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1.
N Engl J Med ; 381(26): 2519-2528, 2019 12 26.
Artículo en Inglés | MEDLINE | ID: mdl-31881138

RESUMEN

BACKGROUND: With the vision of "a world free of schistosomiasis," the World Health Organization (WHO) set ambitious goals of control of this debilitating disease and its elimination as a public health problem by 2020 and 2025, respectively. As these milestones become imminent, and if programs are to succeed, it is important to evaluate the WHO programmatic guidelines empirically. METHODS: We collated and analyzed multiyear cross-sectional data from nine national schistosomiasis control programs (in eight countries in sub-Saharan Africa and in Yemen). Data were analyzed according to schistosome species (Schistosoma mansoni or S. haematobium), number of treatment rounds, overall prevalence, and prevalence of heavy-intensity infection. Disease control was defined as a prevalence of heavy-intensity infection of less than 5% aggregated across sentinel sites, and the elimination target was defined as a prevalence of heavy-intensity infection of less than 1% in all sentinel sites. Heavy-intensity infection was defined as at least 400 eggs per gram of feces for S. mansoni infection or as more than 50 eggs per 10 ml of urine for S. haematobium infection. RESULTS: All but one country program (Niger) reached the disease-control target by two treatment rounds or less, which is earlier than projected by current WHO guidelines (5 to 10 years). Programs in areas with low endemicity levels at baseline were more likely to reach both the control and elimination targets than were programs in areas with moderate and high endemicity levels at baseline, although the elimination target was reached only for S. mansoni infection (in Burkina Faso, Burundi, and Rwanda within three treatment rounds). Intracountry variation was evident in the relationships between overall prevalence and heavy-intensity infection (stratified according to treatment rounds), a finding that highlights the challenges of using one metric to define control or elimination across all epidemiologic settings. CONCLUSIONS: These data suggest the need to reevaluate progress and treatment strategies in national schistosomiasis control programs more frequently, with local epidemiologic data taken into consideration, in order to determine the treatment effect and appropriate resource allocations and move closer to achieving the global goals. (Funded by the Children's Investment Fund Foundation and others.).


Asunto(s)
Control de Enfermedades Transmisibles , Esquistosomiasis Urinaria/prevención & control , Esquistosomiasis mansoni/prevención & control , África del Sur del Sahara/epidemiología , Animales , Antihelmínticos/uso terapéutico , Niño , Estudios Transversales , Enfermedades Endémicas/prevención & control , Humanos , Objetivos Organizacionales , Prevalencia , Schistosoma haematobium/aislamiento & purificación , Schistosoma mansoni/aislamiento & purificación , Esquistosomiasis Urinaria/tratamiento farmacológico , Esquistosomiasis Urinaria/epidemiología , Esquistosomiasis mansoni/tratamiento farmacológico , Esquistosomiasis mansoni/epidemiología , Organización Mundial de la Salud , Yemen/epidemiología
3.
Zootaxa ; 4683(4): zootaxa.4683.4.5, 2019 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-31715911

RESUMEN

We describe a new species of Stenasellus Dollfus, 1897 (Isopoda: Asellota: Stenasellidae) from stagnant freshwater habitats in a cave on Socotra Island, Yemen. S. taitii n. sp. is the first endemic stenasellid found in Socotra, showing relatively closer morphological affinities to species from the Middle East (Oman, Iran) than from the African mainland, corresponding to the known paleogeographical connection of the archipelago to Southern Arabia. With notes on the protection of Socotran groundwaters.


Asunto(s)
Isópodos , Animales , Arabia , Irán , Islas , Medio Oriente , Omán , Yemen
4.
Zootaxa ; 4658(1): zootaxa.4658.1.1, 2019 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-31716755

