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Annals of Tropical Medicine and Public Health. 2017 Mar-Apr; 10(2):396-403.Background: Absence or low uptake of Pap smear is probably the main barrier for high incidence of cervical cancer. Aim: To assess the knowledge, practice, attitude, main barriers and motivating factors of Pap smear among Omani women. Methods: Cross-secal survey in a tertiary referral hospital. The participants were divided into three groups: the patients who attended Outpatient Gynecology Department in Sultan Qaboos University Hospital (SQUH), Oman, the female staff from SQUH, College of Medicine and Health Science and College of Nursing at Sultan Qaboos University (SQU) and the graduating female students at SQU. Results: There were 204 patients, 133 staff, and 157 students. The knowledge of Pap smear among patients, staff and students was as follows: 56.9%, 56.4% and 23.6%, respectively. Those who had an adequate knowledge, 36.8% patients, 23.3% staff and 0.0% students performed Pap smear. Those who performed Pap smear, 32.4% of patients were reminded by their health professionals and 23.3% of staff understood the importance of Pap smear. The common barrier that prevents the uptake of Pap smear among the three groups was their belief that they have a healthy lifestyle. All the groups (70 – 96%) believed that Pap smear can lead to more successful prevention and treatment for cervical cancer. Conclusions: The findings of this study show poor knowledge and performance of Pap smear and good attitude towards Pap smear. More public health education is required to inform the community about the importance of Pap smear as well as to strengthen the curriculum taught in undergraduate university.
Women’s empowerment and its effect on community development in Oman: predictive model and indicators for best practices.
Community, Work and Family. 2017; 1-19.This study investigates the level of women’s empowerment in Omani society from the point of view of female university students from three public universities with respect to educational opportunity, equality in employment and their social status in the community. The study proposes a model for how to empower women based on the perceptions of university females and the factors that must be considered for improving the status of women in Oman. The model also provides indicators for social and community practices using confirmatory factor analysis and Path Analysis to determine pertinent factors and their effects on women’s development. The results showed a strong direct effect of women’s empowerment in Oman on community development. Despite the latest developments in Oman, as long as cultural rigidity remains, tradition upholds a conservative viewpoint of women, and families adhere to their uncompromised principles, women will remain subordinated by these factors according to the viewpoint of participants. This study concludes with recommendations for further research, including enrolment of females in all areas of specialisation creating more job opportunities for women, encouraging women’s leadership, and additional education of women’s rights and needs. © 2017 Informa UK Limited, trading as Taylor & Francis Group
Health Care For Women International. 2015; 36(10):1081-103.To test the hypothesis that advanced maternal age (AMA) of 35 years and above is associated with increased risk of adverse pregnancy outcomes, we performed a population-based retrospective study using data from the 2000 National Health Survey in Oman. The last pregnancy outcomes of mothers aged >/=35 years were compared with adult mothers aged 20-34 years using bivariate and multivariate statistical techniques. Significantly increased risks of spontaneous abortion, gestational diabetes, preeclampsia, prolonged labor, and cesarean section delivery have been observed for advanced maternal age. Our findings may contribute to cross-cultural understanding of the risks associated with AMA and will facilitate evidence-based counseling of older expectant mothers.
Overall adequacy of antenatal care in Oman: secondary analysis of national reproductive health survey data, 2008.
Eastern Mediterranean Health Journal. 2014 Dec; 20(12):781-8.Despite the good health status of women and children in Oman, there are still some gaps to be filled. This study explored the adequacy of antenatal care (ANC) utilization of Omani ever-married women and the sociodemographic and health service determinants of adequate and sufficient ANC. In a secondary analysis of a national dataset (N = 1852 women), the percentages of women who had 4+ ANC visits, attended ANC in the 1st trimester and received care by trained personnel were 96.8%, 74.9% and 99.1% respectively. Overall adequacy of ANC (use and sufficiency of recommended basic services) for the surveyed women was 53.8%. After adjustment of other covariates, being pregnant with the 1st baby was the only significant predictor of overall adequacy of ANC (OR 2.2; 95% CI: 1.6-3.2). Greater awareness of the need for adequate ANC is required for mothers with more than one baby.
Knowledge, attitudes and intended behaviours towards HIV testing and self-protection: a survey of Omani pregnant women Connaissances, attitudes et comportements souhaités concernant le dépistage du VIH et l'autoprotection : Une enquête auprès de femmes enceintes omanaises.
