Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit最新文献

{"title":"Diversity of cutaneous leishmaniasis vectors and reservoirs in Islamic Republic of Iran.","authors":"Ali Jalilian, Seyedeh Zahra Parkhideh, Alireza Zahraei-Ramazani, Ali-Ashraf Aivazi, Morteza Akbari, Sayena Rafizadeh, Yavar Rassi","doi":"10.26719/2026.32.8.553","DOIUrl":"https://doi.org/10.26719/2026.32.8.553","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous leishmaniasis remains a significant public health concern in over 98 countries. Its transmission and development depends on complex ecological interactions between Leishmania spp. and its vectors and reservoir hosts.</p><p><strong>Aim: </strong>To examine the diversity of sand fly species and assess Leishmania major vectors and reservoirs in Mehran County, Ilam Province, Southwest Islamic Republic of Iran.</p><p><strong>Methods: </strong>We collected sand flies (vectors) from different habitats using standard traps, and simultaneously captured rodents (reservoirs) living close to human settlements. We then subjected these vectors and reservoirs to molecular analysis to assess the presence of Leishmania parasites. We analysed the data using the Cochran-Armitage test.</p><p><strong>Results: </strong>Seven sand fly species were identified. Of the 10 638 sand flies collected, 46% were Phlebotomus papatasi, and 31.1% of 74 rodents collected showed microscopic evidence of Leishmania infection. There was significant seasonal variation in the distribution of sand flies and Leishmania infection. The highest distribution was in spring (44%) and lowest in winter (7%) (P < 0.001), while the highest infection rates (≥ 3.33%) were in May, June, September, and October.</p><p><strong>Conclusion: </strong>The presence of L. major infection in both Ph. papatasi and T. indica in Mehran County is evidence that cutaneous leishmaniasis is being transmitted zoonotically. Strategies to control the vectors and reservoirs are needed in this endemic area.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"553-558"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the predictors of treatment-seeking and health care access barriers among transgender individuals in Pakistan.","authors":"Athar Memon, Sameena Ourangzaib, Benjamin R Bates, Shiraz Shaikh","doi":"10.26719/2026.32.8.540","DOIUrl":"https://doi.org/10.26719/2026.32.8.540","url":null,"abstract":"<p><strong>Background: </strong>Transgender individuals in Pakistan face barriers to health care access, increasing the risk of serious disease transmission.</p><p><strong>Aim: </strong>To identify the predictors of treatment-seeking intention and health care access delays among transgender individuals in Karachi, Pakistan.</p><p><strong>Methods: </strong>Between December 2024 and April 2025 we interviewed 360 individuals, aged ≥18 years, who identified as transgender and had accessed health care within the past 12 months. We analysed the data using SPSS version 20 and conducted hierarchical logistic and linear regression analyses to identify the predictors of intention to seek health care and delays in seeking care.</p><p><strong>Results: </strong>Discrimination (B = -0.94, SE = 0.19, P < 0.01) and perceived provider competence (B = 0.35, SE = 0.16, P = 0.03) were significant contextual predictors of intention to seek care. Participants with greater discrimination reported lower intention to seek care, while those perceiving their providers as competent reported higher intention. Older age [odds ratio (OR) = 1.05, 95% confidence interval (CI): 1.01-1.09, P = 0.027], primary and higher education (OR = 5.35, 95% CI: 1.63- 17.60, P = 0.006; OR = 5.49, 95% CI: 1.49-20.11, P = 0.010), and discrimination (OR = 3.77, 95% CI: 1.32-10.74, P = 0.013) were significant predictors of delay in seeking care, while delay was reduced by non-traditional income sources (OR = 0.29, 95% CI: 0.09-0.93, P = 0.036), frequent health care visits (OR = 0.92, 95% CI: 0.86-0.99, P = 0.017), and poor perceived provider competence (OR = 0.29, 95% CI: 0.09-0.92, P = 0.007).</p><p><strong>Conclusion: </strong>Discrimination, perceived provider incompetence and income source significantly influenced intention and delay in seeking care, while age, education and visit frequency predicted delays only. Interventions to address these predictors are essential to increase timely and equitable health care access for transgender individuals in Karachi, Pakistan.