One health framework in Eastern Mediterranean Region [EMR]

On 12th December 2018, an expert meet-ing on one health framework for action on emerging zoonotic infections was held in Amman, Jordan. The meeting, orga-nized by the World Health Organization Regional Office for Eastern Mediterrane-an [WHO EMRO], reviewed the frame-work in the light of improving efficient and coordinated multisectoral "one health" approach among human health, animal and environment sectors to pre-vent, detect and respond to emerging zoonotic infection

Comparison of five international indices of adherence to the Mediterranean diet among healthy adults: similarities and differences

BACKGROUND/OBJECTIVES: To compare five indices of adherence to the Mediterranean Diet (MD) among adults living in the Mediterranean region. SUBJECTS/METHODS: A total of 100 healthy Lebanese adults aged between 18 and 65 years. Face-to-face interviews to collect sociodemographic and medical information, to take anthropometric measurements, and to fill a validated, culturally adapted, food frequency questionnaire (FFQ). The score for each item was calculated following the recommendations for each corresponding index. The five MD indices were Mediterranean Diet Scale (MDScale), Mediterranean Food Pattern (MFP), MD Score (MDS), Short Mediterranean Diet Questionnaire (SMDQ), and the MedDiet score. RESULTS: Significant correlations were detected between items with P-values < 0.001. Minimal agreement was seen between MDScale and MedDiet score and maximal agreement between MDS and MedDiet score. Univariate and multivariate analyses showed that MDS and MedDiet scores had significant correlations with fiber and olive oil intake, main components of the MD. MDScale showed a significant correlation with waist-to-hip ratio and with total energy intake but none of the five indices was correlated to body mass index (BMI). CONCLUSIONS: The indices that showed the highest correlation with variables related to the MD are the MDScale and the MedDiet score; therefore, they can be used to assess our future study populations. Based on the current results, more than half of the study population was non-adherent to the MD and adherence to this diet did not appear to protect against being overweight (BMI ≥ 30).

Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran's position? / 한국역학회지

OBJECTIVES: Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.METHODS: This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.RESULTS: Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.CONCLUSIONS: Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.

Influenza laboratory capacity in the EMR

As of March 2018, a total of 21 influenza laboratories from 20 countries of the WHO Eastern Mediterranean Region [EMR] have built their capacities to detect and diagnose seasonal influenza. Of these, 16 are National Influenza Centers [NICs]. These laboratories have varying capabilities and capacities in monitoring seasonal influenza virus and responding to the emergence of novel influenza virus sub-types, reassortant viruses, and other newly emerging respiratory pathogens in a timely and coordinated manner

Influenza situation in 2017

Influenza activities in the Eastern Mediterranean Region [EMR] of WHO have increased in recent time, during the 2017-2018 influenza season. An upsurge of seasonal influenza cases has been observed through out the Region with influenza A [H1N1] pdm09 being the predominantly circulating influenza virus

Influenza Surveillance in EMR

Surveillance of influenza and other respiratory pathogens in the Eastern Mediterranean Region [EMR] made a significant progress in the last few years with regards to the epidemiological and virological surveillance. As of December 2017, 19 out of the 22 countries have functional influenza surveillance systems. The laboratory diagnostic capacities were enhanced through recognition of 17 functioning National Influenza Centers [NICs]

Comparative analysis of essential medicines for cardiovascular diseases in countries of the WHO Eastern Mediterranean Region

Background: Adequate access to essential medicines for cardiovascular disease is necessary to address the high cardiovascular disease burden in countries of the Eastern Mediterranean Region of the World Health Organization [WHO].

Aims: This study compared the cardiovascular disease medicines included in the WHO Model Essential Medicines List with those in the national essential medicines lists of 19 countries of the Region.

Methods: Data were extracted on the number of cardiovascular medicines and dosage forms in the national lists and compared with those on the WHO Model List [24 medicines in total and 48 dosage forms]. Factors associated with the number of essential cardiovascular medicines on the national lists [burden of cardiovascular diseases and health expenditure per capita] were assessed. The number of medicines from 6 therapeutic groups of cardiovascular medicines listed in the national lists but not in the core WHO Model List were evaluated.

