Geographical Locations - Kuwait

• (Statistical) Number of Inhabitants per Doctor: 515
• CIA World Factbook : Kuwait

Organisations and Networks

UN and Multinational

• FAO
  - FAO - Nutrition Country Profile: State of Kuwait
• WHO
  - WHO Country Profile - Kuwait
  - WHO - Tobacco control: Country Profile: Kuwait
  - WHO - Environmental Burden of Disease: Country Profile – Kuwait
• Regional Office for the Eastern Mediterranean (EMRO) in Cairo
• UNDP - Kuwait

Government

• Ministry of Planning

Non-Government

• Kuwait Institute for Scientific Research

Academic Institutions

• Kuwait Institute for Medical Specialization (KIMS)
  "Kuwait Institute for Medical Specialization (KIMS) of the Ministry of Health, State of Kuwait is the authority responsible for organizing all aspects of postgraduate training of medical practitioners and other health professionals in Kuwait. KIMS was established in 1984 under a decree issued by HH the Amir of Kuwait. The institute is engaged in a variety of activities, including the organization of internship training of pre-registration medical graduates, specialty training at various levels in different medical fields, and continuing medical education programs for health professionals practicing in Kuwait."
• Kuwait University, Health Sciences Center - provides access to faculties and departments related to health

National Policy and Related Documents

Reports, Guidelines, and Projects

• Determination of the prevalence of lymphatic filariasis among migrant workers in Kuwait by detecting circulating filarial antigen
  The main objective of this study was to determine the prevalence of filarial infection among migrant workers in Kuwait. The study was conducted from April 2000 to November 2003. A total of 1050 migrant workers (>90% from the Indian subcontinent) from filarial endemic countries and 260 individuals residing in Kuwait as controls (50 healthy Kuwaiti blood donors, 50 microfilaria-negative individuals from endemic areas and 160 patients with other parasitic infections) were screened for filarial infection. All specimens were tested for microfilaraemia by microscopy of nucleopore-filtered blood (NFB) and detection of circulating filarial antigen (CFA) by an immunochromatographic test (ICT) and the TropBio assay. The overall prevalence of filarial antigenaemia was 18.3% (192 individuals) using the ICT and 20.3% (213 individuals) using the TropBio assay. Thirty-two cases (3 %) of Wuchereria bancrofti were detected by microscopy and the mean microfilaria count in these cases was 816 microfilariae ml^-1. CFA was detected only in two of the 260 control subjects. Statistical analysis to calculate the sensitivity, specificity and prevalence of infection was carried out using maximum-likelihood statistical methods. The overall sensitivity and specificity of the ICT and TropBio assay to detect CFA were comparable. Compared with NFB microscopy, the sensitivity of the ICT was 93.8% and specificity ranged from 84 to 100%. The sensitivity and specificity of the TropBio assay were 90.1 and 100%, respectively. However, the ICT failed to detect CFA in two cases with a microfilarial load of <20 microfilariae ml^-1. In conclusion, the prevalence of filarial infection among the migrant workers in Kuwait was 18.3% as determined by the ICT. [author abstract] [Journal of Medical Microbiology (2006), 55, 401–405]
• Evaluation of asthma clinics in primary care in Kuwait
  Aim: To determine the difference between asthmatics followed in asthma clinics, and asthmatics followed in non-asthma clinics in terms of knowledge about asthma definition, knowledge about provokers, proper inhaler technique, proper medication used and impact of asthma on life. Methods: This is a survey study conducted during the period of May 2005 to April 2006. The study included 136 Kuwaiti asthmatics, 12 years and above who are registered in asthma clinics distributed in different health areas. These cases were matched by age and sex with 136 controls collected from non-asthma ordinary primary care clinics. A specially designed questionnaire was developed based on five broad sections: socio-demographic characteristics, asthma history, asthma knowledge, effect of asthma on patient and finally patient satisfaction. Data were collected through interviews with cases in asthma clinics and controls in other clinics who came for asthma or other complaints. Results: The study showed that there is a significant difference between asthmatics in asthma clinics and those in non-asthma clinics in terms of knowledge about asthma as a disease and its most known provokers. They were more on proper medication especially anti-inflammatory and were more proficient in using the inhaler. Conclusion: Expanding asthma clinics can be used as an opportunity to improve asthma care at primary care level. [author abstract] [Eur J Gen Med 2006; 3(4): 159-166]
• HIV/AIDS prevalence among male patients in Kuwait
