RESUMEN
BACKGROUND: This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups. METHODS: A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study's aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents. RESULTS: The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults. CONCLUSION: The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.
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Odontólogos , Libia , Humanos , Odontólogos/provisión & distribución , Odontólogos/estadística & datos numéricos , Atención a la Salud , Servicios de Salud Dental/estadística & datos numéricos , Servicios de Salud Dental/organización & administración , Sector Privado , Sector Público , Técnicos Dentales , Atención Odontológica/economía , Niño , Financiación Gubernamental , Especialidades Odontológicas , Salud Bucal , Enfermeras y Enfermeros , Auxiliares Dentales/estadística & datos numéricosRESUMEN
Background: There are 26 species of ticks known to exist in Libya. Despite the presence of a number of investigations on ticks in Libya, there are no published studies on ticks in the Al-Qarboulli area. Aim: The aim of this study was to identify the tick species infesting farm animals in the Qarabulli region. Methods: Ticks were collected manually on a monthly basis from the examined hosts (cattle, sheep, dogs, and camels) that were selected randomly in the period between July 2021 and June 2022. Results: A total of 717 ticks were collected on 775 hosts, eight tick species were encountered: Hyalomma excavatum (41.00%), Rhipicephalus sanguineus (23.43%), Hyalomma dromedarii (12.13%), Hyalomma marginatum (9.21%), Hyalomma anatolicum (8.51%), Rhipicephalus annulatus (5.30%), Hyalomma rufipes (0.28%), and Boophilus microplus (0.14%). The mean prevalence of all species was 22.32%. The mean intensity of all species was 0.93 ticks per host. The presence of ticks among the months of the year varied among tick species. Conclusion: The results showed high tick infestation in farm animals of Qarabulli, Libya, suggesting an increased risk of tick-borne diseases. This highlights the need for preventative measures and public awareness to reduce tick populations. Further studies are recommended to understand the spread of tick-borne diseases in the area.
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Camelus , Ixodidae , Infestaciones por Garrapatas , Animales , Libia/epidemiología , Infestaciones por Garrapatas/veterinaria , Infestaciones por Garrapatas/epidemiología , Infestaciones por Garrapatas/parasitología , Camelus/parasitología , Ixodidae/fisiología , Ovinos , Perros , Bovinos , Prevalencia , Femenino , Animales Domésticos/parasitología , Masculino , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Ovejas/parasitologíaRESUMEN
Mutated skeletal muscle ryanodine receptor-1 (RYR1) gene is associated with a spectrum of autosomal dominant and recessive RyR1-related disorders with a wide phenotype. This report describes a variable phenotype associated with a previously unreported RYR1 frameshift pathogenic variant, (NM_000540.2) c.12815_12825del; p.Ala4272Glyfs*307, common in Libyan Jews. Clinical and genetic features of 14 carriers from 8 unrelated families were collected. There were 12 heterozygotes and 2 compound heterozygotes. Six heterozygotes (median age 49.8) were asymptomatic, and six (median age 24.5) presented with myopathy (n = 3) or severe arthrogryposis-like features, severe scoliosis, pes planus, post-anesthesia malignant hyperthermia, or cystic hygroma (in a fetus) (n = 1 each). None had an abnormal echocardiogram study or elevated creatine phosphokinase (CPK) levels. One bi-allelic carrier had a severe skeletal phenotype and myopathy; the other was a fetus with a cystic hygroma. Assessment of variant frequency in 447 Libyan Jews who underwent exome testing for unrelated reason yielded a prevalence of 1:55. The RYR1 p.Ala4272Glyfs*307 variant is common in Libyan Jews. It is associated with a broad phenotypic spectrum, with possible presentation among heterozygotes. Further genotype-phenotype studies are essential to delineate the clinical significance of the variant in mono- and bi-allelic carriers.