Eastern Mediterranean Health Journal. 2014 Oct; 20(10):614-622.Routine HIV testing of all pregnant women in Oman has been introduced without prior knowledge of women’s attitudes towards testing or their behaviour in the event of a positive test. This study recruited 1000 Omani pregnant women from antenatal clinics to explore their knowledge of HIV/AIDS, attitudes towards HIV testing and intended behaviours in the event of a positive test. Mother-to-child transmission was recognized by 86.6% of the women but only 21.0% knew that it was preventable and a few acknowledged the important role of antiviral drugs. Half of the women (51.9%) reported having been tested for HIV and 75.8% agreed about routine HIV testing for all pregnant women. A higher level of knowledge was significantly associated with a favourable intended behaviour related to voluntary testing, disclosure and seeking professional assistance in the event of a positive HIV test. The results are discussed in relation to opt-in and opt-out approaches to voluntary testing during pregnancy.
Can maternal recalled birth size be used as a proxy measure of birth weight? An evaluation based on a population health survey in Oman.
Maternal and Child Health Journal. 2014 Aug; 18(6):1462-1470.To evaluate the utility of maternal recalled birth size (BS) as a proxy measure for actual birth weight (BW) when BW data are missing. Data for the study come from the 2000 National Health Survey of Oman. Frequency distribution, sensitivity and specificity analysis, bivariate, and multivariate statistical techniques were used for data analysis. The BW data exhibited a moderate level of heaping on measurements ending in 0 or 5, suggesting that health personnel often round when recording. About 31 % of actual BW data were missing due to non-availability of health cards. Maternal assessment of BS was found to be closely linked to BW on an aggregate level. However, on an individual level, there was misclassification of birth weights across all categories of BS. The overall agreement between recalled BS and recorded BW was moderate ( = 0.44). Infants with missing BW records were more likely to be low birth weight (LBW). Maternal recalled BS appeared to be a poor proxy for BW. Estimates of LBW based on maternal assessments of BS as small should be considered as an underestimate of its actual prevalence. As infants with missing BW data have different characteristics from those with recorded BW, estimates of LBW depending solely on available BW records will produce a biased prevalence. Health personnel should record actual BW without rounding. They should inform mothers of the birth weight and advise them to retain health cards for future reference.
Parental height and child growth from birth to 2 years in the WHO Multicentre Growth Reference Study.
Maternal and Child Nutrition. 2013; 9 Suppl 2:58-68.Linear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites.Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models.This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother’s and father’s heights) to the children’s predicted adult height. Mid-parental height consistently accounted for greater proportions of observed variability in attained child length than did either paternal or maternal height alone. The proportion of variability explained by mid-parental height ranged from 11% in Ghana to 21% in India. The average proportion of between-child variability accounted for by midparental height was 16% and the analogous within-child estimate was 6%. In the Norwegian and US samples, no significant differences were observed between mid-parental and children’s predicted adult heights. For the other sites, predicted adult heights exceeded mid-parental heights by 6.2-7.8 cm. To the extent that adult height is predicted by height at age 2 years, these results support the expectation that significant community-wide advances in stature are attainable within one generation when care and nutrition approximate international recommendations, notwithstanding adverse conditions likely experienced by the previous generation.
Sultan Qaboos University Medical Journal. 2013 Nov 8; 13(4):477-485.Contact investigation and management form the key for tuberculosis (TB) control in countries with a low tuberculosis incidence. Oman, with a low TB incidence, has implemented contact investigation and management as one important strategy to control TB. However there is a lack of clear guidelines for the investigation and treatment of contacts, especially with regard to children who are contacts of TB cases. The failure to manage children in contact with infectious TB cases indicates a missed opportunity to prevent TB disease in a population which is prone to progress rapidly to severe and complicated illness. This article attempts to provide a concise and practical approach for managing infants and children who are in contact with TB patients. Essential steps in a variety of possible scenarios are briefly discussed.
