Progress toward malaria elimination in Jazan Province, Kingdom of Saudi Arabia: 2000-2014.

BACKGROUND: The draft Global Technical Strategy for malaria aims to eliminate malaria from at least 10 countries by 2020. Yemen and Saudi Arabia remain the last two countries on the Arabian Peninsula yet to achieve elimination. Over the last 50 years, systematic efforts to control malaria in the Kingdom of Saudi Arabia has successfully reduced malaria cases to a point where malaria is now constrained largely to Jazan Province, the most south-western area along the Red Sea. The progress toward elimination in this province is reviewed between 2000 and 2014. METHODS: Data were obtained from the Ministry of Health case-reporting systems, activity reports, unpublished consultants reports, and relevant scientific published papers. Sub-provincial population data were obtained the national household censuses undertaken in 2004 and 2010. Rainfall data were obtained from the Meteorological Department in Jazan. RESULTS: Between 2000 and 2014 there were 5522 locally acquired cases of malaria and 9936 cases of imported malaria. A significant reduction in locally acquired malaria cases was observed from 2000 to 2014, resulting in an average annual incidence (2010-2014) of 0.3 cases per 10,000 population. Conversely imported cases, since 2000, remain consistent and higher than locally acquired cases, averaging between 250 and 830 cases per year. The incidence of locally acquired cases is heterogeneous across the Province, with only a few health districts contributing the majority of the cases. The overall decline in malaria case incidence can be attributed to coincidental expansion of control efforts and periods of exceptionally low rainfall. CONCLUSIONS: Jazan province is poised to achieve malaria elimination. There is a need to change from a policy of passive case detection to reactively and proactively detecting infectious reservoirs that require new approaches to surveillance. These should be combined with advanced epidemiological tools to improve the definitions of epidemiological receptive and hotspot malaria risk mapping. The single largest threat currently remains the risks posed by imported infections from Yemen.

Exploring students' understanding of structured practical anatomy.

OBJECTIVES: The shift from the traditional curriculum to an integrated organ and system-based one has fragmented anatomy courses. Thus, it has become necessary to implement a structured active learning process for the practical teaching of anatomy. We achieved this goal by using an innovative teaching strategy for practical sessions called structured practical anatomy (SPA). We aimed to document the use of SPA for teaching practical anatomy and to evaluate students' perceptions of it. METHODS: We subdivided the students into 10 small groups, which we then assigned to structured stations with different teaching modalities. Finally, we administered the Dundee Ready Education Environment Measure (DREEM) questionnaire to assess the students' perceptions of their learning. RESULTS: Out of 48 items, our study showed a mean total score of 32 ± 7 (out of 48). We classified the students into four categories according to each student's total score; 56.76% of the students had a score of 25-36 in the 'positive' category range, 27% in the 'excellent' category (37-48), 15% in the 'negative' category (13-24) and 0.5% in the 'very poor' category (below 12). Two items on the questionnaire (13-47) were strongly positive items (greater than 3 out of 4), whereas other items were in the positive medium range (2-3 out of 4). CONCLUSIONS: SPA is an effective tool that plays a vital role in enhancing the teaching of practical anatomy. This teaching pedagogy offers an innovation in teaching and learning anatomy. Additionally, the results of the students' perceptions of their learning reflect areas that require further exploration to boost the effectiveness of teaching methods.