scholarly journals Nutritional Anaemia and Obesity in the Eastern Mediterranean Region: The Protective Role of Breastfeeding for Two Years

2018 ◽  
Author(s):  
Azza Abul-Fadl ◽  
Afaf Tawfik ◽  
Ayoub Al-Jawaldeh
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Protective Role ◽  
Overweight And Obesity ◽  
Low Income Countries ◽  
Income Groups

Background: The preexistence of obesity with nutritional anaemia is becoming an increasing problem in the Eastern Mediterranean Region (EMR). Much controversy exists around the role of continued breastfeeding in alleviating the health and survival consequences of these problems in the region. Aim: To examine trends and relationships of nutritional anaemia (NA) in women and children under-five years of age (CU5) with obesity and breastfeeding practices in the EMR. Methods: Data from regional database banks of WHO and UNICEF for anaemia in pregnant and non-pregnant women and CU5 from 22 countries in EMR were retrieved, compiled, and statistically analyzed. Breastfeeding indicators for timely first suckle (TFS), exclusive breastfeeding (EBF) and continued breastfeeding for 12 (BFC12) and 24 months (BFC24), low-birth-weight (LBW), stunting, overweight, total fertility rates (TFR) and mortality rates (MR) were correlated with nutritional anaemia and analyzed by income groups into 5 low income countries (LIC), 11 middle income countries (MIC) and 6 high income countries (HIC). Results: Trends in mean prevalence of anaemia in women showed a concave curve increasing after a short decrease in the early 2000 in all income groups (P > 0.05). Trends in anaemia in the CU5 exhibited a steep decrease from a mean of 52.59 ± 16.4 in 2000 to 37.3 ± 14.9 in 2016 at P < 0.002, the steep decline was significant in HIC (P < 0.01) and MIC (P < 0.02), but not for LIC (P > 0.05). Anaemia prevalence in women and CU5 was significantly correlated to LBW, stunting, and with overweight and obesity in adults but negatively in CU5. All age specific MRs were highly correlated with anaemia in pregnant, non-pregnant and CU5 at P < 0.001 and TFR at P < 0.05. BFC for shorter durations was negatively correlated with anaemia in pregnant women (r-0.5) at P < 0.05 and was positively correlated in MIC and HIC. In non-pregnant women, BFC12 and BFC 24 correlated positively with anaemia prevalence in all three income groups at P < 0.01. Conclusions: Completing optimal breastfeeding for two years should be promoted to protect women and CU5 from anemia and obesity. Nutritional anemia during pregnancy increases regional rates of LBW, stunting and mortality. Spacing out births by encouraging longer duration of breastfeeding, to replenish iron stores, can help alleviate many of the health and nutritional problems in the region.

scholarly journals The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990–2013

2017 ◽  
Vol 41 (S1) ◽  
pp. S156-S157 ◽  
Author(s):  
R. Charara ◽  
A. Mokdad
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Low Income ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Low Income Countries ◽  
Years Of Life Lost ◽  
Life Years

The eastern Mediterranean region (EMR) is witnessing an increase in mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the global burden of disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of total disease burden in EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years. The highest proportion of DALYs occurred in the 25–49 age group. The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Depressive disorders accounted for most DALYs, followed by anxiety disorders. Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to global level. Our findings call for EMR health ministries to increase provision of mental health services and to address stigma of mental illness. Our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability.

scholarly journals Access to fludrocortisone and to hydrocortisone in children with congenital adrenal hyperplasia in the WHO Eastern Mediterranean Region: it takes a village…

2021 ◽  
Vol 6 (10) ◽  
pp. e007195
Author(s):  
Amanda Rowlands ◽  
Asma Deeb ◽  
Asmahane Ladjouze ◽  
Rasha T Hamza ◽  
Salwa A Musa ◽  
...  
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Low Income ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Pharmaceutical Companies ◽  
High Morbidity ◽  
Adrenal Hyperplasia

Congenital adrenal hyperplasia (CAH), if untreated, carries high morbidity and mortality. A higher incidence of CAH is expected in countries where consanguinity is common, such as in the countries of the WHO Eastern Mediterranean Region (EMRO). CAH is managed through lifelong treatment with fludrocortisone and hydrocortisone. In this analysis, performed in the 22 EMRO countries and territories plus Algeria, we review which countries offer a neonatal screening programme for CAH and describe the barriers and opportunities to access oral fludrocortisone and oral and injectable hydrocortisone. Neonatal CAH screening was only available nationally in Qatar, Kuwait and partially in Lebanon and Saudi Arabia. We reviewed the national lists of essential medicines (NEMLs) and found that 13/23 (57%) countries included fludrocortisone and 18/23 (78%) included oral hydrocortisone. Fludrocortisone was not included by any of the low-income countries and oral hydrocortisone was only included by one low-income country. We then contacted paediatric endocrinologists in each country to assess perceived availability of these medicines. Overall, there was a relatively good consistency between inclusion of fludrocortisone and hydrocortisone in the NEML and their actual availability in a country. We propose several mechanisms to improve access, including prequalification by the WHO, a common registration process for groups of countries, pooled procurement, working with local pharmaceutical companies, special access status for medicines not yet registered in a country and compounding. We suggest that access to medicines requires a collaboration between health professionals, families of patients, health authorities, pharmaceutical companies and the WHO.

