Distribution of the Intestinal Parasites According to Species and Gender in Patients Presented to the Microbiology Laboratory in a Tertiary Hospital, in Somalia Between January 2018 and October 2022.

Purpose: In this study, it was aimed to determine the 5-year prevalence of intestinal parasites in patients admitted to the Microbiology laboratory of a tertiary hospital in Somalia. Intestinal parasites; Types of patients, age and sex of the patients, and the distribution by years were examined. Patients and Methods: Stool samples were examined using wet preparation, native lugol and trichrome staining methods. Statistical analysis was performed using IBM SPSS V23 software and a P value of <0.05 was considered statistically significant. Tables and figures were used to show the results. Results: One or more parasites were detected in 6766 of 56,824 stool samples examined. It was observed that Giardia lamblia had a higher prevalence than other parasites (60.84%) in a five-year period. Entamoeba histolytica (33.07%) second rank and Ascaris lumbricoides (3.18%) third rank according to their prevalence. When the distribution of the parasite population by gender is evaluated; no statistically significant difference was found (p = 0.235). When the frequency of parasites was evaluated according to age groups, it was seen that the prevalence of parasites between the ages of 0-15 was higher (45.5%) compared to other age groups. A statistically significant difference was found between the distribution of parasite groups according to age groups (p < 0.001). Conclusion: Considering the effects of intestinal parasites on public health, it is still considered to be an important health problem for developing countries. It is thought that the frequency of parasitic diseases in society will decrease with the education of individuals, effective diagnosis, treatment, and implementation of preventive measures.

Age at Natural Menopause and Influencing Factors in Women Attending the Gynecological Outpatient Clinic at a Tertiary Care Hospital.

Background: Menopause is the irreversible cessation of menstruation that results from the lack of ovarian follicular function and is diagnosed after 12 consecutive months of amenorrhea without reasonable cause. This study aims to determine the average age at natural menopause and identify its associated factors among Somali women. Methods: This is a cross-sectional study conducted at the Mogadishu Somalia Türkiye Recep Tayyip Erdogan research and training hospital's Obstetrics and Gynecology outpatient clinic between June 1 and July 1, 2023. Data was collected from subjects during the data collection period using face-to-face interviews with structured questionnaires consisting of sociodemographic, lifestyle, dietary, and reproductive characteristics. A multivariate logistic regression analysis was conducted to find the association between menopause age and target variables. Results: Out of the 188 participants recruited for the study, the median age of menopause was 45.00 (95% CI = 44.50-45.62), and 48.9% had either premature or early menopause. The majority (53.7%) of the participants had a minimum of eight children. In Spearman's rank correlation analysis, we found a significantly positive correlation between menopausal age and age at first (p<0.01), last childbirth (p<0.01), number of parities (p<0.05), and age at marriage (p<0.05). In multivariate logistic regression, we found that the odds of developing premature or early menopause among unemployed women were 59% lower than those of employed women (AOR = 0.41, 95% CI = 0.18-0.93). Conclusion: In this study, we established that the age of natural menopause was lower than the findings reported by previous authors. We also found that employment status, education, history of contraceptive use, BMI, age at first and last childbirth, and parity were associated with age at natural menopause, suggesting that social, lifestyle, and reproductive factors may have an impact on menopausal age.

Needlestick and Sharps Injuries Among Healthcare Workers at a Tertiary Care Hospital: A Retrospective Single-Center Study.

Background: Healthcare workers are still at risk from needlesticks and sharps injuries, which can expose them to blood-borne diseases like hepatitis B, hepatitis C, and HIV. We aimed to investigate the proportion of needlesticks and sharps injuries among healthcare workers in a tertiary care hospital in Somalia and also evaluate associated risk factors. Materials and Methods: This retrospective study was conducted at the Mogadishu Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital. The data was retrieved from the hospital record of the infection prevention and control department over a six-year period between 2017 and 2022. Results: There were a total of 233 needlestick and sharps injury incidents. The highest number of needlestick and sharps injury cases were reported among nurses (52.4%), followed by cleaners (22.3%), physicians (18.5%), and technicians (6.9%) during the six-year period. Operation theaters were the most frequent place (21.9%) where injuries happened, followed by inpatient care (17.6%) and emergency rooms (16.7%). The most commonly reported instrument that resulted in injuries was a hypodermic needle (81.1%). About 24.9% of the needles or sharps devices that caused needlestick and sharps injury cases were contaminated with hepatitis B. There was a significant difference between gender and place of injury for needlestick and sharps injuries (P=0.001). Conclusion: Healthcare professionals around the world continue to face major health risks from needle stick and sharps injuries. The present study found that 8.6%of healthcare workers sustained a needle stick and sharps injuries incident in the past year. According to our findings, healthcare institutions need to regularly teach healthcare professionals, especially nurses and cleaners about the significance of needle stick and sharps injuries.

