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Restrictions on social movement, social and religious gatherings, travel and businesses were imposed ahead of the first 100 confirmed COVID-19 cases. The Hajj pilgrimage for 2020 was scaled down to limit participants and no cases of COVID-19 were detected among pilgrims. The country maintained all basic health services and immunization programmes and supported all proposals for COVID-19 drugs and vaccines. The country is working to develop its capacity to produce these products and achieve self-sufficiency.

Saudi Arabia took extreme measures to respond to COVID-19 which contributed to limiting the spread and effect of the disease.

Saudi Arabia took extreme measures to respond to COVID-19 which contributed to limiting the spread and effect of the disease.

The prevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) infection during the period of coronavirus disease 2019 (COVID-19) remains uncertain.

This study aimed to provide an update on the epidemiology of MERS-CoV in Saudi Arabia from January 2019 to October 2020.

Data on all laboratory-confirmed cases of MERS-CoV infection in Saudi Arabia from January 2019 to 20 October 2020 were retrieved from the Health Electronic Surveillance Network of the Ministry of Health of Saudi Arabia. Data collected were demographic characteristics of cases, clinical course of the infection, related mortality and association with exposure to confirmed cases or camels.

In total, 299 cases of MERS-CoV infection were reported in the study period. The mean age of cases was 52.4 years. Most of the cases were males (78.9%) and had comorbidities (72.7%), and 11.9% of cases were health care providers. Of the 299 cases, 83 (27.7%) died. Older age and having comorbidities were associated with higher mortality. Exposure to camels was associated with lower mortality. Health care providers also had a lower mortality rate than non-health care providers. Compared with COVID-19, MERS-CoV infection still has a higher mortality rate but with a more predictable pattern and an anticipated deterioration.

MERS-CoV infection remains a public health concern. The percentage of cases that were health care providers (11.9%) is lower than previously reported (19.1-25.0%), possibly due to the various preventive measures put in place to control COVID-19.

MERS-CoV infection remains a public health concern. The percentage of cases that were health care providers (11.9%) is lower than previously reported (19.1-25.0%), possibly due to the various preventive measures put in place to control COVID-19.

Egypt has a shortage of physicians despite thousands of medical students graduating annually.

This study aimed to explore the reasons for Egyptian medical students and young physicians wanting to emigrate.

This cross-sectional study, conducted from February to April 2019, included 711 fifth- and sixth-year medical students and 174 residents from two medical faculties in Egypt, Tanta and Kafrelshiekh. A questionnaire was used to collect data on sociodemographic factors, desire to emigrate and motives for wanting to emigrate.

Most participant (89.4%) wanted to emigrate, and thought their salary was not compatible with their working hours or risks. About half the participants (52.8%) worked part-time in private hospitals. Only 4.9% of participants felt appreciated by the country. Most participants (75.9%) were not satisfied with their relationship with patients and 40.2% were not satisfied with their relationship with colleagues. Verbal abuse was reported by 55.5% of participants and physical assaults by 35.4%. Most participants who wanted to emigrate (85.1%) said they would change their minds if improvements were made in the health sector. N-Ethylmaleimide order Residents generally had less negative attitudes to workplace and professional factors than students.

Physicians emigrate to seek better work and financial incentives. A retention policy needs to be developed to prevent Egyptian physicians from emigrating.

Physicians emigrate to seek better work and financial incentives. A retention policy needs to be developed to prevent Egyptian physicians from emigrating.

The south-eastern Mediterranean experiences frequent desert dust storm events (DDS) that have been shown to be associated with adverse health effects.

This study assessed the perceptions and practices towards DDS of local authorities and stakeholders from 3 countries in the region, Cyprus, Greece and Israel.

Between October 2017 and April 2018, we administered a semi-structured questionnaire to regulatory authorities involved in public protection from DDS as well as social stakeholders in the 3 countries. The questionnaire addressed their knowledge regarding DDS, perceptions on the relationship between DDS and health effects and relevant actions taken towards public protection.

Out of 58 stakeholders contacted, 49 participated in the study (84.5% response rate). Fourteen (28.6%) were regulatory authorities and 35 (71.4%) were social stakeholders. All responders were familiar with DDS but several underestimated the frequency of events while the majority (73%) instinctively reported that elders, childreon increasing awareness among stakeholders and the public and developing national policies, including effective measures to minimize DDS exposure.

Metabolic syndrome is an important cause of cardiovascular disease. Mortality from cardiovascular disease is 12.82 deaths/100 000 population in Zahedan, south-east Islamic Republic of Iran.

This study aimed to determine the incidence of metabolic syndrome and its predicting factors in Zahedan city.

All participants without metabolic syndrome in a 2009 study in Zahedan, available in 2017, were included in this study. Metabolic syndrome was diagnosed based on the criteria of several organizations. Anthropometric indices and blood pressure were measured and blood tests were done. Age-standardized incidence of metabolic syndrome was calculated and its predictors were evaluated in a logistic regression analysis.