scholarly journals Tackling Childhood Stunting in the Eastern Mediterranean Region in the Context of COVID-19

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 239
Author(s):  
Ayoub Al Jawaldeh ◽  
Radhouene Doggui ◽  
Elaine Borghi ◽  
Hassan Aguenaou ◽  
Laila El Ammari ◽  
...  
Keyword(s):  
Low Income ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Reduction Rate ◽  
Eastern Mediterranean Region ◽  
Low Income Countries ◽  
Number Of Children ◽  
Important Health ◽  
Childhood Stunting ◽  
Children Under 5

Over 20 million children under 5 years old in the WHO Eastern Mediterranean Region have stunted growth, as a result of chronic malnutrition, with damaging long-term consequences for individuals and societies. This review extracted and analyzed data from the UNICEF, WHO and the World Bank malnutrition estimates to present an overall picture of childhood stunting in the region. The number of children under 5 in the region who are affected by stunting has dropped from 24.5 million (40%) in 1990 to 20.6 million (24.2%) in 2019. The reduction rate since the 2012 baseline is only about two fifths of that required and much more rapid progress will be needed to reach the internationally agreed targets by 2025 and 2030. Prevalence is highest in low-income countries and those with a lower Human Development Index. The COVID-19 pandemic threatens to undermine efforts to reduce stunting, through its impact on access and affordability of safe and nutritious foods and access to important health services. Priority areas for action to tackle stunting as part of a comprehensive, multisectoral nutrition strategy are proposed. In light of the threat that COVID-19 will exacerbate the already heavy burden of malnutrition in the Eastern Mediterranean Region, implementation of such strategies is more important than ever.

scholarly journals Variation in COVID-19 among Eastern Mediterranean Region countries: A comparative study

2020 ◽  
Author(s):  
Ahmed Hassan Albelbeisi ◽  
Ali Albelbeisi ◽  
Abdel Hamid El Bilbeisi ◽  
Amany El Afifi ◽  
Mahmoud Taleb
Keyword(s):  
Low Income ◽  
Death Rate ◽  
Mediterranean Region ◽  
United Arab Emirate ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Screening Tests ◽  
Low Income Countries ◽  
Substantial Variation ◽  
The World

Abstract Objective: Coronavirus disease 2019 (COVID-19) is spreads in 216 countries and territories among the world including all Eastern Mediterranean Region countries. The aim of the present study was to examine variation of COVID-19 in different income class countries of the Eastern Mediterranean Region. Methods: Five parameters such as the percentage of variation COVID-19 confirmed cases, the percentage of variation number of deaths, death rate per 1000 confirmed cases, the percentage of variation death rate per 1000 confirmed cases, and tests per one million were calculated. Results: The results demonstrated that all Eastern Mediterranean Region countries increase in percentage of COVID-19 confirmed cases except Tunisia, the increasing range from 53.5% in Libya to 4.7% in Morocco. Death rate per 1000 confirmed cases range from 230.1 in Yemen to 0.92 in Qatar. Majority of countries increase in percentage of COVID-19 deaths cases number, which range from 43.7% in Iraq to 1.4% in Morocco. Fourteen countries decrease in percentage of death rate per 1000, the decreasing range from 34.9% in Libya to 0.09 in Yemen. The tests per one million range from 265687 in United Arab Emirate to four in Yemen. Conclusion: The current study findings showed significant variations between the Eastern Mediterranean Region countries, the substantial variation is concerning. The low-income countries appeared more vulnerable compared to high-income countries; the low-income countries should not be alone with this pandemic. Hence then global should be helping these countries and particular plans have to be employed. These must include screening tests COVID-19 virus.

scholarly journals Determine The Problems Of Women Entrepreneurs And The Research Of The Effects Of These Problems On Women's Initiatives: A Case Study Of The Eastern Mediterranean Region

2021 ◽  
Vol 4 (1) ◽  
pp. 225-331
Author(s):  
Dilehan Avşar ◽  
Gökhan Avşar
Keyword(s):  
Labor Market ◽  
Women Entrepreneurs ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Face To Face ◽  
Sectoral Structure ◽  
Lack Of Information ◽  
New Business

