Eastern Mediterranean Health Journal [EMHJ]: a 20-year overview [1995-2014]

The EMHJ was established in 1995 to provide a peer-reviewed platform for health professionals to share their research with the scientific community. The objective of this review was to examine EMR public health research trends, as reflected by EMHJ publications in 20 years [1995-2014], through secondary data analysis. Published articles were categorized according to EMR strategic priority areas [93%], i.e. health systems strengthening [25%]; reproductive and child health [22%]; communicable diseases [26%]; noncommunicable diseases [25%]; emergency preparedness [1.5%]. Most papers were original research articles [85 %], published in English [94 %], but just over half [52 %] mentioned obtaining a form of ethical clearance in the text. Six countries had each over 100 papers published during the study period, i.e. Iran, Egypt, Saudi Arabia, Jordan, Iraq, Pakistan. Half EMHJ publications during this period came from 4 countries only [Iran, Egypt, Saudi Arabia, Jordan], which calls for further study to evaluate why other EMR nations are less well represented and how to encourage greater contribution from them over the coming years

Factors associated with public awareness of the crown health program in the Al-Jouf region

A community-based intervention, the Crown Health Project [CHP], was developed by the Ministry of Health. It was implemented on a small-scale in Al-Jouf Region in Northern Kingdom of Saudi Arabia to assess its feasibility and effectiveness so that it can be scaled up. This study primarily aimed at investigating factors associated with the awareness of CHP in order to improve subsequent campaigns for the program in Al-Jouf and other regions. A secondary aim was to assess possible changes of public awareness during intensification of the awareness campaign between October 2011 and May 2012. A pre- and post-questionnaire cross-sectional approach was undertaken, and the intervention was an awareness campaign. Variables collected included demographic characteristics [e.g., age, gender, education, occupation, urban/rural residence] and CHP awareness [its existence, sources of knowledge about CHP, its goals and objectives, its target diseases, location of activities, participation in such activities]. Logistic regression was used to analyze the awareness of the program according to participant characteristics, with a time of the survey as a variable. Awareness of the program was found to be 11 times higher among postsurvey respondents than presurvey respondents. Respondents of the second survey were better at correctly identifying "health education" as the main goal of the CHP [odds ratio [OR], 4.1; 95% confidence interval [CI], 3.1-5.5], "noncommunicable diseases" as the main diseases targeted [OR, 4.8; 95% CI, 3.6-6.4] and "attention to health" as the purpose [OR, 6.0; 95% CI, 4.0-8.9]. The different activities of the CHP were successful in dramatically increasing awareness of the CHP program in Al-Jouf

Towards an electronic national injury surveillance system in Saudi Arabia

Given the need for a uniform, comprehensive, electronic nationwide surveillance system for injuries in Saudi Arabia, a system was designed with the objectives of establishing an epidemiologic profile of injuries in the country; evaluating injury indicators on an ongoing basis; identifying high-risk groups requiring specific interventions; monitoring and evaluating interventions for effectiveness; and producing reports to assist in planning and resource allocation. A special form for this purpose was designed, modified from validated forms used elsewhere for injury surveillance. This initiative of the Ministry of Health is also expected to help validate data collected by other sectors, such as the Ministry of Interior. This paper reviews the milestones of building the system and aims to prompt a debate within the scientific community, especially within the Eastern Mediterranean Region, about the best way to design injury surveillance systems for the Region in order to fine-tune the proposed system before its full-scale implementation

validation study comparing the sensitivity and specificity of the new Dr. KSU H1N1 RT-PCR kit with reAl time RT-PCR for diagnosing influenza A [H1N1]

A new test [Dr. KSU H1N1 RT-PCR kit] was recently developed to provide a less expensive alternative to reAl time reverse transcriptase-polymerase chain reaction [RT-PCR]. We report the findings of a validation study designed to assess the diagnostic accuracy, including sensitivity and specificity, of the new kit, as compared to reAl time RT-PCR. Cross-sectional validation study conducted from 18-22 November 2009 at a primary care clinic for H1N1 at a tertiary care teaching hospital in Riyadh. Nasopharyngeal swab samples and data on socio-demographic characteristics and symptoms were collected from 186 patients. Swab samples were sent to the laboratory for testing with both reAl time RT-PCR and the new Dr. KSU H1N1 RT-PCR kit. We measured the sensitivity and specificity of the new test across the entire sample size and investigated how these values were affected by patient socio-demographic characteristics and symptoms. The outcomes of the two tests were highly correlated [kappa=0.85; P<.0001]. The sensitivity and specificity of the new test were 99.11% and 83.78%, respectively. The sensitivity of the new test was affected only minimally [96%-100%] by patient characteristics and number of symptoms. On the other hand, the specificity of the new test varied depending on how soon patients were tested after onset of symptoms [100% specificity when swabs were taken on the first day of the symptoms, decreasing to 75% when swabs were taken on or after the third day]. The specificity of the new test also increased with increasing body temperature. The new test seems to provide a cost-effective alternative to reAl time RT-PCR for diagnosing H1N1 influenza. However, further testing may be needed to verify the efficacy of the test in different settings and communities

Smoking among Saudi university students: consumption patterns and risk factors

Tobacco use is increasing among young people, especially in Gulf nations such as Saudi Arabia. The objectives of this study were to estimate the prevalence and behavioural patterns of tobacco use among undergraduate students at King Saud University, Riyadh, Saudi Arabia during the academic year 2008/09 and investigate factors that influenced their tobacco use. A cross-sectional study was done of a representative sample [n = 6793] of the undergraduate student population using a modified version of the global youth tobacco survey questionnaire. The prevalence of smoking was 14.5% among students, 22.2% and 2.2% among fathers and mothers and 43.1% and 14.8% for male and female siblings; 15.0% reported all or most of theirfriends smoked. The most important independent predictors of smoking were: friends' smoking [some: OR - 6.7 and all: OR - 54.9], sister's smoking [OR - 2.2], mother's smoking [OR = 2.1], single status [OR -1.7] and age [OR -1.18]

