Evaluation of the public health empowerment program in the Eastern Mediterranean region.

Background: The Public Health Empowerment Program (PHEP) is a 3-month training program for frontline public health staff to improve surveillance quality and strengthen the early warning system capacities. Studies evaluating the program and its impact on the health systems in the Eastern Mediterranean Region (EMR) are lacking. Therefore, this study aimed to assess the level of PHEP graduates' engagement in field epidemiology activities, assess their perceived skills and capacity to perform these activities and assess the extent to which PHEP helped the graduates to perform field epidemiology activities. Methods: A descriptive evaluation study was conducted based on levels 3 and 4 of Kirkpatrick's model for evaluating training programs to assess the change in graduates' behavior and the direct results of the program. Data were collected using two online surveys targeting PHEP graduates and programs' directors/ technical advisers. Results: A total of 162 PHEP graduates and 8 directors/ technical advisers participated in the study. The majority of PHEP graduates reported that they are often involved in activities such as responding to disease outbreaks effectively (87.7%) and monitoring surveillance data collection (75.3%). High proportions of PHEP graduates rated their skills as good in performing most of field epidemiology activities. The majority of graduates reported that the PHEP helped them much in conducting, reviewing, and monitoring surveillance data collection (92%), responding effectively to public health events and disease outbreaks (91.4%), and communicating information effectively with agency staff and with the local community (85.2%). Conclusion: PHEP appears to be an effective program for improving the public health workforce's skills and practices in epidemiological competencies in the EMR. PHEP strengthened the engagement of the graduates in most field epidemiology activities, especially during COVID-19.

Accuracy of sonographic fetal weight estimation within 14 days of delivery in a Jordanian population using Hadlock formula 1.

OBJECTIVES: To assess the accuracy of sonographic fetal weight estimation within 14 days of delivery in a Jordanian population using Hadlock formula 1 in the third trimester. MATERIALS AND METHODS: Estimated fetal weights and actual fetal weights data were collected from the medical records of pregnant women who had undergone sonographic fetal weight estimation within 14 days of delivery over the period of March 2008 to June 2010. The analysis included 409 Jordanian women; 6 of them had twins, so the study involved estimation of 415 fetal weights, and these were compared to the actual recorded neonatal weights. Using Hadlock formula 1, we compared the estimations with the infants' actual birth weights. The data were analyzed in 2 groups: within 7 days and 8-14 days. RESULTS: The mean estimated fetal weight was 3,133 ± 475 g (range 1,343-4,420 g). The mean actual birth weight was 3,179 ± 450 g (range 1,300-4,450 g). The mean absolute percentage of error of ultrasound fetal weight estimation for all infants was 6.5%; however, it was 6.1 and 8.2% if the fetus was delivered within 7 days or 8-14 days of sonography, respectively. Overall, 78.8% of fetal weight estimations were within 10% of actual birth weight; however it was 81.3 and 69.9% if the fetus was delivered within 7 days or from 8-14 days of sonography, respectively. CONCLUSION: The use of Hadlock formula 1 for sonographic fetal weight estimations in Jordanian women showed acceptable results relative to the actual neonatal weight at birth. However, fetal weight estimation was more reliable when performed within 7 days of delivery.

Thrombophilia-related genetic variations in patients with pulmonary embolism in the main teaching hospital in Jordan.

OBJECTIVE: To study the frequency of Factor V Leiden (FVL), prothrombin gene mutation G20210A and methylenetetrahydrofolate reductase C677T in patients with acute pulmonary embolism (PE); and to investigate whether these factors are more frequent in patients who have no obvious risk factors for venous thrombo-embolism compared to those with obvious risk factors. METHODS: A case-control study conducted at Jordan University Hospital, Amman, Jordan during the period 2005-2007. Compared 92 patients with acute PE to 99 normal subjects. All subjects were investigated for the 3 genetically related thrombophilic factors. RESULTS: The frequency of these factors in patients were 22/92 (23.9%) FVL, 3/92 (3.3%) Factor II (FII) and 48/92 (52.2%) methylenetetrahydrofolate reductase (MTHFR). In the control group, FVL was 12/99 (12.1%), FII 0/99 (0%), and 53/99 (53.5%) MTHFR. There was a statistically significant difference between patients and controls for FVL (p=0.03), but no statistical significance for FII (p=0.10) and MTHFR (p=0.85). In patients with no obvious risk factors, the frequency of these factors were 8/29 (27.6%) FVL, 2/29 (6.9%) FII, and 14/29 (48.3%) for MTHFR compared to patients with obvious risk factors 14/63 (22.2%) for FVL, 1/63 (1.6%) FII, and 33/63 (52.3%) MTHFR. CONCLUSION: The FVL is statistically more frequent in patients with PE compared to the control group, and the frequency of FVL, FII, and MTHFR is not significantly higher in patients with acute PE who have no obvious risk factors compared to those with obvious risk factors.