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Heterocigoto , Judíos , Fenotipo , Canal Liberador de Calcio Receptor de Rianodina , Humanos , Canal Liberador de Calcio Receptor de Rianodina/genética , Femenino , Masculino , Libia , Adulto , Persona de Mediana Edad , Judíos/genética , Adulto Joven , Adolescente , Mutación del Sistema de Lectura , Niño , Enfermedades Musculares/genética , AncianoRESUMEN
BACKGROUND: Libya has experienced decades of violent conflict that have severely disrupted health service delivery. The Government of National Unity is committed to rebuilding a resilient health system built on a platform of strong primary care. AIM: Commissioned by the government, we set out to perform a rapid assessment of the system as it stands and identify areas for improvement. DESIGN AND SETTING: We used a rapid applied policy explanatory-sequential mixed-methods design, working with Libyan data and Libyan policymakers, with supporting interview data from other primary care policymakers working across the Middle East and North Africa region. METHOD: We used the Primary Health Care Performance Initiative framework to structure our assessment. Review of policy documents and secondary analysis of WHO and World Bank survey data informed a series of targeted policymaker interviews. We used deductive framework analysis to synthesise our findings. RESULTS: We identified 11 key documents and six key policymakers to interview. Libya has strong policy commitments to providing good quality primary care, and a high number of health staff and facilities. Access to services and trust in providers is high. However, a third of facilities are non-operational; there is a marked skew towards axillary and administrative staff; and structural challenges with financing, logistics, and standards has led to highly variable provision of care. CONCLUSION: In reforming the primary care system, the government should consolidate leadership, clarify governance structures and systems, and focus on setting national standards for human resources for health, facilities, stocks, and clinical care.
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Atención Primaria de Salud , Libia , Atención Primaria de Salud/organización & administración , Humanos , Política de Salud , Entrevistas como Asunto , Atención a la Salud/organización & administración , Accesibilidad a los Servicios de SaludRESUMEN
Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM2.5) in Libya, drawing on data from the Global Burden of Disease Study 2019. By integrating satellite-based estimates, chemical transport models, and ground-level measurements, PM2.5 exposure and its effects on mortality and disability-adjusted life years (DALYs) across the different sexes and all age groups from 1990 to 2019 are estimated. Our findings reveal that the annual population-weighted mean PM2.5 concentration in Libya was 38.6 µg/m3 in 2019, marking a 3% increase since 1990. In the same year, PM2.5 was responsible for approximately 3368 deaths, accounting for 11% of all annual deaths in the country. Moreover, a total of 107,207 DALYs were attributable to PM2.5, with ischemic heart disease being the leading cause, representing 46% of these DALYs. The analysis also highlights a significant burden of years of life lost (YLLs) at 89,113 and years lived with disability (YLDs) at 18,094, due to PM2.5. Given the substantial health risks associated with air pollution, particularly from ambient particulate matter, Libyan authorities must implement effective policies aimed at reducing air pollution to enhance healthcare outcomes and preventive services.
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Contaminación del Aire , Carga Global de Enfermedades , Material Particulado , Salud Pública , Material Particulado/análisis , Material Particulado/efectos adversos , Humanos , Libia/epidemiología , Femenino , Masculino , Adulto , Adolescente , Persona de Mediana Edad , Niño , Adulto Joven , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Preescolar , Anciano , Lactante , Contaminantes Atmosféricos/análisis , Años de Vida Ajustados por Discapacidad , Exposición a Riesgos Ambientales/efectos adversos , Recién Nacido , Anciano de 80 o más AñosRESUMEN
Among hospitalized patients worldwide, infections caused by multidrug-resistant (MDR) bacteria are a major cause of morbidity and mortality. This study aimed to isolate MDR bacteria from five intensive care units (ICUs) at Tripoli University Hospital (TUH). A prospective cross-sectional study was conducted over a seven-month period (September 2022 to March 2023) across five ICUs at TUH. A total of 197 swabs were collected from Patients', healthcare workers' and ICUs equipment. Samples collected from patients were nasal swabs, oral cavity swabs, hand swabs, sputum specimens, skin swabs, umbilical venous catheter swabs, and around cannula. Swabs collected from health care workers were nasal swabs, whereas ICUs equipment's samples were from endotracheal tubes, oxygen masks, and neonatal incubators. Identification and antimicrobial susceptibility test was confirmed by using MicroScan auto SCAN 4 (Beckman Coulter). The most frequent strains were Gram negative bacilli 113 (57.4%) with the predominance of Acinetobacter baumannii 50/113 (44%) followed by Klebsiella pneumoniae 44/113 (40%) and Pseudomonas aeruginosa 6/113 (5.3%). The total Gram positive bacterial strains isolated were 84 (42.6%), coagulase negative Staphylococci 55 (66%) with MDRs (89%) were the most common isolates followed by Staphylococcus aureus 15 (17.8%). Different antibiotics were used against these isolates; Gram- negative isolates showed high resistance rates to ceftazidime, gentamicin, amikacin and ertapenem. A. baumannii were the most frequent MDROs (94%), and the highest resistance rates in Gram-positive strains were observed toward ampicillin, oxacillin, ampicillin/sulbactam and Cefoxitin, representing 90% of total MDR Gram-positive isolates. ESBL and MRS were identified in most of strains. The prevalence of antibiotic resistance was high for both Gram negative and Gram positive isolates. This prevalence requires strict infection prevention and control intervention, continuous monitoring, implementation of effective antibiotic stewardship, immediate, concerted and collaborative action to monitor its prevalence and spread in the hospital.
