Neglected tropical diseases of the Middle East and North Africa: review of their prevalence, distribution, and opportunities for control.

The neglected tropical diseases (NTDs) are highly endemic but patchily distributed among the 20 countries and almost 400 million people of the Middle East and North Africa (MENA) region, and disproportionately affect an estimated 65 million people living on less than US$2 per day. Egypt has the largest number of people living in poverty of any MENA nation, while Yemen has the highest prevalence of people living in poverty. These two nations stand out for having suffered the highest rates of many NTDs, including the soil-transmitted nematode infections, filarial infections, schistosomiasis, fascioliasis, leprosy, and trachoma, although they should be recognized for recent measures aimed at NTD control. Leishmaniasis, especially cutaneous leishmaniasis, is endemic in Syria, Iran, Iraq, Libya, Morocco, and elsewhere in the region. Both zoonotic (Leishmania major) and anthroponotic (Leishmania tropica) forms are endemic in MENA in rural arid regions and urban regions, respectively. Other endemic zoonotic NTDs include cystic echinococcosis, fascioliasis, and brucellosis. Dengue is endemic in Saudi Arabia, where Rift Valley fever and Alkhurma hemorrhagic fever have also emerged. Great strides have been made towards elimination of several endemic NTDs, including lymphatic filariasis in Egypt and Yemen; schistosomiasis in Iran, Morocco, and Oman; and trachoma in Morocco, Algeria, Iran, Libya, Oman, Saudi Arabia, Tunisia, and the United Arab Emirates. A particularly noteworthy achievement is the long battle waged against schistosomiasis in Egypt, where prevalence has been brought down by regular praziquantel treatment. Conflict and human and animal migrations are key social determinants in preventing the control or elimination of NTDs in the MENA, while local political will, strengthened international and intersectoral cooperative efforts for surveillance, mass drug administration, and vaccination are essential for elimination.

[Leprosy--a stigma in the 21st century]. / Lepra--stigma a XXI. században.

For the initiation of the French journalist Raoul Follereau in 1954 the UNO inaugurated the Leprosy Day (Martyr's Day) that is celebrated on the last Sunday of January every year. Although the bacterium that causes leprosy was isolated by the Norwegian scientist Gerhard Henrik Armauer Hansen in 1873 and from 1982 this disease can be cured with a special pharmaceutical complex, still 219.826 new leprous are detected on Earth every year, according to the data published in August, 2010 by WHO-experts. Ancient Chinese and Hindu source-strings from 600 B. C. are referring to leprosy, however, the disease was imported by the army of Alexander the Great from India around 327-326 B. C. Even the Old and the New Testament from the Holy Bible are mentioning leprosy in several details. During the Middle Ages the Military and Hospitaller Order of St. Lazarus of Jerusalem, established in the Holy Land in 72 A. D., did pioneer work in nursing leprous. In the process of time the medical attendance concerning leprous was organized in special hospitals called "leprosoriums" built on river-banks. Special office and even services were organized for the treatment and isolation of the people infected. Although medical science has prevailed against leprosy, and almost simultaneously even jurisprudence defended the patients' rights via legislation, still mankind can regrettably not get rid of this disease that stigmatizes seriously.

[Neurological evaluation of the leper king Baldwin IV of Jerusalem]. / Manifestaciones neurológicas de la lepra del rey Balduino IV de Jerusalén.

INTRODUCTION: In the medieval period, physicians became more aware of leprosy symptoms and differentiated it from other similar diseases. Baldwin, the leper king of Jerusalem (1161-1185), probably contributed to an increasing interest and tolerance to this disease in medieval Christian states. We review historical descriptions of the neurological manifestations he developed. DEVELOPMENT: William of Tyre gives us a description of first symptoms experienced by the prince when aged nine. He notices that half of his right arm and hand were partially numb. No skin or nervous lesions are described. By his early twenties, muscle weakness makes him unable to walk. He gets blinded, probably due to keratopathy related to facial nerves involvement. Repeated attacks of fever lead to progressive worsening of his disease. He finally dies in Jerusalem, aged twenty-five, probably due to a septicaemia from infected sores. The earliest sign of Baldwin's disease is anaesthesia. Though skin lesions are not described, it is likely that at this point he had a tuberculoid form of leprosy. As his disease finally takes a lepromatous form, we suspect that it began as a borderline, immunologically unstable form. CONCLUSION: Leper king Baldwin biography gives us interesting descriptions of neurological clinical features of leprosy. Besides, it helps us to discover twelfth century medicine knowledge about this disease.

The social implications of population displacement and resettlement: an overview with a focus on the Arab Middle East.

PIP: Involuntary migration is broadly defined as displacement due to development projects, due to war or political upheaval or persecution, or due to natural disasters. The Middle East is considered as having its share of displacement. Migration of an involuntary nature is not covered very well in the literature. This article focuses on Sudanese or Nubian experiences, the Lebanese civil war, the Palestinian diaspora, and relief efforts. The literature review merges studies of refugee populations, victims of disasters, and relocation into a common theoretical orientation and examines the implications for displacement. Initial studies of population movements are identified as having a focus on the necessity and inevitability of dislocation resulting from development and modernization. Relief efforts receive more attention than group movements, and certain populations are at greater risk of migration. Migration is considered to be a demographic regulator as well as part of a natural process of adaptation. Movement within modernization theory is viewed as healthy and based on Western experiences. Case studies of displaced populations refute some of the assumed beneficial effects. Hansen and Oliver-Smith's articles reveal some of the problems with displacement theories. Attention is drawn to involuntary migration as a social event rather than a passive reaction to events, and several distinctions are made about types of migration and resettlement as a process. A new term for displacement from natural disasters is added (environmental refugees). A number of good case studies on involuntary migration are noted. The author posits that the relationship between push forces and strategies of adaptation should be analyzed as an interactive process that continuously informs decision making on national and local levels. Geographers are recognized by Oliver-Smith as among the first to clarify the role of development in creating environmental hazards. The analyses point to underdevelopment as a condition that forces the poor and most vulnerable to move into vulnerable and hazardous economic and geographic circumstances. The Middle East experience emphasize war refugees. The Nubian experience reflects the unnoticed impact of development and the role of the state. The crossover between labor migration and displacement and the pastoral economy is not adequately addressed.^ieng