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":"Bridging the adverse drug reaction reporting gap to strengthen pharmacovigilance systems in low- and middle-income countries.","authors":"Mamunur Rahman, Farhana Rizwan, Fahima Islam","doi":"10.26719/2026.32.5.344","DOIUrl":"https://doi.org/10.26719/2026.32.5.344","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 5","pages":"344-345"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474897","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":"Scaling up human papilloma virus vaccination in Pakistan.","authors":"Sara Asif","doi":"10.26719/2026.32.4.225","DOIUrl":"https://doi.org/10.26719/2026.32.4.225","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 5","pages":"225"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355098","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":"Funding, service and resource gaps at primary health care centres in Iraq.","authors":"David Collins, Ali Al-Taie, David Hipgrave, Omar Abdul Ameer Al Gumrawi, Ahlam Aziz Ali","doi":"10.26719/2026.32.4.182","DOIUrl":"10.26719/2026.32.4.182","url":null,"abstract":"<p><strong>Background: </strong>Limited resources have hampered progress towards Universal Health Coverage at the primary health care level in Iraq.</p><p><strong>Aim: </strong>To analyse the cost of primary health care services in Iraq and identify the resource gaps.</p><p><strong>Methods: </strong>Using the CORE Plus tool, we collected and analysed data on finance and other resources, and services provided by 15 primary health care centres across 11 governorates in Iraq. We calculated the normative utilisation and cost estimates and compared them with the actual figures.</p><p><strong>Results: </strong>Primary health care services were underutilised: only 52% (33-67%) of the 81 listed services were utilised across the 15 centres, and there was an average of only 1.2 visits per capita per year, compared with the estimated need of 4.5 visits. The expenditure incurred for the actual number of services was 2.5 times higher than the normative cost, due to over-staffing, despite shortages of medicines and supplies. The cost of meeting the need for 4.5 visits would be 21% more than the actual expenditure, but staffing costs would have to be reduced by 39% and medicines and supplies financing increased by 640%.</p><p><strong>Conclusion: </strong>Funding for services at the primary health centres in Iraq was insufficient although the centres were overstaffed. To improve access and quality of services and progress towards Universal Health Coverage, staffing should be aligned with service needs and adequate resources provided.</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 5","pages":"182-187"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355161","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":"A case for urgent action on fungal and anaerobic bacterial pathogens control in low- and middle-income countries.","authors":"Ashish William, Vatsala Aggarwal","doi":"10.26719/2026.32.5.240","DOIUrl":"https://doi.org/10.26719/2026.32.5.240","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 5","pages":"240-243"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474934","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":"A review of the burden, resistance patterns and outcomes of hospitalacquired infections in Saudi Arabia.","authors":"Hasan H Alfahemi","doi":"10.26719/2026.32.5.333","DOIUrl":"https://doi.org/10.26719/2026.32.5.333","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired infections remain a major problem in Saudi Arabia, contributing to increases in morbidity, mortality and health care costs.</p><p><strong>Aim: </strong>To review evidence on the epidemiology, risk factors and outcomes of hospital-acquired infections in Saudi Arabia hospitals.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines and narrative synthesis approach, we searched PubMed/Medline and Web of Science, as well as the databases of Google Scholar, Multidisciplinary Digital Publishing Institute, and Springer Nature, for articles published between 2015 and 2025 on hospital and health care-associated infections in Saudi Arabia. We appraised the quality of the studies using the Newcastle-Ottawa scale, Joanna Briggs Institute and risk of bias in nonrandomized studies of interventions tools.</p><p><strong>Results: </strong>Surgical site infections were ≤1%, but higher among caesarean section cohorts (≈4.7%). Gram-negative pathogens (Klebsiella, E. coli, Pseudomonas, Acinetobacter) were predominant, with ≈41% multidrug resistance and ≈25% extensive resistance. Risk factors for infection included intensive care unit stay, use of invasive devices, diabetes, and prolonged procedures. Bundle adherence was high (≈94-100%), but hand hygiene compliance lagged (≈76%). Reported outcomes included longer intensive care unit stay, increased antibiotic use and high mortality in severe central line-associated bloodstream infection cases.</p><p><strong>Conclusion: </strong>Hospital-acquired infections in Saudi Arabia are predominantly associated with the use of invasive devices and driven by resistant gram-negative bacteria. Although national surveillance and bundle programmes have helped improve infection prevention in hospitals, there is a need for strict adherence to antimicrobial stewardship guidelines, enforcement of hand hygiene practices and uniform surgical site infection surveillance methods.