RESUMEN

The onthophagine fauna of the Arabian Peninsula is reviewed. New data from public and private collections are given. The total number of Onthophagini known from the Peninsula now stands at 30 species, without taking into account dubious records, belonging to seven genera. Of these 30 species, three (Onthophagus aethiopicus d'Orbigny, 1902, O. falsus Gillet, 1925 and O. frontalis Raffray, 1877) are reported for the first time from the Arabian Peninsula, six species (Digitonthophagus eucatta Génier in Génier Moretto, 2017, Onthophagus aethiopicus d'Orbigny, 1902, O. brittoni Paulian, 1948, O. falsus Gillet, 1925, O. rugulipennis Fairmaire, 1887, and O. trapezicornis d'Orbigny, 1902) are new records from Saudi Arabia, three (D. eucatta, O. aethiopicus and O. frontalis) are new from Yemen and five (O. bicolor Raffray, 1877, O. latipennis d'Orbigny, 1898, O. nitidulus Klug, 1856, O. quadriarmatus Fairmaire 1892 and O. sellatus Klug, 1845) are new from Oman. Furthermore, Onthophagus infuscatus Klug, 1845 is recorded from Djibouti for the first time. For all the treated species a general distribution, literature citations and eventual unpublished records are provided. A new synonymy (Onthophagus saudiensis Frey, 1962 under O. sticticus Harold, 1867) is proposed. Most of the species were recorded from locations in southern Saudi Arabia, Oman and Yemen, south Tropic of Cancer. Yemen and Saudi Arabia have the highest species numbers, hosting the richest fauna with 24 and 23 species, respectively. The majority of the Onthophagini fauna (73.33 %) has Afrotropical and Afrotropical-Palaearctic affinities, while the Palaearctic and Oriental-Palaearctic species are both represented by 6.66 %. The four Arabian endemisms represent the 13.33 % of the whole fauna. Lastly, a dichotomous key for the identification of Arabian onthophagine species is provided and a redescription of Onthophagus brittoni is supplied.


Asunto(s)
Escarabajos , Animales , Arabia , Omán , Arabia Saudita , Yemen
5.
Zootaxa ; 4651(2): zootaxa.4651.2.2, 2019 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-31716908

RESUMEN

In this paper, we report 10 species of Syllidae, collected in the Socotra Archipelago (Indian Ocean). They belong to eight different genera in four subfamilies namely, Syllinae: Haplosyllis Langerhans, 1879, Megasyllis San Martín, Hutchings Aguado, 2008, Opisthosyllis Langerhans, 1879, Trypanosyllis Claparède, 1864; Eusyllinae: Eusyllis Malmgren, 1867, Odontosyllis Claparède, 1863; Exogoninae: Salvatoria McIntosh, 1885; and Autolytinae: Myrianida Milne Edwards, 1845. Trypanosyllis mercedesae n. sp., is here formally described and distinguished from congeners. Trypanosyllis richardi Gravier, 1900 is re-described, adding important taxonomic information to the original description, based on specimens collected from Djibouti (Gulf of Aden). We provide new insight into the reproduction of Megasyllis heterosetosa (Hartmann-Schröder, 1991) with the description of a specimen with an attached female dicerous stolon, full of oocytes. Odontosyllis polycera (Schmarda, 1861) is described because it is newly recorded for the Indian Ocean. We also provide some remarks about Myrianida pachycera (Augener, 1913), collected with a chain of stolons.


Asunto(s)
Anélidos , Poliquetos , Animales , Femenino , Océano Índico , Yemen
6.
Zootaxa ; 4648(3): zootaxa.4648.3.11, 2019 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-31716943

RESUMEN

Acmaeodera (Acmaeodera) strumiai sp. nov. from Oman, Saudi Arabia, Yemen and Mauritania, and A. (Acmaeotethya) dhofarica sp. nov. from Oman and Yemen are described, illustrated and compared with related species.


Asunto(s)
Escarabajos , Distribución Animal , Animales , Arabia , Mauritania , Omán , Arabia Saudita , Yemen
7.
Zootaxa ; 4636(1): zootaxa.4636.1.1, 2019 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-31712491

RESUMEN

The Socotra Archipelago, located in the eastern Gulf of Aden, has a unique marine environment which combines tropical and 'pseudo-temperate' elements. Studies on the fish biogeography of the archipelago, partially framed in regional studies, have substantially outpaced critical elementary research on the archipelago's fish diversity. The present study seeks to close this gap and identifies the Socotra Archipelago as a major hotspot of coastal fish diversity in the Indian Ocean.       The archipelago supports unique coastal fish assemblages which are predominantly composed of coral-associated ("reef") species, in spite of the limited biogenic reef frameworks. A Preliminary Checklist comprises 682 species with confirmed records and a "Working List" includes an additional 51 records, totalling 733 faunal records in 108 families. The family Labridae is the most speciose, followed by Gobiidae, Pomacentridae, Serranidae and Chaetodontidae. The species richness of the archipelago is the highest when compared to adjacent Arabian ecoregions. The richness of the Acanthuridae, Chaetodontidae, Labridae, Pomacentridae and Pseudochromidae stand out as particularily high, and the richness of several families is as high as or higher than in the entire Red Sea. The total archipelagic richness is extrapolated at up to 875 species based on incidence-based richness models and expert opinion. Inshore fish inventories, covering 497 species, found between 14 and 132 species per site (x̄ = 66). Site diversity decreased across the archipelago from west to east and from north to south. Total fish diversity was highest around Socotra Island, followed by Abd al-Kuri Kal Farun and Darsa Samha. Occurrence frequencies were very unevenly distributed and dominated by Pomacentrus caeruleus and Thalassoma lunare, whilst many species were infrequent. The fish assemblages are dominated by species from the Indo-West Pacific and the north-western Indian Ocean. The assemblages are rich in rare species and hybrids, and include a low number of endemics (4-5), and a high number of species with far-reaching and Western Indian Ocean ranges.