Do Attitude, Awareness and Intention to Perform Female Genital Mutilation or Cutting for Their Daughters of Women Healthcare Providers Differ from Mothers in Somalia?

Aim: This study aimed to determine whether there were differences in attitude, awareness, and intention to perform female genital mutilation or cutting for their daughters in the future between female healthcare providers and mothers. Methods: A comparative cross-sectional study design was used. Results: A total of 508 women were included in the study. Of the participants, 68.7% (n = 349) were mothers (Group I) who visited the hospital and 31.3% (n = 159) were women healthcare professionals (Group II) [27% (n = 137) nurses and 4.3% (n = 22) doctors]. It was found that 8 (1.6%) of the participants did not have FGM/C and the FGM/C ratio was lower in group II (95%) than in group I (100%) (p < 0.001). In group I, 99.7% (n = 299) of the participants and 30.6% (n = 19) of those in group II reported intending to perform FGM for their daughters in the future (p < 0.001). The reasons for FGM/C most cited by participants were a traditional rite of passage into womanhood (78%), religious requirement (69.3%), and preservation of their virginity until marriage (59.3%). "Stop FGM" was given as a message on FGM/C by 60% of the participants (n = 79) who answered (n = 127, 100%) to open-ended questions. Conclusion: The results of this study show that female health professionals with higher education and monthly income had less positive perception of their FGM/C and less intention to allow their daughters to undergo FGM/C.

Clinical characteristics and outcomes of patients hospitalized with measles during an outbreak in Somalia.

Objectives: Measles is a contagious disease associated with significant morbidity and mortality. This paper describes the clinical characteristics and outcomes of patients hospitalized with measles during an outbreak in Somalia from January 2018 to December 2021. Methods: This retrospective study was conducted at Mogadishu Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital. Children aged 6 months to 17 years who were hospitalized with clinical signs and symptoms of measles and its complications were recruited. Results: In total, 110 participants were enrolled. The median age was 16 [interquartile range (IQR) 12-36] years, and 87 (79.1%) were male. All participants presented with fever, typical measles rash, cough and conjunctivitis, and 43 (39.1%) had received the measles vaccine. Overall, 104 (94.6%) participants were admitted with severe respiratory symptoms, and six (5.4%) were admitted due to poor feeding and/or significant dehydration. Overall, all-cause mortality was 1.8% (n=2). The median duration of hospitalization was longer among participants who died compared with those who survived [11 (IQR 8-14) vs 4 (IQR 2-6) days; P=0.046]. Unvaccinated participants were significantly younger than vaccinated participants [36 (IQR 24-72) vs 12 (IQR 9-16) months; P<0.001]. There was a trend towards higher mortality [0/43 (0%) vs 2/67 (3%); P=0.519] and longer length of hospitalization [3 (IQR 2-6) vs 4 (IQR 3-7) days; P=0.056] among unvaccinated participants compared with vaccinated participants. Both the median total leukocyte count [5.7 (IQR 3.9-8.5) vs 11.6 (IQR 5.9-46.3) x 109/L; P<0.001] and platelet count [239 (IQR 202-358) vs 308 (IQR 239-404) x 109/L; P=0.032] were significantly higher among unvaccinated participants compared with vaccinated participants. However, the median haemoglobin concentration was significantly higher among vaccinated participants compared with unvaccinated participants [11.1 (IQR 9.9-12.3) vs 10.1 (IQR 9.1-11.2) g/dL; P=0.006]. Conclusions: Patients with measles in Somalia have a short hospital stay, low mortality rate and low vaccination rate. Timely vaccination and the need for improved care of patients with measles, particularly vulnerable groups including children and those with undernutrition, are encouraged.

An Analysis of the Rate, Indications, and Associated Maternal Mortality for Cesarean Sections at a Tertiary Care Hospital, First Report from Somalia.

