Geographical Locations - Bahrain

• (Statistical) Number of Inhabitants per Doctor: 953
• CIA World Factbook : Bahrain

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Bahrain
  - WHO - Tobacco Control: Country Profile - Bahrain
  - WHO - Environmental Burden of Disease: Country Profile – Bahrain
• WHO Regional Office for the Eastern Mediterranean (EMRO) in Alexandria (Egypt)
• UNDP in Bahrain

Government

• Bahrain Government
• Ministry of Health
• Directorate of Public Health

Non-Government

Academic Institutions

National Policy and Related Documents

• Bahrain Health Strategy: Framework for Action, 2002-2010
  "The Bahrain Health Strategy provides the framework within which various entities across the health sector will operate. It identifies priorities and highlights major issues affecting the quality and performance of health care delivery in Bahrain. It aims to ensure that all efforts are directed toward continuous improvement and development of health systems. It was developed following the scientific process of strategic planning involving Ministry of Health staffs at different levels, as well as various stakeholders, in defining the vision for the future."
• Health Information and Communication Technology Strategy: Health Services Without Walls
  "The Ministry [of Health] has… set out six core principles: "accessibility, affordability, appropriateness, accountability, accreditation and acceptability "(Ministry of Health Direction, 2002). The foundation for these core principles is through the commitment and implementation of an evidence-based management that requires a total restructuring and redevelopment of its information and automation strategies and systems. The Ministry of Health Information Systems Project (MHIS) was initiated in June 2000 to define these strategies and systems, and identify a partner that would re-engineer and modernize the current environment to a knowledge managed health system. Information Technology (IT) and Information Management Systems (IMS) have a central role as an enabler in the healthcare business and the ministry recognizes that it requires a sophisticated IT system to maintain and improve the quality of service in the most cost effective manner."
• National Strategies for Prevention of Blindness
• Primary Care Public Health - Strategic Development - In Arabic

