Clinical, molecular, and drug resistance epidemiology of HIV in Jordan, 2019-2021: A national study.

BACKGROUND: Limited epidemiologic studies have been conducted in Jordan describing the HIV epidemic. This study aimed to address this gap to inform HIV prevention and control. METHODS: A nationally-representative cross-sectional study was conducted among adults living with HIV in Jordan. Laboratory testing included HIV viral load and next-generation-sequencing-based clinical genotype. Log-binomial regression estimated risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS: Among 231 (70%) participants, most were male (184/80%), and from Jordan (217/94%). Among 188 treatment-experienced-participants (>6 months), 165 (88%) were virally suppressed. High-level resistance was most frequent against nucleoside reverse transcriptase inhibitor (13/81%), and integrase-strand transfer inhibitor (INSTI) (10/62%) drugs among viremic (≥1000 HIV copies/mL) treatment-experienced participants with drug-resistant mutations (DRMs, n = 16). Common HIV subtypes (n = 43) were B (6/14%), A1 (5/12%), and CRF01_AE (5/12%); additionally, novel recombinant forms were detected. In multivariate analysis, independently higher risk for late diagnosis (n = 49) was observed with diagnosis through blood donation (vs check-up: RR 2.20, 95%CI 1.16-4.17) and earlier time-period of diagnosis (1986-2014 vs 2015-2021: RR 2.87, 95%CI 1.46-5.62). CONCLUSIONS: Late diagnosis and INSTI resistance endanger national HIV prevention and treatment in Jordan-high-level resistance to INSTI suggests therapeutic drug monitoring is needed for treatment efficacy and conservation of treatment options.

Risk as catalyst for positive change: lessons learnt from public health readiness for cholera in Jordan.

This case study highlights how a looming health crisis was leveraged as drivers for positive change for the health sector, in line with the health security agenda. In Jordan, several authorities are mandated by law to manage health emergencies. Following the declaration of outbreaks of cholera in Iraq, Lebanon and Syria, health authorities in Jordan called for a series of emergency meetings during September 2022 to discuss implications around travel and trade as well as shared waters. WHO was part of the consultations and provided guidance on the application of the International Health Regulations 2005. As the risk for cholera importation persisted, the Ministry of Health assumed its leadership role for the overall health sector response while the Jordanian Center for Disease Control assumed a coordinating function. Roles and responsibilities were enshrined in the National Cholera Preparedness and Response Plan. In consideration of the vulnerability of refugee camps and settlements towards Cholera, the existing Jordan humanitarian coordination platforms such as the Health Sector Working Group were used to share information and to coordinate activities. A whole-of-government risk assessment during December 2022 was complemented by a field visit at Zaatari refugee camp. This helped assess the risk and readiness for a cholera outbreak in Jordan and informed priority activities, such as the establishment of a national risk communication and community engagement working group as well as training on case management.

Implementation of one health approach in Jordan: Joint risk assessment of rabies and avian influenza utilizing the tripartite operational tool.

Background Health challenges at the human-animal-environment interface vary and include zoonotic and food-borne diseases as well as antimicrobial resistance. These are serious threats to animal and public health, and account for the majority of emerging and re-emerging conditions or infectious diseases. Reducing zoonotic disease threats requires an understanding of where and why risks exist. To support countries in building multi-sectoral mechanisms to jointly assess the risks at the human-animal-environment interface, a new operational tool is available to complement the existing tripartite guide to addressing zoonotic diseases in countries. The aim of this study is to conduct joint risk assessment (JRA) of rabies and avian influenza in Jordan utilizing the tripartite Joint Risk Assessment Operational Tool (JRA OT). Methods Representatives of sectors that are involved in zoonotic diseases outbreak investigation, control, surveillance and risk assessment, were trained on JRA OT. The operational tool of tripartite guide to addressing zoonotic diseases in countries that was developed by WHO (World Health Organization), FAO (Food and Agriculture Organization of the United Nations) and WOAH (World Organization for Animal Health) was utilized to conduct risk assessment for rabies and H5N1 avian influenza in Jordan. Results The risk assessment outcome for rabies were as follows: Likelihood is high; impact is moderate with moderate level of uncertainty. The impact of the disease is moderate because the virus transmitted only by animal bite in Jordan. The level of uncertainty is moderate due to existence of some gaps in data available from the ministries regarding the surveillance and collection areas of wild animals with feral dogs. The risk assessment outcome for H5N1 AI indicated a low likelihood estimate with moderate uncertainty level. The impact estimate for H5N1 AI in Jordan is moderate with a low level of uncertainty. Conclusions The tripartite JRA OT provides a helpful and easy to follow guide to bring together expertise and information from all relevant sectors to jointly assess risks from zoonotic diseases and contributes to the understanding and management of shared threats at the human-animal-environment interface.