</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 5","pages":"333-340"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474887","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 errors and therapy problems may drive antimicrobial resistance in Egypt.","authors":"Hebatalla M Abdulaziz, Yasmein Yehya, Abdulrahman M Amin, Lamis Diaa, Shimaa Nasr Eldeen, Abeer Elbehairy, Shimaa S Emam, Shereen M Abdelgawad","doi":"10.26719/2026.32.5.325","DOIUrl":"https://doi.org/10.26719/2026.32.5.325","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance is a challenge in Egypt and the potential contributors are medication errors and drug therapy problems involving antimicrobial agents.</p><p><strong>Aim: </strong>To analyse, for corrective actions, antimicrobial-related drug therapy and management errors reported to the Egyptian National Office for Handling and Reduction of Medication Errors.</p><p><strong>Methods: </strong>We analysed data on antimicrobial-related drug therapy and management error reported to the National Office for Handling and Reduction of Medication Errors by 46 hospitals in 2 Egyptian governorates between January 2020 and November 2024. Using descriptive statistics, and based on the WHO access, watch and reserve classification, we summarised the error types and antimicrobial agents involved.</p><p><strong>Results: </strong>Of the 162 638 valid error reports, 57 592 (35.4%) involved antimicrobials, of which 98.2% were combined drug therapy and management errors. The most common errors were related to prescription (96.7%), including dosing regimen (43.1%) and incorrect indication (33.8%). The most frequently implicated agents were ampicillin/sulbactam (12.0%), levofloxacin (11.5%), ceftriaxone (9.0%), and cefotaxime (7.2%). Watch group antibiotics accounted for 65.4% of the errors, followed by access (27.8%) and reserve (5.7%).</p><p><strong>Conclusion: </strong>Our findings provide important baseline data for strengthening antimicrobial stewardship in Egypt. Appropriate policies are needed to minimise antimicrobial-related errors, improve rational use of antimicrobials, strengthen antimicrobial surveillance, and mitigate the risk of inappropriate watch group prescriptions in Egypt.</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 5","pages":"325-332"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474904","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":"A cross-sectional study of antibiotic prescription patterns in India using the WHO AWaRe classification.","authors":"Shamna S Salim, Althaf Ali, Fazaludeen Koya Muhammed Shaffi, G K Mini, Jinbert L Azariah","doi":"10.26719/2026.32.5.306","DOIUrl":"https://doi.org/10.26719/2026.32.5.306","url":null,"abstract":"<p><strong>Background: </strong>Primary health centres represent the initial point of contact with the health system for most patients, and they account for a large proportion of antibiotic prescriptions in India.</p><p><strong>Aim: </strong>To evaluate the pattern of antibiotic prescriptions at a primary care centre in India based on the WHO AWaRe framework.</p><p><strong>Methods: </strong>From September to November 2024, we collected and analysed data from 525 participants who presented to the outpatient pharmacy of an urban primary health centre in Thiruvananthapuram, Kerala, India, and received a doctor's prescription. Data collected included prescription details, demographic characteristics, disease duration, and relevant clinical history. We assessed the compliance of the prescriptions to the WHO AWaRe guidelines.</p><p><strong>Results: </strong>One hundred and forty-six (27.8%) of the 525 prescriptions analysed contained antibiotics. Access group antibiotics accounted for 51.4% and watch group accounted for 48.6%. No reserve antibiotic was prescribed. The most frequently prescribed antibiotics were amoxicillin-clavulanic acid (34.2%), followed by azithromycin (22.6%) and ciprofloxacin (17.1%). Non-adherence to the WHO AWaRe guidelines was observed in 56.2% of cases.</p><p><strong>Conclusion: </strong>Our findings show lower usage of access group antibiotics than the recommended target of 70% by WHO. Stronger antimicrobial stewardship initiatives and prescriber training are needed to improve rational antibiotic use in this setting.</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 5","pages":"306-311"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474898","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":"Seven-year analysis of national antibiotic consumption in Tunisia.","authors":"Samiha Toumi, Asma Mhiri, Imed Lassoued, Manel Turki, Abderrazek Hedhili","doi":"10.26719/2026.32.5.270","DOIUrl":"https://doi.org/10.26719/2026.32.5.270","url":null,"abstract":"<p><strong>Background: </strong>Monitoring national antibiotic consumption is essential to strengthen antimicrobial stewardship and efforts to combat antimicrobial resistance.</p><p><strong>Aim: </strong>To assess annual antibiotic consumption in Tunisia from 2016 to 2023.</p><p><strong>Methods: </strong>Using SPSS version 27, Spearman correlation, the WHO defined daily dose per 1000 inhabitants per day and the WHO access, watch and reserve classification, we analysed national antibiotic consumption data in Tunisia for 2016 to 2023.