Costs associated with tuberculosis diagnosis and treatment in Yemen for patients and public health services

This study determined the costs associated with tuberculosis [TB] diagnosis and treatment for the public health services and patients in Sana'a, Yemen. Data were collected prospectively from 320 pulmonary and extrapulmonary TB patients [160 each] who were followed until completion of treatment. Direct medical and nonmedical costs and indirect costs were calculated. The proportionate cost to the patients for pulmonary TB and extrapulmonary TB was 76.1% and 89.4% respectively of the total for treatment. The mean cost to patients for pulmonary and extrapulmonary TB treatment was US$ 108.4 and US$ 328.0 respectively. The mean cost per patient to the health services for pulmonary and extrapulmonary TB treatment was US$ 34.0 and US$ 38.8 respectively. For pulmonary and extrapulmonary TB, drug treatment represented 59.3% and 77.9% respectively of the total cost to the health services. The greatest proportionate cost to patients for pulmonary TB treatment was time away from work [67.5% of the total cost], and for extrapulmonary TB was laboratory and X-ray costs [55.5%] followed by transportation [28.6%]

Quality of management for acute respiratory tract infections and diarrhoeal diseases in rural Yemen

To evaluate the performance of health workers with respect to diagnosis and treatment of acute respiratory infection [ARI] and acute diarrhoea [AD] in children < 5 years in 11 rural heath facilities in Yemen, we carried out a cross-sectional study on 219 cases of ARI and 93 cases of AD. Mean score for performance was 30.04 [range 21-39]. The quality of care provided was fair in 89.4% and poor in 4.5% of cases. A "well done" performance of 6.3% was achieved by medical doctors but only 3.6% of medical assistants and 25% of medical assistants scored "poor" for performance, but only 2.5% of medical doctors. Health workers who had received training courses in ARI and AD performed slightly better than those who had not

Profile of paediatric emergency cases in Yemen: the need for evidence-based guidelines

This study describes the status and characteristics of children presenting to emergency services in hospitals and health centres in Yemen in order to inform the development of guidelines for paediatric emergency services. Information was collected from 7 hospitals and 2 health centres in 5 governorates about 3454 cases, mostly aged < 2 years old. The majority of paediatric emergency cases were due to respiratory system problems [28.6%] and gastrointestinal problems [25.5%]; 36.4% of children presented with a duration of complaint exceeding 4 days. One-third of cases [33.2%] were treated with 3rd generation cephalosporins alone or in combination with other antibiotics. The mortality rate was 1.9%. The most important causes of death were cardiac and respiratory failure

Malaria signs and infection rate among asymptomatic schoolchildren in Hajr valley, Yemen

This study recorded malaria signs and the rate of parasitaemia among asymptomatic schoolchildren in Hajr valley, Hadhramout governorate, Yemen. Tests were made for malaria parasites and anaemia in 469 randomly selected primary-school children aged 6-11 years, together with clinical examination to determine spleen size, and interviews to study sociodemographic factors. Of the children, 12.8% had positive malaria blood films and 11.3% had spleen enlargement. There were significant associations between malaria infection, anaemia and splenomegaly and fever. Children with malaria parasitaemia were more often absent from school

Rapid assessment of trachoma in 9 governorates and Socotra Island in Yemen

This study described the pattern of trichiasis, active trachoma and trachoma risk factors in 9 governorates of Yemen plus Socotra Island, using a rapid assessment during October and February 2004. A total of 3169 children aged 1- 9 years were examined in a central meeting point or at home. Active trachoma was found in a high percentage of children in Al-Jawf, Mareb and Shabwah governorates and the SAFE strategy [Surgery, Antibiotic treatment, Facial cleanliness, Environmental improvement] should be directed toward these governorates. Trichiasis cases were also found in Hadramout and Taiz, suggesting that eyelid surgery should be provided in these governorates

Profile of breast lesions among women with positive biopsy findings in Yemen

This study described the profile of breast pathology based on records from a reference histopathology laboratory in Yemen of 773 women with positive biopsy or mastectomy findings. Cancers were classified according to the International classification of diseases for oncology. Benign lesions were found in 79.9% of cases. Fibroadenoma was the most prevalent lesion [30.0%] with a mean age at presentation of 22.2 years, followed by fibrocystic disease [27.4%] and breast inflammation [13.1%]. Invasive carcinoma was found in 155 cases [20.1%], at a mean age of 44.7 years

Intestinal parasitosis and nutritional status in schoolchildren of Sahar district, Yemen

The prevalence and intensity of schistosomiasis and soil-transmitted parasites was estimated among third-year schoolchildren of Sahar district, Sa'dah governorate, Yemen, after 4 schistosomiasis control campaigns. Anthropometric measurements were used to assess nutritional status in relation to infection rates. The prevalence of schistosomiasis infection was low at 5.6%: 3.3% for Schistosoma haematobium [geometric mean 0.16 eggs/10 mL urine] and 2.3% for S. mansoni [0.18 eggs/g faeces]. Ascaris lumbricoides was found in 0.4% of the children while other soil-transmitted helminths were not found. Stunting was found in 50.9%, wasting in 4.5% and underweight in 48.7% of the children examined; however, no positive association was found between infection and nutritional status indicators

