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BACKGROUND: Assessment of growth using Z-score methods is important for clinical care and research, yet growth reference Z-score data for preschool Saudi children are not available. OBJECTIVE: Establish Z-score tables and corresponding growth charts. DESIGN: Uses data from a national survey in 2004-2005. SETTING: Community-based random sample of preschool Saudi children. SUBJECTS AND METHODS: Raw data from the previous nationally representative sample were analyzed using the L, M, and S statistical methods to calculate Z-scores of growth. MAIN OUTCOME MEASURE(S): Z-scores reference values for weight, length/height, head circumference, weight for length/height, and body mass index for age for boys and girls from birth to 60 months of age. RESULTS: For 15 601 Saudi children (7896, 50.6 % boys) Z-score tables and graphs from birth to 60 months of age were derived for boys and girls. The tables and graphs include weight for age, length/height for age, head circumference for age, weight for length/height, and BMI for age. CONCLUSION: Z-score reference data on the growth of preschool Saudi infants and children is essential for healthcare and research. LIMITATION: Does not include regional variations.
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Gráficos de Crecimiento , Estatura , Índice de Masa Corporal , Peso Corporal , Preescolar , Femenino , Cabeza/crecimiento & desarrollo , Humanos , Masculino , Valores de Referencia , Arabia SauditaRESUMEN
BACKGROUND: Previous growth charts for Saudi children have not included detailed tables and parameters needed for research and incorporation in electronic records. OBJECTIVES: The objective of this report is to publish the L, M, and S parameters and percentiles as well as the corresponding growth charts for Saudi preschool children. DESIGN: Community-based survey and measurement of growth parameters in a sample selected by a multistage probability procedure. SETTING: A stratified listing of the Saudi population. SUBJECTS AND METHODS: Raw data from the previous nationally-representative sample were reanalyzed using the Lambda-Mu-Sigma (LMS) methodology to calculate the L, M, and S parameters of percentiles (from 3rd to 97th) for weight, length/height, head circumference, and body mass index-for-age, and weight for-length/height for boys and girls from birth to 60 months. MAIN OUTCOME MEASURES: Length or height and weight of Saudi preschool children. RESULTS: There were 15601 Saudi children younger than 60 months of age, 7896 (50.6 %) were boys. The LMS parameters for weight for age from birth to 60 months (5 years) are reported for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentiles as well as the corresponding graphs. Similarly, the LMS parameters for length/height-for-age, head circumference-for-age, weight-for-length/height and body mass index-for-age (BMi) are shown with the corresponding graphs for boys and girls. CONCLUSION: Using the data in this report, clinicians and researchers can assess the growth of Saudi preschool children. LIMITATIONS: The report does not reflect interregional variations in growth.
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Estatura , Índice de Masa Corporal , Peso Corporal , Gráficos de Crecimiento , Cabeza/crecimiento & desarrollo , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Tamaño de los Órganos , Estudios Prospectivos , Valores de Referencia , Arabia SauditaRESUMEN
AIM: To assess the prevalence of nutritional disorders in children with inflammatory bowel disease (IBD) in Saudi Arabia. METHODS: The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn's disease (CD) and ulcerative colitis (UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index (BMI) of each child [weight (kg)/height(2) (m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and < -2 standard deviation score were used to define overweight and thinness, respectively. Age stratification analysis was performed to investigate any age-related variation in the prevalence of nutritional status between children < 10 years of age and older. RESULTS: There were 374 children from 0.33 to 17 years of age, including 119 (32%) children with UC and 255 (68%) with CD. All of the children were Saudi nationals, and 68 (57%) of the UC and 150 (59%) of the CD children were males. A positive history of anorexia at the time of diagnosis was found in 30 (25%) patients with UC and 99 (39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC (P = 0.037) only in the age group of 10-17 years (P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years (P = 0.020). CONCLUSION: A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care.
