Background Public acceptance of governmental measures are key to controlling the spread of infectious diseases. The COVID-19 pandemic has placed a significant burden on healthcare systems for high-income countries as well as low- and middle-income countries (LMICs). The ability of LMICs to respond to the challenge of the COVID-19 pandemic has been limited and may have affected the impact of governmental strategies to control the spread of COVID-19. This study aimed to evaluate and compare public opinion on the governmental COVID-19 response of high and LMICs in the Middle East and benchmark it to international countries. Methods An online, self-administered questionnaire was distributed among different Middle Eastern Arab countries. Participants’ demographics and level of satisfaction with governmental responses to COVID-19 were analyzed and reported. Scores were benchmarked against 19 international values. Results A total of 7395 responses were included. Bahrain scored highest for satisfaction with the governmental response with 38.29 ± 2.93 on a scale of 40, followed by the Kingdom of Saudi Arabia (37.13 ± 3.27), United Arab Emirates (36.56 ± 3.44), Kuwait (35.74 ± 4.85), Jordan (23.08 ± 6.41), and Lebanon (15.39 ± 5.28). Participants’ country of residence was a significant predictor of the satisfaction score (P < 0.001), and participants who suffered income reduction due to the pandemic, had a history of SARS-CoV-2 infection, and held higher educational degrees had significantly lower satisfaction scores (P < 0.001). When benchmarked with other international publics, countries from the Gulf Cooperation Council had the highest satisfaction level, Jordan had an average score, and Lebanon had one of the lowest satisfaction scores. Conclusion The political crisis in Lebanon merged with the existing corruption were associated with the lowest public satisfaction score whereas the economical instability of Jordan placed the country just before the lowest position. On the other hand, the solid economy plus good planning and public trust in the government placed the other countries of the Gulf Cooperation Council on top of the scale. Further investigation is necessary to find out how the governments of other low-income countries may have handled the situation wisely and gained the trust of their publics. This may help convey a clearer picture to Arab governments that have suffered during the pandemic.

Computed tomography (CT) is a routinely employed diagnostic tool for the detection and diagnosis of disease processes. Despite the primary focus of radiation dose reduction and improvements in CT scanners, radiation dose exposure remains an ever-increasing concern. Scanning protocol optimisation relative to body weight and scanner manufacturer still lags behind the diagnostic reference levels (DRLs) that are set on an international scale. The aim of this systematic review is to evaluate the current status of adult DRLs in head, chest and abdominopelvic CT over time on a global scale. A search was carried out in early 2019 using the Medline, PubMed, EMBASE, SCOPUS and manual databases. The reference lists of published articles were also assessed to identify further articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology was employed to evaluate articles for relevance. Articles were included if they assessed the DRL in head, chest and abdominopelvic scans. The search resulted in 6079 articles, of which 67 were included after a thorough screening process. The literature demonstrates a wide dose variation in reported head, chest and abdominopelvic dose length product (DLP) DRL, ranging from 700–1359, 330–707 and 550–1486 mGy·cm, respectively. Where reported, the volumed CT dose index (CTDIvol) DRL in the head, chest and abdominopelvic studies ranged from 30.4–85.5, 9–15 and 12.3–31 mGy·cm, respectively. The global means were shown to be slightly lower and significantly lower than the reported values of DLP and CTDIvol values for the American College of Radiology and European Commission, respectively. This review emphasises the need for an international standardisation for head and body DRL establishment methods, to provide a more comparable global measurement of dose variations across CT sites as well as regular monitoring of delivered radiation dose to patients.

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