  Objective: To determine the prevalence of human immunodeficiency virus infection among male patients with sexually transmitted disease in Kuwait with emphasis on the type of sexually transmitted diseases and sexual partners. Method: A sentinel surveillance was conducted among male sexually transmitted disease patients, randomly selected among all new sexually transmitted disease patients who visited the Family Planning Clinic during June 1996 to June 1997. The patient data was recorded by the attending physician on a specially designed questionnaire. Results: A total of 1984 subjects were screened, out of which not a single human immunodeficiency virus/ acquired immunodeficiency syndrome case was found. Among the screened, 69% were non-Kuwaitis. Most of the subjects (76%) belonged to the age group 15-34 years, were married (53%), were illiterate (37.5%) and belonged to the low SES group (70%). The most common sexually transmitted diseases were non-specific urethritis (45%) and gonorrhea (42%). With regard to sexual practices, the majority of the respondents showed preference for female prostitutes, both inside (50%) and outside (48%) Kuwait. Conclusion: The absence of any human immunodeficiency virus positive case was probably due to the mandatory screening for granting residency in Kuwait, facilitating early detection of virus carriers among non- Kuwaitis. We, as researchers, are not sure if this study is true representation of human immunodeficiency virus/ acquired immunodeficiency syndrome prevalence among Kuwaiti sexually transmitted disease patients in this country who might seek treatment in private clinics. Moreover, the absence of prostitution as professional trade also tends to show the absence of indigenous circulation of the virus. Nevertheless, continuos surveillance is necessary to maintain and prevent the groups with risky behaviors from contracting the virus through sexual transmission. There is a distinct need to develop public education and awareness programs to serve as measures of prevention and protection. [author abstract] [Saudi Medical Journal 2000; Vol. 21 (9): 852-859]
• Medicine prices in the State of Kuwait: Report of a survey on medicine prices in Kuwait
  Background: A survey of the availability and prices of 35 medicines was undertaken in the public and private sector pharmacies in Kuwait in 2004 using the HAI/WHO medicines price survey methodology. Methods: Public procurement prices were obtained from the Central Medical Stores (CMS) and 25 private retail pharmacies were surveyed for prices that the patient would pay. Availability of innovator brand (IB), most sold generic (MSG; generic product with the highest sales nationally) and lowest priced generic (LPG; generic product with the lowest price at each facility) equivalents was assessed in 25 public health facilities (5 general hospitals and 20 polyclinics) as well as the 25 private pharmacies. Results: Central Medical Stores had over 90% availability of the survey medicines. Availability of the survey medicines at public health facilities on the day of the survey was low (IB 12%, MSG 0%, LPG 12%) but this was mostly related to the restricted distribution of many of the survey medicines within polyclinics. Innovator brands were more likely to be found in private retail pharmacies than generics (IB 84%, MSG 0%, LPG 0%). The public procurement median price ratio (MPR) to MSH reference prices was 5.0 for IB and 1.2 for generic equivalents; in the private pharmacies, the median MPRs for IB, MSG and LPG were 18.3, 16.1, and 15.9 respectively. In private pharmacies, IB beclometasone inhaler had the lowest MPR (3.7) whereas IB ciprofloxacin had the highest MPR of 110. For medicines from private pharmacies, the median MPRs compared to Australian PBS prices were 1.7 (IB), 1.9 (MSG) and 1.9 (LPG). On average, MSG products were 87% of the price of the corresponding IB in private retail pharmacies. The lowest paid government worker of Kuwaiti nationality would need between 0.1 and 3.8 days’ pay to afford the model treatments (for example for gastric ulcer, hypertension and asthma) from private pharmacies. For non-Kuwaiti unskilled workers, however, the model treatments were generally not affordable and would require between 0.8 and 22.0 days’ wages. There was an error rate of 15.5% in the pricing of IB products compared to official price lists, with a tendency towards higher prices. Generic product pricing showed a similar error rate. However, there appeared to be no systematic attempts of overpricing on a product-wide basis. Private pharmacy medicines prices included a total mark-up of 70% over the CIF price based on 2004 drug prices. Conclusions: Public sector procurement of medicines in Kuwait is effective and efficient although the reliance on some innovator brands does not seem necessary. Increased procurement of generics in the public sector could lead to more cost-effective utilisation of resources. Medicines prices in the private sector are almost twice those in Australian PBS reference prices, with a wide range between individual medicines. Limited generic penetration of the market means some medicines would be unaffordable to low-paid non-Kuwaiti workers if they had to purchase them from private retail pharmacies. When generic pharmaceuticals are available they are often priced only 10-15% below the innovator brand price due to lack of competition and the pricing regulation system. Increased availability of low-cost generic medicines in the private retail pharmacies e.g. through taking advantage of the public sector procurement system, could result in dramatic reduction in out-of-pocket pharmaceutical expenses to patients who need to purchase medicines from the private sector. [publication executive summary] [Health Action International (HAI) and the World Health Organization, March 2005]
• Nonlinear pattern of pulmonary tuberculosis among migrants at entry in Kuwait: 1997–2006