Malaria and intestinal parasitosis among children presenting to the Paediatric Centre in Sana'a, Yemen

We studied the profile of malaria and intestinal parasitosis among children presenting to the Paediatric Health Centre in Sana'a from January 1998 to December 2000. In stool samples from 9014 children, Ascaris lumbricoides, Entamoeba histolytica, Giardia lamblia and Trichuris tichiura were the most common. Infection with parasites of direct life-cycle were similar in boys and girls. Schistosome infection was significantly higher in boys than girls, but girls were more infected with ascariasis. The only species of malaria parasite found in blood samples from 753 children with suspected malaria was Plasmodium falciparum, with the highest rates in April-June. The majority of positive cases were Yemeni children, but 10.8% were Sudanese or Ethiopian

Prevalence of rubella antibodies among schoolgirls in Sana'a, Republic of Yemen

To determine the prevalence of rubella antibodies and age of exposure to rubella among Yemeni schoolgirls, we studied the sera samples of 323 female students [age range 11-21 years; mean age 16.26 +/- 1.89 years] drawn from three schools in Sana'a. All samples were screened for rubella IgG antibodies using enzyme linked immunosorbent assay and, if negative, for IgM in order to exclude the possibility of recent exposure. Of 323 sera, 296 [91.64%] were positive for rubella IgG. All IgG negative sera were also IgM negative. Comparable antibody prevalence was observed in all age groups. The prevalence of rubella IgG among Yemeni schoolgirls is high, with most becoming immune between the ages of 11 and 21 years. Although the age of exposure seems to be 13 years, further investigation is needed to confirm this.

Prevalence of rubella antibodies among schoolgirls in Sana'a, Republic of Yemen

To determine the prevalence of rubella antibodies and age of exposure to rubella among Yemeni schoolgirls, we studied the sera samples of 323 female students [age range 11-21 years; mean age 16.26 +/- 1.89 years] drawn from three schools in Sana'a. All samples were screened for rubella IgG antibodies using enzyme linked immunosorbent assay and, if negative, for IgM in order to exclude the possibility of recent exposure. Of 323 sera, 296 [91.64%] were positive for rubella IgG. All IgG negative sera were also IgM negative. Comparable antibody prevalence was observed in all age groups. The prevalence of rubella IgG among Yemeni schoolgirls is high, with most becoming immune between the ages of 11 and 21 years. Although the age of exposure seems to be

Malaria and intestinal parasitosis among children presenting to the Paediatric Centre in Sana'a, Yemen

We studied the profile of malaria and intestinal parasitosis among children presenting to the Paediatric Health Centre in Sana'a from January 1998 to December 2000. In stool samples from 9014 children, Ascaris lumbricoides, Entamoeba histolytica, Giardia lamblia and Trichuris trichiura were the most common. Infection with parasites of direct life-cycle were similar in boys and girls. Schistosome infection was significantly higher in boys than girls, but girls were more infected with ascariasis. The only species of malaria parasite found in blood samples from 753 children with suspected malaria was Plasmodium falciparum, with the highest rates in April-June. The majority of positive cases were Yemeni children, but 10.8% were Sudanese or Ethiopian

Hepatitis B infection in Yemenis in Sana'a: pattern and risk factors

A cross-sectional seroepidemiological study was conducted among 2652 individuals [age range: 1 month-95 years; median 23 years] who presented at Sana'a Central Health Laboratory in response to a campaign to control hepatitis B virus. Screening was carried out by reverse passive haemagglutination. Specificity of positive samples was determined by enzyme immunoassay. Of 2321 participants, 7.4% were carriers of hepatitis B surface antigen. Risk factors determined by bivariate analysis were age, sex, residence, exposure to cutting and puncturing tools and blood transfusion. Multivariate analysis revealed age to be the best predictor of the carrier rate of hepatitis B virus

Nutritional status of Yemeni schoolchildren in Al-Mahweet Governorate

The nutritional status of 948 children selected randomly from Al-Mahweet Governorate schools was investigated. Age range was 5-18 years with a mean of 10.6 +/- 2.8 years. Among the children, 3.4% had depleted iron and 43.4% had below average skin-fold thickness. Approximately half of the children were either stunted or chronically underweight and 1 child in 20 was underfed. Depleted fat stores affected two-fifths of the children and approximately one-fifth were anaemic. Urban residents scored significantly higher on nutritional parameters than rural children. Serum ferritin levels were significantly greater among males than females whereas mean height-for-age, weight-for-age and skin-fold thickness were lower

[ quality of partially treated drinking-water produced in Sana'a City]

We assessed the quality of partially treated drinking water in 30 private establishments in Sana'a City, Republic of Yemen. We also compared the assessed water with the quality of 43 private wells and 18 estate wells. Microbiological examinations showed that 83% of the samples were contaminated; 50% with fecal coliforms and 33% with total coliforms. Concentration of mineral exceeded nominal values in 7% of the samples for nitrates, 10% for iron salts and in 20% of the samples for fluorides. In 33% of the samples, fluoride concentrations were lower than normal. Only 16.7% of the samples were found microbiologically and chemically potable