Asunto(s)
Biodiversidad , Peces , Animales , Océano Índico , Islas , Yemen
8.
BMC Infect Dis ; 19(1): 879, 2019 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-31640583

RESUMEN

BACKGROUND: In Yemen, the underlying causes of infectious vaginitis have been neglected. Therefore, this study aimed to determine the prevalence and risk factors associated with bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonal vaginitis (TV) among non-pregnant reproductive-aged women. METHODS: A cross-sectional study was conducted among 347 non-pregnant reproductive-aged women seeking primary healthcare in Sana'a city, Yemen. Data about sociodemographic characteristics, lifestyle-related behaviors, routine hygienic practices, menstrual care and history and type of contraceptive intake were collected using a structured questionnaire. Vaginal discharge samples were collected and examined for discharge characteristics and pH by a gynecologist. Then, samples were examined for BV, VVC and TV. Data were analyzed using suitable statistical tests. RESULTS: Vaginal infections were prevalent among 37.6% of reproductive-aged women, where BV was the most prevalent (27.2%). VVC was significantly higher among symptomatic women and significantly associated with itching (P = 0.005). Using bivariate analysis, the age of < 25 years (odds ratio [OR] = 1.9, 95% confidence interval [CI]: 1.16-3.10; P = 0.010) and using intrauterine contraceptive devices (IUCDs) (OR = 1.8, 95% CI: 1.09-2.89; P = 0.020) were significantly associated with BV, while history of miscarriage was significantly associated with a lower risk of BV (OR = 0.5, 95% CI: 0.31-0.85, P = 0.009). However, polygyny was significantly associated with VVC (OR = 3.4, 95% CI: 1.33-8.66; P = 0.007). Multivariable analysis confirmed that age of < 25 years and using IUCD were the independent predictors of BV, while history of miscarriage was an independent protective factor against BV. On the other hand, marriage to a polygamous husband was the independent predictor of VVC. CONCLUSIONS: More than a third of non-pregnant reproductive-aged women seeking PHC in Sana'a have single or mixed infections with BV, VVC or TV. BV is the most frequent cause of vaginitis and is significantly associated with the age of < 25 years and using IUCDs, while VVC is significantly higher among women with polygamous husbands. Health education of polygamous husbands and their wives, regular monitoring of BV among IUCD users and screening women for vaginitis before treatment are recommended.


Asunto(s)
Candidiasis Vulvovaginal/epidemiología , Vaginitis por Trichomonas/epidemiología , Vaginosis Bacteriana/epidemiología , Adolescente , Adulto , Candidiasis Vulvovaginal/etiología , Coinfección , Estudios Transversales , Femenino , Humanos , Dispositivos Intrauterinos/estadística & datos numéricos , Matrimonio , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Atención Primaria de Salud/estadística & datos numéricos , Factores de Riesgo , Vaginitis por Trichomonas/etiología , Vaginosis Bacteriana/etiología , Yemen/epidemiología , Adulto Joven
9.
Ann Parasitol ; 65(3): 217-223, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31578845