Results: Countries with the lowest percentage of medicines from the WHO Model List out of the total cardiovascular disease medicines in the national lists were Djibouti [21%], Tunisia [22%], Saudi Arabia and Iraq [31% each], and Bahrain and Libya [32% each]. The most common medicine dosage form in the national lists was tablets while some that needed oral liquid forms were not listed by any country. Tunisia [8%], Jordan [14%], Bahrain and Saudi Arabia [15% each] had the lowest alignment of dosage forms from the WHO model list.

Conclusions: Countries should improve the selection of essential medicines for cardiovascular diseases to promote access to therapy

Analysis of Joint External Evaluations in the WHO Eastern Mediterranean Region

Background: Joint External Evaluation [JEE] was developed as a new model of peer-to-peer expert external evaluations of IHR capacities using standardized approaches.

Aims: This study aimed to consolidate findings of these assessments in the Eastern Mediterranean Region and assess their significance.

Methods: Analysis of the data were conducted for 14 countries completing JEE in the Region. Mean JEE score for each of the 19 technical areas and for the overall technical areas were calculated. Bivariate and multivariate analyses were done to assess correlations with key health, socio-economic and health system indicators.

Results: Mean JEE scores varied substantially across technical areas. The cumulative mean JEE [mean of indicator scores related to that technical area] was 3 [range: 1–4]. Antimicrobial resistance, Biosecurity and Biosafety indicators obtained the lowest scores. Medical countermeasures, personnel deployment and linking public health with security capacities had the highest cumulative mean score of 4 [range: 2–5]. JEE scores correlated with most of the key indicators examined. Countries with better health financing system, health service coverage and health status generally had higher JEE scores. Adolescent fertility rate, neonatal mortality ratio and net primary school enrollment ratio were primary factors within a country's overall JEE score.

Conclusions: An integrated multisectoral approach, including well-planned cross-cutting health financing system and coverage, are critical to address the key gaps identified by JEEs in order to ensure regional and global health security

Salt intake reduction strategies in the Eastern Mediterranean Region

Background: The high burden of noncommunicable diseases [NCDs], particularly cardiovascular diseases [CVDs], in countries of the Eastern Mediterranean Region requires an immediate public health attention. The World Health Organization [WHO] has recommended salt reduction as a “best buy”, recognizing it as one of the most cost–effective approaches in preventing NCDs and reducing CVDs and medical costs.

Aims: In the context of the global target to reduce salt intake by 30% by 2025, the objective of this review is to present an up-to-date overview of the current salt reduction initiatives in the Region by highlighting regional and national policies, strategies, and activities that aim at characterizing and/or reducing the intakes of dietary salt.

Methods: This review details the WHO policies and strategies which address salt reduction in the WHO Eastern Mediterranean Region.

Results: The high intake levels of sodium in the countries of the Region are emphasized. The policies and strategies in place to address this situation are described, however, there is a need for more data on intake levels.

Conclusions: There are a number of salt reduction initiatives currently being undertaken in the countries of the Region. The WHO should continue to play a key role in providing evidence-based tools for the planning, implementation, and surveillance of national salt reduction initiatives

Situational analysis: regional review of the substance use Atlas 2015

The Atlas project on substance use is a global WHO project that aims to collect and disseminate data on resources for the prevention and treatment of substance use disorders. Information on resources available in the WHO Eastern Mediterranean Region was first published in 2012. The Atlas questionnaire was updated in 2014 and data were collected in all WHO Member States. All countries of the Region submitted the Atlas questionnaire. This report presents the latest key information on resources for the prevention and treatment of substance use disorders in the Eastern Mediterranean Region based on the responses of the countries to the questionnaire. Current estimates show that the burden attributable to drug use disorders in the Region is high. Health system resources for the prevention and treatment of substance use disorders vary across countries, but are generally still insufficient to provide adequate care and treatment for people with these disorders. Countries need to strengthen prevention and treatment of substance use disorders, particularly by increasing coverage of treatment interventions