Effect of stemming on text similarity for Arabic language at sentence level.

Semantic Text Similarity (STS) has several and important applications in the field of Natural Language Processing (NLP). The Aim of this study is to investigate the effect of stemming on text similarity for Arabic language at sentence level. Several Arabic light and heavy stemmers as well as lemmatization algorithms are used in this study, with a total of 10 algorithms. Standard training and testing data sets are used from SemEval-2017 international workshop for Task 1, Track 1 Arabic (ar-ar). Different features are selected to study the effect of stemming on text similarity based on different similarity measures. Traditional machine learning algorithms are used such as Support Vector Machines (SVM), Stochastic Gradient Descent (SGD) and Naïve Bayesian (NB). Compared to the original text, using the stemmed and lemmatized documents in experiments achieve enhanced Pearson correlation results. The best results attained when using Arabic light Stemmer (ARLSTem) and Farasa light stemmers, Farasa and Qalsadi Lemmatizers and Tashaphyne heavy stemmer. The best enhancement was about 7.34% in Pearson correlation. In general, stemming considerably improves the performance of sentence text similarly for Arabic language. However, some stemmers make results worse than those for original text; they are Khoja heavy stemmer and AlKhalil light stemmer.

Trend of Cutaneous Leishmaniasis in Jordan From 2010 to 2016: Retrospective Study.

BACKGROUND: Cutaneous leishmaniasis (CL) is endemic in the Middle East, with countries such as Syria reporting high incidence rates. OBJECTIVE: This study aimed to assess the trends in the incidence of cutaneous leishmaniasis (CL) in Jordan from 2010 to 2016. METHODS: This retrospective study included all cases of CL that had been reported to the Leishmaniasis Surveillance System in the Department of Communicable Diseases at the Jordan Ministry of Health during the period from 2010 to 2016. A total of 1243 cases were reported and met the case definition. RESULTS: A total of 1243 cases (60.65% [754/1243] males and 39.34% [489/1243] females) were diagnosed during the study period. Of this sample, 233 patients (19.13%) were aged <5 years old, 451 (37.03%) were aged between 5-14 years old, 190 (15.60%) were aged between 15-24 years old, and 344 (28.24%) were aged ≥25 years old. Of those, 646 (51.97%) were Jordanians and 559 (44.97%) were Syrians. The average annual incidence rate of 1.70 per 100,000 people between 2010 and 2013 increased to 3.00 per 100,000 people in the years 2014 to 2016. There was no difference in incidence rates between Jordanians and Syrian refugees between 2010 and 2012. After 2012, the incidence rate increased significantly among Syrian refugees from 1.20 per 100,000 people in 2012 to 11.80 per 100,000 people in 2016. On the contrary, the incidence rate did not change significantly among Jordanians. CONCLUSIONS: The incidence rate of leishmaniasis in Jordan has increased in the last three years because of the influx of Syrian refugees into Jordan. A massive effort toward reservoir and vector control, along with actively pursuing diagnosis in endemic foci, will be helpful. Proper and studious reporting of cases is also a necessity for the eradication of this disease.