Quality of life among the Arab population two years after COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has resulted in severe consequences worldwide. Our study aims to assess the quality of life (QoL) domains and its determinants among the general population in Arab countries after two years of the COVID-19 pandemic. METHODS: An anonymous online cross-sectional survey using the short version of World Health Organization QoL (WHOQOL-BREF) instrument was distributed among Arab adults in 15 Arab Countries. RESULTS: A total of 2008 individuals completed the survey. Amongst them, 63.2% were 18-40 years and 63.2% were females, 26.4% had chronic disease, 39.7% confirmed having contracted COVID-19, and 31.5% had experienced the unfortunate loss of relatives due to COVID-19. The survey revealed that 42.7% reported good physical QoL, 28.6% were satisfied with psychological QoL, 32.9% had a sense of well-being in the social domain, and 14.3% had good QoL in the environmental domain. The predictors of physical domains were as follows: being a male (ß = 4.23 [95%CI 2.71, 5.82]), being from low-middle income country (ß = -3.79 [95%CI -5.92, -1.73]) or being from high-middle-income country (ß = -2.95 [95%CI -4.93, -0.92]), having a a chronic disease (ß = -9.02 [95%CI -10.62,-7.44]) having a primary/secondary education (ß = -2.38 [95%CI -4.41, -0.054]), number of years of work experience ≥ 15 years (ß = 3.25 [95%CI 0.83, 5.73]), income-per-capita [ranged from (ß = 4.16 [95%CI -5.91, -2.40]) to (ß = -11.10 [95CI%, -14.22, -8.11])], a previous COVID-19 infection (ß = -2.98 [95%CI -4.41, -1.60]), and having relative died from COVID-19 (ß = -1.56 [95%CI -3.01, -0.12]). The predictors of psychological domain were having a chronic disease (ß = -3.15 [95%CI -4.52, -1.82]), a postgraduate education (ß = 2.57 [95% CI 0.41, 4.82]), number of years of work experience ≥ 15 years (ß = 3.19 [95%CI 1.14, 5.33]), income-per-capita [ranged from (ß = -3.52 [95%CI -4.91, -1.92]) to (ß = -10.31 [95%CI -13.22, -7.44])], and a previous COVID-19 infection (ß = -1.65 [95%CI -2.83, -0.41]). The predictors of social domain were being a male (ß = 2.78 [95%CI 0.93, 4.73]),  being single, (ß =-26.21 [-28.21, -24.32]), being from a low-income country (ß = 5.85 [95%CI 2.62, 9.13]), or from a high-middle-income country (ß = -3.57 [95%CI -6.10, -2.12]), having a chronic disease (ß = -4.11 [95%CI -6.13, -1.11]), and income-per-capita [ranged from (ß = -3.62 [95%CI -5.80, -1.41]) to (ß = -11.17 [95%CI -15.41, -6.92])]. The predictors of environmental domain were being from a low-middle-income country (ß = -4.14 [95%CI -6.90, -1.31), from a high-middle-income country (ß = -12.46 [95%CI -14.61, -10.30]), or from a low-income-country (ß = -4.14 [95%CI, -6.90, -1.32]), having a chronic disease (ß = -3.66 [95%CI -5.30, -1.91]), having a primary/secondary education (ß = -3.43 [95%CI -5.71, -1.13]), being not working (ß = -2.88 [95%CI -5.61, -0.22]), income-per-capita [ranged from (ß = -9.11 [95%CI -11.03, -7.21] to (ß = -27.39 [95%CI -31.00, -23.84])], a previous COVID-19 infection (ß = -1.67 [95%CI -3.22, -0.21]), and having a relative who died from COVID-19 (ß = -1.60 [95%CI -3.12, -0.06]. CONCLUSION: The study highlights the need for public health interventions to support the general population in the Arab countries and mitigate its impact on their QoL.

Self-medication practices against COVID-19 infection and awareness among residents of Mogadishu, Somalia: A cross-sectional analysis.