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Farmacorresistencia Bacteriana Múltiple , Hospitales Universitarios , Unidades de Cuidados Intensivos , Humanos , Libia/epidemiología , Estudios Transversales , Prevalencia , Estudios Prospectivos , Masculino , Femenino , Antibacterianos/farmacología , Pruebas de Sensibilidad Microbiana , Adulto , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Gramnegativas/efectos de los fármacos , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Bacterias Grampositivas/aislamiento & purificación , Bacterias Grampositivas/efectos de los fármacos , Persona de Mediana EdadRESUMEN
The primarily bat-associated argasid tick, Secretargas transgariepinus (White, 1846), is a member of the Afrotropical and southern Palaearctic fauna. Probably because of its secretive life style, little is known about this species and records of its collection are scant. Based on morphological revisions of the available specimens, we report new Middle Eastern records for this tick species that had been misidentified as other bat-associated argasid taxa. These specimens are larvae from three localities, and represent the first records of S. transgariepinus from two countries: one larva from Sabratha (Libya) was collected from an unidentified bat species (possibly Eptesicus isabellinus), seven larvae from Azraq-Shishan (Jordan), and 78 larvae from Shamwari (Jordan) were all collected from Otonycteris hemprichii. Twenty larvae from Shamwari were also tested for the presence of both, viral or bacterial microorganisms by PCR. Three ticks were found to be infected with the Murid gammaherpesvirus 68 (MHV-68), one with Borrelia burgdorferi sensu lato, and four with a Rickettsia sp. closely related to Rickettsia slovaca. The findings represent a first evidence for the occurrence of these possible pathogens in S. transgariepinus.
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Argasidae , Quirópteros , Larva , Animales , Jordania , Larva/microbiología , Libia , Quirópteros/parasitología , Argasidae/microbiología , Reacción en Cadena de la PolimerasaRESUMEN
OBJECTIVES: Diabetic ketoacidosis (DKA) stands as a critical, acute complication of type 1 diabetes. Despite its severity, there exists a dearth of data concerning the frequency and prevalence of DKA at the onset of type 1 diabetes in Libyan children. This study aimed to ascertain the frequency of DKA during the initial presentation of type 1 diabetes among children aged 0.5-14 years admitted to Tripoli Children's Hospital between 2011 and 2018. METHODS: Employing a retrospective approach, the study examined the proportion of children with newly diagnosed type 1 diabetes who presented with DKA. Data analysis included estimating DKA frequency concerning age at presentation, sex, and age groups. The comparative analysis involved assessing DKA frequency between 0.5 and <2 and 2-14 years age groups. Logistic regression analysis evaluated the impact of age group, sex, and family history of type 1 diabetes on DKA and severe DKA occurrence. RESULTS: Among 497 children with newly diagnosed type 1 diabetes, 39.2â¯% presented with DKA, of these 44.5â¯% had severe DKA. Females exhibited a higher DKA rate than males (OR 1.63, 95â¯% CI 1.13-2.34, p=0.009). Very young children (0.5 to <2 years) presented with DKA more frequently than those aged 2-14 years (OR 4.73, 95â¯% CI 2.65-8.47, p<0.001), and they were more likely to present in severe DKA (63.9 vs. 39.1â¯%, [OR 7.26, 95â¯% CI 3.65-14.41, p<0.001]). CONCLUSIONS: The frequency of DKA at type 1 diabetes onset among children admitted to Tripoli Children's Hospital is notably high, with nearly half of the DKA episodes categorized as severe. Very young children notably demonstrated a fivefold increase in the likelihood of presenting with DKA.