Khat use and related addiction, mental health and physical disorders: the need to address a growing risk

Khat use is a drug problem characteristic of the Eastern Mediterranean Region, which is a widespread culturally accepted practice in some countries and is becoming more prevalent in others. Although limited use may not be accompanied by serious consequences, prolonged exposure could lead to dependence, psychosis and other psychiatric disorders and physical conditions such as hypertension, cardiovascular complications, sexual dysfunction, hepatoxicity and reduced birth weight of infants born to khat-chewing mothers. The widespread use and its burden on health and economy has raised concerns in the Region, although the extent of the problem is not well assessed. Additionally, most countries do not have a clear policy and plan with regard to khat use, and therefore there is hardly any structured prevention and treatment plan in place to respond to the problem. This review presents a picture of the extent of the problem, elaborates on related existing research initiatives and international treaties, policies and health service provisions, and outlines best policy and programme interventions in khat-use countries

Establishment of Emerging and Dan-gerous Pathogens Laboratory Net-work [EDPLN] in EMR

A plan to establish an Eastern Mediterranean Region [EMR Emerging and Dangerous Pathogen Laboratory Network [EMR EDPLN] has been kicked off. The network would be made up of competent and well-equipped regional laboratories with strong linkage to surveillance and epidemiology components for Emerging and Dangerous Pathogens [EDPs] in order to ensure early detection and confirmation of EDPs out-breaks, as well as to enhance rapid and effective outbreak response

Hajj 1438 H: no public health event of concern reported

World Health Organization [WHO] Regional Office for the Eastern Mediterranean [EMRO] deployed a team of experts, upon the invitation of the Minister of Health of Saudi Arabia, to support, assess and oversee the public health preparedness for hajj 2017 [1438 H]. No disease outbreak or public health event of concern was reported among the nearly 2.4 million pilgrims visiting the holy sites during this year's hajj

Emerging and Dangerous Pathogens Laboratory Network in WHO Eastern Mediterranean Region

The WHO's Regional Office for the Eastern Mediterranean [EMRO] has progressed towards establishing an Emerging and Dangerous Pathogens Laboratory Network [EDPLN]. The main purpose of the network is to enhance laboratory diagnostic capacity of Regional laboratories and to timely respond to health emergencies in the Region

EQAP Results for NICs in 2017

In 2017, 18 laboratories from the Eastern Mediterranean Region [EMR] were invit-ed to participate to the External Quality Assessment Programme [EQAP] Panel 16 for the Detection of Influenza Viruses by RT-PCR. It included, all the 16 Na-tional Influenza Center [NICs] and two national Influenza laboratories. Among those laboratories, 16 participated and received samples between April and May while all returned correct results before the closing date for analysis achieving an overall score of 100% with all correct results for seasonal and non-seasonal influenza viruses

First EMARIS conference and fourth meeting in Jordan

WHO Regional Office for the Eastern Mediterranean will hold the First Scientific Conference on Acute Respiratory Infections [ARIs] in the Eastern Mediterranean Region together with the Fourth Meeting of the Eastern Mediterranean Acute Respiratory Infection Surveillance [EMARIS] Network in Amman, Jordan during the period from 11 to 14 December 2017. This conference is the result of a continuous collaboration effort between WHO, the centers for diseases control and prevention in Atlanta [US-CDC] and the Global Health Development [GHD] in Amman, Jordan

Health threats reported in 2017

In 2017, a variety of emerging and reemerging infectious disease threats were reported in the Eastern Mediterranean Region [EMR]. Most of the threats began in 2016, including chikungunya in Pakistan, or were already endemic in the country, for example, Crimean-Congo hemorrhagic fever [CCHF] in Afghanistan. However, new threats, such as diphtheria in Yemen, have also been observed this year