The number of women entrepreneurs who start a new business or own a business has been increasing rapidly in recent years. The aim of this study was to determine the problems faced by women entrepreneurs registered in the associations and chambers of business in the Eastern Mediterranean Region during their entrepreneurship and to examine the effects of these problems on women entrepreneurs. The main purpose of this study is to define the role of female labor force in the new sectoral structure in the changing labor market. In addition, it is aimed to identify the existing entrepreneurship activities, to examine the barriers to entrepreneurship and to propose solutions to the problems identified in line with the findings. The role of women entrepreneurs in the labor market is examined. Evaluating these factors, which are thought to affect the business life of women entrepreneurs, to develop suggestions that can contribute to their development and empowerment. Within the scope of this study, women entrepreneurs in the Eastern Mediterranean Region were investigated. In the preliminary study, women entrepreneurs registered as women entrepreneurs were identified by contacting the Chamber of Commerce, Chamber of Industry, Organized Industrial Zone and Commodity Exchange, and the research was conducted through face-to-face questionnaires with the entrepreneurs who accepted the interview in Eastern Mediterranean Region. At the end of the study, the most common problems faced by women engaged in entrepreneurship activity were; low level of education, insufficient financial support and lack of information. In developing countries such as Turkey, especially in terms of the effects of women's entrepreneurship development should not be ignored.

scholarly journals Overweight and obesity in the Eastern Mediterranean Region: can we control it?

2004 ◽  
Vol 10 (6) ◽  
pp. 789-793 ◽  
Author(s):  
A. O. Musaiger
Keyword(s):  
Socioeconomic Factors ◽  
Mediterranean Region ◽  
Dietary Habits ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Overweight And Obesity ◽  
National Programmes ◽  
The Status ◽  
Prevalence Of Obesity ◽  
And Control

Obesity has become an epidemic problem worldwide, and in the Eastern Mediterranean Region the status of overweight has reached an alarming level. A prevalence of 3%-9% overweight and obesity has been recorded among preschool children, while that among schoolchildren was 12%-25%. A marked increase in obesity generally has been noted among adolescents, ranging from 15% to 45%. In adulthood, women showed a higher prevalence of obesity [35%-75%] than men [30%-60%]. Several factors, such as change in dietary habits, socioeconomic factors, inactivity and multiparity [among women] determine obesity in this Region. There is an urgent need for national programmes to prevent and control obesity in the countries of the Region

scholarly journals The role of MEFV gene in COVID 19 disease, as a protective factor

2020 ◽  
Author(s):  
Farhad Salehzadeh ◽  
Ehsan Shahbazifar ◽  
Farhad Pourfarzi ◽  
Rassol Molatefi ◽  
Behzad Davarnia ◽  
...  
Keyword(s):  
Protective Factor ◽  
Eastern Mediterranean ◽  
Mefv Gene ◽  
Positive Family History ◽  
Eastern Mediterranean Region ◽  
Gene Mutations ◽  
Protective Role ◽  
Carrier Rate ◽  
Novel Coronavirus

Abstract Background In early 2020, an outbreak of pneumonia caused by a novel coronavirus became pandemic. This study evaluates the potential immune-genetically role of MEFV gene mutations in COVID 19 patients. Methods 50 COVID 19 PCR positive patients who were hospitalized in COVID 19 referral centers between 1st of March to 30th of April in 2020 were evaluated for MEFV gene mutations using ARMS PCR and Sanger sequencing. Results MEFV gene mutations were found in 6 (12%) of the patients. No homozygote or compound heterozygote forms were detected. The total mutant allele frequency was 6%. The carrier rate was 12% which is significantly lower than previously studied rate of 25%. The most common MEFV variant was E148Q in 3 (6%). There was no mutant variant of MEFV gene among the expired patients. None of the MEFV gene mutant patients had FMF symptoms or positive family history of FMF disease. Conclusion Considering the high carrier rate of MEFV gene mutations in the eastern Mediterranean region and a significantly lower prevalence of these mutations in COVID 19 patients, it seems that MEFV gene mutations may have a protective role in incidence of the disease.

scholarly journals Implementation of WHO Recommended Policies and Interventions on Healthy Diet in the Countries of the Eastern Mediterranean Region: From Policy to Action

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3700
Author(s):  
Ayoub Al-Jawaldeh ◽  
Asmus Hammerich ◽  
Radhouene Doggui ◽  
Kaia Engesveen ◽  
Krista Lang ◽  
...  
Keyword(s):  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Scale Up ◽  
Eastern Mediterranean Region ◽  
Absolute Number ◽  
Overweight And Obesity ◽  
Healthy Diet ◽  
Salt Reduction ◽  
Nutrition And Diet ◽  
Concrete Action