Reports, Guidelines, and Projects

• Child and Maternal Mortality
  "Due to a relatively high standard of health, one that has been improving over the past decades as a result of the government commitment to providing free quality health care to its citizens, Bahrain is on track to meeting the 2015 target of reducing child and maternal mortality. Child and maternal mortality rates in Bahrain are relatively low, close to the level recorded in advanced economies, and it is likely that there will be a further decline in mortality rates as a result of health precautions taken by pregnant women, as well as progress in prenatal medicine." [MDG Report Bahrain 2003, United Nations Development Program in Bahrain]
• Chronic Conditions Management in Bahrain – a Word of Truth
  "Over the past decades, the Eastern Mediterranean region has experienced a [sic] epidemiologic transition; chronic diseases are now the leading cause of death among adults. This so called epidemiologic transition is partly due to the rapid ageing of the developing world’s population and the progressive urbanization and socioeconomic transformation. Other major factors include changes in nutritional patterns with over consumption of fatty foods. The focus on secondary and tertiary care, rather than preventive care, had increased the incidence of chronic diseases… In this report, [the author] will discuss the different definitions of chronic conditions, an adapted prospective definition, the burden of chronic conditions in Bahrain, the organization of chronic condition care in Bahrain, identifying and evaluating chronic conditions and their impact and finally the concept of self management and its application to the Bahraini population." [Bahrain Medical Bulletin, Vol. 30, No.1, March 2008]
• Clinical relevance of virulence genes in Campylobacter jejuni isolates in Bahrain
  There are no data describing the genetic make-up of Campylobacter strains (an important aetiological agent of diarrhoea) circulating in the Arabian Gulf region. Here, the molecular characterization of two virulence genes in Campylobacter jejuni from Bahrain and the relationship with clinical infection are reported. Molecular screening for cytolethal distending toxin (cdtB) and invasion-associated marker (iam) genes was carried out on C. jejuni stool isolates collected from January 2002 to January 2004 in Bahrain. The molecular characterization was correlated with the patients’ socio-demographic and clinical parameters. Of the 96 C. jejuni strains tested, 50 (52%) were cdtB⁺/iam⁺, 30 (31%) were cdtB⁺/iam^- and 16 (17 %) were cdtB^-/iam^-. Sixty-nine per cent (66/96) of patients were less than 3 years old, with significantly higher detection of cdtB⁺/iam⁺ and cdtB⁺/iam^- strains (P <0.001 and P <0.01, respectively) in this age group. Seventy patients (73 %) were symptomatic. In the group that were less than 3 years old, 62 and 85% of those with cdtB⁺/iam⁺ and cdtB⁺/iam^- strains, respectively, were symptomatic compared with 100% for those over 3 years of age. However, the presence of cdtB^-/iam^- strains still resulted in clinical infection in the children under 3 years but not in the older patients. This is the first report describing the molecular characterization of virulence genes in Campylobacter isolates from this region. The findings indicate that strains of different virulence genetic make-up are circulating in the population, with children under the age of 3 years being most vulnerable. Further work on the molecular characterization, gene expression and determination of the invasive phenotypes of C. jejuni strains circulating in different regions is needed. [author abstract] [Journal of Medical Microbiology (2006), 55, 839–843]
• Genetic Diseases in Bahrain
  "Non-communicable diseases, especially genetic diseases, are assumed to be a major cause of morbidity and mortality. Genetic disorders are a significant burden on health care delivery systems. Their chronic nature requires life-long medical attention, expensive supportive and symptomatic therapy and specialized care. Effective control of these diseases requires that their natural history, frequency and distribution be studied." [Centre for Arab Genomic Studies:Chapter 5 of Genetic Disorders in the Arab World: Bahrain (Volume 2, 2006), pp.72-91]
• Genetic Disorders in the Arab World: Bahrain
  This book "aims to provide an update on the situation of genetic disorders in the UAE, as well as an overview of genetic disorders and genetic research undertaken in Bahrain." [Genetic Disorders in the Arab World, Volume 2, 2006 (Centre for Arab Genomic Studies)]
• Guideline on Influenza A H1N1 (Swine Influenza) Preparedness for Health Care Workers in Bahrain (Version 2)
  Aimed at Bahraini healthcare professionals, these guidelines state: "This guideline has been developed to assist you in preparation for and the recognition of severe respiratory diseases that may have been acquired overseas, such as Influenza A/H1N1 (swine influenza), avian influenza, or SARS. This guideline will be valuable when there are suspected or confirmed cases of efficient human to human transmission of these diseases. Because of the current threat, I urge you to consider how you can apply this information in your practice. Doctors, Pharmacists, Emergency Department Staff and international Border staff will be the first point of contact by affected members of the public if such diseases appear in Bahrain. It is important that as a health care worker, you keep up-to-date with current information on the health risks involved with traveling. Your vigilance in recognizing and responding to respiratory diseases in people who have traveled overseas is essential in the prevention of a major outbreak in Bahrain." [Kingdom of Bahrain Ministry of Health, 30 June 2009]
• Guidelines for the Management of Malaria in Bahrain
  Examines the various drugs used for treatment of malaria, complications and management of the disease, the situation of malaria in Bahrain, and surveillance. [Kingdom of Bahrain Ministry of Health, Public Health Directorate, Communicable Diseases Control Section, 2003]
• Malaria in Bahrain, 2002: A report to The Third Inter-Country Meeting Of National Malaria Programme Managers
  "Bahrain has achieved interruption of local malaria transmission since 1980, and therefore classified as a country from Group1. Keeping this great achievement is an important objective as part of malaria control strategy. Malaria and vector control operations are now directed within Roll Back Malaria framework toward better and successful situation of control." [Kingdom of Bahrain Ministry of Health, Public Health Directorate, Environmental Health Section, 2002]
• Management of Public Health Pesticides in the Kingdom of Bahrain – A report to The Inter-Country Workshop on Public Health Pesticide Management
  Examines the laws governing pesticide use in Bahrain and the current situation (in 2003) with regards to its use. [Kingdom of Bahrain Ministry of Health, Public Health Directorate, 2003]
• National nutrition survey for adult Bahrainis aged 19 years and above