Characteristics and risk factors of tobacco consumption among University of Sharjah students, 2005

This study aimed to estimate the prevalence, patterns and risk factors of tobacco consumption among a stratified random sample of students at University of Sharjah, United Arab Emirates [UAE], during 2005. The overall reported smoking prevalence among 1057 sampled students was 15.1%; cigarette smokers were 9.4% and waterpipe smokers 5.6%. While women comprised only 8.9% of cigarette smokers, they were 26.2% of waterpipe smokers. Multiple linear regression analysis showed that the most important predictors for smoking among the students were: male sex, having a smoking friend, having a smoking family member [father/mother/both], non-UAE nationality and older age. There is a need to intensify efforts to prevent young people from starting smoking and to help young smokers to stop

Helminthic infections associated with the use of raw wastewater for agricultural purposes in Beni Mellal, Morocco

We aimed to determine the possible risks associated with raw wastewater use for agricultural purposes, particularly the transmission of helminthic infections among children. In a randomly-selected sample of 1343 children, 740 of them were from five regions using raw wastewater for agriculture, while 603 were from four control regions that do not use such water. The prevalence of helminthic infection was found to be significantly higher among children in regions using wastewater, compared to control regions. Behavioural characteristics and public water supply were found to be associated with higher infection rates. Adequate treatment of wastewater as well as public health education are highly recommended

Epidemiological aspects and cost of managing hypertension in Saudi Arabian primary health care centres

The main epidemiological features and the direct cost of management of hypertension for a sample of registered patients in primary health care centres in Al-Khobar, Saudi Arabia were examined. Epidemiological features were gathered through patient interviews and from medical records, while direct cost of management was obtained using a standard formula. Consultation accounted for the highest direct cost of disease management [67%]; investigations and drugs were responsible for 16% and 17%, respectively. Number of visits, frequency of follow-up and use of additional drugs were significantly associated with higher total direct cost and higher cost of consultation. Medical education for physicians regarding cost containment and the complete documentation of medical treatment is advised

Self medication practices and the forces which shape it

Little consideration has been given to self-care/self-medication, a basic level of health care. This study focuses on self-medication, its practices, forces which shape it and defines areas in which future research could be directed. Sixty nine studies from different countries have been reviewed and carefully analyzed. They are chiefly concerned with descriptive information, offering little exploration of the successful use of self-medication, its common ailments, sources of information and regulations. Nevertheless, they do provide an information base on the extent and practices of self-medication in different communities and cultures. The study indicated that self-medication is a very popular practice all over the world. A striking feature is the uniformity of the types of ailments in self-medication, but the rationale in its practice differs. Developed countries generally adopt a more appropriate approach, supported by adequate drug provisions control and consumer's information. In developing countries, inappropriate drug use appears to be the rule rather than exception. In these countries pharmaceuticals are widely available through formal and informal outlets, and large numbers of people usually have little access to drug information. In conclusion, there is shortage of both quantitative and qualitative assessments of self-medication. The study findings help define areas in which future research could be directed

Compliance with antituberculosis drugs among tuberculosis patients in Alexandria, Egypt

Tuberculosis is an important reemerging disease with increasing global morbidity and mortality. Tuberculosis control is hindered by patient noncompliance with treatment regimens. To study compliance to antituberculosis drug regimens, 172 patients diagnosed with tuberculosis during the first three months of 1995 were investigated. The patients were interviewed at their homes during July and August 1995. More than one-third [34.9%] of the patients were not adhering to the antituberculosis drug regimen. Factors increasing drug compliance included: disease symptoms, knowledge about the disease, family history of tuberculosis and hospitalization. More information about the disease and the importance of compliance should be provided to tuberculosis patients at the time of diagnosis and initiation of therapy. Supervision of drug administration by health care personnel is stressed

HIV Seropositivity and KAP towards AIDS among drug addicts in Alexandria

HIV/AIDS has become the leading public health problem worldwide; the EMR is no exception from this pandemic. Intravenous drug abuse is an important route for indigenous transmission of HIV in their region. This work aimed at testing HIV seroprevalence and KAP concerning AIDS among a group of drug addicts admitted for treatment at the Alexandria Psychiatric Hospital. All 100 addicts chosen for the study were interviewed using a specially designed questionnaire, subjected to ELISA testing for HIV as well as urine testing for 5 groups of psychoactive drugs; namely, amphetamine, cannabis, benzodiazepines, opiates and barbiturates. None of the addicts were found seropositive for HIV. The mean age of addicts was 35.75 +/- 11.45 years, half of whom were of primary education or could just read and write. Most addicts acknowledged AIDS causation [86%], its inevitable fatality [80%], absence of a vaccine [84%] and prevention by safe sexual behaviors [92%]. Half of them used two or more drugs [especially opiates] for more than 10 years, through IV route [alone or in combination]. However, most addicts [85%] denied needle sharing and only 29% acknowledged its possible transmission through needle- sharing. Stratifying by route of drug administration, only 22% of IV drug users [IDU] and 37% of non-IV users [NIDU] stated that it could be transmitted through needle sharing. 32% acknowledged extramarital sexual relationships. About 11% of IDU and 8.7% of NIDU suffered from an STD [mainly gonorrhea]. It is recommended that routine HIV testing be performed for all diagnosed drug addicts. Integration of health education concerning HIV/AIDS in rehabilitation programs targeted at this group is needed to further emphasize the additional dangers of drug abuse, through possible HIV infection