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Trastornos de la Nutrición del Niño/epidemiología , Fenómenos Fisiológicos Nutricionales Infantiles , Colitis Ulcerosa/epidemiología , Enfermedad de Crohn/epidemiología , Estado Nutricional , Obesidad Infantil/epidemiología , Delgadez/epidemiología , Adolescente , Distribución por Edad , Niño , Trastornos de la Nutrición del Niño/diagnóstico , Trastornos de la Nutrición del Niño/fisiopatología , Preescolar , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/fisiopatología , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/fisiopatología , Femenino , Humanos , Lactante , Masculino , Evaluación Nutricional , Obesidad Infantil/diagnóstico , Obesidad Infantil/fisiopatología , Prevalencia , Estudios Retrospectivos , Arabia Saudita/epidemiología , Delgadez/diagnóstico , Delgadez/fisiopatologíaRESUMEN
BACKGROUND AND OBJECTIVES: Limited data are available on the prevalence of congenital anomalies based on a community survey in Middle East countries. The prevalence of congenital anomalies is expected to be high in these countries because of the high consanguinity rate and high maternal age. The aim of this cross-sectional study was to establish the prevalence of congenital anomalies in Saudi Arab children. DESIGN AND SETTINGS: This is a prospective, cross-sectional, community-based study conducted over 2 years among the Saudi population. SUBJECTS AND METHODS: The study sample was determined by a multi-stage probability random sampling of household representatives of the Saudi Arab population. The health status of children was obtained during household visits by primary care physicians who performed a history and physical examination of all children and adolescents younger than 19 years. All cases of congenital anomalies were recorded. RESULTS: During the 2-year study period (2004-2005), a total of 45 682 children were screened. The commonest congenital anomalies found in this survey were Down syndrome, congenital deafness, and congenital blindness with prevalence rates of 6.6 per 10 000, 4.8 per 10000, and 1.3 per 10000 children, respectively. The prevalence of cleft lip with or without cleft palate was 0.9 per 10000 children, achondroplasia was 0.7 per 10000, and Dandy-Walker syndrome was 0.4 per 10000. Crouzon syndrome, Treacher-Collins syndrome, Angelman syndrome, and Turner syndrome had equal prevalence of 0.2 per 10000 children. CONCLUSION: The data suggest a significant decline in the prevalence of Down syndrome; however, the prevalence of other anomalies like congenital deafness is still high.
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Anomalías Congénitas/epidemiología , Consanguinidad , Edad Materna , Adolescente , Niño , Preescolar , Anomalías Congénitas/fisiopatología , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Prevalencia , Estudios Prospectivos , Arabia Saudita/epidemiologíaRESUMEN
BACKGROUND: Despite the extensive reporting of pediatric ulcerative colitis (UC) from industrialized developed countries, reports from developing countries are limited to small-case series from single centers. The objective of our large multicenter study was to determine the clinical, laboratory, endoscopic characteristics of UC in children from a developing country, Saudi Arabia. DESIGN AND SETTINGS: A retrospective study of children diagnosed with UC under the age of 18 years during the period from 2003 to 2012. METHODS: Patients enrolled from 15 medical centers from different regions in Saudi Arabia. A unified database collection form specifically designed for this study was completed by all participating centers. RESULTS: A total of 188 children were diagnosed with UC during the study period (97 males [51.6%] and 91 females [48.4%]). The mean age at diagnosis was 9.1 years, and the mean duration of symptoms before diagnosis was 8.7 months. Consanguinity was present in 57 cases (32.6%), and the family history of inflammatory bowel disease (IBD) was noted in 16 cases (9%). The most common clinical presentation was blood in stool (90%), followed by diarrhea (86%) and abdominal pain (62%). Laboratory investigations revealed elevated erythrocyte sedimentation rate (82%), anemia (75%), thrombocytosis (72%), and hypoalbuminemia (33%). The extent of the disease was pan colonic in 46.1%, and confined to left side of colon and rectum in 23% and 9.6% of the cases, respectively. CONCLUSION: This demographically pediatric IBD retrospective study revealed age-related variation in the distribution of IBD. Clinical presentation, with a high prevalence of positive consanguinity and positive family history, was noted in young patients with UC. The data from this study indicate that UC is increasingly recognized in Saudi Arabia and show many similarities to data from North America and Europe.