BJOG. 2013 Sep; 120 Suppl 2:111-6, v.The Middle Eastern site in the INTERGROWTH-21(st) Project was Muscat, the capital city of Oman, with approximately 10,500 births per year. The sample for the Newborn Cross-Sectional Study (NCSS) was drawn from two hospitals covering 96% of the region's births. The Fetal Growth Longitudinal Study (FGLS) sample was recruited from four primary health facilities serving Khoula Hospital, using the eligibility criteria in the INTERGROWTH-21(st) protocol. Special activities to encourage participation in this population included local advocacy campaigns to encourage early antenatal booking and ultrasound dating in the population. The major challenges at the site were the recruitment of sufficient numbers of women at an early gestational age, and the timely measurement of all newborns within 12 hours of birth. Many individuals and institutions collaborated effectively over a period of several years on these studies, which required careful planning and close monitoring for their successful implementation. (c) 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology (c) 2013 RCOG.
Journal of Biosocial Science. 2012 Sep; 44(5):571-94.The practice of consanguineous marriage has been the culturally preferred form of marriage in most Arab and the Middle Eastern countries, including Oman, but due to a paucity of population-based data in the past there is a dearth of information about its form and dynamics in Oman. Recent national-level surveys allow this gap to be filled. This paper examines the prevalence, trends and determinants of consanguineous marriages in Oman using data from the 2000 Oman National Health Survey. The results indicate a very high prevalence of consanguineous marriage in Oman, as more than half (52%) of marriages are consanguineous. First cousin unions are the most common type of consanguineous unions, constituting 39% of all marriages and 75% of all consanguineous marriages. The study observed various patterns of consanguinity, some of them common with other Arab nations, and some unique in nature. Women's age at marriage, employment, place of childhood residence and geographical region appear to be significant determinants of consanguineous marriages. Consanguineous marriage shows a strong association with marital stability, early age at marriage and early-age childbearing. There has been no appreciable change in the prevalence of consanguineous unions in Oman over the last four decades despite massive socioeconomic development and modernization. However, recent marriage cohorts show slight declining trends. The results suggest that consanguinity is likely to remain stable in the future or decline at a slow rate. Specific health education and genetic counselling should be followed in line with WHO recommendations to minimize the negative health consequences of consanguinity for child health.
Accounting the unaccounted: A case of women's participation in shellfish harvesting in the Sultanate of Oman.
Gender, Technology and Development. 2013 Mar; 17(1):31-53.This exploratory study is aimed at documenting some basic socioeconomic attributes of fisherwomen engaged in shellfish gathering in the southern part of the Sultanate of Oman. The primary data were collected through face-to-face interviews with participants. The survey results were evaluated from a gender and development perspective, and plausible policy measures are advocated. It is hoped that the findings of this exploratory research will generate new insights into the design of testable hypothesis for future research, with a well-defined focus on the enhancement of the well-being and livelihoods of Omani fisherwomen.
The National Committee for Vaccines Regulation and Surveillance of Vaccine-Preventable Diseases in the Sultanate of Oman: evidence-based approach and consensus decision-making.
Vaccine. 2010 Apr 19; 28 Suppl 1:A39-A41.The National Committee for Vaccines Regulation and Surveillance of Vaccine-Preventable Diseases serves as the National Immunization Technical Advisory Group (NITAG) in the Sultanate of Oman. It is the only advisory body to assist the Government in establishing policies and strategies and in evaluating new vaccines with respect to technology, quality and safety. It has six to eight core members as well ex officio members. Committee members are appointed for a period of 3 years by the Minister of Health and committee members declare their potential conflicts of interests and sign a confidentiality agreement. The cost of vaccines and the overall immunization program are considered when the committee makes its recommendations. Evidence-based decision-making could be facilitated by introducing more economic expertise to the committee.
International Journal of Middle East Studies. 2010 Jan 14; 42(1):123-144.Rapid population growth constitutes one of the most critical problems confronting many Middle Eastern and North African countries, placing incremental pressure on their finite water and other natural resources and challenging their abilities to grow sufficient food, accommodate school and university graduates with jobs, build adequate urban and rural infrastructures, contain rapid urbanization, and alleviate poverty, illiteracy, malnutrition, and disease. More than one-third of the population is under the age of fifteen in a majority of countries and, thus, has yet to marry and reach reproductive age. As a result, in most places the number of women of childbearing age (fifteen to forty-nine) will more than double in the next thirty years. Because there are so many young people, by one estimate the region's economies would have to generate half as many additional jobs by 2010 as existed in 1996 to avoid an increase in already high unemployment rates, particularly among young adults. The growing bulge of unemployed young people has serious political ramifications for many Middle Eastern regimes, from Algeria to Saudi Arabia. These problems will likely get worse in the short term because of demographic momentumthe parents of the future have already been born.