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Diabetes Mellitus Tipo 1 , Cetoacidosis Diabética , Centros de Atención Terciaria , Humanos , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 1/complicaciones , Masculino , Femenino , Niño , Cetoacidosis Diabética/epidemiología , Cetoacidosis Diabética/etiología , Estudios Retrospectivos , Libia/epidemiología , Adolescente , Preescolar , Factores de Riesgo , Lactante , Centros de Atención Terciaria/estadística & datos numéricos , Prevalencia , Hospitales Pediátricos/estadística & datos numéricos , Estudios de Seguimiento , PronósticoRESUMEN
Breast cancer (BC) is a leading cause of cancer deaths in Libyan women. BRCA1 variants differ globally due to the diversity of genetic makeup and populations history. Their distribution, prevalence, and significance in Libyans remain largely unexplored. This study investigated the characteristics and distribution of BRCA1 variants in exons 5, 11, and 20 in Libyan families with BC. Thirty-six BC patients at ≤ 45 years, between 46-50 years and with a family history of breast, ovarian, pancreatic or prostate cancer in close relatives, or with triple-negative BC, were selected from 33 unrelated families during 2018-2020 at the National Cancer Institute, Sabratha, Libya. From these 33 families, 20 women (18 BC patients and two unaffected) were screened for BRCA1 exons 5, 11 and 20 using Sanger sequencing. All families completed an epidemiology and family history questionnaire. Twenty-seven variants (26 in exon 11 and 1 in exon 20, minor allele frequency of < 0.01) were detected in 10 of 18 unrelated families (55.6%.) Among the 27 variants, 26 (96%) were heterozygous. A frameshift pathogenic variant, c.2643del, and one novel variant c.1366A>G were identified. Furthermore, seven variants with unknown clinical significance were detected: c.1158T>A, c.1346C>G, c.1174C>G, c.3630 G>T, c.3599A>T, and c.3400 G>C in exon 11, and c.5244T>A in exon 20. Six variants with conflicting pathogenicity interpretations, c. 3460T>A, c. 3572 G>A, c. 3700 G>C, c. 1246C>G, c. 1344C>G, and c. 1054 G>A, were also identified. Twelve benign/likely benign variants were identified. Rare BRCA1 variants that have not been reported in North Africa were found in Libyan patients. These findings provide preliminary insights into the BRCA1 variants that could contribute to hereditary BC risk in Libyans. Further functional, computational, and population analyses are essential to determine their significance and potential impact on BC risk, which could ultimately lead to more personalized management strategies.
