Significant Decline of Malaria Incidence in Southwest of Iran (2001–2014)

Iran is considered as one of the malaria endemic countries of the Eastern Mediterranean Region (EMR) and is at risk due to neighboring Afghanistan, Pakistan in the east, and Iraq to the west. Therefore the aim of the present investigation is the evaluation of the trend of malaria distribution during the past decade (2001–2014) in Khuzestan province, southwestern Iran. In this retrospective cross-sectional investigation, blood samples were taken from all malaria suspicious cases who were referred to health centers across Khuzestan province. For each positive subject a questionnaire containing demographic information was filled out. Data analysis was performed using SPSS 18. From a total of 541 malaria confirmed cases, 498 (92.05%) were male and 43 (7.95%) were female. The highest number of infections was seen in 2001 with 161 (29.75%) cases and the lowest was in 2014 with 0 (0%). Also,Plasmodium vivaxwas identified as dominant species in 478 (88.35%) individuals andP. falciparumcomprised 63 (11.65%). The highest infection rate was observed in non-Iranian populations with number 459 (84.85%) and imported cases 508 (93.90%). Also, the majority of subjects were over 15 years of age, 458 (84.65%). Due to proximity to endemic countries which has made the malaria campaign difficult, more effort is needed to control the infection in order to achieve malaria elimination.

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COVID-19 Pandemic Affects the Medical Students’ Learning Process and Assaults Their Psychological Wellbeing

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115792 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5792

Author(s):

Marium Aftab ◽

Alsaleem Mohammed Abadi ◽

Shamsun Nahar ◽

Razia Aftab Ahmed ◽

Syed Esam Mahmood ◽

...

Keyword(s):

Medical Students ◽

Psychiatric Illness ◽

Eastern Mediterranean ◽

Learning Difficulties ◽

Eastern Mediterranean Region ◽

Female Gender ◽

Psychological Wellbeing ◽

Post Traumatic Stress ◽

African Region ◽

Cross Sectional

Background: With the emergence of the COVID-19 pandemic, people are living within a milieu of stress, anxiety, and fear. Medical students are susceptible to these emotional injuries, but their psychological wellbeing and learning may further be assaulted by future uncertainties and altered teaching and training programs. Our objective was to find the extent of the psychological impact of the pandemic and the learning difficulties they are experiencing; Methodology: This cross-sectional study included 418 undergraduate and postgraduate medical students from all over the world. A questionnaire was uploaded in Google survey form. It included background characteristics, questions for psychiatric impact like PHQ-9, GAD-7, ZF-OCS, and questions for learning difficulties perceived in comparison to the pre-pandemic time. Results: Among participants, 34.9% of students were male and 65.1% female. Around 46.4% belonged to the WHO, Eastern Mediterranean region, 26.8% from South East Asia region, 17.5% from the region of America, 5.5% from the European region,2.2%from the Western Pacific region, and 1.7% from the African region. Symptoms due to psychiatric illness were noticed in 393 (93.1%); depression in 386 (92.3%), anxiety in 158 (37.8%), obsessive compulsion disorder in 225 (53.8%), and post-traumatic stress syndrome in 129 (39.9%). Female gender, geographical region, and history of previous psychiatric illness were significantly related to almost all the psychiatric illnesses. Regarding learning difficulty, 96% of students faced problems: trouble with memorizing in 54.0%, concentration problems in 67.0%, about 55.5% of students made more mistakes, while 44.5% noted an increase in reaction time for solving questions. In addition, 90% experienced greater difficulty in overall learning during the pandemic in comparison to the pre-pandemic time. Conclusion: Assault on psychological wellbeing, struggling to memorize, inattention and difficulty in concentration on studies, along with perceived overall trouble with learning, have emerged as collateral damage from the COVID-19 pandemic with respect to medical students.

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Intention of Healthcare Workers to Receive COVID-19 Vaccine: A Cross-Sectional Survey in 10 Countries in Eastern Mediterranean Region

10.1101/2021.03.20.21253892 ◽

2021 ◽

Author(s):

Yasir Ahmed Mohammed Elhadi ◽

Azza Mehanna ◽

Yusuff Adebayo Adebisi ◽

Mohammad Yasir Essar ◽

Haider M El Saeh ◽

...