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"540-547"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritising early detection of breast cancer in Pakistan and Eastern Mediterranean Region.","authors":"Rehan Jan, Maryam Jan, Noman Jan","doi":"10.26719/2026.32.8.559","DOIUrl":"https://doi.org/10.26719/2026.32.8.559","url":null,"abstract":"","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"559-560"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics, circumstances and forensic findings on immersion deaths in Saudi Arabia.","authors":"Dalia Alsaif, Nasser Al-Shahrani, Abdullah Al Ekli, Mohammed Al-Shehri, Abdullah Al-Zahrani, Mona Al-Shammari, Sahar Y Issa","doi":"10.26719/2026.32.8.548","DOIUrl":"https://doi.org/10.26719/2026.32.8.548","url":null,"abstract":"<p><strong>Background: </strong>Drowning is a preventable cause of death; however, forensic evidence on immersion deaths in coastal areas of Saudi Arabia remains limited.</p><p><strong>Aim: </strong>To describe the characteristics, circumstances and forensic findings on immersion deaths in the Eastern Province of Saudi Arabia.</p><p><strong>Methods: </strong>We reviewed and analysed data on 189 cases of immersion deaths referred to Dammam Forensic Medicine Centre from April 1999 to January 2024, including the victims' demographic characteristics, type of water body, cause and manner of death, postmortem findings, and histopathology and toxicology results.</p><p><strong>Results: </strong>The majority of the victims were male (83%) and aged 26-50 years. Most bodies were recovered from the sea (52%), most cases occurred in Khobar (53%), and deaths were most frequent during summer (47%). Among the 60 autopsied cases, drowning was the most common cause of death (58%), and accidental death accounted for 60% of cases. External examination alone was performed in 68% of cases, and toxicology results were mostly negative (82%).</p><p><strong>Conclusion: </strong>Immersion deaths in Eastern Province of Saudi Arabia mainly involved adult males and occurred in the coastal areas, particularly during summer. Targeted water safety interventions and comprehensive forensic investigations are needed to prevent immersion deaths in coastal areas of Saudi Arabia.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"548-552"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of urine-based rapid diagnostic malaria tests in Pakistan.","authors":"Rashid Ali, Muhammad Asrar, Salma Sultana, Amna Sajjad","doi":"10.26719/2026.32.8.535","DOIUrl":"https://doi.org/10.26719/2026.32.8.535","url":null,"abstract":"<p><strong>Background: </strong>Urine-based rapid diagnostic tests offer a non-invasive alternative for malaria diagnosis; however, their use has not been evaluated in Faisalabad, Pakistan.</p><p><strong>Aim: </strong>To assess the diagnostic accuracy of a urine-based rapid diagnostic test for detecting Plasmodium vivax and Plasmodium falciparum infections in Faisalabad, Pakistan.</p><p><strong>Methods: </strong>From January 2023 to December 2024, we collected and analysed laboratory samples from 360 febrile patients aged ≥5 years, with clinical symptoms suggestive of malaria, at a district headquarters hospital in Faisalabad, Punjab, Pakistan. We analysed the data using SPSS version 25 and used Cohen's kappa coefficient to assess the inter-test reliability agreement between blood- and urine-based rapid diagnostic tests.</p><p><strong>Results: </strong>Of the 360 participants, microscopy identified Plasmodium vivax in 216 (60.0%) cases, Plasmodium falciparum in 108 (30.0%), and mixed infections in 36 (10.0%). Blood-based rapid diagnostic tests showed higher positive predictive value than urine-based tests (94.3% vs 85.2%) and higher sensitivity. Overall agreement between tests was 91.1% (Cohen's kappa = 0.83).</p><p><strong>Conclusion: </strong>Urine-based rapid diagnostic tests showed good agreement with blood-based tests, providing a practical non-invasive option for malaria screening in this setting. Further multicentre studies are recommended.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"535-539"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High insulin injection frequency is a key independent predictor of health-related quality-of-life in diabetic patients in Algeria.","authors":"Mohammed Nassim Boukli Hacene, Amina Youcef, Meriem Saker, Nawal Brikci-Nigassa, Ali Lounici, Kaouel Meguenni","doi":"10.26719/2026.32.8.505","DOIUrl":"https://doi.org/10.26719/2026.32.8.505","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is widely studied in Algeria, but its associated health-related quality-of-life remains underexplored.