Systematic review on chronic non-communicable disease in disaster settings

AbstractBackgroundNon-communicable diseases (NCDs) constitute the leading cause of mortality globally. Low and middle-income countries (LMICs) not only experience the largest burden of humanitarian emergencies but are also disproportionately affected by NCDs, yet primary focus on the topic is lagging. We conducted a systematic review on the effect of humanitarian disasters on NCDs in LMICs assessing epidemiology, interventions, and treatment.MethodsA systematic search in MEDLINE, MEDLINE (PubMed, for in-process and non-indexed citations), Social Science Citation Index, and Global Health (EBSCO) for indexed articles published before December 11, 2017 was conducted, and publications reporting on NCDs and humanitarian emergencies in LMICs were included. We extracted and synthesized results using a thematic analysis approach and present the results by disease type. The study is registered at PROSPERO (CRD42018088769).ResultsOf the 85 included publications, most reported on observational research studies and almost half (48.9%) reported on studies in the Eastern Mediterranean Region (EMRO), with scant studies reporting on the African and Americas regions. NCDs represented a significant burden for populations affected by humanitarian crises in our findings, despite a dearth of data from particular regions and disease categories. The majority of studies included in our review presented epidemiologic evidence for the burden of disease, while few studies addressed clinical management or intervention delivery. Commonly cited barriers to healthcare access in all phases of disaster and major disease diagnoses studied included: low levels of education, financial difficulties, displacement, illiteracy, lack of access to medications, affordability of treatment and monitoring devices, and centralized healthcare infrastructure for NCDs. Screening and prevention for NCDs in disaster-prone settings was supported. Refugee status was independently identified both as a risk factor for diagnosis with an NCD and conferred worse morbidity.ConclusionsAn increased focus on the effects of, and mitigating factors for, NCDs occurring in disaster-afflicted LMICs is needed. While the majority of studies included in our review presented epidemiologic evidence for the burden of disease, research is needed to address contributing factors, interventions, and means of managing disease during humanitarian emergencies in LMICs.

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Correction to: A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions

BMC Health Services Research ◽

10.1186/s12913-019-4766-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Hamid Ravaghi ◽

Mahnaz Afshari ◽

Parvaneh Isfahani ◽

Victoria D. Bélorgeot

Keyword(s):

Systematic Review ◽

Mediterranean Region ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Original Publication

In the original publication of this article [1], one author’s name needs to be revised from Pavaneh Isfahani to Parvaneh Isfahani.

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Meta-Analysis and Systematic Review of Micro- and Macro-Nutrient Intakes and Trajectories of Macro-Nutrient Supply in the Eastern Mediterranean Region

Nutrients ◽

10.3390/nu13051515 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1515

Author(s):

Radhouene Doggui ◽

Hanin Al-Jawaldeh ◽

Jalila El Ati ◽

Rawhieh Barham ◽

Lara Nasreddine ◽

...

Keyword(s):

Systematic Review ◽

Energy Supply ◽

Nutrient Intake ◽

Mediterranean Region ◽

Eastern Mediterranean ◽

Daily Intake ◽

Eastern Mediterranean Region ◽

High Energy ◽

Institute Of Medicine ◽

Nutrient Deficiencies

The Eastern Mediterranean Region (EMR) is experiencing a nutrition transition, characterized by the emergence of overnutrition and micro-nutrient deficiencies. No previous study has comparatively examined nutrient intake in adults across countries in the EMR. This review examined the adequacy of nutrients in adults living in the EMR. Moreover, it analyzed the food balance sheets (FBS) for 1961–2018 to identify the trajectory of energy supply from macro-nutrients in the EMR. A systematic search was conducted from January 2012 to September 2020. Only observational studies were retained with a random sampling design. An assessment of the methodological quality was conducted. Levels of nutrient daily intake and their adequacy compared to the daily reference intake of the Institute of Medicine were reported across the region. No studies were identified for half of the region’s countries. Although nutrient energy intake was satisfactory overall, fat and carbohydrate intake were high. Intake of vitamin D, calcium, potassium, zinc, and magnesium were below that recommended. The analysis of the FBS data allowed for the identification of four linear patterns of trajectories, with countries in the EMR best fitting the ‘high-energy-supply from carbohydrate’ group. This systematic review warrants multi-sectorial commitment to optimize nutrient intake.

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Posttraumatic Stress in Adult Civilians Exposed to Violent Conflict, War and Associated Human Rights Abuses in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

Journal of Affective Disorders ◽

10.1016/j.jad.2021.06.042 ◽

2021 ◽

Author(s):

Jana Stein ◽

Helen Niemeyer ◽

Caroline Meyer ◽

Christina Wirz ◽

Anna Eiling ◽

...

Keyword(s):

Systematic Review ◽

Human Rights ◽

Posttraumatic Stress ◽

Mediterranean Region ◽

Eastern Mediterranean ◽

Meta Analysis ◽

Eastern Mediterranean Region ◽

Violent Conflict ◽

Human Rights Abuses

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Self-medication with antibiotics in WHO Eastern Mediterranean Region: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-39213/v1 ◽

2020 ◽

Author(s):

Reza Negarandeh ◽

Shah Jahan Shayan ◽

Rajab Nazari ◽

BSc. Frank Kiwanuka ◽

MSc. Sanaz Akhavan Rad

Keyword(s):

Systematic Review ◽

Mediterranean Region ◽

Respiratory Infections ◽

Eastern Mediterranean ◽

Meta Analysis ◽

Eastern Mediterranean Region ◽

World Health ◽

Common Source ◽

Self Medication ◽

Inappropriate Use

Abstract Background Recently, inappropriate use of antibiotics has been correlated with life-threatening side-effects such as adverse effects, increased cost of treatment, and the higher rate of microbial resistance. Besides, it leads to a waste of resources. Therefore, this review sought to determine the pooled prevalence of self-medication with antibiotics, self-medicated illness, reasons for self-medication, antibiotics used for self-medication, source of obtaining antibiotics, the inappropriate practice of antibiotics and suggested recommendations for talking self-medication with antibiotics in the Eastern Mediterranean Region of the World Health Organization (EMRWHO). Methods Review conforms to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Database search was conducted in PubMed, Scopus, Embase, and Web of Science using a combination of keywords which included; antimicrobial, antibacterial, antibiotic, self-medication, self-treatment, self-prescription, non-prescribed, irrational use, inappropriate use, misuse, abuse and Eastern Mediterranean Region of WHO countries. The lists of references of the selected articles were also hand-searched to obtained additional relevant articles. Studies published in English from 2000 to 2018 were included in the review. Results We report on data from 60 articles and 49629 participants in this review. The overall prevalence of self-medication with antibiotics in EMRWHO was 47.2% (95% CI 41.6% – 52.9%). Yemen has the highest pooled rate with a rate of 75.0% (95% CI 63.4% − 83.9%), whilst Lebanon has the lowest pooled rate with a prevalence of 28.7% (95% CI 18.4% − 41.8%). The most common illnesses implicated in antibiotic self-medication were upper-respiratory infections and the most common antibiotic was Amoxicillin-Clavulanic acid. The commonest reasons for antibiotic self-medication include: saving time and money. Pharmacies pointed out as the most common source of obtaining antibiotics for self-medication. Conclusion Self-medication with antibiotics is significantly high in the member states of EMRWHO. Intervention such as an educational program for communities’ members to change their behaviors, policy on the mechanism of distribution of antibiotics is called for in this area.

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