Background: There has been an increase in worldwide cesarean section rates, although they remain low in most Sub-Saharan African countries, including Somalia. The present is the first hospital-based study that analyzes the rate, indications, and associated maternal mortality of cesarean deliveries reported from Somalia. Methods: This retrospective study reviewed data of all deliveries from 2015 to 2021 using electronic medical records in the hospital information system. Retrieved data include baseline demographic characteristics, mode of delivery, indications and the type of cesarean section, and the documented maternal mortality during the study period. Results: During seven years, there were 12,540 total deliveries. Among these, 2703 were cesarean sections giving an overall cesarean section rate of 21.6%. The mean age of the patients was 26.7±7.3 years [14-44 years]. Multiparous mothers constituted 67.7% during the study period. According to cesarean deliveries, nulliparous mothers (55.7%) underwent the maximum number of cesarean sections. Emergency cesarean section was the predominant intervention compared to elective C-sections (59.2% vs 40.8%). Primary CS was the most common predominant, while repeat CS increased timely, 77.7% vs 22.3%, respectively. Overall, previous C-sections and fetal distress were the two most common indications for cesarean delivery (22.3% and 22.1%), respectively. C-sections were predominant in women of younger age, Primiparity, having term deliveries, and did not receive regular antenatal care. The maternal mortality rate was 1.7%, and 61% was due to direct obstetric hemorrhage, including postpartum hemorrhage, Placenta abruption, and uterine rupture. Conclusion: The study findings showed a slight increase in cesarean delivery rates during the study period. This rate is higher than the 10-15% recommended by the WHO in developing countries. Policies and efforts to decrease unnecessary cesarean sections should be promoted and implemented at each health facility.

Somalian women with female genital mutilation had increased risk of female sexual dysfunction: a cross-sectional observational study.

Studies regarding the impact of female genital mutilation/cutting (FGM/C) on sexual function are scarce. This study is the first to explore the rate of female sexual dysfunction (FSD) among Somalian women who underwent FGM and its association with different FGM types. This study was carried out among women with a history of FGM who visited our clinic for a medical check-up. It relied on data including socio-demographic features, type of FGM determined by an examination, and the Female Sexual Function Index (FSFI) scores. Overall, 255 women were included. While 43.9% (n = 112) of the respondents had a history of Type 3 FGM, 32.2% had Type 2 (n = 82), and 23.9% had Type 1 (n = 61) FGM. Among all patients, 223 had FSD (87.6%). There was a significant association between the FGM type and FSD (p < 0.001). The mean total FSFI score for the patients with Type 1, 2, and 3 FGM was 22.5, 19.7, and 17.3, respectively, all indicating FSD. The FSD is prevalent among mutilated Somalian women. Patients with Type 3 FGM had the lowest mean total FSFI scores indicating that the impact on sexual function was correlated with the extent of tissue damage during FGM.

Knowledge, attitude, and practice (KAP) regarding erectile dysfunction disease and its medications among community pharmacy technicians in Mogadishu Somalia.

Background: Erectile Dysfunction (ED) is the most common sexual dysfunction worldwide. This study is the first reported from Somalia to the best of our knowledge. Objective: The current study aimed to assess knowledge, attitude, and practice (KAP) regarding erectile dysfunction disease and its medications among community pharmacy technicians in Mogadishu, Somalia. Method: The current is a cross-sectional descriptive study conducted among pharmacy technicians in Mogadishu to assess their KAP regarding erectile dysfunction disease and its medications. A convenient sampling technique was used. A structured questionnaire contained 45 questions, including; demographic characteristics (4 items), the knowledge of erectile dysfunction disease and its medications (18 items), attitudes (5 items), and practice (15 items) were assessed among technicians. A total of 200 respondents participated in the study. Results: Knowledge. 79 and 72.5% of technicians comprehended the condition of ED and whom it affects; however, about half did not know the underlying risk factors and complications associated with PDE5 inhibitors. Attitude: 77-85% of technicians believe medication requires prescriptions, medications may have complications, and quality medications are essential. Practice: 64% of technicians give ED medication with prescriptions, and 85% do not consult a physician. 64.5% of technicians always provide the same type of medication, and 63% do not give the same dose to each client. About half of the technicians also vend herbal medicines to clients, such as honey, fish, and sea urchins. Conclusion: The findings of this study suggest pharmacy technicians have some knowledge, although not sufficient for understanding the risks and complications of medications. Technicians did not engage in good standard practices despite this knowledge and attitudes. These findings highlight the need for regulations to support good practice among pharmacy technicians and the quality, safety, and efficacy of medicines in Mogadishu by establishing the National Medicine Regulatory Authority.