Saudi Medical Journal. 2010 Jan; 31(1):64-8.OBJECTIVE: To investigate retrospectively the prevalence of human immunodeficiency virus (HIV)-1 and 2 among pregnant women during a 10-year period. METHODS: The total number of pregnant women attending the Sultan Qaboos University Hospital (SQUH), Muscat, Oman between January 1995 and December 2005 was 11553 women. Their age range was 16-45 years (average of 28.67.6 years). The women were tested for HIV-1 and 2 using the standard enzyme-linked immunosorbent assay (ELISA). Positive samples were further tested by Western Blot. The data were statistically analyzed using the Statistical Package for Social Sciences Version 10.0. RESULTS: By ELISA testing, 21 women were positive for HIV-1 (prevalence rate: 0.2%) and 3 women were weakly positive for HIV-1 (24 women; 0.2% prevalence rate). However, 15 women were confirmed HIV-1 positive using the Western Blot method (prevalence rate: 0.13%) with an average of 1.5 positive women per year. None of the women were found positive for HIV-2. CONCLUSION: This relatively high prevalence of HIV-1 among pregnant women attending SQUH, highlights the need for screening all pregnant women attending different hospitals and antenatal clinics in Oman. This is essential for preventing the transmission of HIV-1 and 2 to the infants and to the community, and for the appropriate medical treatment and counseling of affected women.
Eastern Mediterranean Health Journal. 2008 May-Jun; 14(3):579-89.To describe the epidemiology of measles in Oman and the implications for a vaccination programme, we conducted a retrospective record-based study from 1 January 2000 to 31 December 2003 using data from the national epidemiological surveillance system. All cases notified as suspected measles during the study period were included. Of the 185 notified cases, 19.4% were confirmed measles positive. Blood samples for measles IgM were collected in 97.3% of cases. The mean age of measles cases was 8.0 (SD 10.7) years. The estimated overall incidence rate of measles for the study period was 0.53 per 100,000 person-years. Regression analysis indicated measles was significantly commoner among non-Omanis and children who had not been vaccinated.
Eastern Mediterranean Health Journal. 2008 May-Jun; 14(3):571-578.To elucidate the bacterial etiology of childhood diarrhoea in Dhahira, 856 children less than 12 years admitted for diarrhoea to Ibri Regional Referral Hospital from 2000 to 2002 were studied. The mean age was 2.4 (SD 2.3) years; the majority (92.9%) were less than 5 years. Bacterial etiology was found in 15.2% of cases; 10.6% due to Shigella and 2.1% to Salmonella. Sh. sonnei was the commonest Shigella serogroup isolated. Salmonella infection was significantly associated with cramps, while Shigella infection was associated with fever, bloody stools and cramps. Antibiotics were prescribed in 36.2% of cases and the resistance to the common antibiotics tested was low. (author's)
Tuberculosis suspicion and knowledge among private and public general practitioners: Questionnaire Based Study in Oman.
BMC Public Health. 2008; 8:177.Early detection of smear positive TB cases by smear microscopy requires high level of suspicion of TB among primary care physicians. The objective of this study is to measure TB suspicion and knowledge among private and public sector general practitioners using clinical vignette-based survey and structured questionnaire. Two questionnaires were distributed to both private and public GPs in Muscat Governorate. One questionnaire assessed demographic information of the respondent and had 10 short clinical vignettes of TB and non-TB cases. The second questionnaire had questions on knowledge of TB, its diagnosis, treatment, follow up and contact screening based on Ministry of Health policy. TB suspicion score and TB Knowledge score were computed and analyzed. A total of 257 GPs participated in the study of which 154 were private GPs. There was a significant difference between private and public GPs in terms of age, sex, duration of practice and nationality. Among all GPs, 37.7% considered TB as one of the three most likely diagnoses in all 5 TB clinical vignettes. Private GPs had statistically significantly lower TB suspicion and TB knowledge scores than public GPs. In Oman, GPs appear to have low suspicion and poor knowledge of TB, particularly private GPs. To strengthen TB control program, there is a need to train GPs on TB identification and adopt a Private Public Mix (PPM) strategy for TB control. (author's)
Determinants of persistent underweight among children, aged 6 -- 35 months, after huge economic development and improvements in health services in Oman.