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Proteína BRCA1 , Neoplasias de la Mama , Exones , Mutación de Línea Germinal , Humanos , Libia/epidemiología , Femenino , Persona de Mediana Edad , Neoplasias de la Mama/genética , Neoplasias de la Mama/epidemiología , Proteína BRCA1/genética , Adulto , Predisposición Genética a la Enfermedad , Frecuencia de los GenesRESUMEN
Background: Reproductive efficiency affects dairy cow profitability. Ovarian function in postpartum (P.P.) has been better understood using ultrasound and hormonal assays. Optimizing ovulation synchronization and carefully timing artificial insemination (TAI) can greatly enhance reproductive rates in dairy cows. Aim: This experiment was designed to investigate the reproductive performance and ovarian activity in early postpartum lactating dairy cows using the Presynch-PGF2α, Ovsynch protocol, and TAI. Methods: Randomly the cows were assigned to a control group and a treatment group, based on the chronological order of their calving date. On day 14 P.P., both groups received two cloprostenol treatments, 14 days apart. Ultrasonographic inspections were conducted on day 14 to check ovarian activity and uterine contents. On day 11, after presynchronization, cows in the treatment group were given 100 µg IM. of cystorelin, followed by a luteolytic dose of 500 µg IM., cloprostenol on day 7, and a second dose of cystorelin on day 8 (36 hours later). After the second cystorelin injection by 16-20 hours, cows were inseminated, while the control group had all cows displaying spontaneous estrus between day 0 and day 28 were artificially inseminated. Results: Ovarian activity began to improve at 82.61% on day 19 P.P., with complete recovery between days 24 and 27 P.P. The second cloprostenol injection approached, causing follicular size to reach 8.41 ± 1.04 mm. After the second injection, ovarian activity switched from follicular to luteal, with corpus luteum rates of 23.91% and 26.1%. The presynchronized PGF2α regimen significantly enhanced ovarian activity from days 19-35 P.P. Ovulation and pregnancy rates in the Ovsynch group were 54.2% and 41.7% at the first timed artificial insemination (TAI), compared to 54.5% and 31.8% in the control group. There was no significant impact between them; it was just high in the presynchronized Ovsynch group. However, the P.P. period was minimized to 47-49 days till the first AI reached a 41.7% pregnancy rate and 20.8% at the second AI, for an overall 62.5%. Conclusion: The current study concludes that presynchronization during preservice in clinically normal P.P. dairy cows reduces P.P. duration, increases ovarian activity performance, and reduces ovarian dysfunctions from day 19 to day 35 P.P., as well as improves the pregnancy rate.
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Bovinos , Sincronización del Estro , Fertilidad , Ovulación , Libia , Femenino , Animales , Periodo Posparto , Sincronización del Estro/métodos , Ovario/diagnóstico por imagen , Ovario/efectos de los fármacos , Fertilidad/efectos de los fármacos , Fertilidad/fisiología , Progesterona/metabolismo , Ovulación/efectos de los fármacos , Ultrasonografía/veterinaria , Dinoprost/farmacología , Hormona Liberadora de Gonadotropina/farmacología , Cloprostenol/farmacología , Inseminación Artificial/veterinariaRESUMEN
Pseudomonas aeruginosa is a multidrug-resistant bacterium capable of forming biofilms. This study aimed to assess resistance of clinical isolates from Libyan hospitals to antipseudomonal antibiotics, the prevalence of selected extended-spectrum ß-lactamases and carbapenemase genes among these isolates, and the microorganisms' capacity for alginate and biofilm production. Forty-five isolates were collected from four hospitals in Benghazi and Derna, Libya. Antimicrobial susceptibility was determined using agar disc diffusion. The presence of resistance genes (blaCTXM, blaTEM, blaSHV-1, blaGES-1, blaKPC, and blaNDM) was screened using PCR. Biofilm formation was quantified via the crystal violet assay, while alginate production was measured spectrophotometrically. Resistance to antipseudomonal antibiotics ranged from 48.9% to 75.6%. The most prevalent resistance gene was blaNDM (26.7%), followed by blaGES-1 (17.8%). Moreover, all isolates demonstrated varying degrees of biofilm-forming ability and alginate production. No statistically significant correlation was found between biofilm formation and alginate production. The dissemination of resistant genes in P. aeruginosa, particularly carbapenemases, is of great concern. This issue is compounded by the bacteria's biofilm-forming capability. Urgent intervention and continuous surveillance are imperative to prevent further deterioration and the catastrophic spread of resistance among these formidable bacteria.
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Antibacterianos , Proteínas Bacterianas , Biopelículas , Pruebas de Sensibilidad Microbiana , Infecciones por Pseudomonas , Pseudomonas aeruginosa , beta-Lactamasas , Pseudomonas aeruginosa/aislamiento & purificación , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/genética , Libia/epidemiología , Humanos , beta-Lactamasas/genética , Proteínas Bacterianas/genética , Biopelículas/efectos de los fármacos , Antibacterianos/farmacología , Infecciones por Pseudomonas/microbiología , Infecciones por Pseudomonas/epidemiología , Farmacorresistencia Bacteriana Múltiple/genética , HospitalesRESUMEN
The sea crossing from Libya to Italy is one of the world's most dangerous and politically contentious migration routes, and yet over half a million people have attempted the crossing since 2014. Leveraging data on aggregate migration flows and individual migration incidents, we estimate how migrants and smugglers have reacted to changes in the border enforcement regime, namely the rise in interceptions by the Libyan Coast Guard starting in 2017 and the corresponding decrease in the probability of rescue to Europe. We find support for a deterrence effect in which attempted crossings along the Central Mediterranean route declined, and a diversion effect in which some migrants substituted to the Western Mediterranean route. At the same time, smugglers adapted their tactics. Using a strategic model of the smuggler's choice of boat size, we estimate how smugglers trade off between the short-run payoffs to launching overcrowded boats and the long-run costs of making less successful crossing attempts under different levels of enforcement. Taken together, these analyses shed light on how the integration of incident- and flow-level datasets can inform ongoing migration policy debates and identify potential consequences of changing enforcement regimes.