  This study was conducted at the national level to establish a baseline information on the nutritional status of adult Bahraini population by attempting to identify their dietary habits, define the prevalence of obesity, any diet related chronic diseases and possible association with lifestyle and socioeconomic factors. A total number of 2301 person (1118 males and 1183 females) participated in this survey. The target population was adult Bahrainis 19 years of age and over. Data collection included anthropometric measurements, 24 hrs dietary recall and food frequency questionnaire. Lifestyle, eating habits, self-reported health conditions and socio-economic data were collected using a general questionnaire. Hemoglobin levels were determined using finger prick technique. The WHO- BMI standards were adopted to define obesity. The dietary data were computerized using Dankost 2000 database (Danish/WHO diet analysis software package based on Middle East foods) and the data were analyzed using Epi Info Software. Results showed high prevalence of overweight (36.7% males and 28.3% females) and obesity (23.3% males and 34.1% females). The consumption of protein, fat and carbohydrates were found to be high. The intake of calcium was around 80% for males and 70% for females of the reference nutrient intakes for the United Kingdom adult population. While the intake of sodium was 300% of the recommended levels, the potassium intake did not exceed 55%. Results also showed that 21% and 37% of males and females, respectively, suffer from anemia, which might be attributed to the deficiency of iron, folic acid, and unhealthy dietary habits, as well as hereditary anemia. [author abstract]
• National Study on the Prevalence of Iodine Deficiency Disorders among School Children Aged 8-12 years old in Bahrain
  "Iodine deficiency disorder (IDD) continues to be an important public health problem in many countries. In the Eastern Mediterranean Region, 348 million (74% of the population) are considered to be at risk of iodine deficiency. The main objective of this study was to estimate the prevalence of goitre and iodine deficiency among school children in Bahrain."
• Nutrition Country Profile: Kingdom of Bahrain
  "The Kingdom of Bahrain is a small country of the Near East which has experienced a major improvement in the standard of living in the last decades… There have been major improvements in access to health services and education. Health Services provide free medical care to all Bahraini citizens. Over the last three decades life expectancy has increased from 60 to 74 years. The quality of maternal and child health care is reflected in the low infant mortality rate and in the decrease in maternal mortality. The Human Development Index has reached a high level. The proportion of the population affected by poverty is minor. Social programmes are well established and will enable the National Millennium Development Goals to be met. Due to globalization and to the rapid increase in living standards, dietary patterns have undergone an intense westernization. Consumption of fast-foods and eating out have become common. Lifestyles are often sedentary. Almost two-thirds of the adults are either overweight or obese. This nutrition transition will cause a sharp increase in the incidence of non-communicable diseases… Regarding micronutrient deficiencies, iron deficiency anemia remains an important public health problem. High prevalence is observed among preschool children and women, but more data are needed to assess the impact of current intervention programmes such as iron supplementation and flour fortification with iron. Vitamin A and iodine deficiency are not considered public health problems in Bahrain. Despite notable efforts of the government in the nutrition and health sectors, the obesity epidemic is progressing and innovative ways of combating it are needed.”"[Food and Agriculture Organization of the United Nations (FAO)]
• Obesity among Adult Bahraini Population: Impact of Physical Activity and Educational Level
  Background: In the populations of the Arabian Peninsula, obesity has emerged as the leading cause of morbidity and mortality over a 25-year period of swift socioeconomic progress. The objective of this study was to determine the body weight distribution, prevalence and risk factors for the overweight and obese in the native adult Bahraini population. Subjects and Methods: A cross-sectional national epidemiological community survey was conducted involving 2013 Bahraini subjects aged 40-69. The males were aged 40-59 years, with a mean age of 49 years, while the females were aged 50-69 years, with a mean age of 59. The sample was adjusted for gender, age, and area of residence distribution. A questionnaire describing the demographic, social, educational status and income status was completed. Measurements were made of height and weight, and body mass index (BMI) was calculated for each subject. WHO classification was used for defining overweight (BMI 25-29.9 kg/m²) and obesity (BMI ≥30 kg/m²) categories. Results: The age-standardized prevalence rate among native Bahraini men and women was high. Approximately 32% of women and 25% of men were obese (BMI 30.0 kg/m²). The prevalence of obesity was significantly higher among female subjects than males throughout all the age groups. Overweight and obesity were more prevalent among those with higher levels of education and people with high incomes. A significant relationship was found between obesity and education, physical inactivity and TV watching of 16 hours a week or more. Subjects’ self-appraisal and their report of physicians’ diagnosis of health disorders revealed a significantly higher prevalence of ill health among obese subjects. There was a progressive decrease of BMI for male and female subjects with age. Although 28% of participants (564) had body mass index 30 kg/m², only 42% (267) of these obese individuals rated themselves as overweight. In addition, obesity was inversely related to physical activity at work in men. Conclusion: We conclude that the prevalence of obesity among the native middle-aged and elderly Bahraini population is high. We noted that the prevalence of obesity increased as the level of education increased, which reflects the perception of obesity being a sign of affluence among Bahraini population. There is a necessity to develop an action plan for controlling obesity and its metabolic consequences among the populations of the Arabian Gulf. [author abstract] [Annals of Saudi Medicine 2001; 21(3-4): 183-187]
• Profile of stroke in Bahrain
  Objectives: As no report on the pattern of stroke in Bahrain is available, we sought to determine the stroke types, the annual incidence rate, and the risk factors associated with different types of stroke in Bahrain nationals and expatriates in Bahrain. Methods: Case records of patients admitted with stroke from January 1995 to December 1995 in a tertiary level hospital, the only one with a well established neurology service in Bahrain were reviewed. Diagnosis of stroke and its type were confirmed by clinical and computerized tomography of brain. Risk factor analysis was made based on clinical, laboratory and other relevant investigational data. Results: The majority of strokes occurred in middle and late age Bahrainis. Males predominated in all types of strokes, except in the hemorrhagic type, among the Bahrainis. The crude annual incidence rate was 57 per 100,000 Bahrainis. The frequency of stroke types in Bahrainis was cerebral infarction in 53%, cerebral hemorrhage in 30% and unspecified in 16.5%; as against 76%, 10% and 15% in non Bahrainis. Subarachnoid hemorrhage was rare (2%). Hypertension, dyslipidemia, diabetes mellitus and ischemic heart disease and smoking were common risk factors for ischemic and hemorrhagic strokes. Conclusions: Stroke incidence in Bahraini nationals is similar to that in developing countries and from other parts of the Arabian Peninsula. The differences observed in age and gender distribution and in the stroke types between Bahraini nationals and non Bahraini expatriates is most likely a reflection of the demographic structure existing in Bahrain. [author abstract] [Neurosciences 2000; Vol. 5 (1): 30-34]

Educational Resources

• WWW Virtual Library: Bahrain
• ArabNet: Bahrain
• CDC - Travel Information: Middle East
• Library of Congress, Country Study: Bahrain