RESUMEN

The majority of the population in Yemen lives in rural areas and suffers from parasitic infections. Therefore, the present study aimed to determine the prevalence of intestinal parasitoses and schistosome infections among the students enrolled in the primary schools in Hajjah governorate ­ north of Yemen, along with an assessment of praziquantel (PZQ) in the treatment of microscopy-confirmed cases of Schistosoma mansoni and Schistosoma haematobium. For this purpose, 780 samples (320 stool and 460 urine) were examined microscopically. The present study revealed an overall infection rate of 75.3% (241/320) with intestinal parasites and Schistosoma mansoni. The detected parasite species included Entamoeba histolytica (27.8%), Hymenolepis nana (12.2%), Giardia lamblia (9.7%), Entamoeba coli (9.4%), S. mansoni (9.1%), Ascaris lumbricoides (6.9%), Trichuris trichiura (3.1%), Enterobius vermicularis (2.8%) and Ancylostoma duodenale (2.2%). Schistosoma haematobium was prevalent among 1.7% (8/460) of the investigated students. On the other hand, PZQ yielded a cure rate of 75.7% of Schistosoma-infected students when administered at 40 mg/kg body weight. However, a 100% cure rate was achieved when administered at 60 mg/kg body weight. Therefore, the findings of the present study highlight the importance of monitoring PZQ efficacy through large-scale studies in different settings endemic for schistosomosis in the country.


Asunto(s)
Parasitosis Intestinales , Praziquantel , Esquistosomiasis , Animales , Niño , Heces/parasitología , Humanos , Parasitosis Intestinales/tratamiento farmacológico , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Praziquantel/uso terapéutico , Prevalencia , Schistosoma haematobium , Esquistosomiasis/tratamiento farmacológico , Esquistosomiasis/epidemiología , Esquistosomiasis/parasitología , Esquistosomiasis Urinaria/tratamiento farmacológico , Esquistosomiasis Urinaria/epidemiología , Esquistosomiasis Urinaria/parasitología , Esquistosomiasis mansoni/tratamiento farmacológico , Esquistosomiasis mansoni/epidemiología , Esquistosomiasis mansoni/parasitología , Estudiantes , Resultado del Tratamiento , Orina/parasitología , Yemen/epidemiología
10.
Sex Reprod Health Matters ; 27(2): 1610279, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31533590

RESUMEN

The political situation in Yemen has been precarious since 2011 when popular protest broke out amid the Arab Spring, calling for President Saleh to step down. In March 2015, a Houthi insurgency took control of the capital, Sana'a and ignited a civil conflict that is now characterised by foreign political and military involvement. Since 2015, health facilities have been a primary target for airstrikes and bombing. Seaports have been blockaded barring the delivery of essential medicines and supplies, contributing to the near collapse of an already fragile health system. Since 2012, Save the Children (SC) has been implementing a Family Planning (FP) and Post-abortion Care (PAC) programme in two governorates heavily affected by the conflict. Despite the risks associated with the conflict, there remains a strong demand for SC's FP and PAC services. Ongoing programmatic support and capacity strengthening have allowed quality FP and PAC services to continue for Yemenis even when humanitarian access is impeded. Since the onset of conflict in March 2015, 16 facilities provided services to 43,218 new FP clients (with 23% accepting a long-acting method) and treated 3627 women with PAC. Over 93% of FP clients would recommend FP services at the facility to a friend or family member. Findings support growing evidence that women affected by conflict require family planning services, and that demand does not decline as long as quality services remain accessible. An adaptable reproductive health programme model that embraces innovative approaches is necessary for establishing services and maintaining quality during acute conflict.


Asunto(s)
Servicios de Planificación Familiar , Accesibilidad a los Servicios de Salud , Servicios de Salud Reproductiva/estadística & datos numéricos , Aborto Inducido , Adolescente , Adulto , Conflictos Armados , Anticoncepción , Servicios de Planificación Familiar/estadística & datos numéricos , Femenino , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Satisfacción del Paciente , Política , Embarazo , Sistemas de Socorro , Yemen , Adulto Joven
11.
Glob Health Action ; 12(1): 1659098, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31496422