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Migrantes , Humanos , Mar Mediterráneo , Europa (Continente) , Italia , LibiaRESUMEN
Approximately 2.2% of Libyans have chronic hepatitis B (CHB) and are at the highest risk of developing end-stage disease complications. Several resource-limited countries, including Libya, may be far from achieving the WHO goal of hepatitis B elimination by 2030 as a result of several testing and linkage to care (LTC) barriers. In Libya, data about the current HBV infection situation is scarce. Therefore, our study aimed to evaluate the trends of HBV in eastern Libya, Tobruk region, and try to identify the region-specific gaps and barriers that could potentially delay the WHO goal of HBV elimination. An eighteen-year retrospective review of records of the main district medical center in the region was done to estimate the trends of HBV infection and qualitative interviews with the clinical staff of the CHB registry in the region were conducted to investigate the current status of HBV management. Out of 392,952 records, 371 (0.09%) HBV-positive were recorded and declining trends of the infection were noticed over the study period. Until late 2019, there was no linkage to care or follow-up for people with HBV infection. However, a CHB registry was established in late 2019 to manage HBV infections in the region, yet there are several barriers such as the lack of diagnostic infrastructure for liver function assessment and antiviral treatment. Despite the significant decline observed in the occurrence of HBV infection and introduction of important HBV management steps such as establishment of the CHB registry, there are still several barriers that could delay the elimination of the infection.
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Hepatitis B Crónica , Humanos , Libia/epidemiología , Masculino , Femenino , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/prevención & control , Hepatitis B Crónica/terapia , Adulto Joven , Adolescente , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Erradicación de la Enfermedad/organización & administración , Virus de la Hepatitis B , Accesibilidad a los Servicios de SaludRESUMEN
OBJECTIVES: To identify the factors influencing communication between patients and dentists in Libya and their effects on patient satisfaction and trust. We explored the impact of these interactions on the subsequent utilisation of dental health services from the patient's perspective. DESIGN: Qualitative descriptive study in a purposive sample of patients from oral health centres in Janzour city in Libya who were over eighteen years old. Sixteen semi-structured interviews (30-90 minutes) were conducted online. RESULTS: Trust was the prime concern among patients. Other factors also positively impacting communication and patient satisfaction included information interaction, active participation, moral support, explanation about processes and the dentists' comprehension of how a patient feels. The online interviews revealed four key thematic areas that reflected the patient-dentist communication phases: 1) Welcoming and establishing a good interpersonal rapport phase; 2) the Information-sharing phase; 3) Treatment decision-making phase, and 4) Satisfaction self-evaluation phase. CONCLUSION: These data emphasise the significance of soft skills, particularly effective communication, in the context of dental practice. The findings underscore the importance of personal values and interpersonal skills among dental professionals, as these factors play a pivotal role in shaping the success of dental healthcare provision.
