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Dhabya Abdulaziz AlSada1*, Eman Merza AlSalman2, Fatima Hasan AlNooh2, Mooza Khalid AlThawadi1, Nawal abbas Habib3
Background: Primary healthcare centers (PHCs) in Bahrain are the first point of contact for patients with urgent and non-urgent concerns. Effective triage ensures timely prioritization, safe patient flow, and optimal use of resources in high-volume primary care settings. Evidence on triage preparedness among PHC nurses remains limited.
Objectives: To assess triage-related knowledge, attitudes, and practices among nurses in PHCs in Bahrain and identify factors associated with triage competence.
Methods: A cross-sectional study was conducted from July 1 to July 31, 2021, across 27 government PHCs in Bahrain. An online self-administered questionnaire targeting nurses in treatment rooms, including diabetic nurses, mother and child health nurses, and nursing supervisors. Nurses from private facilities, COVID-19 pool, mobile units, and temporary hospital placements were excluded. Data were analyzed using SPSS, and associations between triage competence and demographic and professional characteristics were examined.
Results: Among 555 nurses, most were aware of a triage protocol (96.9%) and knew how to access its manual (88.3%). Only 5.2% attended formal triage training, while 1.4% held related certifications. Although 74.2% found the manual easy to use, only 25.8% were very confident in their ability to apply it. Triage was mainly performed for urgent complaints (91%) and for no-appointment cases (90.6%). Professional titles, years of experience, and triage training were significantly associated with higher knowledge and confidence.
Conclusion: Despite high awareness of triage protocols, gaps in formal training and confidence persist among PHC nurses in Bahrain. Structured triage education and standardized implementation are recommended to enhance triage safety and quality.
Dana Arekat1*, Reem AlSherooqi1, Suha Hejres2, Rehab Helmey2, Nitya Kumar3, Denis Quill4, John
G Flood1
Background: Primary hyperaldosteronism is a significant but often overlooked cause of secondary hypertension. It is characterized by excessive aldosterone production by the adrenal glands. A considerable gap exists in the prevalence of primary hyperaldosteronism, its diagnosis, and management, particularly in regions like the Middle East.
Methods: A Retrospective observational study of 158 patients who were screened for primary hyperaldosteronism between 2022 and 2023 was conducted. Access to their E-Files was granted by King Hamad University Hospital.
Results: All the patients underwent laboratory & clinical investigations to rule out secondary causes of hypertension. Elevated renin: aldosterone ratio was observed in 41 (26.8%), with 17 (11%) confirmed cases of primary hyperaldosteronism. Nine were males, eight were females, and all were Bahraini except one. Imaging showed hyperplasia in five cases, eight adenomas, and two patients did not have documented imaging done. Two of the patients had morphologically normal adrenals on imaging. Out of the eight cases with adenoma, six had bilateral disease, and two had unilateral. Of the seventeen patients, fourteen were treated with mineralocorticoid receptor antagonists, resulting in an increase in potassium levels (from 1.7-3.9 to 3.1-5.4 mmol/L) and a decrease in blood pressure (128/78-180/100 to 116/79-50/78 mmHg) post-treatment.
Conclusion: The incidence and prevalence of primary hyperaldosteronism in the Kingdom of Bahrain remain an area of active research. The available data highlights the potential underdiagnosis of primary hyperaldosteronism in this region, necessitating further comprehensive studies.
Keywords: Primary hyperaldosteronism, Renin, Aldosterone, Hypertension, Potassium