RESUMEN

Background: HIV/AIDS prevention has historically encountered many obstacles. Understanding the factors affecting HIV/AIDS prevention is central to designing and implementing suitable context-specific interventions. Research relating to HIV prevention in the Middle East and North African region is required to address the gradually increasing HIV epidemic. Objective: This study aimed to explore the perspectives of employees/health care professionals who are working or have worked within HIV prevention in Sudan and Yemen on the challenges and facilitating factors facing HIV prevention. Methods: A qualitative approach was employed using an open-ended questionnaire. Sixteen stakeholders from governmental and non-governmental agencies participated in the study. The questionnaire focused on the various challenges and facilitating factors facing HIV prevention as well as proposed possible solutions from the perspectives of the participants. The data were analysed using thematic analysis. Results: The study illustrated the similarities in context and HIV prevention systems between Sudan and Yemen. Thematic analysis resulted in three main themes: I) much is achieved despite difficulties; II) a programme left to be paralysed; this theme addressed the main obstacles facing HIV prevention in Sudan and Yemen generating a total of six sub-themes; III) comprehensive change is needed. The participants drew focus and attention to vital changes required to improve the delivery of HIV prevention services. Conclusion: Increased financial support for HIV prevention in Sudan and Yemen is urgently needed. De-stigmatisation and increased political support, advocacy and improved legislation for people living with HIV (PLHIV) are required for the sustainability and effectiveness of HIV prevention programmes in Sudan and Yemen. Civil society organisations must be aided and supported in their role in engaging key populations.


Asunto(s)
Eficiencia Organizacional , Infecciones por VIH/prevención & control , Promoción de la Salud/organización & administración , Femenino , Apoyo Financiero , Personal de Salud , Humanos , Entrevistas como Asunto , Masculino , Vigilancia de la Población , Investigación Cualitativa , Sudán , Encuestas y Cuestionarios , Yemen
12.
Health Qual Life Outcomes ; 17(1): 142, 2019 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-31420045

RESUMEN

BACKGROUND: Substantial efforts are currently focused on investigating and developing new multidrug-resistant tuberculosis (MDR-TB) drugs and diagnostic methods. In Yemen, however, the evaluation of health-related quality of life (HRQoL) and the effect of current MDR-TB treatment on the QoL are commonly ignored. This study evaluated the HRQoL during and after treatment and identified the risk factors that are predictive of HRQoL score differences. METHOD: A prospective cohort study was conducted in four of the five main MDR-TB centres in Yemen. The patients confirmed with MDR-TB completed the SF-36 V2 survey at the beginning of treatment, end of treatment (continous phase) and at the 1 year follow-up after completing treatment. A total normal base score (NBS) of < 47 reflects impairment of functions, whereas a mental component summary (MCS) score of < 43 indicates a risk of depression. RESULT: At the beginning of treatment, the mean scores for all health domains were < 47 NBS points (PF = 40.7, RP = 16.1, BP = 21.6, GH = 28.3, VT = 14.55, SF = 25.9, RE = 13.7, and MH = 14.7). At the completion of treatment, all eight health domains increase compare to beginning of treatment (PF = 59.3, RP = 31.1, BP = 40.9, GH = 48.5, VT = 30.5, SF = 46.6, RE =26.6 & MH = 27.7), but a follow-up duration of 1 year after completing treatment showed decreased NBS points in all domains (PF = 51.5, RP = 30.6, BP = 39.1, GH = 47.8, VT = 30.2, SF = 43.7, RE =26.4 & MH = 27.2). Age, history of streptomycin use, baseline lung cavity, marital status and length of sickness before MDR-TB diagnosis were predictive of in PCS score differences, whereas, age, smoking, baseline lung cavity, stigma, residence, marital status and length of sickness before MDR-TB diagnosis were predictive of MCS scores differences. CONCLUSION: The length of sickness before DR-TB diagnosis was found to be predictive of the trends in both PCS and MCS scores. Despite the positive outcome of MDR-TB treatment, the low HRQoL scores obtained for all heath domains and especially for mental health reflect a high depression status of patients even after 1 year of completing therapy. Moreover, the poor HRQoL, particularly regarding mental health, of study participants at the end of treatment demands the need for urgent attention from national tuberculosis control programme managers. Therefore, the Yemen Ministry of Health and the National Tuberculosis Control Programme should implement an intervention programme to enhance HRQoL at the end of treatment to avoid any further negative consequences of MDRTB in patients after treatment. Moreover, The HRQoL data of patients with MDR-TB must be collected at the different stages of MDR-TB treatment to provide an additional parameter for assessing the effectiveness of the treatment programme. TRIAL REGISTRATION: SNOYEM 1452. Registered 01 February 2013.


