scholarly journals Antibiotic Resistance Surveillance and Control in the Mediterranean Region: report of the ARMed Consensus Conference

2009 ◽  
Vol 3 (09) ◽  
pp. 654-659 ◽  
Author(s):  
Michael A. Borg ◽  
Barry D. Cookson ◽  
Peter Zarb ◽  
Elizabeth A. Scicluna ◽  
ARMed Steering Group & Collaborators *
Keyword(s):  
Health Care ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Mediterranean Region ◽  
Care Delivery ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Consensus Conference ◽  
The Mediterranean ◽  
And Control

Antimicrobial resistance has become a global threat to effective health care delivery. This is particularly the case within the Mediterranean region, where data from recent studies suggests the situation to be particularly acute. A better knowledge base, as well as a collaborative effort, is therefore required to address this ever increasing challenge to effective patient care. Over its four-year period, the Antibiotic Resistance Surveillance and Control in the Mediterranean Region (ARMed) project investigated the epidemiology of antimicrobial resistance, as well as its contributory factors, in a number of countries in the southern and eastern Mediterranean region through the collection of comparable and validated data. The project culminated in a consensus conference held in Malta in November 2006. The conference provided a forum for expert delegates to agree on a number of priority strategic recommendations that would be relevant to resistance containment efforts in the region. There was general agreement on the need for surveillance and audit to underpin any intervention to tackle antimicrobial resistance, both to monitor changing epidemiological trends in critical pathogens as well as to identify antibiotic consumption practices and effectiveness of prevention and control of health care associated infections. In addition, the importance to convey these data to key users was also stressed in all workshops, as was better education and training of health care workers. The recommendations also made it clear that ownership of the problem needs to be improved throughout the region and that resources, both financial as well as human, must be allocated by the respective policy makers in order to combat it.

scholarly journals Integration of health care delivery in the Eastern Mediterranean Region of the World Health Organization

2000 ◽  
Vol 6 (4) ◽  
pp. 747-757
Author(s):  
M. I. Al Khawashky
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Mediterranean Region ◽  
Care Delivery ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Health Resources ◽  
World Health ◽  
District Health ◽  
Health Organization

This paper reviews developments in the integration of health care delivery in the Eastern Mediterranean Region. It describes the integrated intersectoral support of socioeconomic community development [district health systems and basic development needs], the functional intrasectoral integration of health services and interventions, and health resources integration

scholarly journals Antibiotic resistance in the southeastern Mediterranean – preliminary results from the ARMed project

2006 ◽  
Vol 11 (7) ◽  
pp. 11-12 ◽  
Author(s):  
M A Borg ◽  
E Scicluna ◽  
M De Kraker ◽  
N Van de Sande-Bruinsma ◽  
E Tiemersma ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Mediterranean Region ◽  
Methicillin Resistance ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Clinical Samples ◽  
E Coli ◽  
Preliminary Results ◽  
The Mediterranean

Sporadic reports from centres in the south and east of the Mediterranean have suggested that the prevalence of antibiotic resistance in this region appears to be considerable, yet pan-regional studies using comparable methodology have been lacking in the past. Susceptibility test results from invasive isolates of Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Enterococcus faecium and faecalis routinely recovered from clinical samples of blood and cerebrospinal fluid within participating laboratories situated in Algeria, Cyprus, Egypt, Jordan, Lebanon, Malta, Morocco, Tunisia and Turkey were collected as part of the ARMed project. Preliminary data from the first two years of the project showed the prevalence of penicillin non-susceptibility in S. pneumoniae to range from 0% (Malta) to 36% (Algeria) [median: 29%] whilst methicillin resistance in Staphylococcus aureus varied from 10% in Lebanon to 65% in Jordan [median: 43%]. Significant country specific resistance in E. coli was also seen, with 72% of isolates from Egyptian hospitals reported to be resistant to third generation cephalosporins and 40% non-susceptible to fluoroquinolones in Turkey. Vancomycin non-susceptibility was only reported in 0.9% of E. faecalis isolates from Turkey and in 3.8% of E. faecium isolates from Cyprus. The preliminary results from the ARMed project appear to support previous sporadic reports suggesting high antibiotic resistance in the Mediterranean region. They suggest that this is particularly the case in the eastern Mediterranean region where resistance in S. aureus and E. coli seems to be higher than that reported in the other countries of the Mediterranean.