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Comunicación , Utilización de Instalaciones y Servicios , Humanos , Adolescente , Libia , Satisfacción del Paciente , OdontólogosRESUMEN
The diagnosis of acute lymphoblastic leukemia (ALL), which is the most common type of cancer in children, has become more accurate with the use of flow cytometry. Here, this technology was used to immunophenotype leukemic cells in peripheral blood samples from Libyan pediatric ALL patients. We recruited 152 newly diagnosed patients at Tripoli Medical Center (Tripoli, Libya) by morphological examination of blood and bone marrow. Twenty-three surface and cytoplasmic antigen markers were used to characterize B and T cells in circulating blood cells by four-color flow cytometry. Six children (3.9%) turned out to have biphenotypic acute leukemia, 88 (57.9%) had B ALL, and 58 (38.1%) had T ALL. There were 68 cases of pro-B ALL CD10-positive (44.7%), 8 cases of pro-B ALL CD10-negative (5.2%), 6 cases of pre-B ALL (3.9%), and 6 of mature-B ALL (3.9%). CD13 was the most commonly expressed myeloid antigen in ALL. We present immunophenotypic data for the first time describing ALL cases in Libya. The reported results indicate that the most common subtype was pro-B ALL, and the frequency of T-ALL subtype was higher compared to previous studies. Six cases were positive for both myeloid and B lymphoid markers. Our findings may provide the basis for future studies to correlate immunophenotypic profile and genetic characteristics with treatment response among ALL patients.
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Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Niño , Citometría de Flujo/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Enfermedad Aguda , Inmunofenotipificación , Libia/epidemiologíaRESUMEN
BACKGROUND: Molar incisor hypomineralisation (MIH) is a developmental enamel defect in the first permanent molars and frequently in the incisors. It poses a unique challenge to the dental practitioner because of its nature, clinical presentations and treatment strategies. AIM: This study assessed the perception of Libyan dentists in Benghazi regarding MIH and its management. DESIGN: Paper-based, self-administered questionnaires were distributed to dentists in Benghazi, Libya. The questionnaires investigated the awareness of MIH, knowledge of MIH aetiology, clinical challenges of MIH treatment and choices of restorative management. Descriptive statistics, chi-squared test and binary logistic regression analysis were performed at a significance level of ≤.05. RESULTS: A total of 389 questionnaires were completed and analysed, giving an overall response rate of 76% (389/511). Most participants were female (85%, 332), with an average of 6.05 (SD = 6.24) years of experience. The majority of participants (67%) recognised MIH in their practice. Statistically significant differences in the awareness of MIH and its prevalence were observed according to the type of practice (p ≤ .001) and experience of dentists (p ≤ .001). Dentists working in public dental practice were less familiar with MIH and less likely to report it. Likewise, novice dentists were less aware of MIH than more experienced colleagues. The most reported aetiological factor in MIH was genetics by 60.2% of respondents, followed by environmental contamination (47.6%) and fluorides (42.9%). Most participants (92.3%) considered MIH a clinical problem. Aesthetics and diagnosis were the most reported challenging aspects (59.4% and 44.2%, respectively). The most commonly selected restorative options were high-fluoride glass ionomer cement (43.2%) and preformed metal crowns (41.6%). CONCLUSION: The majority of participants reported awareness of the existence of MIH condition. Nevertheless, variations in estimating MIH prevalence and its proper treatment, as well as factors influencing its treatment and diagnosis, were recorded. It is recommended that the current dental curriculum is reviewed, and scientific evidence providing dental practitioners with updated information on the diagnosis and clinical management of MIH should be circulated.
Asunto(s)
Hipoplasia del Esmalte Dental , Odontólogos , Humanos , Libia , Femenino , Hipoplasia del Esmalte Dental/terapia , Masculino , Encuestas y Cuestionarios , Odontólogos/psicología , Pautas de la Práctica en Odontología/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Adulto , Diente Molar , Hipomineralización MolarRESUMEN
During the COVID-19 pandemic, many educational institutions switched to e-learning educational platforms. This approach was essential but raised challenges, particularly in training practitioners for medical emergencies. This approach not only led to global challenges and a need for rapid adaptation, but also raised inequities across countries, with some facing far more technical challenges than others. In Libya, low investment in education technology and unpredictable internet connectivity limited its integration into schools and universities even before the pandemic. The current study reports feedback from an online continuing dental education (CDE) course for dental practitioners that was developed emergently during the pandemic and aimed to address the challenges posed by Libya's internet environment. Participants were recruited through social media and received an 8-hour online CDE course consisting of three modules. Participants were invited to complete a pre-course demographic/informational survey on a Google form. After passing all modules, students were prompted to complete a post-course survey consisting of 23, five-point Likert scale questions. Respondents included 43 females (74.1%) and 15 males (25.9%). For ~50% of the cohort (n = 32), this was their first online clinical course. 87.9% of post-course participants rated the course as a positive learning experience, while 90.9% agreed their learning outcomes had been achieved. Most participants (97%) agreed the course instructor explained all concepts clearly. In total, 81.8% agreed that the technology effectively supported their learning. Most agreed that a clear demarcation between each course module existed and that the language and depth of the material were adequate. Some students reported technical difficulties, and 33.3% saw repetitions in the modules. However, all post-course respondents said they would recommend the online course to colleagues. Libyan dental practitioners showed high satisfaction levels towards the e-learning process, course content, instructors' attitudes, and overall e-learning experience despite the inherent e-learning challenges posed in this country.
