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Background Border malaria is a major obstacle for the malaria elimination in Saudi Arabia. Today, the southern border of Saudi Arabia is a region where malaria cases are resurging, and malaria control is dwindling mainly due to the humanitarian crisis and the conflict in Yemen. This study analyses the current border malaria epidemiology along the southern border of Saudi Arabia from 2015 to 2018. Methods All reported cases maintained by the malaria elimination centres in Aledabi and Baish, Jazan Province, Saudi Arabia, from 2015 to 2018 were analysed to examine the epidemiological changes over time. Pearson’s Chi-Square test of differences was utilized to assess differences between the characteristics of imported and local causes and between border cases. A logistic regression model was used to predict imported status was related to living along side of the border area. Results A total of 3210 malaria cases were reported in Baish and Aledabi malaria centres between 2015 and 2018, of which 170 were classified as local cases and 3040 were classified as imported cases. Reported malaria cases were mainly among males, within the imported cases 61.5% (1868/3039) were residents of the border areas. Conclusions Given the complexity of cross-border malaria, creating a malaria buffer zone that covers a certain margin from both sides of the border would allow for a joint force, cross-border malaria elimination programme. To initiate a malaria elimination activity and cases reported as belonging to this zone, rather than being pushed from one country to the other, would allow malaria elimination staff to work collaboratively with local borderland residents and other stakeholders to come up with innovative solutions to combat malaria and reach malaria-free borders.

Background Livelihood activities and human movements participate in the epidemiology of vector-borne diseases and influence malaria risk in elimination settings. In Saudi Arabia, where malaria transmission intensity varies geographically, it is vital to understand the components driving transmission within specific areas. In addition, shared social, behavioural, and occupational characteristics within communities may provoke the risk of malaria infection. This study aims to understand the relationship between human mobility, livelihood activities, and the risk of malaria infection in the border region of Jazan to facilitate further strategic malaria interventions. In addition, the study will complement and reinforce the existing efforts to eliminate malaria on the Saudi and Yemen border by providing a deeper understanding of human movement and livelihood activities. Methods An unmatched case–control study was conducted. A total of 261 participants were recruited for the study, including 81 cases of confirmed malaria through rapid diagnostic tests (RDTs) and microscopy and 180 controls in the Baish Governorate in Jazan Provinces, Saudi Arabia. Individuals who received malaria tests were interviewed regarding their livelihood activities and recent movement (travel history). A questionnaire was administered, and the data was captured electronically. STATA software version 16 was used to analyse the data. Bivariate and multivariate analyses were conducted to determine if engaging in agricultural activities such as farming and animal husbandry, recent travel history outside of the home village within the last 30 days and participating in spiritual gatherings were related to malaria infection status. Results A logistical regression model was used to investigate components associated with malaria infection. After adjusting several confounding factors, individuals who reported travelling away from their home village in the last 30 days OR 11.5 (95% CI 4.43–29.9), and those who attended a seasonal night spiritual gathering OR 3.04 (95% CI 1.10–8.42), involved in animal husbandry OR 2.52 (95% CI 1.10–5.82), and identified as male OR 4.57 (95% CI 1.43–14.7), were more likely to test positive for malaria infection. Conclusion Human movement and livelihood activities, especially at nighttime, should be considered malaria risk factors in malaria elimination settings, mainly when the targeted area is limited to a confined borderland area.

Candidemia, a bloodstream infection caused by Candida species, poses a significant clinical challenge, especially in immunocompromised individuals and intensive care unit (ICU) patients. Prompt diagnosis and treatment are crucial, as delayed antifungal therapy is associated with higher mortality rates. This study, conducted at King Abdulaziz University Hospital (KAUH) in Saudi Arabia, aimed to investigate the clinical and microbiological aspects of candidemia. This study is a retrospective analysis, KAUH in Saudi Arabia, using data from January 2017 to March 2021. Advanced fungal diagnostic technologies, including MALDI-TOF MS, BioFire, and Vitek 2 systems, were utilized. Patient demographics, clinical characteristics, Candida species distribution, and antifungal susceptibility were assessed. Univariate, bivariate, and multivariate statistical analyses were conducted. Among 418 patients, was the most prevalent species (32.1%), followed by (23.4%) and (18.4%). Various Candida species exhibited different antifungal susceptibility patterns, with high sensitivity to Amphotericin B (95%) and Fluconazole (94%). Sensitivity to Caspofungin varied significantly among species (p = 0.023), with showing the highest sensitivity (95%). The overall mortality rate was 67%. None of Candida Species exhibited a statistically significant association with death, however other factors including age, autoimmune diseases, and dialysis were associated with increased mortality risk. This study provides valuable insights into the epidemiology and clinical characteristics of candidemia at KAUH, highlighting the importance of species identification and tailored antifungal therapy. These findings can inform strategies to improve patient care and infection control in Saudi Arabian healthcare settings, contributing to global efforts to mitigate the impact of invasive fungal infections.

