Hepatitis B and C in the Syrian Arab Republic: a review

This paper reviews the epidemiology and determinants of hepatitis B and C in the Syrian Arab Republic as well as their treatment and prevention. A systematic search of Medline, PubMed and Index Medicus for the Eastern Mediterranean Region was carried out in addition to a review of grey literature and relevant datasets in the Syrian Arab Republic. Low to low-intermediate levels of endemicity of both infections were noted at the national level. However, striking geographic differences and high prevalence among high-risk groups were noticeable. As a result of data limitations, further research is needed, and a national control strategy to combat hepatitis B and C in the Syrian Arab Republic should be developed, especially during the current conflict

Results of the feasibility test of the Practical Approach to Lung Health in the Syrian Arab Republic

We assessed implementation of the Practical Approach to Lung Health [PAL] in primary care facilities in the Syrian Arab Republic and its short-term impact on respiratory care in patients aged 5+ years. After training on PAL for 76 general practitioners in 75 health centers, referrals and sputum smear examinations for patients increased. The mean number of drugs prescribed per patient decreased by 14.8% and that of antibiotics by 33.3%, while prescriptions for inhaled medications increased. The mean cost of drug prescriptions fell by 26.2%

Community-based study of unintentional injuries among preschool children in Damascus

To assess injuries among 1125 preschool children in Damascus, and to investigate the risk factors, a retrospective home survey of childhood injuries for a period of 12 months was carried out in 4 areas of residence: agricultural rural, non-agricultural rural, periurban and urban. More than 75% of mothers believed that injuries were preventable. During the year preceding the study, 261 injuries were reported, an incidence of 23%. The most frequent injuries were from falls, 52.0%, and most injuries [73.9%] occurred inside the home. Area of residence was the only independent predictor for the occurrence of childhood injuries

Patterns and determinants of maternity care in Damascus

This descriptive study was designed to describe the patterns and determinants of maternity care among Syrian women living in Damascus. All 39 birth registers in 2 large provinces were used to recruit 500 mothers of healthy newborns. Mothers were interviewed in their homes using a semistructured questionnaire. Multivariate analysis of the determinants of the frequency of use of antenatal care showed the following variables were significant: urban residence and visit to antenatal care in the 1[st] trimester. The significant variables for an early visit to antenatal care were the woman's level of education; being pregnant with the 1st baby; and number of visits to antenatal care. Being young [age < 20 years] also correlated with early timing of the 1st antenatal visit

Routine care of normal deliveries as applied in Syrian maternity wards

routine practices during normal childbirth have not been studied in Syria. Our study was designed to describe the routines of normal childbirth as practiced in maternity wards in Syrian hospitals and to assess whether these routines are in accordance with the best evidence-based practices. a nationally representative sample of 57 hospitals was visited: 33 were government hospitals and 24 were private hospitals. The personnel in charge were interviewed using a specially designed questionnaire that covered both management and technical points. only 2 of the 57 hospitals had a written policy concerning childbirth, although 29 had a written breast-feeding policy. All except two hospitals reported the capability of doing a cesarean section at any time. Results on hospital routines are presented in the light of the available best-evidence guidelines. the study highlights the urgent necessity to formulate a national policy for care in normal birth. This policy needs to be designed bearing in mind the best evidence available and the nature of the national setting

Gender differences and tuberculosis in the Syrian Arab Republic: patients' attitudes, compliance and outcomes

In a prospective study of gender and TB outcomes, 552 newly diagnosed smear-positive patients throughout the Syrian Arab Republic were interviewed at recruitment [from January 2002 to July 2002] and followed until the end of treatment. Delay in diagnosis was significantly longer among males. Significant differences between males and females were noted in relation to the place they usually use to seek care. Gender did not seem to affect knowledge and attitudes of TB patients. Although the women reported more barriers to seeking care, compliance with treatment tended to be higher and the treatment success rate was significantly higher among females than males. Multivariate analysis showed that male sex was a significant predictor of a negative treatment outcome, after controlling for other significant sociodemographic and health care related variables

Reasons for underreporting of notifiable diseases by Syrian paediatricians

We investigated reasons for underreporting of notifiable diseases among Syrian paediatricians. Self-administered questionnaires and self-addressed envelopes were sent to all paediatricians listed in the recent records of the Syrian Medical Association. Of 723 questionnaires, 55 were returned by the post office due to an incorrect address. Only 160 questionnaires [23.9%] were answered. Approximately 50% of paediatricians gave two reasons for underreporting: lack of reporting forms and ignorance of reporting telephone numbers. Nearly 70% indicated that the most important improvements would be the availability of easy reporting forms and a condensed and feasible list of notifiable diseases

Causes of death among Syrian children using verbal autopsy

The causes of death in children under five years were studied using a structured verbal autopsy questionnaire. Possible determinants of death were also investigated. About 44% of deaths were among neonates [below 28 days of age]; the major causes of death in neonates were prematurity [33%] and birth-related factors [30%]. In infants [1-11 months of age], the leading cause of death was congenital malformations [24%]. Accidents were responsible for one-third of deaths in children aged 1-4 years. Factors that might have contributed to death were investigated. The public health importance of causes of death was evaluated and its implications were discussed