scholarly journals Human brucellosis in Gaza Strip, Palestine

1998 ◽  
Vol 4 (2) ◽  
pp. 225-233
Author(s):  
R. Awad

The magnitude of the brucellosis problem in the Gaza Strip and the exposure to risk factors among cases were investigated. The incidence of brucellosis in 1996 was 8/100 000. The age-specific incidence rate was approximately equal in all age groups, with a mean age of infection of 20 years. Cases were reported from all districts, with a particularly high incidence in the Mid-zone district and Gaza City, and most cases had onset of illness in spring and summer. The main reported risk factor was consumption of milk and milk products, especially home-made cheese [70.4%], and 22.2% of cases were among animal breeders. The proportion of chronic and relapsing cases was very high [17%]

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamedraed Elshami ◽  
Mariam Thalji ◽  
Hanan Abukmail ◽  
Ibrahim Al-Slaibi ◽  
Mohammed Alser ◽  
...  

Abstract Background High awareness of cervical cancer (CC) risk factors is important to decrease the morbidity and mortality associated with CC. This study aimed to assess the knowledge level of Palestinian women about CC risk factors and to determine the factors associated with good knowledge. Methods This was a national cross-sectional study. Adult women from hospitals, primary healthcare centers, and public spaces of 11 governorates in Palestine were recruited using a stratified convenience sampling. A translated-into-Arabic version of the validated CC awareness measure (CeCAM) was used to assess the knowledge about the 11 CC risk factors. For each correctly identified risk factor, the participant was given one point. The total score was calculated and was categorized into three categories: poor knowledge (0–3), fair knowledge (4–7), and good knowledge (8–11). Results A total of 7223 participants completed the Arabic CeCAM (response rate = 89.3%) and 7058 questionnaires were included in the final analysis: 2655 from the Gaza Strip and 4403 from the West Bank and Jerusalem. Participants recruited from the Gaza Strip were younger, getting lower monthly incomes, and with less chronic diseases than participants recruited from the West Bank and Jerusalem. The most frequently identified risk factor was ‘having a weakened immune system’ (n = 5458, 77.3%) followed by ‘infection with a sexually transmitted infection’ (n = 5388, 76.3%). The least identified risk factor was ‘having many children’ (n = 1597, 22.6%). Only 1670 women (23.7%) had good knowledge of CC risk factors. Women living in the Gaza Strip were more likely than women living in the West Bank and Jerusalem to have good knowledge (25.2% vs 22.7%). Completing a secondary or diploma degree, being employed, and having a monthly income of ≥ 1450 NIS (around $450) were all associated with lower likelihood of having good knowledge of CC risk factors. Conversely, knowing someone with cancer was associated with higher likelihood of having good knowledge. Conclusion The overall awareness of CC risk factors was low. There is a substantial need to establish educational programs to promote Palestinian women’s awareness of CC.


2020 ◽  
Vol 14 (1) ◽  
pp. 94-104
Author(s):  
Bassam A. Tayeh ◽  
Tareq J. Salem ◽  
Yazan I. Abu Aisheh ◽  
Wesam S. Alaloul

Background: The construction industry is generally associated with a high level of risk and ambiguity because of the nature of its working contexts. In the Gaza Strip, construction projects are among the riskiest projects, which require the application of the right rules and adherence to the proper management standards. Identification of these risks is the first step in risk management. Aims: This study aims to investigate and understand the main risks faced by the construction projects in the Gaza strip. Methods: A questionnaire survey was conducted to achieve the study aim, whose applicability was tested through a pilot study. Using targeted participants from engineering offices and consulting engineering companies, 70 questionnaires were distributed and collected with a response rate of 85.71%. The Quantitative method was used for data analysis using SPSS. 38 risk factor statements were considered from the seven clusters of risk factors. Results: The results show that the political risk factor was determined to be the highest with a Relative Important Index (RII) of 75.47%, while the design factor was the least factor with an average RII of 61.89%. Conclusion: It is recommended that companies should appoint a specialist in the field of risk management.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandra Chamat-Hedemand ◽  
Niels Eske Bruun ◽  
Lauge Østergaard ◽  
Magnus Arpi ◽  
Emil Fosbøl ◽  
...  

