Trends of H1N1 Cases, Tabuk Region, Kingdom of Saudi Arabia, 2009 - 2015 Open Access

Al Asseri, Yahya Abdullah (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/8p58pd42q?locale=en
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Abstract

Background: In 2009 a new strain of influenza A (H1N1) emerged and spread globally, leading to the first influenza pandemic of the 21st century. The Kingdom of Saudi Arabia (KSA) had special responsibility because it stewards the annual mass gathering of the Hajj. Tabuk province is a port of pilgrims coming for Hajj; studying trends of H1N1 cases there could yield new and important information.

Methods: A cross-sectional retrospective analysis of all reported H1N1 cases in Tabuk province between 2009 and 2015 was undertaken to estimate the trends by incidence rates (IRs) and 95% confidence intervals (CIs) using Byars approximation. These data were part of the case-based regional surveillance shared by the Department of Infectious Diseases, Tabuk General Directorate of Health.

Results: A total of 471 cases of H1N1 were recorded during the period 2009 - 2015. The number of cases was greatest in 2009, when there were 317 cases and an IR of 39.9 cases/100,000 (95% CI = 35.7 - 44.5). The IR decreased over time and 242 males and 220 females were affected mortality rates of 2.5% and 2.7%, respectively. Saudis composed the majority of cases: 403 cases with a total of 12 deaths (3% mortality rate). The mean age of cases was 28.6 years with a standard deviation (SD) of 18 years; the mean age of deaths was 40.7 years with an SD of 22 years. Fever was the most prominent symptoms with a range of occurrence from 94% to 100%, followed by cough with 60% to 86%. The epidemic curve showed November in 2009 and December in 2015 as months with greatest number of cases.

Discussion: H1N1 trends in Tabuk showed that the new virus was still circulating with a similar distribution from 2011 - 2015. However, surveillance for influence has not been evaluated since inception and to ensure effective public health practice, we recommend a formal evaluation be initiated.

Table of Contents

Abstract.................................................................................................3

Acknowledgement:.................................................................................5

Chapter 1 - Introduction.........................................................................7

Chapter 2 - Literature Review.................................................................11

Chapter 3 - Manuscript..........................................................................23

Abstract...............................................................................................23

Introduction.........................................................................................24

Methods...............................................................................................25

Results.................................................................................................28

Discussion............................................................................................32

Chapter 4 - Conclusion and Recommendations........................................36

References............................................................................................37

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