The impact of the COVID-19 pandemic on service delivery for noncommunicable diseases in the Eastern Mediterranean Region.

Background: The COVID-19 pandemic has adversely affected the delivery of noncommunicable diseases (NCDs) services globally as health systems are overwhelmed by the response to the pandemic. Aims: The World Health Organization (WHO) Regional Office for the Eastern Mediterranean conducted an assessment to evaluate the impact of COVID-19 on NCD-related services, programmes, funding and consideration of NCDs in COVID-19 response. Methods: Data were collected from countries of the WHO Eastern Mediterranean Region (EMR) in mid-2020 through a web-based questionnaire on NCD services-related infrastructure, policies and plans, staffing, funding, NCD services disruptions and their causes, disruption mitigation strategies, data collection on comorbidity, surveillance, and suggestions for WHO technical guidance. The data were exported into Microsoft Excel and summarized. Countries were grouped according to socioeconomic level. Results: Nineteen of the 22 countries in the EMR responded: 95% had NCD staff reallocated to support their COVID-19 response. Lower-income countries were less likely to include NCDs in their pandemic response plans and more likely to report disruption of services. The most commonly disrupted services were hypertension management (10 countries 53%), dental care (10 countries 53%), rehabilitation (9 countries 47%), palliative care (9 countries 47%) and asthma management (9 countries 47%). Conclusion: The COVID-19 pandemic has disrupted the continuity of NCD-related services in EMR countries. The ability to mitigate service disruptions varied noticeably between countries. The mitigation measures implemented included triaging of patients, novel NCD medicines supply chains and dispensing interventions, and the use of digital health and telemedicine. Guidance and support for systems resilience, preparedness and response to crises are recommended.

Vitamin D Insufficiency and Deficiency in the Eastern Mediterranean Region (EMR)-Misconceptions in Public Health Practice: A Scoping Review 2019-2020.

Vitamin D insufficiency and deficiency are a growing concern in the reasonably sunny Eastern Mediterranean Region (EMR). Variances in the metabolism of vitamin D across populations were observed and several biological and environmental factors are reported to affect its pathways and regulatory mechanisms. Methodologies for the assessment of vitamin D indicator metabolite and threshold levels for inadequacy remain evidently controversial. This review was conducted to appraise how vitamin D status is evaluated in populations of EMR. Online databases including PubMed and Google Scholar, and websites of UN agencies and ministries of health were searched thoroughly. Surveys and cross-sectional studies conducted between 2009 and 2019 which are reporting vitamin D levels in countries of EMR were retrieved and included in this review. Surveys from Afghanistan, Iran, Iraq, Jordan, Kuwait, Oman, Pakistan, and Saudi Arabia, were included in this review. The indicator mostly reported for vitamin D status assessment was 25-hydroxyvitamin D in serum samples. Differences between countries in the cut-off levels used for assessment of vitamin D status were observed. Mostly the surveys adopted either the Institute of Medicine (IOM) or the Endocrine Society (ES) guidance, but even those showed overlap in defining insufficiency and deficiency. This discordance in cut-offs jeopardizes the credibility of results and regional and global comparability. We concluded that there is a lack of consensus on the methodologies used to assess vitamin D levels across EMR. There is an urgent need for guidance on clinical and public health practices on the assessment of vitamin D status.

Anthropometric assessment of school children in Khartoum Locality, Khartoum State, Sudan - 2014/2015.

ABSTRACT: Anthropometric measurements are used to assess growth of children which is affected by different biological and environmental factors. The importance of the period after the first 1000 days of life has been identified in the attempt to restore normal growth and body functions. The objectives of this study are to assess the growth and nutritional status of school children in Khartoum locality, Khartoum State, Sudan and to verify socioeconomic status and sex as factors influencing growth of children. This is a cross-sectional school-based study including 390 children, males and females, of ages between 5-12 years (60-44 months) from private and public schools. Anthropometric measurements were taken by standardized techniques and calibration and age was calculated in months. Using WHO's Anthroplus and SPSS, BMI for age z-scores (BAZ), height for age z-scores (HAZ) and weight for age z-scores (WAZ) were calculated and descriptive and analytical statistics were generated and tested. According to the WHO reference, 3.3% of the studied children were severely thin, 6.9% were thin, 8.7% were overweight and 6.7% were obese. The children showed low mean BAZ and a similar mean HAZ compare to WHO reference. Children in public schools showed significantly lower means compared to those in the private schools in all indicators; BAZ, HAZ and WAZ. Girls showed significantly higher means compared to boys with a significant occurrence of overweight and obesity among girls especially in private schools. Weak negative correlation between HAZ and age and weak positive correlation between HAZ and BAZ were detected. Further studies and tailored interventions are recommended.