Abstract Background Infective endocarditis (IE) is diagnosed in 7–8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. Methods In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk < 3%, moderate-risk 3–10%, high-risk 10–30% and very high-risk > 30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE > 10%), TTE (IE 3–10%), or “wait & see” (IE < 3%). Results We included 6393 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have ≥3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to “wait & see” strategy if they neither have a risk factor nor ≥3 positive BC bottles, while a TTE is recommended if they have either ≥3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor ≥3 positive BC bottles, but to TTE and TOE if they have either ≥3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. Conclusion In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19556-e19556
Author(s):  
Kitsada Wudhikarn ◽  
Radhika Bansal ◽  
Arushi Khurana ◽  
Matthew Hathcock ◽  
Michael Ruff ◽  
...  

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]


2018 ◽  
Vol 58 (6) ◽  
pp. 1125 ◽  
Author(s):  
B. J. Horton ◽  
R. Corkrey ◽  
G. N. Hinch

In eight closely recorded Australian Merino and crossbred sheep flocks, all lamb deaths were examined and the cause of deaths identified if possible. Dystocia was identified as one of the major causes of lamb death and this study examined factors that could be used to identify ewes at high risk of dystocia, either to avoid dystocia or to assist with early intervention where possible. Dystocia was least common in lambs of ~4.8 kg, but there was a higher risk at both lower and higher birthweights. Dystocia with both low and high birthweight was more common in older ewes, ranging from negligible low birthweight dystocia in ewes less than 3 years old at lambing, to 5% in older ewes. Low birthweight dystocia increased with increasing litter size, with 40% dystocia in ewes at least 4 years of age with triplets. In contrast, high birthweight dystocia was not affected by litter size. A previous record of low birthweight dystocia was a risk factor for future low birthweight dystocia, but the same relationship was not observed for high birthweight dystocia. A high lambing ease score (difficult birth) with high birthweight was a risk factor for future high birthweight dystocia, but this was not the case for low birthweight dystocia. These differences between the risk factors for low and high birthweight dystocia suggest that they have different causes. High ewe liveweight and condition score during pregnancy may be additional indicators of the risk of dystocia, particularly for ewes with high liveweight in the first 60 days of pregnancy. For most ewes dystocia was difficult to predict, but there was a small proportion of ewes with a very high risk of dystocia and if these could be identified in advance they could be monitored much more closely than the rest of the flock.


2004 ◽  
Vol 2 (1) ◽  
pp. 23-35 ◽  
Author(s):  
B. Shomar ◽  
G. Müller ◽  
A. Yahya ◽  
S. Askar ◽  
R. Sansur

The purpose of this study was to determine the fluoride levels in water, soil and tea, and to identify the major fluoride minerals in soil that supply water with fluoride ions. Another aim was to study the prevalence of dental fluorosis in permanent dentition of the school children of the Gaza Strip. Monitoring of fluoride levels in 73 groundwater wells and 20 topsoil samples for the last three years revealed a general trend of increasing from north to south of the Gaza Strip. A linear regression analysis found a correlation coefficient of r=0.93 between the fluoride concentrations in groundwater and soil for the same geographic areas. However, the X-ray diffraction technique (XRD) results showed that none of the four major fluoride minerals were detected in the tested soil samples; the PHREEQC model showed that fluorite (CaF2) was the main donating mineral of fluoride ions to groundwater.A high positive correlation was found between fluoride concentrations in groundwater and occurrence of dental fluorosis. Among 353 school children of the five geographic areas of the Gaza Strip the prevalence of dental fluorosis was 60%, and 40% had no signs of fluorosis in their permanent dentitions. The highest occurrence, 94%, was in Khan Yunis, followed by 82% in Rafah, 68% in the middle area, 29% in Gaza and the lowest occurrence of 9% was in the northern area. These percentages were directly proportional to the average content of fluoride in groundwater of each area: 2.6, 0.9, 1.7, 1.2, and 0.7 ppm, respectively. The exception was Rafah where people drank from new groundwater wells that have been dug in the last 10 years.The occurrence of the disease was due to intake of high amounts of fluorides in drinking water, tea and fish. Communication with population indicated a heavy intake of tea starting from a very young age; not uncommonly tea is put in nursing bottles. No significant correlation was found between prevalence figures and gender or age groups. This high prevalence indicates a need to examine other sources of F including diet.


