Zika virus strategic response framework for the gulf states-2016: an urgent need for collaboration

The Zika virus [ZIKV] became the latest threat to global health security when WHO declared on 1[st] February 2016, that recently reported clusters of microcephaly and other neurological disorders in Brazil constitute a Public Health Emergency of International Concern [PHEIC]. These clusters were reported concurrently with an outbreak of ZIKV, which has been ongoing in Brazil and other countries in the America region since 2015. A growing body of clinical and epidemiological data possibly leans towards a causal role for ZEKV as the occurrence of the clusters of microcephaly and other neurological disorders principally the Guillain-Barre' syndrome are associated in time and place with the ongoing ZIKV transmission in the America region. So far, Zika viral transmission has been documented in a total of 69 countries and territories with autochthonous transmission from 2007 to 10 August 2016. The geographical range of ZIKV has been increasing steadily. Considering the presence of competent vectors that transmit ZIKV in some parts of the Gulf countries, and the close relationship with Brazil, a local transmission of the virus is plausible once the virus is introduced through travel. This review suggests the integration of epidemiological and entomological surveillance for monitoring and control of the vectors of ZIKV. The risks associated with ZIKV infection and the possible threat to the Gulf Sates was described. A strategic Zika response framework [SRF] for the Gulf States has been developed to meet their urgent need for a collaborative and coordinated response for prevention and spread of ZIKV infection. A coordinated response of all partners in the Golf States across sectors and services at national, as well as, regional levels is required

Studies on Aedes AegyptI resistance to some insecticides in the Jazan district, Saudi Arabia

The present study provided information on the susceptibility status of the adult and larvae of Aedes aegypti mosquitoes in Jazan region of Saudi Arabia. Bioassay tests were performed on adults and larvae by using WHO recommended concentrations and test kits. Adults of Ae. aegypti mosquitoes were exposed to test papers impregnated with Lambda-cyhalothrin [0.05%], Cyfluthrin [0.15%], Deltamethrin [0.05%], Permethrin [0.75%], Fenitrothion [1%], Bendiocarb [0.1%] and DDT [4%] insecticides. Ae. aegypti mosquitoes were found to be susceptible only to Cyfluthrin; [mortality rate was 100%], whereas variable resistances were observed from the rest of the other insecticides tested [mortality rates ranged between 93.6 and 17%]. Larvae were subjected to different concentrations of Diflubenzuron, Methoprene [IGRs] and Temephos [Organophosphate]. Adult emergence inhibition [IE50 and IE95] values for the IGRs and the [LC[50] and LC[95]] for Temephos were determined by log-probit regression analysis. Ae. aegypti larvae were resistant to Temephos [LC[50] 61.8 - LC[95] 35600.1 mg/l] and showed high susceptibility to Methoprene than Diflubenzuron [IE[50] 0.49 - IE[95] 10.9 mg/l] and [IE[50] 0.86 and IE[95] 93.8 mg/l], respectively. Larvae were more susceptible to Methoprene than Diflubenzuron by 1.8 folds

Quality of documentation of electronic medical information systems at primary health care units in Alexandria, Egypt

Limited data are available about the implementation of electronic records systems in primary care in developing countries. The present study aimed to assess the quality of documentation in the electronic medical records at primary health care units in Alexandria, Egypt and to elicit physician's feedback on barriers and facilitators to the system. Data were collected at 7 units selected randomly from each administrative region and in each unit 50 paper-based records and their corresponding e-records were randomly selected for patients who visited the unit in the first 3 months of 2011. Administrative data were almost complete in both paper and e-records, but the completeness of clinical data varied between 60.0% and 100.0% across different units and types of record. The accuracy rate of the main diagnosis in e-records compared with paper-based records ranged between 44.0% and 82.0%. High workload and system complexity were the most frequently mentioned barriers to implementation of the e-records system

Thyroid dysfunction and autoimmunity in Down's syndrome children

The present study was undertaken to investigate high prevalence of thyroid dysfunction and presence of thyroid autoantibodies in children with Down's syndrome. Thyroid function was studied in 30 children with Down's syndrome; their age ranged from 2 to 15 years with mean value of 7.5 +/- 3.53 years and in 40 healthy children of similar age and sex. The study revealed that seventeen [57%] of 30 children with Down's syndrome had normal level of TSH and free T4 [2.47 +/- 0.61 mIU/L] and [1.62 + 0.30 ng/dI], respectively, when compared with healthy children [2.37 +/- 0.54 mIU/L and 1.5 +/- 0.38 ng/dI], respectively. Eleven [37%] of 30 children with Down's syndrome had high level of TSH and low level of free T4 [3.82 +/- 0.45 mIU/L and 0.63 +/- 0.097 ng/dI], respectively, when compared to normal children. Only 2 of 30 children with Down's syndrome had low level of TSH and high level of free T4 and were excluded from the study. The increase in height/cm during the growth in 11 children that acquired hypothyroidism was lower before starting the treatment with thyroxine; but after one year with thyroxine treatment there was an increase in height [90.7 +/- 14.17] before treatment and [107.40 +/- 10.77] height/cm after treatment when compared to 17 children with normal thyroid function but with Down's syndrome [98.18 +/- 8.48 cm]. Only one of 11 children with Down's syndrome that acquired hypothyroidism had thyroid autoantibodies before the age of 7 years but 7 had thyroid autoantibodies after this age. Three of the children with Down's syndrome that had euthyroid function had thyroid autoantibodies before the age of 7 years of age, but 9 had thyroid autoantibodies after this age. Most children with Down's syndrome [55%] acquired hypothyroidism after the age of 7 years and after this age they had thyroid autoantibodies [microsomal and thyroglobulin autoantibodies]

Effect of hepatitis-C in adolescents on growth hormone axis, immunoglobulins and thyroid hormones

The objective of this study was to evaluate the changes in the serum of hepatitis-C in adolescent patients as regard growth hormone, [GH] and insulin growth factor-I [IGF-I] system, immunoglobulin M [IgM] and immunoglobulin G [IgG] and thyroid hormones [T3, T4 and TSH].The study included two groups, each formed of 25 adolescents. Group one formed of hepatitis-c infected adolescent patients and the other group included 25 healthy adolescents as controls. Biochemical and radiochemical analysis revealed significant increase in [GH] serum level [4.7 +/- 4.1 ng/ml] with decrease in [IGF-I] serum level [2.7 +/- 0.7 n mol/l] in hepatitis-c group compared to controls. Immunoglobulin IgC and IgM were also increased, respectively, in comparison to the controls group. Thyroid [T3] was the only hormone significantly increased in hepatitis C group, while T3 and TSH hormone showed no significant changes in HCV patients. These data indicated that HCV infection had an inhibitory effect on liver receptors leading to failure of their binding with GH revealed by high levels of circulating GH. Also, HCV infection affects GH stimulating synthesis of IGF-1. Liver diseases such as HCV frequently associated with thyroid dysfunctions, as failure of [T4] hormone to be converted to the metabolic active form [T3], lead to increase in T4 serum level. Enhancement of initiation of autoimmunity in HCV adolescents also appears through an increase in IgG and IgM serum levels