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Colitis Ulcerosa/epidemiología , Colitis Ulcerosa/patología , Adolescente , Distribución por Edad , Sedimentación Sanguínea , Niño , Preescolar , Colitis Ulcerosa/etiología , Colon/patología , Consanguinidad , Bases de Datos Factuales , Femenino , Predisposición Genética a la Enfermedad , Humanos , Lactante , Recién Nacido , Masculino , Prevalencia , Recto/patología , Estudios Retrospectivos , Arabia Saudita/epidemiología , Distribución por SexoRESUMEN
There is limited information about inflammatory bowel disease in Arab children. Hence, the objective of this study was to report on the epidemiology of this condition in our community. Medical records were analysed for all children below 18 years of age diagnosed with inflammatory bowel disease (IBD) and followed up in our institution over a period of 10 years. From 1993 to 2002, 50 consecutive children were diagnosed to have IBD. This gives an estimated incidence of 0.5 cases/100 000/year and a prevalence of 5 cases/100 000 populations for the region of Riyadh, Saudi Arabia. Most of the children (90 per cent) were Saudi nationals and the female to male ratio was 1 : 0.6. The age range was between 5 and 18 years with 16 per cent of the cases diagnosed in children below 12 years of age. Chronic ulcerative colitis was the commonest form accounting for 48 per cent, followed by Crohn's disease and indeterminate colitis in 38 per cent and 16 per cent of the children, respectively. The best agreement between colonoscopic and histopathologic findings (89 per cent) was in children with ulcerative colitis followed by normal findings and Crohn's disease in 63 per cent and 35 per cent of the cases, respectively. It was concluded that the incidence and prevalence of IBD in this report are lower than in any other population. Nevertheless, comparison with older data suggests that the incidence is increasing.
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Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/epidemiología , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/epidemiología , Adolescente , Distribución por Edad , Edad de Inicio , Niño , Colonoscopía , Países en Desarrollo , Femenino , Humanos , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/epidemiología , Masculino , Prevalencia , Pronóstico , Estudios Retrospectivos , Arabia Saudita/epidemiología , Índice de Severidad de la Enfermedad , Distribución por SexoRESUMEN
BACKGROUND: Biopsy of the small bowel is frequently obtained by endoscopic forceps instead of the classical suction capsule, yet reports from developing countries are scarce. AIM OF THE STUDY: to report our experience on the diagnostic value of this procedure in our community. PATIENTS AND METHODS: A retrospective analysis of all endoscopic duodenal biopsies (EDB), performed on all patients below 18 years of age. Data retrieved from the records included age, gender, nationality, indication for biopsy, the endoscopic findings, and the results of histopathology. RESULTS: From 1993 to 2002, 241 endoscopic biopsies were performed on 241 consecutive children. Most of the children (96%) were Saudi nationals, the age range between six weeks to 18 years, and male to female ratio was 0.7:1. All of the biopsy material was adequate for routine histopathology. The commonest indications for biopsy were short stature and chronic diarrhea in 116/241 (48%) and 102/241 (43%) of the children respectively. Refractory rickets accounted for 11/241 (5%) of the indications. The prevalence of villous atrophy was highest in children presenting with chronic diarrhea (40%), compared to short stature (22%). Other less common, but important findings were villous atrophy in three unusual conditions (one refractory rickets, one unexplained anemia, and one polyendocrinopathy), two cases of intestinal Giardia lamblia infestation, three cases of intestinal lymphangiectasis and one case of Mycobacterium avium intracellulare. Unexpected endoscopic findings were documented in 34/241 (14%) of the children. CONCLUSIONS: Endoscopic duodenal biopsy is adequate not only for the diagnosis of villous atrophy, but also for the detection of other gastroenteropathies. Accordingly, when expertise and equipment are available, EDB should be the procedure of choice not only in industrialized but also in developing countries.
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BACKGROUND: Pediatric colonoscopy is routinely performed in most hospitals in Saudi Arabia and yet published data are scarce. The objective of this report is to describe our experience in the practice of pediatric colonoscopy in Saudi Arabia. PATIENTS AND METHODS: Retrospective analysis of data of all patients below 18 years of age who underwent colonoscopy over a 10-year period. RESULTS: From 1414 H (1993 G) to 1423 H (2002 G), two hundred and seventeen colonoscopies, of which 183 diagnostic procedures, were performed on 183 children. The majority (94%) were Saudi nationals, the age range was between 5 months and 18 years, and the female to male ratio was 1:0.8. Colonoscopy was total in 58 (32%) and limited in 125 patients (68%). The commonest reason for not completing the procedure was securing the diagnosis in 45/125 patients (36%). The commonest indication was rectal bleeding (35%). The highest yield was in children with bloody diarrhea (91%) and the lowest in those with abdominal pain (27%) with an overall yield of 44%. Colitis was the most common diagnosis occurring in 66% of the children. CONCLUSION: this report highlights the role of colonoscopy in the recognition of diseases of the colon in our community and identifies some of the problems areas associated with the performance of this procedure in our institution.