Journal of Health, Population and Nutrition. 2007 Sep; 25(3):359-369.Over the last decades, health indicators have witnessed major improvements in the Sultanate of Oman. This study was aimed at factors associated with underweight among children in four regions of Oman, as, in 1998, underweight was prevalent among 17.9% of children aged less than five years. A case-control study was conducted in 2002: 190 cases were 6-35-month old children with weight-for-age less than -2 z-scores. Controls were individually matched by village of residence, sex, and age. The questionnaire included anthropometry of children, child-feeding practices, morbidity, anthropometry of mothers, parity, birth-spacing, and socioeconomic characteristics. Conditional logistic regression was used for analyses. Birth-weight of less than 2,500 g was strongly associated with underweight and also were height of mother, low level of education of mother, bad quality of water in households, diarrhoea of children in the last two weeks, and regular use of infant formula. Factors, such as birth-weight, height of mother, supply of safe water in household, and care for mothers and children were the determinants of persistent underweight after huge economic development and improvements in health services. Further research is also needed to investigate further specific determinants of low birth-weight in the Omani context and try to disentangle emaciation and determinants of linear growth retardation. (author's)
Gastric and cutaneous dissemination of visceral leishmaniasis in a patient with advanced HIV [letter]
International Journal of Infectious Diseases. 2008 Jan; 12(1):111-113.Visceral leishmaniasis (VL) is a well-recognized opportunistic infection in patients with HIV-1 infection. Several reports indicate a rising trend in VL/HIV co-infection. The majority of HIV/Leishmania co-infected cases show classic features of VL. Atypical features such as dissemination to the gastrointestinal tract and to the skin may also occur. We describe herein a patient with advanced HIV-1 infection residing in a non-endemic area for leishmaniasis. The diagnosis of HIV had been made 4 years prior to this admission. Unfortunately, the Centers for Disease Control and Prevention (CDC) stage at the time of diagnosis was not known. He presented with atypical features of visceral leishmaniasis. In particular, the patient had dissemination to the esophagus, the stomach, and to the skin. (excerpt)
Towards the elimination of tuberculosis in a developing country: 25 years of tuberculosis control in Oman.
International Journal of Tuberculosis and Lung Disease. 2007 Feb; 11(2):175-180.The objective was to analyse trends of tuberculosis (TB) in Oman (1981-2005) in relation to the socio-economic development of the country. Data were used from the National Tuberculosis Control Programme (NTP). Information on TB cases' age, sex and type were obtained from the national book (1981-1991) and the computer database (1992-2005). TB notification rates among Omani nationals declined by more than 85% from 1981 to 1995. During the period 1981-1993, the TB notification rate declined by around 15% per year, compared to only 3.6% per year in subsequent years. Males and the age group >/= 50 years have higher rates than females and younger age groups, respectively. Non-nationals contributed 21% of all TB cases notified and 40% of all smear-positive cases. Of cases among nationals notified between 2004 and 2005, 95% had a family income lower than the national average. Although TB notification in Oman has declined by more than 85% over the last 25 years, the decline has slowed down over the last 10years, requiring a detailed analysis of existing TB control measures and implementation of additional measures for TB elimination. (author's)
Studies in Family Planning. 2007 Jun; 38(2):121-128.Drawing from a sample of 1,365 ever-married nonpregnant women in Oman who underwent a gynecological examination and laboratory tests as part of the 2000 National Health Survey, this study examines the prevalence of and risk factors associated with reproductive morbidities among women in Oman. Of the respondents, 4 percent had a sexually transmitted infection (STI), 25 percent had a reproductive tract infection (RTI), 10 percent suffered from genital prolapse, and 11 percent had a urinary tract infection (UTI). Younger women were two times more likely than older women to have an STI. More empowered women were more likely to have any RTI. Women with six or more children were more than three times more likely to have experienced genital prolapse, compared with those who had fewer children. UTIs were significantly associated with urban residence, being empowered, and having six or more children. A comparative analysis with other countries in the Arab world showed some variations in prevalence and riskfactors. In light of the wide prevalence of reproductive morbidities, reproductive health services in Oman should be strengthened. (author's)