Mean age (standard deviation) of the participants was 45.46 (12.63) years in 2017. The incidence of metabolic syndrome varied from 17.21% to 27.18% depending on the criteria used and it was higher in women. High age-standardized incidence was associated with large waist circumference (55.81%) and high blood pressure (25.32%). The highest adjusted odds ratios (OR) for metabolic syndrome were for high triglycerides (OR = 23.75; 95% confidence interval (CI) 9.92-56.84%), large waist circumference (OR = 22.42; 95% CI 9.03-55.70%), high blood pressure (OR = 16.91; 95% CI 8.54-33.50%) and high fasting blood sugar (OR = 13.22; 95% CI 6.74-25.94%). Waterpipe smoking, sex, low-density lipoprotein and wrist circumference were also associated with metabolic syndrome.

The incidence of metabolic syndrome has increased in Zahedan. Effective, interventions, including to promote healthy diet, physical activity and avoidance of waterpipe smoking, are needed to control this condition.

The incidence of metabolic syndrome has increased in Zahedan. Effective, interventions, including to promote healthy diet, physical activity and avoidance of waterpipe smoking, are needed to control this condition.

Typhoid fever is spread by ingestion of contaminated food or water, which is linked to infrastructure; specifically, sewage and sanitation. In developing countries, infrastructure varies according to socioeconomic status (SES). Balochistan is the least developed province of Pakistan.

To analyse the association between the clinical features of typhoid fever and socioeconomic status.

A quantitative, cross-sectional study was conducted in Quetta, Balochistan, Pakistan. Between May and October 2017, 143 patients presented to tertiary care hospitals and private clinics with a complaint of fever lasting ~3 days, along with a clinical history of headache, malaise, diarrhoea or constipation, abdominal pain, dry cough, and anorexia. All patients had a positive blood culture for Salmonella enterica serotype Typhi. Eighteen patients dropped out of the study, leaving 125.

Seventy (56%) participants had low socioeconomic status (SES), 40 (32%) middle SES and 15 (12%) high SES. The strongest predictors of presenting with typhoid fever were patients' clinical condition when presenting to health facilities, followed by SES. Most respondents had a treatment duration of 1-2 weeks. SES had a high impact on source of drinking water supply.

The strongest predictor of reporting typhoid fever was the current clinical condition of the patients, followed closely by SES. The incidence of typhoid fever in the low SES patients was almost the same as in the middle and high SES patients. Patients with low SES were more susceptible to contracting typhoid fever due to poor health status and facilities.

The strongest predictor of reporting typhoid fever was the current clinical condition of the patients, followed closely by SES. The incidence of typhoid fever in the low SES patients was almost the same as in the middle and high SES patients. Patients with low SES were more susceptible to contracting typhoid fever due to poor health status and facilities.

Early child development is a crucial factor for children that controls health and well-being in later life.

To determine the influence of sociodemographic factors on the Early Child Development Index (ECDI) among children aged < 5 years.

The analysis was performed using cross-sectional survey data from 2019, 2017-2018 and 2018 Multiple Indicator Cluster Surveys from Bangladesh, Ghana and Costa Rica, respectively. We used the χ

test for bivariate analysis and binary logistic regression model for multivariate analysis for all 3 countries. All the statistical analyses were performed with IBM SPSS version 25 and R version 4.0.0.

Child age and sex, followed by maternal education level, economic status, child nutritional status, reading children's books, and maternal functional difficulties had the greatest effect on ECDI. Children aged 36-47 months had lower odds of development than those aged 48-59 months, and boys had lower odds of development than girls in Bangladesh, Costa Rica and Ghana. Urban children had lower odds of development than rural children in Costa Rica but higher odds in Ghana.

We recommend that governments should take the necessary steps to enhance children's early development and well-being in all 3 countries by raising education, improving economic conditions and providing balanced nutrition.

We recommend that governments should take the necessary steps to enhance children's early development and well-being in all 3 countries by raising education, improving economic conditions and providing balanced nutrition.

Little is known about the role of occupational-related physical activity and risk factors for cardiovascular disease.

This study aimed to assess the association between different types of physical activity (work-related, transport-related, home-time and leisure-time) and risk factors for cardiovascular disease in a sample of Iranian workers.

This cross-sectional study was conducted from February to November 2018 among 415 workers of a rubber factory in Tehran province. Physical activity levels of the participants were measured using the International Physical Activity Questionnaire. Blood sample were analysed for cardiovascular disease risk factors (fasting blood sugar ≥ 100 mg/ dL, triglycerides ≥ 150 mg/dL, total cholesterol ≥ 200 mg/dL, systolic blood pressure ≥ 130 mmHg, diastolic blood pressure ≥ 85 mmHg and waist circumference ≥ 102 cm). Alanine aminotransferase and aspartate aminotransferase were also measured, as was body mass index (BMI).

Risk factors for cardiovascular disease differed significantly according to type of physical activity.