The COVID-19 pandemic is impacting national and international public health. Routine childhood immunization may be adversely affected by COVID-19 mitigation measures. We aimed to identify the prevalence of delayed immunization and explore the reasons and barriers for delayed immunization during the COVID-19 pandemic in the Qassim region, Saudi Arabia. We conducted a cross-sectional study using an online self-administered questionnaire for parents of children under two years of age during the period from 1 May to 30 June 2020. Most of the 749 participants (82.6%) were mothers, with 31 to 40 years being the most common age group (49.8%). Nearly three-quarters (73.2%) of the parents had appointments scheduled for their child’s vaccination during the pandemic, and approximately 23.4% of the parents reported a delay of more than one month in the immunization of their child. The most common reason for the delay was the fear of being infected by COVID-19 (60.9%). Large household size and lack of insurance were risk factors for immunization delay. The COVID-19 pandemic has affected the timeliness of routine childhood immunization in Saudi Arabia. Childhood immunization should be prioritized, as well as the implementation of focused strategies to achieve significant and sustainable vaccination rates during pandemics.

BackgroundOverburdened healthcare systems during the coronavirus disease (COVID-19) pandemic led to suboptimal chronic disease management, including that of pediatric type 1 diabetes mellitus (T1DM). The pandemic also caused delayed detection of new-onset diabetes in children; this increased the risk and severity of diabetic ketoacidosis (DKA). We therefore investigated the frequency of new-onset pediatric T1DM and DKA in Saudi Arabia during the COVID-19 pandemic and compared it to the same period in 2019.MethodsWe conducted a multicenter retrospective cohort study, including patients aged 1–14 years admitted with new-onset T1DM or DKA during the COVID-19 pandemic (March–June 2020) and the same period in 2019. We assessed factors including age, sex, anthropometric measures, nationality, duration of diabetes, diabetes management, HbA1c levels, glycemic control, cause of admission, blood gas levels, etiology of DKA, DKA complications, length of hospital stay, and COVID-19 test status.ResultDuring the lockdown, 106 children, compared with 154 in 2019, were admitted to 6 pediatric diabetes centers. Among the admissions, DKA was higher in 2020 than in 2019 (83% vs. 73%; P=0.05; risk ratio=1.15; 95% confidence interval, 1.04–1.26), after adjusting for age and sex. DKA frequency among new-onset T1DM and HbA1c levels at diagnosis were higher in 2020 than in 2019 (26% vs. 13.4% [P=<0.001] and 12.1 ± 0.2 vs. 10.8 ± 0.25 [P<0.001], respectively). Females and older patients had a higher risk of DKA.ConclusionThe lockdown implemented in Saudi Arabia has significantly impacted children with T1DM and led to an increased DKA frequency, including children with new-onset T1DM, potentially owing to delayed presentation.

Objectives: To examined the safety of schools, availability of school personnel to help in diabetes management, glycemic control, absenteeism, and differences in diabetes care between public and private schools. Methods:This cross-sectional study used an online platform to circulate surveys to parents of children with type 1 diabetes mellitus )T1DM( attending school or kindergarten in all regions of Saudi Arabia from February to May 2019. Results:The 411 questionnaires received were completed mostly by mothers )80.8%(. Limited trained staff were found to be responsible for management of diabetes at school, and parents had relatively poor perceptions regarding the care of children with diabetes at school. Glucagon availability, trained staff, possibility of contacting a treating physician during school hours, a written plan for diabetes, and parents' confidence in schools all scored low and were significantly related to school type. Hemoglobin A1c )HbA1c( level was significantly related to insulin regimen. Conclusion:Parents had poor perceptions regarding diabetes care at school. There was no or very limited availability of glucagon kits and trained staff for management of children with T1DM. This study suggests a need to improve the management of diabetes at schools.

Diabetes in children has increased globally, and the World Health Organization ranks Saudi Arabia 7th in prevalence and 5th in incidence of type 1 diabetes (T1D). Type 2 diabetes (T2D) in children and adolescents has been identified in Saudi Arabia but its prevalence is still unknown. Despite advances in diabetes management including new insulins, insulin delivery systems, glucose monitoring and easy access to media for disease awareness, diabetes in children continues to be challenging in many aspects. Problems include delayed diagnosis, suboptimal glycemic control, early and late disease complications, transition from pediatric to adult care and raising of obesity and T2D, poor psychological and school support. This review summarizes the pediatric and adolescent diabetes studies in Saudi Arabia to date and explores the country-specific treatment challenges and potential solutions.

Background and Aims:Anaphylaxis is a common emergency and life-threatening hypersensitivity reaction defined as a rapid generalized allergic reaction. Prior international studies have shown that school personnel is often not familiar with the signs of hypersensitivity or with appropriate management strategies that should be initiated at school for children with an anaphylactic reaction. Moreover, no studies have evaluated the awareness of anaphylaxis by school teachers in Saudi Arabia. The aim of this study was to determine teachers’ knowledge, attitudes, and practices toward anaphylaxis in Al-Qassim, Saudi Arabia.Methods:This was a cross-sectional study conducted at a public school in Al-Qassim, Saudi Arabia via a validated fourteen items questionnaire aimed to survey teacher knowledge, attitudes, and practices toward anaphylaxis. The questionnaires were disseminated using a multistage random sampling technique to Saudi national's teachers from different regions in Al-Qassim.Results:Most teachers had a low level of knowledge (85.3%) of anaphylaxis and positive attitudes (72.9%), and the level of practice was reported as low (48.9%) to moderate (47.5%). The most common sources of information regarding anaphylaxis were the internet and social media. When considering significant factors associated with knowledge, attitudes, and practices (KAP), we found that sex, years of experience in teaching and witnessing students suffering from anaphylaxis were all positively associated with KAP.Conclusion:The overall knowledge and practices of teachers regarding anaphylactic reactions were poor, although teachers’ attitudes toward learning this information were positive. Thus, teachers need further education regarding the management of allergic reaction.