Findings of Community Based Screening in the Kingdom of Saudi Arabia, 2014

Research Article

Austin J Endocrinol Diabetes. 2016; 3(3): 1047.

Findings of Community Based Screening in the Kingdom of Saudi Arabia, 2014

Al Slail FY¹*, Al Saeedi MY², Afridi HU³, Al Omari SA4 and Kheir OO¹

1National Diabetes and Prevention Program, Ministry of Health, Saudi Arabia

2General Non-communicable Diseases, Ministry of Health, Saudi Arabia

³Public Health Specialist, WHO, Libya

4Obesity prevention and control program, Ministry of Health, Saudi Arabia

*Corresponding author: Fatima Al-Slail, Director of the National Diabetes Prevention and Control Program, Ministry of Health, Riyadh, Saudi Arabia

Received: July 18, 2016; Accepted: August 08, 2016; Published: August 11, 2016


Introduction: Community based screening and awareness especially for non- communicable diseases is regularly done in annual festivals in KSA. The Directorate for Non Communicable Diseases participates in all the government sponsored community gatherings including annual festivals. However, the findings of screenings are not existent.

Methodology: A cross sectional study was conducted to assess the common non-communicable diseases and its associated risk factors. Festival visitors were invited and trained investigators conducted screening and filled the questionnaire after obtaining the written informed consent. Screening was done to assess diabetes, hypertension and osteoporosis. The questionnaire includes questions on socio-demographic characteristics, diet, physical activity, and selfreported history of chronic diseases.

Results: Among 830 visitors who opted for screening, the frequency of diabetes was 12.7 %, border line hypertension 18%, hypertension 37.7%, osteopenia 16.9% and osteoporosis 1.2 %. Age, BMI and having history of diabetes were independently associated with Diabetes.

Conclusion: Community based screening can become more organized and effective in kingdom of Saudi Arabia by following the recommendations of American Association of Diabetes Educators.

Keywords: Cross-sectional; Diabetes; Hypertension; Osteoporosis; Noncommunicable; Screening


The prevalence of Non-Communicable Diseases (NCD’s) including diabetes type II, and its associated risk factors is increasing at alarming rate in Kingdom of Saudi Arabia (K.S.A) [1]. Global comparative prevalence data of 2013 ranked Saudi Arabia as seventh highest diabetes type II prevalent country in the world (24%) and is estimated to be sixth highest prevalent country (24.51%) in 2035 [2]. The most recent community based national NCD survey by Ministry of Health (MOH) reports that the total prevalence of diabetes (age15 and above) was 13.4% in 2013. [3].

Ministry of Health, KSA while realizing the emerging problem, established Diabetes Control and Prevention Program (DCPP) at Non Communicable Disease Directorate in 2005. Presently the Program is endeavoring to implement the National Executive Plan of Diabetes Control 2010-2015, adopted from the Gulf Plan, prepared in collaboration with World Health Organization. An electronic diabetes registry was established in 2009, registering the diabetes type II patients from all the PHCC’s of the 20 administrative regions of the kingdom. Till date (5th January 2015) only 345213 type II patients are registered which are far below the target. Efforts are underway to strengthen screening activities at community and primary health facility level.

Community Based Screenings (CBS) are rampant because it includes the honoring of community organizations’ requests and efforts to improve health, particularly among populations with barriers to care such as lack of access, trust, and convenience. These screening events can help educate community members about diabetes-related concepts and serve as a bridge to appropriate clinical care [4]. Studies also recommend earlier diagnosis and intervention to minimize the progression of diabetes and the development of associated complications [5,6]. Many individuals throughout the KSA have been screened at malls and festivals with objectives to raise awareness and screen the undiagnosed people. However very limited studies are available on the findings of the community based screening. Every year, Janadriyah Festival takes place in KSA. It is one of the biggest cultural and heritage festival organized by the National Guards. The NCD Directorate participates in the festival every year and this time conducted a study. The findings of this study aim to inform the scientific community about the frequency of common NCD’s and its associated factors among the visitors of Janadriyah Festival visitors in Riyadh, Saudi Arabia. It will also help the researchers to find unified way of screening and reporting.


A cross sectional study was conducted in 2014 among Jandariyah festival visitors to assess the common non-communicable diseases and its associated risk factors. Study was approved by the IRB, Ministry of Health. The visitors were informed and invited for screening through announcements and posters display at the entry gates and other important sites of the festival area. The team of NCD Directorate present in Janadriyah was having a separate area of screening for male and female visitors. After obtaining the written informed consent, a pre tested questionnaire was filled by the interviewers which include questions on socio-demographic characteristics, diet, physical activity, and self- reported history of NCDS.

Weight, height, and blood pressure were measured by a trained professional. Omron HN286 (SN: 201207-03163F) and Omron M6 Comfort (HEM-7223-E) instruments were used to measure weight and blood pressure respectively. Random Blood Sugar was measured through Abbott Diabetes Care Optium Xceed glucometer. Subject bone mass was assessed by calcaneal Quantitative Ultrasound by Hologic Sahara. Visitors were classified based on T-scores according to WHO criteria into three categories (X). 1. Normal (T-score 1 and above), 2. Osteopenia (T-score 1 to-2.5) and 3. Osteoporosis (T-score 2.5 and below) [7].

We measured weight and height to calculate Body Mass Index (BMI) as weight (kg)/height (m2). For descriptive purposes, participants were classified into three groups: 1) normal weight, BMI between 18.5 and 24.9; 3) 2). Overweight, BMI between 25.0 and 29.9; 3) Obese class , BMI equal/greater than 30 and above) [8]. The BP was classified as having 1. Normal, SBP, less than 120 and DBP less than 80. 2). Borderline hypertension as SBP, between 120 and less than 140, and DBP between 80 and less than 90. Hypertension is reported as having SBP equal/greater than SBP, 140 and DBP 90 [9]. Those who measured equal/more than 200 mg/dl were reported as diabetic. The statistics of daily fruits and vegetables consumption per day was reported as written in the questionnaire. 1). No consumption on daily basis, 2). 2-4 servings per day and 3). Five times or more servings per day. Similarly the physical activity was reported as not practicing, less than 60 min/week and 150 min or more per week. The history of chronic infections and family history of chronic infections were asked by having the responses as Diabetes, Hypertension, Asthma, Cholesterol, Cancer and Others.

Statistical analysis

The socio demographic characteristic, lifestyle characteristics, history of chronic illness and family history of chronic illness of respondents were analyzed according to gender. History of chronic illness was analyzed as multi response variable. We used a univariate analysis to assess the association between diabetes and its associated factors. To control for confounding and interactions, a backward elimination multivariate logistic regression model was used to measure association between outcome variables and other co-morbids. Variables were removed one by one based on the significance level of their effect on the model, starting with the variable with the highest p > 0.5, till all variables kept had a p ≤ 0.5 in the analysis of effect.


A total of 830 festival visitors visited the screening facility of NCD, MOH and filled the questionnaire. The mean age of the participants was 44 with SD of 9.55. The lowest age was 12 years being a female and highest was 81 years being a male. Majority of the males (35.3%) were between 30 and less than 40 years of age, while in female age 40 and less than 50 of years of age were in majority (36.1%). The visitors were predominantly married (89%), Saudis (95.1%) followed by Egyptians (1.2%). Among the visitors there were housewives (31.8%), civil servants (34.4%) and having military background (8.7%) (Table 1).