Parasitic infections are a primary cause of illness worldwide and a public health problem. This study highlighted the prevalence of intestinal parasitic (IP) infections and their updated epidemiologic status from 2019 to 2023 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. A retrospective study was conducted from 2019 to 2023 at King Abdulaziz University Hospital. The laboratory results, socio-demographic information, and the year of data collection were collected from the hospital's parasitology laboratory. The data were analyzed using SPSS version 26. Ethical approval was obtained from the National Committee of Bioethics (NCBE) - King Abdul Aziz City for Science and Technology, with an approval number of 258-22. During the study period, 7673 stool samples were requested for intestinal parasite examination. The prevalence of IP infection from 2019 to 2023 was 212/7673, with a percentage of 2.8%. Infected patients had a mean (SD) age of 37.68 (17.27) years. Most infected patients were females (61%) and from Saudi Arabia (37.1%). Most stool samples were brown (79.1%), and about half were soft (51.7%). 2019 had the highest number of infected cases (28.3%), while the number of cases decreased in 2023 (8.8%), the lowest during five years. The most predominant parasite among study subjects was Blastocystis hominis (48.11%). The prevalence of IP infection is lower than in previous comparable surveys. Maintaining personal hygiene, conducting epidemiological surveillance, and enhancing environmental sanitation can prevent and control infections.

The study aimed to assess the effect of chronic diseases on health-related quality of life (HRQoL) among university students. A cross-sectional analytic study was conducted at King Abdulaziz University, involving 1173 students. Questionnaire on chronic diseases, HRQoL using the 36-item Short Form Health Survey (SF-36), alongside other factors was distributed electronically. Regression analysis was used to identify factors associated with HRQoL. The mean ± SD scores across SF-36 dimensions varied, with physical functioning scoring the highest (74.81 ± 27.82) and energy/fatigue the lowest (38.52 ± 24.03). The physical and mental component summary scores were 68.07 ± 18.67 and 49.20 ± 23.17, respectively. The study found a 23.1% prevalence of multimorbidity. Multimorbidity was associated with significantly lower HRQoL across all dimensions. Female sex, low family income, and lack of exercise were predictors of poor HRQoL. High-impact diseases were strongly associated with poorer physical health. The study revealed significant burden of multimorbidity that demands targeted interventions. Focus on modifiable risk factors, such as exercise and socioeconomic support, could enhance overall well-being and prevent negative health outcomes.

Polyamines are positively-charged organic molecules that are important for cellular growth and division. Polyamines and their synthesizing enzymes are particularly abundant in rapidly proliferating eukaryotic cells such as parasitic protozoa and cancer cells. Polyamine biosynthesis inhibitors, such as Elfornithine, are now being considered for cancer prevention and have been used effectively against Trypanosoma brucei. Inhibitors of polyamine biosynthesis have caused growth arrest of Plasmodium falciparum blood stages in vitro, but in P. berghei only partial inhibition has been observed. While polyamine biosynthesis enzymes are characterized and conserved in Plasmodium spp., little is known on the biological roles of these enzymes inside malaria parasite hosts. The bifunctional polyamine biosynthesis enzyme S-adenosyl methionine decarboxylase/ornithine decarboxylase (AdoMetDC/ODC) was targeted for deletion in P. yoelii. Deletion of AdoMetDC/ODC significantly reduced blood stage parasitemia but Anopheles transmission was completely blocked. We showed that male gametocytogenesis and male gamete exflagellation were abolished and consequently no ookinetes or oocyst sporozoites could be generated from adometdc/odc(–) parasites. Supplementation of putrescine and spermidine did not rescue the defective phenotypes of male gametocytes and gametes of the knockout parasites. These results highlight the crucial role of polyamine homeostasis in the development and functions of Plasmodium erythrocytic stages in the blood and in the mosquito vector and validate polyamine biosynthesis pathway enzymes as drug targeting candidates for malaria parasite transmission blocking.