The novel coronavirus disease (COVID-19) pandemic has affected several countries worldwide, resulting in a considerable strain on healthcare systems and increased trend of self-medication practices. This study aims to evaluate the awareness of COVID-19 and the prevalence of self-medication during the pandemic among residents in Mogadishu, Somalia. A cross-sectional study was conducted using a structured and pretested questionnaire between May 2020 and January 2021. Participants from various disciplines were randomly recruited within the study location and interviewed about their self-medication practices during the pandemic. Descriptive statistics were used to summarise the respondents' information and responses to the questionnaire items. Associations between participants' demographic characteristics and specific items relating to self-medication practices were analysed using the Chi-square test. A total of 350 residents participated in the study. Approximately 63% of the participants reported having practised COVID-19 related self-medication with the main reasons being pharmacists' advice (21.4%) and having an old prescription (13.1%), whereas 37.1% did not report their reasons for self-medication. Most participants (60.4%) engaged in self-medication despite not having any symptoms and 62.9% had taken antibiotics in the last three months. Most participants were aware that no medication has been approved for COVID-19 (81.1%), the negative effects of self-medication (66.6%), and the transmission routes of the virus. Meanwhile, more than 40% of the participants have not worn a mask while outside their homes, and do not follow the international COVID-19 guidelines. The most prevalent drug used by participants for self-medication against COVID-19 was paracetamol (81.1%) and antibiotics (78%). The factors associated with awareness of COVID-19 and self-medication practices included age, gender, educational qualification, and occupation. This study revealed considerable high self-medication practices among Mogadishu residents, thus highlighting the need to promote awareness regarding the adverse effects of self-medication and sanitisation guidelines in addressing COVID-19 at the community level.

ICU-Managed Patients' Epidemiology, Characteristics, and Outcomes: A Retrospective Single-Center Study.

Background: Resources are limited, and it is exceedingly difficult to provide intensive care in developing nations. In Somalia, intensive care unit (ICU) care was introduced only a few years ago. Purpose: In this study, we aimed to determine the epidemiology, characteristics, and outcome of ICU-managed patients in a tertiary hospital in Mogadishu. Methods: We retrospectively evaluated the files of 1082 patients admitted to our ICU during the year 2021. Results: The majority (39.7%) of the patients were adults (aged between 20 and 39 years), and 67.8% were male patients. The median ICU length of stay was three days (IQR = 5 days), and nonsurvivors had shorter stays, one day. The mortality rate was 45.1%. The demand for critical care services in low-income countries is high. Conclusion: The country has a very low ICU bed capacity. Critical care remains a neglected area of health service delivery in this setting, with large numbers of patients with potentially treatable conditions not having access to such services.

Acceptance of COVID-19 Vaccine Booster Doses Using the Health Belief Model: A Cross-Sectional Study in Low-Middle- and High-Income Countries of the East Mediterranean Region.

Coronavirus disease (COVID-19) booster doses decrease infection transmission and disease severity. This study aimed to assess the acceptance of COVID-19 vaccine booster doses in low, middle, and high-income countries of the East Mediterranean Region (EMR) and its determinants using the health belief model (HBM). In addition, we aimed to identify the causes of booster dose rejection and the main source of information about vaccination. Using the snowball and convince sampling technique, a bilingual, self-administered, anonymous questionnaire was used to collect the data from 14 EMR countries through different social media platforms. Logistic regression analysis was used to estimate the key determinants that predict vaccination acceptance among respondents. Overall, 2327 participants responded to the questionnaire. In total, 1468 received compulsory doses of vaccination. Of them, 739 (50.3%) received booster doses and 387 (26.4%) were willing to get the COVID-19 vaccine booster doses. Vaccine booster dose acceptance rates in low, middle, and high-income countries were 73.4%, 67.9%, and 83.0%, respectively (p < 0.001). Participants who reported reliance on information about the COVID-19 vaccination from the Ministry of Health websites were more willing to accept booster doses (79.3% vs. 66.6%, p < 0.001). The leading causes behind booster dose rejection were the beliefs that booster doses have no benefit (48.35%) and have severe side effects (25.6%). Determinants of booster dose acceptance were age (odds ratio (OR) = 1.02, 95% confidence interval (CI): 1.01-1.03, p = 0.002), information provided by the Ministry of Health (OR = 3.40, 95% CI: 1.79-6.49, p = 0.015), perceived susceptibility to COVID-19 infection (OR = 1.88, 95% CI: 1.21-2.93, p = 0.005), perceived severity of COVID-19 (OR = 2.08, 95% CI: 137-3.16, p = 0.001), and perceived risk of side effects (OR = 0.25, 95% CI: 0.19-0.34, p < 0.001). Booster dose acceptance in EMR is relatively high. Interventions based on HBM may provide useful directions for policymakers to enhance the population's acceptance of booster vaccination.

Demographic Characteristics and Risk Factors Affecting the Development of Postpartum Acute Kidney Injury in Somalia: Single-Center Experience.