Keyword(s):

Mediterranean Region ◽

Healthcare Workers ◽

Online Survey ◽

Health Workers ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

To Receive

Background: Healthcare workers intention to be vaccinated is an important factor to be consider for successful COVID-19 vaccination programme. Our study aimed to understand the intention of health workers to receive COVID-19 vaccine and associated concerns across 10 countries in Eastern Mediterranean Region (EMRO). Method: A cross-sectional study was conducted in January 2021 among healthcare workers using an online survey. A total of 2806 health workers (physicians, nurses and pharmacists) completed and returned the informed consent along with the questionnaire electronically. Data were analyzed using IBM SPSS software package version 20.0. Results: More than half of the respondents (58.0%) intend to receive COVID-19 vaccine, even if the vaccination is not mandatory for them. On the other hand, 25.7% of respondents were not intending to undertake COVID-19 vaccination while 16.3 % answered undecided. The top three reasons for not intending to be vaccinated were unreliability of COVID-19 vaccine clinical trials (62.0%), fear of the side effects of the vaccine (45.3%), and that COVID-19 vaccine will not give immunity for a long period of time (23.1%). Conclusion: Overall, our study revealed suboptimal acceptance of COVID-19 vaccine among healthcare workers in the 10 countries in EMRO.

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Attitudes, perceptions, and smoking behavior of university faculty and staff following the introduction of a comprehensive tobacco-free policy: a repeated cross-sectional survey in Lebanon

10.21203/rs.3.rs-20890/v1 ◽

2020 ◽

Author(s):

Dina Farran ◽

Rima Nakkash ◽

Mahmoud Al-Hindi ◽

Maya Romani ◽

Martin John Owen Asser ◽

...

Keyword(s):

Educational Attainment ◽

Policy Implementation ◽

Eastern Mediterranean ◽

Smoking Behavior ◽

Eastern Mediterranean Region ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Faculty And Staff ◽

One Year ◽

Lower Educational Attainment

Abstract Background A growing body of research have evaluated the effect of university tobacco-free policies on faculty and staff, however, none of these studies has been carried out in the Eastern Mediterranean region. This study evaluates changes in faculty and staff attitudes, perceptions and smoking behavior, one year post-adoption of a tobacco-free policy in a medium-sized university in Lebanon and the region. Methods Two cross-sectional surveys were conducted in 2017 and 2018: pre- and one year post-policy implementation. A random sample of 625 and 624 participants took part in the 2017 and 2018 studies respectively. Results Faculty and staff had a positive attitude towards the policy at the two time points. The belief that there should be exceptions to the policy significantly decreased from 79% to 59% (p=0.002) among all smokers, particularly those with lower educational attainment (81% to 57%, p=0.007). Perception of compliance among peer smokers increased from 73% to 87% (p= 0.009). The proportion of smokers did not significantly change one year post-policy implementation, however, 44% of smokers with lower educational attainment, compared to only 7% of those with higher educational attainment (p< 0.001), reported a decrease in their smoking behavior outside campus. Conclusion The policy had a positive effect on the attitude, behavior and perception of policy benefits among smokers with lower educational attainment, who constitute the majority of smokers. Studies tackling the effectiveness of university or workplace smoke-free policies are scarce in the Middle East. Findings from this study inform and support future efforts to develop university and workplace tobacco free policies.

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Awareness and Preparedness of Field Epidemiology Training Program Graduates to Respond to COVID-19 in the Eastern Mediterranean Region: Cross-Sectional Study

JMIR Medical Education ◽

10.2196/19047 ◽

2020 ◽

Vol 6 (1) ◽

pp. e19047 ◽

Cited By ~ 1

Author(s):

Mohannad Al Nsour ◽

Yousef Khader ◽

Abdulwahed Al Serouri ◽

Haitham Bashier ◽

Shahd Osman

Keyword(s):