Asunto(s)
COVID-19 , Femenino , Masculino , Humanos , Estudios Transversales , COVID-19/epidemiología , Libia/epidemiología , Pandemias , Odontólogos , Educación Continua en Odontología , Rol ProfesionalRESUMEN
Introduction: According to data from the World Health Organization (WHO), in the last year cholera has re-emerged in various areas of the planet, particularly in Africa. The resurgence of this disease is closely linked to poor hygiene, which is sometimes the result of wars or environmental disasters, as in Lebanon and Syria since autumn 2022 and today in Libya. Discussion: The spread of cholera is chiefly caused by the presence of contaminated water, in environments with inadequate hygiene and sanitation. Another cause, however, is the lack of access to adequate vaccination and treatment campaigns. Method: In this short paper, the authors highlight the possibility of a resurgence of epidemic cholera in Libya, especially in light of the consequences of the devastating cyclone Daniel and the simultaneous collapse of two dams upstream of the city of Derna. They also highlight the concern that cholera and other infectious diseases may also spread in Morocco, which was hit by a severe earthquake on 8 September last. The focus of the paper is the awareness that the spread of epidemic diseases is very often linked to human actions, which may trigger or exacerbate the effects of natural disasters. Conclusions: Since these events have devastating effects both on the environment and on people and their psychophysical balance, it is evident that we need to devote greater attention to the health of the planet, to which the health and survival of the human species is strictly and inextricably linked. Indeed, disasters related to phenomena of anthropization facilitate the spread of infectious diseases, placing a heavy burden on local and global health organizations and the health of entire populations. A change of course is therefore essential, in that human actions must be aimed at limiting rather than aggravating the spread of diseases.
Asunto(s)
Cólera , Enfermedades Transmisibles , Terremotos , Humanos , Cólera/epidemiología , Cólera/terapia , Brotes de Enfermedades , Libia/epidemiología , África del Norte/epidemiología , MarruecosRESUMEN
Background: The rock goby, Gobius paganellus, is not a commercial species. This species has an essential role in the coastal ecosystem as a biological indicator. Therefore, it has been selected as the study's model species. Aim: Due to the insufficient studies that have described the hepatopancreas of G. paganellus, this study aimed to provide information on the anatomical and histological structure of the hepatopancreas of the alimentary canal of this species on the western coast of Libya. Methods: Fifty mature G. paganellus specimens were collected from the northwest of Libya (Tajoura, Jodaem, and Farwa Island). Total length and total weight of the samples were measured and performed by using gross anatomy and histology. Then, the histological sections (3-5 µm) were stained with hematoxylin and eosin (H and E). Results: Morphologically, the liver has a large pyriform lobe. The dorsal surface of the liver is shiny and smooth, and the ventral surface contains shallow sulci; each sulus has a large blood vessel. Histologically, the liver is wrapped with a thin capsule of fibro-connective tissue. The hepatic parenchyma is made of hepatocytes with blood sinusoids. The hepatocytes are polygonal-shaped cells and have no hepatic lobules or portal triads. Melano-macrophage centers are distributed next to the blood vessels and bile ducts. The bile ducts are lined by columnar epithelial cells. The exocrine pancreatic tissue was observed in the liver parenchyma, and it consists of acini that are composed of pyramidal cells and contain zymogen granules. Conclusion: The liver of this species has both pancreatic and liver tissue, which was discovered in this investigation for the first time.