2021 ◽  
pp. 1-21
Author(s):  
Samar Hameed ◽  
Ihab A. Naser ◽  
Mohamed A. Ghussein ◽  
Mohammed S. Ellulu

Abstract Objective: This study aims to investigate the association between iron body status and postpartum depression (PPD) among mothers during the postpartum period. Design: This is a Case-Control study. Setting: Governmental primary health care centers in the Gaza Strip, Palestine. Participants: This study involved 300 mothers a month after delivery, with one 150 mothers that were recruited in the Cases group who were diagnosed with PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥10. The Control group included 150 mothers did not have PPD (EPDS <10). Body iron status represented by the index of sTfR/log Ferritin. Results: Among PPD mothers, 43.3% had low ferritin level vs. 15.3% for controls (P<0.001) and cases vs. controls difference in mean hemoglobin level was -0.61 (95% C.I -0.86, -0.35). The results of the Multiple Logistic Regression reported that there is a statistically significant association between PPD and the body iron status existed, as mothers who suffered from iron deficiency (ID) were three times more likely to have PPD (ORadj 3.25; p = 0.015). Furthermore, the results of the final regression model showed that the other factors that can lead to PPD are; absence of psychological guidance services (ORadj 8.54; p = 0.001), suffering from undesired feeling in the last pregnancy (ORadj 1.77; p = 0.034), in addition to having one of the mental health disorders in the last pregnancy (p = 0.001). Conclusion: Body iron status might be a risk factor for postpartum depression and other possibilities of. reverse causality may worsen the condition.


Author(s):  
Katherine E Goodman ◽  
Laurence S Magder ◽  
Jonathan D Baghdadi ◽  
Lisa Pineles ◽  
Andrea R Levine ◽  
...  

Abstract Background The relationship between common patient characteristics, such as sex and metabolic comorbidities, and mortality from COVID-19 remains incompletely understood. Emerging evidence suggests that metabolic risk factors may also vary by age. This study aimed to determine the association between common patient characteristics and mortality across age-groups among COVID-19 inpatients. Methods We performed a retrospective cohort study of patients discharged from hospitals in the Premier Healthcare Database between April – June 2020. Inpatients were identified using COVID-19 ICD-10-CM diagnosis codes. A priori-defined exposures were sex and present-on-admission hypertension, diabetes, obesity, and interactions between age and these comorbidities. Controlling for additional confounders, we evaluated relationships between these variables and in-hospital mortality in a log-binomial model. Results Among 66,646 (6.5%) admissions with a COVID-19 diagnosis, across 613 U.S. hospitals, 12,388 (18.6%) died in-hospital. In multivariable analysis, male sex was independently associated with 30% higher mortality risk (aRR, 1.30, 95% CI: 1.26 – 1.34). Diabetes without chronic complications was not a risk factor at any age (aRR 1.01, 95% CI: 0.96 – 1.06), and hypertension without chronic complications was only a risk factor in 20-39 year-olds (aRR, 1.68, 95% CI: 1.17 – 2.40). Diabetes with chronic complications, hypertension with chronic complications, and obesity were risk factors in most age-groups, with highest relative risks among 20-39 year-olds (respective aRRs 1.79, 2.33, 1.92; p-values ≤ 0.002). Conclusions Hospitalized men with COVID-19 are at increased risk of death across all ages. Hypertension, diabetes with chronic complications, and obesity demonstrated age-dependent effects, with the highest relative risks among adults aged 20-39.


2014 ◽  
Vol 143 (7) ◽  
pp. 1360-1367 ◽  
Author(s):  
I. H. M. FRIESEMA ◽  
M. SCHOTSBORG ◽  
M. E. O. C. HECK ◽  
W. VAN PELT

SUMMARYShiga toxin-producingEscherichia coli(STEC) infections have been associated with severe illness. Ruminants are seen as the main reservoir and the major transmission route is considered to be foodborne. In The Netherlands, a case-control study was conducted, using data collected during 2008–2012. Patients were interviewed and controls completed a self-administered questionnaire. Patients travelling abroad were excluded from the analyses. STEC O157 and non-O157 were examined separately and differentiated into two age groups (<10 years, ⩾10 years). We included 130 O157 cases, 78 non-O157 cases and 1563 controls. In both age groups of O157 patients, raw spreadable sausage was the main risk factor for infection. For STEC non-O157 cases aged <10 years, contact with farm animals was the main risk factor and in non-O157 cases aged ⩾10 years, consumption of beef was the main risk factor. During 2008–2012, risk factors for STEC infections in the Dutch population differed between age groups and serogroup categories, and were related to eating meat and contact with farm animals. Advising the public about the risks of consuming raw or undercooked meat (products) and hygiene habits in case of contact with farm animals, could help in the prevention of STEC infections.


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