scholarly journals A Collaborative Initiative to Strengthen Sustainable Public Health Capacity for Polio Eradication and Routine Immunization Activities in the Eastern Mediterranean Region

10.2196/14664 ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. e14664
Author(s):  
Magid Al Gunaid ◽  
Faris Lami ◽  
Najwa Jarour
Keyword(s):  
Public Health ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Polio Eradication ◽  
Routine Immunization ◽  
Vaccine Preventable Diseases ◽  
Global Polio Eradication Initiative ◽  
Eradicate Polio ◽  
And Control

The many challenges in the Eastern Mediterranean region put the involved countries at risk of polio transmission and affect their ability to meet progress targets in eliminating vaccine-preventable diseases. The Global Health Development (GHD) and Eastern Mediterranean Public Health Network (EMPHNET) are working together on the project “Strengthening sustainable public health capacity in the Eastern Mediterranean region for polio eradication and routine immunization activities” with an overall goal of improving routine immunization, eradicating poliovirus, and controlling/eliminating or eradicating other vaccine-preventable diseases in the Eastern Mediterranean region. The aim of this manuscript is to describe the project and the achievements of GHD/EMPHNET over the last 3 years (2016-2018) to build effective surveillance and immunization systems in the Eastern Mediterranean region through the development of a sustainable and competent public health system to eradicate polio and control/eliminate vaccine-preventable diseases. This project assists the targeted Eastern Mediterranean region countries to build effective surveillance and immunization systems in an effort to expand their capacities to eradicate polio and control/eliminate other vaccine-preventable diseases. The project is streamlined with the Global Polio Eradication Initiative, the Centers for Disease Control and Prevention’s Strategic Framework for Global Immunization 2016-2020, and the Polio Eradication and Endgame Strategic Plan 2013-2018. The project also supports the Global Health Security Agenda by focusing on efforts to accelerate progress toward a world safe and secure from infectious disease threats. Project activities were designed to respond to countries’ needs and assist them in building their institutional and workforce capacity to effectively plan, implement, and evaluate activities to eradicate polio and strengthen routine immunization activities. The project activities covered a set of areas including surveillance of acute flaccid paralysis and other vaccine-preventable diseases, family and community engagement, workforce capacity building, improvement of data quality, management and use of information systems, use of polio assets to control/eliminate other vaccine-preventable diseases, support of countries to develop national strategies, piloting of innovative initiatives, program evaluation and accountability, and immunization strengthening. The project adopts the Global Polio Eradication Initiative strategies for assisting countries to strengthen routine immunization services, maintain highly sensitive acute flaccid paralysis surveillance, and sustain polio eradication functions.

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 Epidémiologie moléculaire du sérotype 9 du virus de la fièvre catarrhale ovine en région méditerranéenne

2009 ◽  
Vol 62 (2-4) ◽  
pp. 148
Author(s):  
K. Nomikou ◽  
S. Maan ◽  
N. S. Maan ◽  
P. P.C. Mertens
Keyword(s):  
South Africa ◽  
South African ◽  
Mediterranean Region ◽  
Reference Strain ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Eastern European ◽  
The Family ◽  
The Mediterranean ◽  
First Time

