunization in Saudi Arabia.

Methods: The study was carried out from September 2001 to February 2002. Using multistage sampling techniques, samples were collected from 5 regions of Saudi Arabia and sent for laboratory assay from the following age groups; 50 samples at 12 months, 50 at 6 years, and 100 at 17 years.

Prevalence of physical activity and inactivity among Saudis aged 30-70 years. A population-based cross-sectional study.

Objective: To assess physical activity levels among Saudi adults, and to examine the relationships of physical activity with body mass index (BMI), waist circumference (WC) and obesity prevalence.

Methods: Data taken from the Coronary Artery Disease in Saudis Study which is a National Epidemiological Health Survey carried out between 1995 and 2000. Participants included 17395 Saudi males and females aged 30-70 years, selected randomly using a multistage stratified cluster sampling technique.

Pattern and factors associated with glycemic control of Saudi diabetic patients.

Background: The pattern and factors which can be associated with the glycemic control of Saudi adult diabetic patients were examined in this study.

Patients And Methods: Confirmed diabetic patients from all regions of Saudi Arabia constituted the study population. Random blood glucose <10 mmol/L and >10 mmol/L was used to categorize patients into good and poor glycemic control patients, respectively.

Childhood epidemiology of hepatitis A virus in Riyadh, Saudi Arabia.

The prevalence of anti-HAV antibody in children was tested in subjects presenting at clinics in Riyadh, Saudi Arabia. A blood sample was taken to test for the presence of IgG (indicating past infection) and a questionnaire concerning personal and epidemiological data relating to hepatitis A was completed. In total, 592 children aged 6 months to 15 years were suitable for the analysis.

Follow-up of Saudi children vaccinated with Haemophilus influenzae type B vaccine.

Background: Saudi children vaccinated with a primary series of Hib vaccine (HbOC) at six weeks, three and five months have shown higher antibody titers compared to recent data from the U.S. The aim of this study was to evaluate the persistence of antibodies and to measure the immunogenicity of a booster dose of Haemophilus influenzae type b (Hib) vaccine in Saudi children.

Immunogenicity of FDA DTP versus WHO DTP.

Background: The aim of this report was to study the immunogenicity of three doses of DTP in six-week-old Saudi infants when given either as World Health Organization (WHO) DTP or Federal Drug Administration (FDA) DTP formula.

Methods: As part of the Haemophilus influenzae type b immunization research protocol, six-week-old infants were randomized into three groups to receive three doses of HbOC and WHO DTP formula, HbOC and FDA DTP formula, or in a control group to receive the usual vaccines without HbOC, at six weeks, three months and five months. Antibody levels for PRP, tetanus, diphtheria and pertussis were measured after the third dose.

Hypertension in Saudi Arabia.

Objective: To determine the prevalence of hypertension among Saudis of both gender, between the ages of 30-70 years in rural as well as urban communities. This work is part of a major national study on Coronary Artery Disease in Saudis Study (CADISS).

Methods: This is a community-based study conducted by examining subjects in the age group of 30-70 years of selected households during a 5-year period between 1995 and 2000 in Saudi Arabia.

Serosurvey of hepatitis B surface antigen in pregnant Saudi women.

In 1990, Saudi Arabia began vaccinating all children at school entry against hepatitis B. We evaluated hepatitis B surface antigen (HBsAg) prevalence rate among pregnant Saudi women 12 years later in 5 regions of the country. Using multistage sampling, 2664 pregnant Saudi women were recruited.

Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions?

Objective: Preeclampsia, gestational hypertension, and unexplained intrauterine growth restriction may have similar determinants and consequences. In this study, we compared determinants and perinatal outcomes associated with these obstetric conditions.

Study Design: We analyzed 39,615 pregnancies (data from the WHO Antenatal Care Trial), of which 2.

Metabolic syndrome in Saudi Arabia.

Objectives: Metabolic syndrome (MS) is a well-established risk factor for the development of coronary artery disease (CAD). We designed this study to obtain the prevalence of MS and each of its components in Saudi Arabia. This study is part of Coronary Artery Disease in Saudi Study (CADISS).

Impact of health education on knowledge and attitudes of Saudi paramedical students toward HIV/AIDS.

Objective: To assess the impact of health education on the knowledge and attitudes of paramedical students in Saudi Arabia toward HIV/AIDS.

Methods: We carried out an interventional study on a sample selected from students of health institutes and health colleges in Saudi Arabia during the calendar year 2002-2003.

Results: The intervention shows a positive effect on students' knowledge regarding means of transmission of HIV and means of protection from HIV/AIDS.

Serosurvey of measles, mumps and rubella antibodies in Saudi children.

Objective: A serosurvey study to evaluate the proportion of children with antibodies against diseases targeted by the Expanded Program of Immunization in the Kingdom of Saudi Arabia.

Methods: Using multistage sampling techniques, we collected samples and sent them for laboratory assay from the following age groups; 100 samples at 6 months, 12 months, 18 months, 6 years, 13 years, and 17 years. We conducted the study from September 2001 to February 2002.

Measles in Saudi Arabia: from control to elimination.

This article describesthe tremendous efforts made in the field of measles immunization in Saudi Arabia in the past 20 years, from the control phase to the elimination phase. Mandatory measles vaccination with one-dose Schwartz vaccine was introduced in 1982 by a royal decree, a step aimed at increasing vaccine coverage. In 1991, a two-dose schedule was implemented using Edmonston-Zagreb measles vaccine, with a first dose at 6 months to protect children younger than 9 months and a second dose of MMR at 12 months of age to protect those who did not respond to the first dose.

Immunogenicity of meningococcal ACYW135 polysaccharide vaccine in Saudi children 5 to 9 years of age.

Meningococcal tetravalent polysaccharide vaccines were observed to be immunogenic in Saudi children 5 to 9 years of age, with >90% having serum bactericidal antibody titers of > or = 8 for serogroups A, Y, and W135; for serogroup C, 77% were putatively protected after vaccination.