Vegetables are a crucial component of every diet and a good source of vitamins and minerals. Many raw vegetables, such as salads, are consumed, and consuming raw vegetables contaminated with human and animal feces can lead to a variety of intestinal parasite diseases. The goal of this cross-sectional study was to investigate the incidence of contamination of green leafy vegetables with human intestinal parasites, as well as identify the most common parasite species and any seasonal variation in parasite abundance in green leafy vegetables found and sold for human consumption in various markets and stores in Jeddah. To the best of our knowledge, no research has been conducted on the prevalence of parasite-contaminated vegetables in Jeddah. From September 2020 to July 2021, 250 leafy vegetables (coriander, watercress, lettuce, parsley, leek, and green onion) were collected from various markets and stores in Jeddah. The vegetables were sorted, labelled, and evaluated in the laboratory after being completely washed with distilled water, examined for sediment, staining, and microscopically examined. Chromatographic immunoassay tests were also used to confirm parasite identification. Intestinal parasites were discovered in 35.2% of the vegetables (88/250). Coriander was the most contaminated (64.2%), while green onion was the least contaminated (21.9%). Blastocystis spp. was the most often discovered parasite (55.7%), followed by Strongyloides spp. larva (22.7%) and Entamoeba coli cysts (6.8%). Summer has the greatest percentage of parasites, followed by autumn, while winter has the fewest. There was no statistically significant relationship between the kind of vegetable, seasonal parasite prevalence in green vegetables, and parasite type.These findings highlight the importance of inspecting vegetables grown or imported from endemic countries for parasite contamination. In Jeddah, several fresh green vegetables were tainted with intestinal parasites. This demonstrates that those who consume raw vegetables regularly may be susceptible to parasitic illnesses. These findings highlight the need of monitoring vegetables grown or imported from parasitic-endemic areas. As a result, it is critical to establish strategies and control measures to limit the likelihood of parasites in food-borne diseases.

These studies explore malaria on the southern border of Saudi Arabia, a region where malaria cases are resurging, and elimination efforts are stalled. Malaria is a major public health concern on the southern border due to the area’s favorable ecology, competent vectors, frequent transmission in active foci, population movements, and underserved mobile and migrant populations (MMPs), which may serve as a parasite reservoir. The geographic focus of this study is in Jazan province, located in Saudi Arabia’s border with Yemen, where security is unstable due to conflict and civil unrest in Yemen. Public health surveillance methods for implementing effective malaria elimination strategies in the region require knowledge and understanding of current epidemiological trends and human activities that contribute to sustained malaria transmission in the geographically, historically, and politically complex region.The objectives of this dissertation are to describe malaria trends at border areas; to assess surveillance current tools ‘travel history’, a criterion to classify cases; to assess human livelihood activities contributing to malaria transmission; to identify and understand attitudes about malaria held by Mobile and Migrant Populations (MMPs); to identify treatment and prevention seeking behaviors of these populations. This information is critical to prioritize interventions tackling border malaria and implementation of effective malaria elimination strategies in the border region.Study results showed that small-scale human movement within the region is more associated with a risk of malaria infection than factors such as socio–economic status, agricultural livelihood activities, rearing animals, and participation in daily or seasonal spiritual gatherings. The peer navigator recruitment method, which uses a standard chain referral approach, showed that MMPs in Jazan have high levels of malaria knowledge and risk perception but low levels of treatment-seeking behavior and access to prevention. The reliability of the current surveillance tools used to characterize and report malaria cases based on international travel history decreased in elimination settings located closer to the border. These results have significant implications for malaria elimination strategies, including identifying risk factors for malaria transmission, developing disease surveillance methods targeting hard-to-reach populations, and serving as a foundation and baseline data for future border health studies of malaria and another vector–borne disease in this region.