Perceived Social Stigma of Cutaneous Leishmaniasis in Hubuna, Saudi Arabia.

Background: Cutaneous Leishmaniasis (CL) is a vector-borne skin infection that remains prevalent in regions with poor socioeconomic conditions. Stigmatization occurs when individuals with physical or psychological disorders interact with societal stereotypes. The aim of this study was to explore the perceived social stigma surrounding CL among people residing in Hubuna, Saudi Arabia. Methods: This cross-sectional community-based survey recruited 618 individuals aged 18 years and above using the snowball sampling technique to reach hidden cases within the target population. Data was collected using a self-administered questionnaire and the Explanatory Model Interview Catalogue for Perceived Social Stigma (EMIC-SS-12) was used to assess the level of perceived social stigma. It includes questions on demographic variables, behaviors, and experiences. The analysis was performed using SPSS. Results: The study included 618 participants, the majority of whom were women and girls (54.2%), with a mean age of 28 ± 12.7 years. The median score for perceived social stigma was 26.0. Only 2.1% (n = 13) of participants had the highest EMIC-SS-12 score of 36, while 7.6% (n = 47) scored zero. The mean score for overall perceived social stigma was 1.89 ± 0.91, while the mean score for experienced stigma was 1.99 ± 1.02. Univariate analysis showed that sex, employment, location of lesions, and number of lesions were insignificantly associated with stigmatization (P-value < 0.05), because these associations were uncertain because the CI includes or very close to 1. Conclusion: The study reveals insights into stigmatization associated with CL in the Habuna area of Saudi Arabia. It found that the median of perceived social stigma was 26. Factors such as sex, employment status, and location of the lesion are uncertainly associated with stigma. It is crucial to explore negative behaviors and perceptions and develop suitable health education programs.

Structure, functions, performance and gaps of event-based surveillance (EBS) in Sudan, 2021: a cross-sectional review.

BACKGROUND: Event-based surveillance (EBS) is an essential component of Early Warning Alert and Response (EWAR) as per the International Health Regulations (IHR), 2005. EBS was established in Sudan in 2016 as a complementary system for Indicator-based surveillance (IBS). This review will provide an overview of the current EBS structure, functions and performance in Sudan and identify the gaps and ways forward.  METHODS: The review followed the WHO/EMRO guidelines and tools. Structured discussions, observation and review of records and guidelines were done at national and state levels. Community volunteers were interviewed through phone calls. Directors of Health Emergency and Epidemic Control, surveillance officers and focal persons for EBS at the state level were also interviewed. SPSS software was used to perform descriptive statistical analysis for quantitative data, while qualitative data was analysed manually using thematic analysis, paying particular attention to the health system level allowing for an exploration of how and why experiences differ across levels. Written and verbal consents were obtained from all participants as appropriate. RESULTS: Sudan has a functioning EBS; however, there is an underestimation of its contribution and importance at the national and states levels. The link between the national level and states is ad hoc or is driven by the need for reports. While community event-based surveillance (CEBS) is functioning, EBS from health facilities and from non-health sectors is not currently active. The integration of EBS into overall surveillance was not addressed, and the pathway from detection to action is not clear. The use of electronic databases and platforms is generally limited. Factors that would improve performance include training, presence of a trained focal person at state level, and regular follow-up from the national level. Factors such as staff turnover, income in relation to expenses and not having a high academic qualification (Diploma or MSc) were noticed as inhibiting factors. CONCLUSION: The review recommended revisiting the surveillance structure at national and state levels to put EBS as an essential component and to update guidelines and standard operation procedures SOPs to foster the integration between EBS components and the overall surveillance system. The need for strengthening the link with states, capacity building and re-addressing the training modalities was highlighted.

Insecticide Residues in Cotton, Sorghum and Fallow Soil from the Nuba Mountains Cotton Corporation of South Kordofan State, Sudan.

BACKGROUND: Soil is the final depot of most environmental contaminants, including pesticides. Soil may be contaminated by pesticides as a result of direct application or drift during spray activities. Soil contamination with pesticide residues may affect the quality of food crops, animal products, and soil micro-organisms which may in turn negatively affect human health and the environment. OBJECTIVES: The main objective of the current study was to determine the soil residues of commonly used pesticides in rain-fed crops grown by the Nuba Mountains Cotton Corporation (NMCC) in South Kordofan state of Western Sudan. METHODS: Four locations (representing the four directions around the state capital Kadugli) were chosen for sample collection: Alefain (East Kadugli), Elmashaish (West Kadugli), Ed Dalling uncultivated area (North Kadugli) and Lagawa (Southwest Kadugli). Nine soil samples were randomly taken from each location representing areas under cotton, sorghum, and uncultivated land covered with natural vegetation. Soil samples were analyzed by gas chromatography (GC) equipped with electron capture detector (ECD) and GC-mass spectrometry (MS). RESULTS: The results generally indicated that organophosphate levels were greater than organochlorine and pyrethroids with heptachlor, malathion, and dimethoate present in all samples analyzed, while the level of p,p-dichlorodiphenyltrichloroethane (DDT) was below the detection limit. Endosulfan α and ß isomers were detected in some samples. Dimethoate had the highest level (22.02 mg/kg), while ß endosulfan was found at the lowest level (0.015 mg/kg). Generally, samples collected from cotton soils showed higher residue levels compared to sorghum soil with average concentrations of 307.25 mg/kg versus 58.63 mg/kg, respectively. Almashaish showed the highest residues levels followed by Alefain, Lagawa, and Ed Dalling with total residues of 57.56 mg/kg, 26.34 mg/kg, 22.63 mg/kg, and 17.07 mg/kg, respectively. CONCLUSIONS: The current study sheds light on the residue levels of some of the commonly used pesticides in the cotton rain-fed scheme in South Kordofan State, western Sudan. The study calls for regular residue monitoring in various environmental components in the area and suggests possible management measures. COMPETING INTERESTS: The authors declare no competing financial interests.

The Role of the Global Health Development/Eastern Mediterranean Public Health Network and the Eastern Mediterranean Field Epidemiology Training Programs in Preparedness for COVID-19.

The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR's Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.