Training Program ◽

Mediterranean Region ◽

Online Survey ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Risk Groups ◽

Surveillance Systems ◽

Cross Sectional ◽

Field Epidemiology ◽

Field Epidemiology Training Program

Background The Field Epidemiology Training Program (FETP) is a 2-year training program in applied epidemiology. FETP graduates have contributed significantly to improvements in surveillance systems, control of infectious diseases, and outbreak investigations in the Eastern Mediterranean Region (EMR). Objective Considering the instrumental roles of FETP graduates during the coronavirus disease (COVID-19) crisis, this study aimed to assess their awareness and preparedness to respond to the COVID-19 pandemic in three EMR countries. Methods An online survey was sent to FETP graduates in the EMR in March 2020. The FETP graduates were contacted by email and requested to fill out an online survey. Sufficient number of responses were received from only three countries—Jordan, Sudan, and Yemen. A few responses were received from other countries, and therefore, they were excluded from the analysis. The questionnaire comprised a series of questions pertaining to sociodemographic characteristics, knowledge of the epidemiology of COVID-19, and preparedness to respond to COVID-19. Results This study included a total of 57 FETP graduates (20 from Jordan, 13 from Sudan, and 24 from Yemen). A total of 31 (54%) graduates had attended training on COVID-19, 29 (51%) were members of a rapid response team against COVID-19, and 54 (95%) had previous experience in response to disease outbreaks or health emergencies. The vast majority were aware of the main symptoms, mode of transmission, high-risk groups, and how to use personal protective equipment. A total of 46 (81%) respondents considered themselves well prepared for the COVID-19 outbreak, and 40 (70%) reported that they currently have a role in supporting the country’s efforts in the management of COVID-19 outbreak. Conclusions The FETP graduates in Jordan, Sudan, and Yemen were fully aware of the epidemiology of COVID-19 and the safety measures required, and they are well positioned to investigate and respond to the COVID-19 pandemic. Therefore, they should be properly and efficiently utilized by the Ministries of Health to investigate and respond to the current COVID-19 crisis where the needs are vastly growing and access to outside experts is becoming limited.

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Awareness and response to Coronavirus Disease (Covid-19) epidemic among the Arab population in the Eastern Mediterranean Region and Arab Peninsula

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v6i4.809 ◽

2020 ◽

Vol 6 (4) ◽

Author(s):

Mhammad Saleh ◽

Marwan Saleh ◽

Mohammed Nabil Zahid

Keyword(s):

Social Media ◽

Online Survey ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Arabic Language ◽

Control Measures ◽

Full Time ◽

Arab Population ◽

Cross Sectional ◽

Infection Control Measures

Objectives: This online survey planned to analyze the knowledge and apprehension about coronavirus among the Arab populations. Methods: a cross-sectional questionnaire-based survey was conducted from 15th May 2020 to 27th May 2020. The survey included a total of 443 Arab participants. Divided into four groups according to the age; under 20 years old (28 participants), 20- 40 (359), 40- 60 (49), and 7 participants were over 60. According to gender; male (318 participants) and female (125). Based on education level, participants were categorized as a secondary school (5 participants), high school (28), university graduated (327), and postgraduate (83). Results: Most of the participants showed a good adaptation for the precautions concerning isolation and quarantine. 299 participants stayed at home during the COVID-19 outbreak by taking a break from jobs or performing their jobs from home. 144 participants performed partial or full-time jobs from 20-60 groups of age. Most of the population were dependent on social media to receive the update about the virus. 141 participants said that they are not up to date enough about the COVID-19 related to the language barrier. Conclusion: The majority of the participants had heard about COVID-19 and were aware of the infection control measures. Most of the participants strictly adapted to quarantine during the outbreak. Further steps need to be taken to enhance the social media accounts and internet websites in the Arabic language which concern medical and educational content.

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Detection ofToxoplasma gondiiby PCR and Mouse Bioassay in Rodents of Ahvaz District, Southwestern Iran

BioMed Research International ◽

10.1155/2014/383859 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

J. Saki ◽

S. Khademvatan

Keyword(s):

Rattus Norvegicus ◽

Chronic Infection ◽

Rattus Rattus ◽

Mouse Bioassay ◽

Intermediate Hosts ◽

Khuzestan Province ◽

Zoonotic Parasite ◽

Southwestern Iran ◽

Southwest Of Iran ◽

Southwest Iran

Toxoplasma gondiiis obligate coccidian zoonotic parasite. Felidae family is definitive and wide ranges of warm-blooded vertebrates are intermediate hosts for the parasite. Rodents are measured as an important source ofT. gondiiinfection for the definitive host. Thus, this study aimed to investigateToxoplasminfection in rodents of Ahvaz district, southwest of Iran. A total of 100 rodents (73Rattus norvegicus, 21Rattus rattus, and 6Mus musculus) were collected and studied by GRA6PCR and mouse bioassay. The finding indicated that 6 out of 100 (6%) and 2 out of 100 (2%) samples were positive by PCR and mouse bioassay, respectively. The results show notable chronic infection in the rodent and potential transmission of the infection among animal and men in the region. Accordingly, this study recommended investigating of theT. gondiiinfection in definitive and other intermediate hosts in other points of Khuzestan province, Southwest, Iran.

