Eastern Mediterranean Health Journal [2022; Vol.28, Issue 6]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region.

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région.

Trends of stunting, underweight and overweight among children aged < 5 years in Kuwait: findings from Kuwait Nutritional Surveillance System (2007–2019)

Background: There is a paucity of data on the secular trends of stunting and overweight among children aged < 5 years in oil-rich countries in the Middle East. Aims: To examine the secular trends of stunting, underweight and overweight in children aged < 5 years in Kuwait between 2007 and 2019. Methods: We used large individual data records (n=48 108) from the Kuwait Nutritional Surveillance System (KNSS) to calculate height/length-for-age z score (HAZ), weight-for-age z score and body mass index (BMI)-for-age z score using World Health Organization growth references. Stunting and underweight were defined as < -2 standard deviation (SD) and overweight (including obesity) as ≥ +2 SD. Trends of stunting, underweight and overweight were investigated using logistic regression models. Results: The prevalence of stunting, underweight and overweight was 5.15%, 2.33% and 10.78%, respectively. Stunting increased during the study period, among children aged < 2 years. There was no increasing trend in overweight during the study period. These findings were corroborated by the distribution of HAZ and BMI-for-age z scores. Current prevalence of combined stunting and overweight was 1.53% in boys and 1.98% in girls. Conclusion: Current prevalence of stunting and underweight is low in Kuwait indicating that undernutrition is no longer a major public health issue. There is a tendency for stunting to increase in children aged < 2 years, highlighting the need to investigate early causes of stunting such as maternal and pregnancy-related factors.

Sanjad Sakati syndrome: a case series from Jordan

Sanjad Sakati syndrome is a rare autosomal recessive disorder that has been described in Arabs. We report 8 patients from 7 Jordanian families, 6 of whom underwent genetic testing and were found to have a 12 bp [155-166 del] deletion within the tubulin-specific chaperone E [TBCE gene] in exon 3 at lq42-43. All patients had severe growth retardation, distinct phenotypic features and hypoparathyroidism. Parental consanguinity was recorded in all families. This is the first genetically proven case series of Sanjad Sakati syndrome in Jordan

Influence of parental and socioeconomic factors on stunting in children under 5 years in Egypt

We assessed the relationship between parental and socioeconomic characteristics and nutritional status of children under 5 years in Egypt. Data from the 2000 Egypt Demographic and Health Survey were used. A logistic regression technique was used to estimate the odds of being malnourished. Children whose mothers had a higher level of education and were > 150 cm had a lower risk of stunting than those of mothers with no education and shorter height [< 150 cm]. Parental consanguinity, rural residence, high birth order and short birth interval significantly increased the odds of stunting. Children aged >/= 12 months had greater odds of stunting than those < 12 months

Socioeconomic predictors of unconstrained child growth in Muscat, Oman

We conducted a study to identify socioeconomic factors associated with unconstrained growth among preschoolers in Muscat, Oman. A sample of children born in 1995 and aged 28-43 months was drawn from the Child Health Registers of 2 health care centres. Sociodemographic data were collected by oral interview and maternal and child anthropometry measured. Regression analysis was used to identify socioeconomic indicators and cut-offs associated with unconstrained growth. Children from households with a monthly income > or = 800 Omani rials and mother's education > or = 4 years attained height-for-age levels comparable to the current international growth reference. By screening using this criterion, we could obtain a suitable sample for the World Health Organization Multicentre Growth Reference Study in Muscat

Influence of mothers' characteristics on their perceptions and use of the growth chart

Although growth charts are recommended for monitoring children, recent reports indicate poor use by mothers. We investigated maternal knowledge and perceptions of growth charts and identified characteristics affecting use. At outpatient paediatric clinics of a Riyadh hospital, 305 mothers with children under age 5 were interviewed by questionnaire during May-June 2001. Overall awareness of growth charts was 35.8% and ever-use was 8.6%. Education, parity and number of living children were significantly associated with knowledge. Among mothers who ever used growth charts [8.7%], only 10% reported doctors recommended changes in health care because of them. Overall, 71% wanted to monitor their child's growth, but 20% did not know how. Increased health education in all health care delivery systems is needed

Effects of passive smoking on children's health: a review

Since the mid-1980s there has been increasing interest in the effects of passive smoking on the health of children. It has been estimated that the total nicotine dose received by children whose parents smoke is equivalent to their actively smoking between 60 and 150 cigarettes per year. This review article considers the evidence for a relationship between passive smoking and disorders such as: prenatal damage to the fetus; poor growth indicators; respiratory illness; atopy and asthma; coronary heart disease; and sudden infant death syndrome. We conclude that paediatricians should not be complacent about the hazards of passive smoking for children and that public health education efforts should be continued

Prevalence of endocrine complications in beta-thalassaemia major in the Islamic Republic of Iran

To identify the prevalence of endocrine dysfunction in Iranians with beta-thalassaemia, we assessed thyroid, parathyroid, pancreatic and adrenal function in 150 beta-thalassaemic patients aged 10-22 years at the Paediatrics Unit, Shiraz University of Medical Sciences. Primary hypothyroidism was found in 6.0% of patients [mean age: 14.6 +/- 1.9 years], hypoparathyroidism in 7.3% [14.5 +/- 3.2 years], type 1 diabetes mellitus in 7.3% [13.9 +/- 2.8 years] and adrenal insufficiency in 1 patient. The relatively high frequency of endocrine dysfunction found in our study may be a result of poor disease control and management in early life when irreversible tissue damage occurs due to iron overload. These findings reinforce the importance of regular follow-up of patients with beta-thalassaemia major for early detection and management of associated complications

Growth of preschool children in the Libyan Arab Jamahiriya: regional and sociodemographic differences

This cross-sectional study was performed in two regions of the Libyan Arab Jamahiriya. The aim was to study the growth and nutritional status of children under 5 years of age and the effect of socioeconomic factors on child development. Anthropometric indices [weight-for-age, height-for-age and weight-for-height] differed in the two regions. The prevalence of stunting was significantly higher among children from mainly rural Al Jabel Al Garby [6.1%] than those from urban Tripoli [2.5%]. The z-scores that correlated strongly with under-nutrition included: mother's education, child's age and sex, and region. Stunting was significantly related to age and region and to maternal education level and family size. Wasting was highly correlated with maternal education

Nutritional stunting in Egypt: which nutrient is responsible?

We looked at the relationship between linear growth retardation and deficiencies of certain nutrients in Egyptian children. A group of 107 stunted children aged between 10 and 18 years were subjected to history-taking, physical examination and laboratory investigations. Selected cases were referred to radiology for assessment of bone age. Thirty-nine children were enrolled as controls. Serum haemoglobin, alpha-tocopherol, retinol and magnesium levels were significantly decreased in stunted children compared with the controls. Serum zinc levels were also lower in the stunted group but not significantly so. We conclude that several nutrient deficiencies occur simultaneously in stunted children and all of them may be responsible for stunting