Early Diagnosis of Classic Homocystinuria in Kuwait through Newborn Screening: A 6-Year Experience

Kuwait is a small Arabian Gulf country with a high rate of consanguinity and where a national newborn screening program was expanded in October 2014 to include a wide range of endocrine and metabolic disorders. A retrospective study conducted between January 2015 and December 2020 revealed a total of 304,086 newborns have been screened in Kuwait. Six newborns were diagnosed with classic homocystinuria with an incidence of 1:50,000, which is not as high as in Qatar but higher than the global incidence. Molecular testing for five of them has revealed three previously reported pathogenic variants in the CBS gene, c.969G>A, p.(Trp323Ter); c.982G>A, p.(Asp328Asn); and the Qatari founder variant c.1006C>T, p.(Arg336Cys). This is the first study to review the screening of newborns in Kuwait for classic homocystinuria, starting with the detection of elevated blood methionine and providing a follow-up strategy for positive results, including plasma total homocysteine and amino acid analyses. Further, we have demonstrated an increase in the specificity of the current newborn screening test for classic homocystinuria by including the methionine to phenylalanine ratio along with the elevated methionine blood levels in first-tier testing. Here, we provide evidence that the newborn screening in Kuwait has led to the early detection of classic homocystinuria cases and enabled the affected individuals to lead active and productive lives.

Mapping Kuwait bathymetry using passive multispectral remote sensing

Mapping bathymetry is essential for many fields, including science, engineering, and the military, among others. Bathymetry is extremely important in the scientific field because it is linked to many physical and environmental issues such as coastal erosion, sea-level rise, and water quality. Traditionally, conventional methods, such as pre-measured cable passage, were used to estimate depths. Lately, echo-sounder assessments were used on hydrograph ships. This method is effective, but it is very costly in both economic and time terms. Remote sensing technology provides modern methods for mapping bathymetry, such as the use of active and passive remote sensing. Many satellite sensors cover multispectral bands. Some are commercial, such as IKONOS and WorldView, while others are freely available, such as Landsat 8 and Sentinel-2. In this study, Landsat 8 (15 meters spatial resolution) was used to estimate the depths of the waters of Kuwait, an Arabian Gulf country located on the Northwestern side of the gulf. Ground truthing points (GTPs) were used to build a bathymetric model of Kuwaiti territorial water (KTW) using the ratio transform algorithm (RTA) applied on Landsat 8 data. The results showed a good ability of Landsat 8 and RTA to estimate the depths of Kuwait’s waters, where the relationship between the derived model from Landsat 8 and the GTPs was positive (r2 = 0.9634). Meanwhile, the accuracy of the derived bathymetric model was evaluated by computing the Root Mean Square Error (RMSE = ± 1.66 meters) and Mean Absolute Error (MAE ± = 1.29).

A Large Case Series of Neurocysticercosis in Kuwait, a Nonendemic Arabian Gulf Country in the Middle East Region

Neurocysticercosis (NCC), a leading global cause of severe progressive headache and epilepsy, in developed or affluent countries is mostly diagnosed among immigrants from poor or developing Taenia solium taeniasis-endemic countries. Taeniasis carriers in Kuwait are routinely screened by insensitive stool microscopy. In this study, enzyme-linked immunoelectrotransfer blot (EITB) was used as a confirmatory test for NCC. Screening was performed on 970 patients referred for suspected NCC on the basis of relevant history and/or ring-enhancing lesions on computed tomography and/or magnetic resonance imaging during a 14-year period in Kuwait. Demographic data and clinical details were retrieved from laboratory or hospital records. EITB was positive in 150 subjects (15.5%), including 98 expatriates mostly originating from taeniasis-endemic countries and, surprisingly, 52 Kuwaiti nationals. The clinical details of 48 of 50 NCC cases diagnosed during 2014–2019 were available. Most common symptoms included seizures, persistent headache with/without fever, and fits or loss of consciousness. Cysticercal lesions were located at various brain regions in 39 of 48 patients. Multiple members of 3 families with NCC were identified; infection was linked to domestic workers from taeniasis-endemic countries and confirmed in at least 1 family. Our data show that NCC is predominantly imported in Kuwait by expatriates originating from taeniasis-endemic countries who transmit the infection to Kuwaiti citizens.

Unwelcome? English as a Medium of Instruction (EMI) in the Arabian Gulf

The Qatari college EFL (English as a Foreign Language) classroom is revisited in the author’s second action research study conducted in the small Arabian Gulf country. The literature review allowed the author to gather themes that lead to this groundbreaking inquiry of the residual effects resulting from educational language reforms in the country. Due to the beginning stages of English as a medium of instruction (EMI) in Qatar, to the author’s knowledge, no such research has taken place until now. The qualitative data collection method involved 11 focus group participants from the researcher’s advanced-intermediate IEP (Intensive English Program) class that underwent a semi-structured interview. Results determine that, if given the choice, students would rather receive instruction in the Arabic medium instead of English to pursue undergraduate studies. The author offers additional research questions and recommendations in understanding the student perspective and why the EMI reforms have not been successful.

Child sexual abuse data from an Arabian Gulf country revisited

We revisit our previous work on child abuse in Kuwait, with a focus on the sexual abuse data, and discuss the findings in the context of the local culture. In 2006, a nationwide sample of 4467 senior high-school students (mean age 16.9; 48.6% boys) at government secondary schools was studied. Over their lifetime, 8.6% had been sexually attacked, 5.9% had experienced someone threatening to have sex with them, 15.3% had experienced unwanted sexual exposure, and 17.4% had had someone touch their sexual parts (boys 21.1%, girls 14.0%; P < 0.001). Most perpetrators were members of the extended family. The way to assist ‘dysfunctional families’, where ‘family honour’ and the need for peaceful relations with neighbours have priority over the mental health of female victims, is to propagate the finding that child sexual abuse has a wide-ranging deleterious impact on psychosocial functioning.