</p><p><strong>Aim: </strong>To assess health-related quality-of-life and predictors of reduced health-related quality-of-life among Algerian patients with type 1 or type 2 diabetes mellitus receiving insulin therapy.</p><p><strong>Methods: </strong>From July 2019 to February 2020, we interviewed 400 confirmed diabetes patients who had been receiving insulin treatment for ≥6 months at the Internal Medicine Department of Tlemcen University Hospital and outpatient clinics in Agadir and Boudghen. We analysed the data using SPSS version 25 and used independent t test or one-way analysis of variance to analyse differences in EuroQol 5-Dimension 5-Level index values and EuroQol visual analogue scale scores across subgroups. We used χ² test to compare the differences in reported problems across EuroQol 5-Dimension 5-Level dimensions among the subgroups. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean EuroQol 5-Dimension 5-Level index value was 0.595 ± 0.23, and mean EuroQol visual analogue scale score was 60.51 ± 20.45. Multiple linear regression associated ≥4 insulin injections per day with reduced healthrelated quality-of-life, and this relationship was strong and persistent even after controlling for clinical factors such as haemoglobin A1c levels. It affected mostly the psychological dimensions.</p><p><strong>Conclusion: </strong>Our finding shows moderate health-related quality-of-life and a significant psychological burden among insulin-treated patients. It identifies high insulin injection frequency as a key predictor of reduced health-related quality-of-life, independent of glycaemic control. We recommend multidimensional measures, based on mental health support and education, to mitigate treatment burden beyond traditional diabetes management.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"505-512"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of the geographical distribution of Shisha outlets for targeted tobacco control policies in Oman.","authors":"Salma Al Kalbani","doi":"10.26719/2026.32.8.498","DOIUrl":"https://doi.org/10.26719/2026.32.8.498","url":null,"abstract":"<p><strong>Background: </strong>The availability and accessibility of Shisha strongly influence smoking behaviours, thus raising public health concerns and necessitating targeted interventions.</p><p><strong>Aim: </strong>To examine the geographic distribution of Shisha outlets in Oman and its implications for tobacco control policies.</p><p><strong>Methods: </strong>We obtained anonymised secondary data from the Oman Ministry of Economy on 1074 registered shisha outlets established across Oman's 11 governorates between January 2020 and October 2024. We analysed the data using SPSS version 27 and summarised it using frequencies and percentages.</p><p><strong>Results: </strong>Most of the outlets (97.1%) were Shisha cafés, with two-thirds (65.2%) in Muscat Governorate, followed by Dhofar (15.1%) and North Batinah (9.7%). Dhofar recorded a decrease in outlets from 16 in 2020 to 7 in 2024.</p><p><strong>Conclusion: </strong>The number of Shisha outlets in Oman increased during the 5-year period, thus increasing availability and accessibility. This widespread availability has the potential to normalize smoking behaviours and undermine tobacco control efforts. There is a need to strengthen zoning regulations, licensing, plain packaging, and health warnings to reduce availability and access.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"498-504"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ending diseases together: the case for multi-communicable disease elimination in the Eastern Mediterranean Region.","authors":"Adham Rashad Ismail, Benedetta Allegranzi","doi":"10.26719/2026.32.8.485","DOIUrl":"https://doi.org/10.26719/2026.32.8.485","url":null,"abstract":"<p><p>For decades, communicable disease control in the Eastern Mediterranean Region (EMR) has been largely organised disease by disease. Malaria, tuberculosis, viral hepatitis, and HIV programmes have each developed their own surveillance systems, supply chains, partnerships, and reporting lines at the national level and to WHO. This structure has delivered real, hard-won gains, and diseasespecific programmes remain the backbone of the region's technical capacity. But it has also produced parallel systems that perform, in many settings, functions that could be shared.