</p><p><strong>Results: </strong>Overall antibiotic consumption increased from 31.6 defined daily dose per 1000 inhabitants per day in 2016 to 32.4 in 2023, with lower values for 2019-2022 (P = 0.096). Private sector consumption consistently exceeded public sector levels and access group antibiotics were the most consumed (78% in 2016, 65% in 2021 and 75% in 2023). Beta-lactam penicillins was most consumed (exceeding 60% in most years), followed by macrolides, lincosamides and streptogramins (≈10% in most years), while oral antibiotics represented 98% of total consumption.</p><p><strong>Conclusion: </strong>The predominance of generics indicates the need for vigilant antimicrobial stewardship to prevent costdriven overuse and mitigate resistance. There is a need to strengthen national antibiotic use surveillance, including in private sector facilities, and promote a more rational use of antibiotics.</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 5","pages":"270-277"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474914","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":"Multidrug resistance and mortality in patients with hospitalacquired urinary tract infections in Islamic Republic of Iran.","authors":"Sara Minaeian, Ajay Mv Kumar, Marjan R Farzami, Vinayagamoorthy Venugopal, Divya Nair, Kianosh Kamali, Mohammed Zeinali, Arash Seifi, Soheil Rahmani Fard, Azita Nabizadeh","doi":"10.26719/2026.32.4.197","DOIUrl":"10.26719/2026.32.4.197","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired urinary tract infections are a frequent complication in intensive care units. They are increasingly being associated with multidrug-resistance, especially in low-resource settings.</p><p><strong>Aim: </strong>To assess the uropathogenic and antimicrobial resistance patterns and identify patient-related factors associated with multidrug resistance and mortality among patients with hospital-acquired urinary tract infections in Tehran, Islamic Republic of Iran.</p><p><strong>Methods: </strong>We analysed secondary data on all patients aged ≥ 18 years who had hospital-acquired urinary tract infections and were admitted to intensive care units of 45 public and private hospitals in Tehran, Islamic Republic of Iran, between 2022 and 2024. We examined the associations between the demographic and clinical variables using prevalence ratios and the outcomes of interest using relative risks. P ≤ 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 2467 patients, 60% were catheterised. A bacterial pathogen was isolated from 77% and Candida spp. from 23%. The most common pathogens were Escherichia coli (26%), Klebsiella spp. (22%) and Candida spp. (23%). Seventy-two percent of 1590 patients assessed exhibited multidrug resistance. Males, catheterised patients and patients with extended catheter use (> 8 days) had higher prevalence of multidrug resistance. Overall mortality rate was 42% and mortality was highest among patients with prolonged catheter use (57%), those admitted in public hospitals (51%) and those infected with Candida spp (60%).</p><p><strong>Conclusion: </strong>The alarmingly high prevalence of multidrug resistance and high mortality rate among patients with hospital-acquired urinary tract infections indicate the need to enhance infection prevention and control practices in Iranian hospitals, and to significantly improve antibiotic susceptibility testing and antimicrobial resistance surveillance.</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 5","pages":"197-205"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355133","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":"Gaps in HIV treatment and care in Morocco.","authors":"Wiam Ait Driss, Rania El Fargani, Zakaria Boudrik, Noureddine Jaghnoune, Noura Tassi","doi":"10.26719/2026.32.5.293","DOIUrl":"https://doi.org/10.26719/2026.32.5.293","url":null,"abstract":"<p><strong>Background: </strong>HIV remains a public health concern in Morocco, with persistent gaps in early diagnosis and retention in care, particularly outside major urban centres.</p><p><strong>Aim: </strong>To describe HIV care delivery and patient outcomes at a referral centre in Safi, Morocco.</p><p><strong>Methods: </strong>We collected and analysed sociodemographic, clinic and biological data of 283 HIV-confirmed patients who were actively followed up between December 2018 and December 2021 at the HIV referral centre of Mohamed V Provincial Hospital, Safi, Morocco.</p><p><strong>Results: </strong>Sexual transmission accounted for 91.1% of infections. At diagnosis, 53.6% were asymptomatic. Treatment coverage was 92.6%. Median CD4 cell count increased from 351 cells/mm³ at initiation to 597 cells/mm³ after 12 months. Viral suppression increased from 45.8% at 3 months to 88.0% at 12 months. Of the patients, 10.2% were lost to follow-up, 6.7% died and 3.6% were transferred to other centres.</p><p><strong>Conclusion: </strong>Although treatment coverage and virologic outcomes were high among the patients, late diagnosis, loss to follow-up and mortality remain important challenges, indicating the need for interventions to address the underlying challenges.</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 5","pages":"293-296"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474850","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}