Bluetongue virus (BTV) is the prototype species of the genus Orbivirus within the family Reoviridae. There are 24 (possibly 25) distinct serotypes of BTV, eleven of which have entered, or have been identified in Europe and the Mediterranean region since 1998 (types 1, 2, 4, 6, 8, 9, 11, 15, 16, 24 and 25). The first BTV to arrive in Greece during 1998 was serotype 9 (iso­late GRE1998/01), followed by BTV-16 (GRE1999/13) during 1999. BTV-9 spread to mainland Greece, South-Eastern Bulgaria and European Turkey during 1999, to Italy during 2000, then to Serbia, Montenegro, Kosovo, Macedonia, Bulgaria, Croatia, mainland Italy and Sicily in 2001. In 2002, BTV-9 was again identified in Bosnia, Bulgaria, Montenegro, Yugoslavia and Albania, and was identified in Libya for the first time in 2008. The whole genome was sequenced for representative field and vaccine strains of BTV-9 and 16 from the Mediterranean region, identifying the levels of genetic heterogeneity in each genome segment. The early European isolates of BTV-9 (1998 onwards) were identified as ‘eastern’ strains related to those from India, Indonesia and Australia. BTV-16 isolates are also eastern strains that are most closely related to strains from Turkey and the South African reference strain of type 16 (originally from Pakistan). Analyses of the more conserved genome segments coding for structural and non-structural proteins of BTV-9 (from Bosnia, Bulgaria, Greece and Turkey) and BTV-16 (from Greece and Turkey) show that the Eastern European isolates of these two serotypes have the remaining eight genome segments (1, 3, 4, 5, 7, 8, 9 and 10) with more than 99% similarity, in each case belonging to the same eastern lineage. These data show that the BTV-9 and 16 isolates that were circulating in the Mediterranean region are reassortants, with the majority of their genome seg­ments derived from a single parental lineage. However, the BTV-9 isolate from Libya (LIB2008/08) is more closely related to the western BTV-9 reference strain from South Africa than to the earlier BTV-9 isolates from Eastern Europe. Analysis of the more conserved segments of LIB2008/08 showed only 79.8–80.2% similarity with the eastern European BTV-9 isolates from the Eastern Mediterranean region, but 89–93.5% similarity with the BTV-9 reference and vaccine strains from South Africa. BTV-9 from Libya belongs to a distinct western lineage of viruses and represents both a new introduction to the Mediterranean region and a new threat to Europe.

scholarly journals COVID-19 financing strategies for refugees and migrants in the Eastern Mediterranean Region

2021 ◽  
Vol 27 (12) ◽  
pp. 1229-1238
Author(s):  
Elena Habersky ◽  
Aya Damir
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Health Care Systems ◽  
Eastern Mediterranean Region ◽  
Health Financing ◽  
Efficient Manner ◽  
Internally Displaced ◽  
Care Systems

Background: The COVID-19 pandemic has had devastating consequences on health care systems worldwide. While the world was slowly moving towards achieving health for all, the pandemic destroyed progress made over the past 25 years and exposed the vulnerability of health care systems and health insurance schemes as well as their lack of resilience. Heath care systems failed to respond in a timely and efficient manner, lives have been, and continue to be, lost and vulnerable populations, especially refugees and migrants, are more at risk than ever as many are left out of country vaccination programmes. Aims: The Eastern Mediterranean region hosts 13 million internally displaced persons and 12 million refugees as of 2018. Thus, adopting inclusive health financing mechanisms is crucial to addressing the crisis and protecting indigenous and displaced populations. Methods: By looking at regional best practices and the response of the United Nations, we outline possible financing tools for including refugees and migrants in health insurance schemes for COVID 19 and introduce novel solutions for addressing gaps in funding. Results: Among the suggested solutions are the inclusion of refugees and migrants in national health care systems, setting up community-based health insurance for migrant and refugee populations, as well as introducing a catastrophe bond financing scheme. Conclusions: While COVID-19 is far from over, many countries in the EMR have included migrants in their COVID-19 vaccine rollout plans. While this is not the first instance of inclusion in some countries, many others are unable or do not prioritize migrants in their health systems, to the detriment of the entire country. This paper, therefore, tackles the possible health financing measures which curb or prevent migrants from accessing such systems and presents possible solutions to change the status quo.

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