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Are we ready for a person-centered care model for patient-physician consultation? A survey from family physicians of East Mediterranean Region

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v1i2.679 ◽

2013 ◽

Vol 1 (2) ◽

pp. 394

Author(s):

Waris Qidwai ◽

Kashmira Nanji ◽

Tawfik Khoja ◽

Salman Rawaf ◽

Nabil Yasin Al Kurashi ◽

...

Keyword(s):

Mediterranean Region ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Educational Status ◽

Cross Sectional Study ◽

Second Phase ◽

Care Model ◽

Cross Sectional ◽

Person Centered Care ◽

Centered Care

Background: Person-centered care has long been identified as a key component of health systems and one of the six domains of quality. This study aimed to identify the perceptions of patients and physicians regarding person-centered care in the Eastern Mediterranean Region (EMR).Methods: A multicountry, cross-sectional study was conducted in 6 countries of EMR during July 2012 to September 2012. From each country, an expert Family Physician (FP) was identified and invited for the study. During the first phase, 190 FPs practicing for at least 6 months were recruited. In the second phase, the recruited FPs approached 300 patients aged > 18 years with 1 or more recurring problems. Data analysis was conducted using SPSS version 19.Results: Of a total of 360 patients, 53% were between 25-40 years of age and the majority 55.7% were females. Among physicians, 66.8% were females and 72.1% had undergone specialization in Family Medicine from EMR. About 36% of the patients, while 62.6% of the physicians, preferred a person-centered care model of care. Among physicians, field of specialization (AOR= 0.7; 95% C.I: 0.3-0.9) and regularity in continuing medical education sessions (AOR= 0.3; 95% C.I: 0.1-0.5) were significant factors for preferring a person-centered care model. Educational status (AOR= 3.0; 95% C.I: 1.1-7.9) was associated with a preference for person-centered care among patients.Conclusion: The results of the study highlight that a majority of physicians prefer person-centered care, while patients prefer a mix of both patient- and physician-centered care. Strategies should be developed that will help physicians and patients to embrace person-centered care practices.

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Should we remain hopeful? The key 8 weeks: Spatiotemporal epidemic characteristics of COVID-19 in Sichuan Province and its comparative analysis with other provinces in China and global epidemic trends

10.21203/rs.3.rs-20551/v3 ◽

2020 ◽

Author(s):

Xinyin Xu ◽

Jing Zeng ◽

Runyou Liu ◽

Yang Liu ◽

Xiaobo Zhou ◽

...

Keyword(s):

Early Stage ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Sichuan Province ◽

Control Measures ◽

Health Crisis ◽

First Case ◽

Imported Cases ◽

And Control ◽

Epidemiological Characteristics

Abstract Background: The COVID-19 spread worldwide quickly. Exploring the epidemiological characteristics could provide a basis for responding to imported cases abroad and to formulate prevention and control strategies in areas where COVID-19 is still spreading rapidly. Methods: The number of confirmed cases, daily growth, incidence and length of time from the first reported case to the end of the local cases (i.e., non-overseas imported cases) were compared by spatial (geographical) and temporal classification and visualization of the development and changes of the epidemic situation by layers through maps. Results: In the first wave, a total of 539 cases were reported in Sichuan, with an incidence rate of 0.6462/100,000. The closer to Hubei the population centres were, the more pronounced the epidemic was. The peak in Sichuan Province occurred in the second week. Eight weeks after the Wuhan lockdown, the health crisis had eased. The longest epidemic length at the city level in China (except Wuhan, Taiwan, and Hong Kong) was 53 days, with a median of 23 days. Spatial autocorrelation analysis of China showed positive spatial correlation (Moran's Index >0, p<0.05). Most countries outside China began to experience a rapid rise in infection rates 4 weeks after their first case. Some European countries experienced that rise earlier than the USA. The pandemic in Germany, Spain, Italy, and China took 28, 29, 34, and 18 days, respectively, to reach the peak of daily infections, after their daily increase of up to 20 cases. During this time, countries in the African region and Southeast Asian region were at an early stage of infections, those in the Eastern Mediterranean region and region of the Americas were in a rapid growth phase. Conclusions: After the closure of the outbreak city, appropriate isolation and control measures in the next 8 weeks were key to control the outbreak, which reduced the peak value and length of the outbreak. Some countries with improved epidemic situations need to develop a continuous "local strategy at entry checkpoints" to respond to a possible second local epidemic.