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BACKGROUND: Difficulty in swallowing is not uncommon among children and yet little information is available in the literature. We report our experience on the pattern of this condition. METHODS: We extracted data from the medical records of 42 children with dysphagia on age at presentation, nationality, gender, and final diagnosis. RESULTS: From 1993 to 2002, 96% of 42 children presenting with dysphagia were Saudi nationals, ranging in age from 3 months to 18 years, with a male to female ratio of 1:0.6. An etiologic diagnosis was found in 30 children (72%). Esophagitis, esophageal strictures and motility disorders were the most common causes of dysphagia, occurring in 16 (38%), 7 (17%), and 4 (10%) children, respectively. Two children had esophageal webs and one had an esophageal ring. Age-related analysis indicated that most of the cases of esophagitis (11/16, 69%) and strictures (5/7, 71%) occurred in young children whereas most nondemonstrable causes occurred in older children (9/12, 75%). CONCLUSION: This report documents a pattern of dysphagia in Saudi Arab children that is similar to descriptions from other countries.
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Trastornos de Deglución/epidemiología , Adolescente , Niño , Preescolar , Trastornos de Deglución/etiología , Trastornos de la Motilidad Esofágica/complicaciones , Estenosis Esofágica/complicaciones , Esofagitis/complicaciones , Femenino , Humanos , Lactante , Masculino , Arabia Saudita/epidemiologíaRESUMEN
Peptic ulcer disease (PUD) has been reported to occur in children worldwide, but no information is available for our community. The aim of the study was to report our experience on the pattern of this condition in Saudi Arabian children. The records of all children below 18 years of age who were diagnosed by endoscopy to have PUD over a period of 10 years were analysed. From 1993 to 2002, 24 children out of 521(5 per cent) who presented with upper gastrointestinal tract (GIT) symptoms were diagnosed by endoscopy to have PUD. All but one (96 per cent) were Saudi nationals, the average age was 15 years (range 5-18 years), and the male to female ratio was 7:1. The commonest presentation was chronic abdominal pain in 15/24 (63 per cent) of the children, followed by vomiting associated with abdominal pain in four (17 per cent). Hematemesis and melena occurred in three (13 per cent), and two children (8 per cent), respectively. There were 20 duodenal (92 per cent) and four gastric ulcers. The primary type was the most common, occurring in 19 (79 per cent) of the children. Histopathology results of antral biopsies were available for 15 children; all of them had antral gastritis. Helicobacter pylori organisms were present in 13/15 (87 per cent) of the antral biopsy specimens. In Saudi children, peptic ulcer disease occurs more commonly in boys. It is a rare cause of upper GIT symptoms, but highly associated with H. pylori antral gastritis. This study documents a pattern similar to descriptions from other countries.
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Infecciones por Helicobacter/epidemiología , Helicobacter pylori/aislamiento & purificación , Úlcera Péptica/epidemiología , Adolescente , Distribución por Edad , Niño , Preescolar , Países en Desarrollo , Endoscopía Gastrointestinal , Femenino , Infecciones por Helicobacter/diagnóstico , Humanos , Incidencia , Masculino , Úlcera Péptica/diagnóstico , Estudios Retrospectivos , Medición de Riesgo , Arabia Saudita/epidemiología , Índice de Severidad de la Enfermedad , Distribución por SexoRESUMEN
Upper gastrointestinal (UGI) endoscopy is an important tool in the evaluation of patients presenting with haematemesis. The objective of this study was to report the yield of this procedure in a Saudi Arabian population. We analysed the result UGI endoscopy in children and adolescents of 0-18 years of age who presented with haematemesis over a period of 10 years. From 1993 to 2003, endoscopy was performed on 60 consecutive children presenting with haematemesis. This group represented 12% of the indications during the same period. The majority (98%) were Saudi nationals, with an age range from 4 days to 18 years, and a male to female ratio of 1:1.5. The overall yield of endoscopy was 75%; however, the yield was higher (91%) in children below 12 years of age. Gastritis was the commonest cause of haematemesis (44%), followed by oesophagitis (36%). However, age-related analysis shows that oesophagitis was a more common cause of haematemesis in the younger age group (45%) than gastritis in adolescents (30%). In contrast, gastritis was more common in older children (56%) than oesophagitis (28%). Peptic ulcer disease and oesophageal varices were seen in only 3 (7%) and 2 children (4.3%), respectively. The overall yield of endoscopy in our patients is similar to that in most reports. However, oesophagitis and gastritis were the commonest causes of haematemesis, whereas oesophageal varices and peptic ulcer disease were much less common.