  Background: There is a paucity of published data on the pattern of pulmonary tuberculosis among migrant workers entering Middle Eastern countries particularly Kuwait. The objectives of this study were to use routine health surveillance data i) to estimate the prevalence of pulmonary tuberculosis among migrant workers at entry in Kuwait and ii) to determine the occurrence of any time trends in the proportions of pulmonary tuberculosis positive workers over the study period. Methods: The monthly aggregates of daily number of migrants tested and the number of pulmonary tuberculosis cases detected during routine health examinations of migrant workers from tuberculosis high-prevalence countries were used to generate the monthly series of proportions (per 100,000) of pulmonary tuberculosis cases over 120 months between January 1, 1997 and December 31, 2006 and analysed using time series methods. Results: The overall prevalence (per 100,000) of documented pulmonary tuberculosis cases among screened migrants was 198 (4608/2328582). Year-specific prevalence (per 100,000) of tuberculosis cases consistently declined from 456 (95% CI: 424 – 490) in 1997 to 124 (95% CI: 110 – 140) in 2002 before showing a steady increase up to 183 (95% CI: 169–197) in 2006. The second-order polynomial regression model revealed significant (P < 0.001) initial decline, followed by a significant (P < 0.001) increasing trend thereafter in monthly proportions of tuberculosis cases among migrant workers. Conclusion: The proportions of documented tuberculosis cases among migrant workers showed a significant nonlinear pattern, with an initial decline followed by a significant increasing trend towards the end of the study period. These findings underscore the need to maintain the current policy of migrants' screening for tuberculosis at entry. The public health authorities in Kuwait and perhaps other countries in the region may consider complementing the current screening protocol with interferon-γ assays to detect migrants with latent Mycobacterium tuberculosis infection. An appropriate curative or preventive chemotherapy of detected tuberculosis cases may help in further minimizing the risk of local transmission of M. tuberculosis, while contributing in global efforts to control this public health menace. [author abstract] [BMC Public Health 2008, 8:264]
• The Economic Impact of Smoking on the Health System in Kuwait
  Objective: To estimate some of the cost and the economic impact of smoking on health services in Kuwait Design: A cross-sectional survey Setting: Al-Saqer and Al-Yarmok Primary Care Centers, Kuwait Subjects: Two thousand two hundred and sixteen (2216) male persons were enrolled in this study. Intervention: Each patient was interviewed by a trained doctor. Main Outcome measures: The incidence of upper and lower respiratory tract system symptoms with current smokers compared to non-smokers. Results: Our study showed a high prevalence of smoking in Kuwait among adult males aged >18 years (40.6 %). It also showed a high incidence of both upper and lower respiratory tract system symptoms with current smokers compared to non-smokers (67.5 and 76.9% respectively compared to 32.5 and 23.1%). Conclusion: Smoking increases health care costs by increasing the number of clinic visits due to respiratory illness thereby increasing health services utilization and leading to additional societal burden. [author abstract] [Kuwait Medical Journal 2007, 39 (2):120-125]
• The role of national medical education in Kuwait
  Objectives: This study highlights the role of national medical education in the promotion of medical manpower. This was emphasized through tracking the development in the size and professional structure of the main category of the Kuwait national health care delivery system, the physicians, throughout the years 1996 to 2001. Methods: Data were ascertained from three sources: Department of Vital and Health Statistics and Department of Manpower, Ministry of Health for data on physicians, and Department of Statistics and Information Sector, Ministry of Planning, Kuwait for data on population. Results: The study revealed increasing trends toward employment of Kuwaiti female physicians, employment of Kuwaiti physicians to upper and lower ranks, and rarity of Kuwaiti physicians in some specialties, such as anesthesia. Conclusion: The study emphasized the role of national medical education in increasing the number of Kuwaiti graduates. Moreover, the study highlighted the apparent influence of KIMS in enhancement of higher medical specialization training programs as witnessed by the predominance of Kuwaiti physicians in the leading job categories. Besides, the study generated essential information required for planning the qualitative and quantitative pattern of the higher specialization programs. [author abstract] [Bulletin of the Kuwait Institute for Medical Specialization 2002; 1: 58-62]
• Unique Endemicity of Cryptosporidiosis in Children in Kuwait
  To understand the transmission of Cryptosporidium infection in children, fecal specimens from 62 Kuwaiti children with gastrointestinal symptoms found to be positive by microscopy were genotyped and subtyped with a small subunit rRNA-based PCR-restriction fragment length polymorphism analysis and a 60-kDa glycoprotein-based DNA sequencing tool. The median age of infected children was 4.5 years, and 77% of infections occurred during the cool season of November to April. Fifty-eight of the children (94%) had Cryptosporidium parvum, three (5%) had Cryptosporidium hominis, and one (1%) had both C. parvum and C. hominis. Altogether, 13 subtypes of C. parvum (belonging to four subtype allele families) and C. hominis (belonging to three subtype allele families) were observed, with 92% of specimens belonging to the common allele family IIa and the unusual allele family IId. Thus, the transmission of cryptosporidiosis in Kuwaiti children differed significantly from other tropical countries. [author abstract] [Journal of Clinical Microbiology, Vol. 43, No. 6, June 2005, pp.2805–2809]

Educational Resources

• WWW Virtual Library: Kuwait
• ArabNet: Kuwait business : Health Care
• CDC - Travel Information: Middle East
• Library of Congress, Country Study: Kuwait