Non-communicable diseases (NCDs) are responsible for almost two-thirds of the deaths in the 22 countries and territories of the WHO Eastern Mediterranean Region and unhealthy diets are a major contributor. Prevalence of overweight and obesity has increased among adults, adolescents and older children in recent decades. Among countries with the highest prevalence there are signs that the increase is slowing down or even that prevalence is declining. There has been no increase in the prevalence rate in younger children, although the absolute number of children under five years affected by overweight has increased. This review summarizes prevalence data and examines current implementation of regulatory, fiscal and voluntary measures to promote healthy diet across the Region. The last decade has seen a step up in such action. Ten of the Region’s countries have policies relating to trans-fatty acids and they are increasingly implementing specific regulatory measures. Thirteen countries had fully or partially implemented national salt reduction policies by 2019. Only four countries had adopted policies relating to aspects of marketing food to children by 2019, and concrete action in this area is still lacking. Eight countries have introduced taxes—sometimes at a rate of 50%—on carbonated or sugar-sweetened beverages. In order to meet the agreed global and regional goals relating to nutrition and diet-related NCDs, countries will need to build on this progress and scale up action across the Region while intensifying efforts in areas where concrete action is lacking.

scholarly journals Overweight and Obesity in Eastern Mediterranean Region: Prevalence and Possible Causes

2011 ◽  
Vol 2011 ◽  
pp. 1-17 ◽  
Author(s):  
Abdulrahman O. Musaiger
Keyword(s):  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Nutrition Transition ◽  
Age Groups ◽  
Eastern Mediterranean Region ◽  
Overweight And Obesity ◽  
Cultural Elements ◽  
Sugary Beverages ◽  
Duration Of Breastfeeding ◽  
Skipping Breakfast

The objective of this paper was to explore the prevalence of overweight and obesity among various age groups as well as discuss the possible factors that associated with obesity in the Eastern Mediterranean Region (EMR). A systematic review of published papers between 1990 and 2011 was carried out. Obesity reached an alarming level in all age groups of the EMR countries. The prevalence of overweight among preschool children(<5 years) ranged from 1.9% to 21.9%, while the prevalence of overweight and obesity among school children ranged from 7% to 45%. Among adults the prevalence of overweight and obesity ranged from 25% to 81.9%. Possible factors determining obesity in this region include: nutrition transition, inactivity, urbanization, marital status, a shorter duration of breastfeeding, frequent snacking, skipping breakfast, a high intake of sugary beverages, an increase in the incidence of eating outside the home, long periods of time spent viewing television, massive marketing promotion of high fat foods, stunting, perceived body image, cultural elements and food subsidize policy. A national plan of action to overcome obesity is urgently needed to reduce the economic and health burden of obesity in this region.

Risk Factors of COVID-19 Critical Outcomes in the Eastern Mediterranean Region: A Multicountry Retrospective Study (Preprint)

2021 ◽  
Author(s):  
Faris Lami ◽  
Maisa Elfadul ◽  
Hiba Abdulrahman Rashak ◽  
Mohannad Al Nsour ◽  
Hashaam Akhtar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Heart Diseases ◽  
Eastern Mediterranean Region ◽  
Renal Diseases ◽  
Contributing Factors ◽  
Country Study ◽  
Wide Scale

BACKGROUND The establishment of empirical evidence in the Eastern Mediterranean Region (EMR) necessitates the implementation of wide-scale studies to describe the demographic, clinical features, and severity profile ofCOVID-19 patients. OBJECTIVE Hence, this study aimed to to assess the patterns of COVID-19 severity and mortality in seven countries and to determine the risk factors of COVID-19 severity and mortality. METHODS This multi-country study was based on a retrospective review of medical records of hospitalized patients confirmed to have COVID-19. This study included data from Iraq, Pakistan, Sudan, Somalia, Morocco, Egypt, and Yemen. All demographic and clinical data were extracted from hospital records (paper files) by trained data collectors. RESULTS A total of 4141 patients were included in this study from seven countries. Comorbidities were reported by nearly half of the patients, with hypertension (HT)(24.7%)and diabetes (22.7%) being the most common. Older age, diabetes mellitus, hypertension, and heart diseases were significantly associated with COVID-19 severity and mortality. Ever smoking and renal diseases were significantly associated with severity but not mortality, while male gender, respiratory diseases, and malignancy were significantly associated with mortality but not severity. CONCLUSIONS The study confirmed the role of comorbidities and demographic features on the severity and mortality of COVID-19. Understanding the contributing factors ensures attentive care and informs clinical management of patients with poorer prognosis in early stages of

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