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Should we remain hopeful? The key 8 weeks: spatiotemporal epidemic characteristics of COVID-19 in Sichuan Province and its comparative analysis with other provinces in China and global epidemic trends

BMC Infectious Diseases ◽

10.1186/s12879-020-05494-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Xinyin Xu ◽

Jing Zeng ◽

Runyou Liu ◽

Yang Liu ◽

Xiaobo Zhou ◽

...

Keyword(s):

Early Stage ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Sichuan Province ◽

Control Measures ◽

Health Crisis ◽

First Case ◽

Imported Cases ◽

And Control ◽

Epidemiological Characteristics

Abstract Background The COVID-19 spread worldwide quickly. Exploring the epidemiological characteristics could provide a basis for responding to imported cases abroad and to formulate prevention and control strategies in areas where COVID-19 is still spreading rapidly. Methods The number of confirmed cases, daily growth, incidence and length of time from the first reported case to the end of the local cases (i.e., non-overseas imported cases) were compared by spatial (geographical) and temporal classification and visualization of the development and changes of the epidemic situation by layers through maps. Results In the first wave, a total of 539 cases were reported in Sichuan, with an incidence rate of 0.6462/100,000. The closer to Hubei the population centres were, the more pronounced the epidemic was. The peak in Sichuan Province occurred in the second week. Eight weeks after the Wuhan lockdown, the health crisis had eased. The longest epidemic length at the city level in China (except Wuhan, Taiwan, and Hong Kong) was 53 days, with a median of 23 days. Spatial autocorrelation analysis of China showed positive spatial correlation (Moran’s Index > 0, p < 0.05). Most countries outside China began to experience a rapid rise in infection rates 4 weeks after their first case. Some European countries experienced that rise earlier than the USA. The pandemic in Germany, Spain, Italy, and China took 28, 29, 34, and 18 days, respectively, to reach the peak of daily infections, after their daily increase of up to 20 cases. During this time, countries in the African region and Southeast Asian region were at an early stage of infections, those in the Eastern Mediterranean region and region of the Americas were in a rapid growth phase. Conclusions After the closure of the outbreak city, appropriate isolation and control measures in the next 8 weeks were key to control the outbreak, which reduced the peak value and length of the outbreak. Some countries with improved epidemic situations need to develop a continuous “local strategy at entry checkpoints” to to fend off imported COVID-19.

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Differences in Dietary Intakes among Lebanese Adults over a Decade: Results from Two National Surveys 1997–2008/2009

Nutrients ◽

10.3390/nu11081738 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1738 ◽

Cited By ~ 5

Author(s):

Lara Nasreddine ◽

Jennifer J. Ayoub ◽

Fatima Hachem ◽

Jiana Tabbara ◽

Abla M. Sibai ◽

...

Keyword(s):

Eastern Mediterranean ◽

Dietary Assessment ◽

Nutrition Transition ◽

Temporal Trends ◽

Age Groups ◽

Eastern Mediterranean Region ◽

Fats And Oils ◽

Dietary Intakes ◽

Cross Sectional ◽

Middle Income

Amidst the ongoing societal and economic shifts in the Eastern Mediterranean region (EMR), this study aims at investigating temporal trends in food consumption and nutrient intakes among Lebanese adults, by age and sex. Data were derived from two national cross-sectional surveys conducted in Lebanon during two time periods (1997; 2008/2009). In both surveys, dietary assessment was based on 24-h recalls. The results, expressed as % energy intake (%EI), revealed a significant decrease (p < 0.001) in the consumption of bread, fruits, fresh fruit juices, milk and eggs, whereas the consumption of added fats and oils, poultry, cereals and cereal-based products, chips and salty crackers, sweetened milk and hot beverages increased over time (p < 0.001). A significant increase in dietary energy (kcal/day) and fat intake (%EI) was observed, coupled with decreases in carbohydrate intake (%EI) and dietary density of vitamin A and vitamin C (per 1000 kcal) (p < 0.001). These changes were noted in both genders and across age groups, albeit there were some disparities between groups. In conclusion, based on national nutrition surveys, this study is the first to characterize the nutrition transition in a middle-income country of the EMR, shedding light on priority areas for nutrition policies and interventions.

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