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"485-487"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has COVID-19 influenced parental perceptions and knowledge about polio vaccination in Pakistan?","authors":"Amjad Ullah, Asad Jamal, Muhammad Khan, Ubaid Ullah Mian, Siraj Ud Din, Muskan Hotak, Hamid Naeem","doi":"10.26719/2026.32.8.528","DOIUrl":"https://doi.org/10.26719/2026.32.8.528","url":null,"abstract":"<p><strong>Background: </strong>Despite global vaccination efforts, Pakistan remains one of the last 2 countries where wild poliovirus is still endemic.</p><p><strong>Aim: </strong>To assess the change in parental knowledge and perceptions about polio vaccination after COVID-19 pandemic.</p><p><strong>Methods: </strong>From January to April 2025 we interviewed 308 parents, who were permanent residents for ≥2 months, with at least one child aged 0-5 years and willing to provide informed consent, in 4 administrative subdivisions of North Waziristan District, Pakistan. We analysed the data using SPSS version 22 and used McNemar's test to assess changes in perceptions.</p><p><strong>Results: </strong>Average short answer knowledge score increased from 6.2 ± 2.3 pre-COVID-19 to 8.3 ± 2.1 post-COVID-19, resulting in overall significantly better knowledge of polio vaccination (P < 0.0001). Good knowledge (mean score ≥ 9) increased from 36.3% to 58.7%, knowledge of the viral etiology increased from 50.0% to 71.4%, and misconceptions decreased from 64.9% to 35.1%. Recommendations by health care providers (85%), social media campaigns (76%) and advocacy by religious leaders (55%) contributed to the improvement in knowledge.</p><p><strong>Conclusion: </strong>Parental knowledge increased, with more positive attitude towards polio vaccination, due to the COVID-19 pandemic. Building on this, further improvements can be achieved through strategic community engagement with health workers, religious leaders and social media, towards overcoming vaccine hesitancy and achieving polio eradication.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"528-534"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication adherence among multimorbid individuals in Saudi Arabia.","authors":"Haifa Alturki, Nawaf Alnuwaysir, Ghaya Almutairi, Shahad Alonazi, Rayouf Al Otaibi, Reham Alharbi, Joury Dabbour","doi":"10.26719/2026.32.8.513","DOIUrl":"https://doi.org/10.26719/2026.32.8.513","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is increasingly common among adults in Saudi Arabia. As treatment regimens become more complex, medication adherence becomes more challenging. Understanding the behavioural drivers of non-adherence is essential to improving outcomes and reducing preventable complications.</p><p><strong>Aim: </strong>To assess the prevalence of medication adherence among individuals aged ≥45 with multimorbidity, examine the association between the number and type of chronic conditions and adherence, and identify key reasons behind nonadherence.</p><p><strong>Method: </strong>Between March and May 2025, we interviewed 339 Saudi adults aged ≥45 with ≥2 chronic conditions. The data was analysed using SPSS version 28. Reliability testing was performed using Cronbach's alpha, Fisher's Exact Test and binary logistic regression were used to assess associations between adherence and other variables. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Only 14.7% of the study participants were adherent to their medication. Significant associations were found between adherence and age, education, heart disease, and anaemia. Adults aged 45-54 years had higher odds of nonadherence than those aged 65+ years (OR = 3.78, 95% CI: 1.36-10.49, P = 0.01), and participants with a bachelor's degree or higher had higher odds of non-adherence (OR = 3.51, 95% CI: 1.24-9.95, P = 0.01). Having a heart disease was linked to better adherence (OR = 0.45, 95% CI: 0.23-0.86, P = 0.02), whereas having anaemia predicted non-adherence (OR = 7.19, 95% CI: 0.96-53.68, P = 0.02). The most common reasons for non-adherence were poor refill planning (68.1%) and skipping medication when feeling better (22.1%).</p><p><strong>Conclusion: </strong>Medication non-adherence among multimorbid adults in Riyadh was alarmingly high (>85%). Interventions should address behavioural barriers, refill planning and establishment of reminder systems.</p>","PeriodicalId":93985,"journal":{"name":"Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit","volume":"32 8","pages":"513-520"},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}