Background and Aim: Although postpartum acute kidney injury (PPAKI) is declining in developing countries, it is still a leading cause of maternal and fetal morbidity and mortality. The study aimed to determine the causes, risk factors, and the outcomes of patients with postpartum acute kidney injury managed at Mogadishu Somali Turkey Training and Research Hospital, in Mogadishu, Somalia over a two years period. Methods: This study was conducted retrospectively at Mogadishu Somali-Turkey Training and Research Hospital, Somalia's largest teaching and referral hospital. During a two-year period (January 2020 to December 2021), we evaluated women who had acute kidney injury during the postpartum period and were hospitalized in our hospital. The data was also evaluated for postpartum admission day and hospital stay. The requirement for dialysis and the results were documented. Maternal outcomes are categorized as follows: Complete recovery after discharge/follow-up, chronic dependence on hemodialysis and death during admission. Results: We studied 79 postpartum AKI patients. The mean age of the participants was 28.67 ± 6.14. Most patients (51%) were aged 20-30, followed by 30-40 (29%). According to self-reported comorbidities, most individuals had no history of chronic diseases, 8 (10.1%) had hypertension and 3 (3.8%) had heart failure, and DM and HTN 2(2.5%). The most common causes of PPAKI were eclampsia (24.1%), hemorrhagic shock, intrauterine mortality (16.5%), placenta abruptio and uterine rupture (8.9%). Hemorrhage (5.1%) and placenta previa (2.5%). The patient's outcome was associated with age (p=0.04), platelet (p=0.024), and hospital stay (p=0.009). Conclusion: Postpartum acute kidney injury is very common in underdeveloped nations. Preeclampsia/Eclampsia, obstetric bleeding, and intrauterine death are the leading causes of postpartum acute kidney injury in Somalia. This tragic scenario may be avoided by providing appropriate antenatal care and raising awareness among Somali women about the benefits of antenatal care provided by public institutions.

Prevalence of Acute Kidney Injury in Covid-19 Patients- Retrospective Single-Center Study.

Introduction: In December 2019, a coronavirus disease 2019 (COVID-19) disease outbreak started in Wuhan, Hubei Province, China, and spread rapidly to other regions of the world. Although diffuse alveolar injury and acute respiratory failure were the most prominent characteristics, further investigation of organ involvement is essential. Aim: In this study, we aim to determine the prevalence of acute kidney injury (AKI) in covid-19 patients and also the relationship between inflammatory markers, the severity of lung involvement, and acute kidney injury in COVID-19 patients. Methods: This was a retrospective analysis of 102 COVID-19 patients presented to a tertiary teaching hospital in Mogadishu during the second wave of Covid-19 2021. Patients' age, gender, comorbidities, hemoglobin, platelet, and white blood cell counts, glucose, urea, creatinine, sodium, potassium, CRP, ferritin, real-time polymerase chain reaction (RT PCR) Covid-19 test and CT scan findings were all collected. Results: The mean age of the patients was 58 (Range 23-91 years), including 64 men and 38 women. The prevalence of acute kidney injury was 12.7%. There was a significant association between acute kidney injury, CRP and ferritin with the p values of P<0.003 and P<0.004, respectively. For severity of lung involvement with computed tomography finding, 35 (34.3%) had mild, 35 (34.3%) had moderate and 32 (31.4%) had severe lung involvement. There was significant association between the lung involvement, Ferritin and CRP levels with P values of P<0.005 and P<0.007 respectively. Conclusion: Our findings indicate that acute kidney injury is common in covid-19 patients and can increase the morbidity and mortality of these patients. As a result, clinicians in low-resource countries such as Somalia should be more vigilant about kidney injury in patients with severe COVID-19.

A systematic review on risk factors for khat chewing among adolescents in the African continent and Arabian Peninsula.

INTRODUCTION: Khat is a flowering plant with stimulant effect on the nervous system and produce psychological dependence. Despite its harmful effects, the ingestion of khat has been part of cultural norms and the legality of khat varies by region. OBJECTIVE: This systematic review aimed at critically evaluating the available evidence on the risk factors of khat chewing among adolescents. METHODS: A systematic review was conducted on published research studies from five databases Scopus, PubMed, Science-direct, Ovid and google scholar using keywords khat chewing OR qat chewing AND associated factors OR risk factors OR contributing factors AND adolescents OR teenagers. Articles included were either cross-sectional, cohort, case-control or qualitative studies which were published between the year 1990 till present. Excluded articles were the non-English written articles, descriptive studies and irrelevant topics being studied. RESULTS: Out of 2617 records identified and screened, six were included for the analysis and interpretation of the data. All included studies were cross-sectional study design. All six studies reported having family members who chewed khat significantly predict khat chewing among adolescents, followed by five articles for friends or peers who also chewed khat and four articles for male gender. Smoking was also found to have the highest odds (OR = 18.2; 95% CI: 12.95-25.72) for khat chewing among adolescents. CONCLUSION: The review highlights the crucial role of family members, friends or peers and male gender to predict khat chewing among adolescents. Effectiveness of health promotion programs to educate and reduce khat chewing among adolescents will require active participation of family members and friends.