Pediatrics International. 2007 Jun; 49(3):400-402.Neonatal esophageal perforation is a rare condition. Incidence of such an occurrence spontaneously is only 4%. The majority are iatrogenic and the incidence is approximately 63%. Commonest among iatrogenic causes of esophageal perforation are balloon dilatation of the strictures secondary to repair of the esophageal atresia and intubation and instrumentation during aggressive resuscitative measures, practised in modern day intensive care units on premature and low-birthweight babies. Non-iatrogenic inflicted injury to the esophagus such as in child abuse is very rare. Such cases are commonly due to foreign body insertion. Perforations usually occur in the cervical esophagus near the cricopharyngeus, where it is the narrowest. Injury leads to occlusion at this point by spasm or reflex constriction. Any device, object or instrument thrust into the hypopharynx can cause perforation. Mechanisms of injury among such inflicted injuries apart from forcible insertion of any object such as a bottle or a pacifier include pressure over the chest during suffocation; direct blows and caustic ingestion. (excerpt)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S78-S83.The World Health Organization (WHO) Multicentre Growth Study (MGRS) Middle East site was Muscat, Oman. A survey in Muscat found that children in households with monthly incomes of at least 800 Omani Rials and at least four years of maternal education experienced unconstrained growth. The longitudinal study sample was recruited from two hospitals that account for over 90% of the city's births; the cross-sectional sample was drawn from the national Child Health Register. Residents of all districts in Muscat within the catchment area of the two hospitals were included except Quriyat, a remote district of the governorate. Among the particular challenges of the site were relatively high refusal rates, difficulty in securing adherence to the protocol's feeding recommendations, locating children selected for the cross-sectional component of the study, and securing the cooperation of the children's fathers. These and other challenges were overcome through specific team building and public relations activities that permitted the successful implementation of the MGRS protocol. (author's)
African Journal of Reproductive Health. 2004; 8(3):188-197.To assess the prevalence and correlates of gynecologic and related morbidity in Omani women, a nationally representative sample of Omani women selected by a multi-stage, stratified probability sampling procedure was selected (total = 364). Questionnaire interview, physical and gynecological examination, and laboratory investigations were used to elicit information. The prevalence of lower reproductive tract infections was 22.4%, upper reproductive tract infections 2.7%, and cervical dysplasia was very rare. Genital prolapse was present in lo%, 11 % had a urinary infection, 27% were anaemic, 23% were hypertensive, and 54% were either overweight or obese. The predictors of common morbidities were assessed using regression analysis according to a prespecified conceptual model. (author's)
Annals of Saudi Medicine. 2001; 21(3-4):170-173.Following an intensive public health eradication program, the focus of schistosomiasis mansoni at Salalah in Southern Oman (the only focus of schistosomiasis in Oman), appeared to have been eradicated in 1994. Since the vector snails for Schistosoma mansoni (and also for S. haematobium) were widely endemic in freshwater springs at Salalah, and reintroduction of infection (or introduction in the case of S. haematobium) was possible, we undertook a prospective study in 1995 for schistosomiasis in patients at the Sultan Qaboos University Hospital (SQUH), and to obtain evidence of visits by these patients to Salalah. From May 1995 to May 2000, Omani and expatriate patients presenting at SQUH were evaluated for possible schistosomiasis (residence in an endemic region, suggestive clinical features) by a search for ova in stool, urine, or in tissue biopsies, or when ova were absent, by serodiagnosis. A retrospective survey of schistosomiasis patients diagnosed in SQUH from 1990 to April 1995 was also performed. Ministry of Health (MOH) data on reports of schistosomiasis (a notifiable disease) in Oman from 1991 to 2000, were obtained. Thirty patients with schistosomiasis were identified, 10 retrospectively and 20 in the prospective study. Patients were aged 9 to 60 years, and 25 of them (10 Omanis, 14 Egyptians, 1 Sudanese) contracted the infection in Africa, while 5 Omanis became infected in Salalah (3 in 1999). Twelve patients had schistosomiasis mansoni, 6 had schistosomiasis haematobia, and in the rest, infection by both parasites was confirmed or possible. The most common presentation (23%) was hepatosplenic schistosomiasis with portal hypertension. No patient admitted to contaminating freshwater with excreta in Salalah. MOH data revealed 3 to 14 cases of schistosomiasis were reported annually between 1991 and 2000, and that all schistosomiasis cases reported from 1994 to 1998 originated from Africa. Schistosomiasis remains an important health problem in Oman. Many doctors are unfamiliar with the clinical features and methods of diagnosis, thereby frequently causing delays in diagnosis. Because vector snails are endemic in Salalah, schistosomiasis patients must be detected and treated early. At infested freshwater sites at Salalah, mollusciciding should continue indefinitely, and notices should warn visitors not to contaminate the spring water. (author's)