“…The total participants were (n= 45,306). The study included 19 studies from 12 Arab countries; Yemen (Nasser and Zhang, 2019;Nasser et al, 2018), KSA (Al-Ghaneem et al, 2016;Hassan et al, 2014;Mandil et al, 2011;Mandil et al, 2010), Kuwait (Husain et al, 2016), Bahrain (Alzayani andHamadeh, 2015), Jordan (Obeidat et al, 2014;Khader and Alsadi, 2008;Alomari et al, 2006), Lebanon (Jradi et al,2013), Tunisia (Maatouk et al, 2013, Egypt (Khan et al, 2012;Abolfotouh et al, 2007), Palestine (Musmar, 2012), Syria (Al Kubaisy et al, 2012), Libya (Abou-Faddan and Ahmed, 2012) and UAE (Mandil et al, 2007) as shown in (Table1).…”