Asunto(s)
Calidad de Vida , Tuberculosis Resistente a Múltiples Medicamentos/psicología , Adulto , Depresión/complicaciones , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Encuestas y Cuestionarios , Tuberculosis Resistente a Múltiples Medicamentos/complicaciones , Tuberculosis Resistente a Múltiples Medicamentos/terapia , Yemen
13.
Saudi J Kidney Dis Transpl ; 30(4): 832-842, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31464240

RESUMEN

Microalbuminuria (MA) has been recognized as a sensitive marker of early glomerular injury and a predictor of kidney dysfunction in patients with sickle cell disease (SCD). Limited data are available about MA in SCD children in the Arab countries and none from Yemen. The aim of this study is to determine the prevalence and correlates of MA among 101 children aged 1-16 years, with SCD at their steady state. Children were recruited during their routine health-care visits to the pediatric outpatient clinic in Al-Sadaqa general teaching hospital, Aden, Yemen, between September 2014 and February 2015. A random spot urine sample for each child was screened for MA using Micral-Test strips method. Data on clinical history, anthropometry, blood pressure (BP), and laboratory investigations were obtained. The overall prevalence of MA in this sample was 30.7%, with male predominance (80.6%) (P <0.05). The mean age of children with MA was 7.5 ± 3.2 years, and 10% of them were under five years of age. MA was correlated to both hemoglobin and hematocrit levels, which found to have protective effect against MA (Odds ratio = 0.17 and 0.59, respectively, P <0.05). No correlations were found between MA with age, height, weight, body mass index, recurrent clinical events (painful crises, blood transfusions, and hospitalizations), or fetal hemoglobin levels. BP measurements for all individuals were within the normal ranges, but systolic and diastolic BP were significantly higher in those with MA than without. This study demonstrated a high prevalence of MA in Yemeni children with SCD, and affecting young children as early as 2.5 years of age. Screening for MA as one of the early renal injury markers in children with SCD may help in the prevention of permanent loss of renal function and subsequent renal insufficiency in adulthood.


Asunto(s)
Albuminuria/epidemiología , Anemia de Células Falciformes/epidemiología , Enfermedades Renales/epidemiología , Adolescente , Factores de Edad , Albuminuria/diagnóstico , Albuminuria/orina , Anemia de Células Falciformes/sangre , Anemia de Células Falciformes/diagnóstico , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Enfermedades Renales/diagnóstico , Enfermedades Renales/orina , Masculino , Prevalencia , Factores de Riesgo , Factores Sexuales , Yemen/epidemiología
14.
Glob Health Sci Pract ; 7(Suppl 2): S231-S246, 2019 08 22.
Artículo en Inglés | MEDLINE | ID: mdl-31455621

RESUMEN

BACKGROUND: Unsafe abortion contributes to maternal mortality worldwide and disproportionately affects the most disadvantaged women and girls; thus, improving the treatment of complications of abortion is essential. Shifting PAC treatment from sharp dilation and curettage (D&C) to the use of aspiration techniques, notably manual vacuum aspiration (MVA), and medical treatment with misoprostol improves health outcomes. Equally critical is ensuring that women have access to voluntary contraception after an abortion to prevent future unintended pregnancies. In humanitarian settings, access to voluntary family planning to disrupt the cycle of unsafe abortion is even more critical because access to quality services cannot be guaranteed due to security risks, migration, and devastation of infrastructure. Save the Children applied a multipronged postabortion care (PAC) approach in the Democratic Republic of the Congo (DRC), Somalia, and Yemen that focused on capacity building; assurance of supplies and infrastructure; community collaboration and mobilization; and monitoring and evaluation. METHODS: Program-level data were extracted for each of the 3 countries from the inception of their program through 2017. The sources of information included monthly service delivery reports that tracked key PAC indicators as well as qualitative data from evaluations of community mobilization activities. RESULTS: The number of PAC clients increased in all countries. In the DRC in 2012, 19% of PAC clients requiring treatment received D&C; in 2017 the percentage was reduced to 3%. In 2013, 25% of all PAC clients in Yemen were treated with D&C; this percentage was reduced to 3% in 2017. The proportion of women choosing contraception after an abortion increased. In 2012, only 42% of all PAC clients in the DRC chose a contraceptive method; by 2017, the proportion had increased to 70%. Somalia had substantial increases in PAC demand, with the percentage of all PAC clients electing contraception increasing from 64% in 2012 to 82% in 2017. In Yemen, where the health system has been constrained due to severe conflict, the percentage of PAC clients choosing voluntary contraception rose from 17% in 2013 to 38% in 2017. Uptake and demand for PAC was mobilized through targeted community outreach in each context. CONCLUSION: These data demonstrate that providers can effectively shift away from D&C as treatment for PAC and that contraceptive uptake by PAC clients can increase substantially, even in settings where the use of contraception after abortion is often stigmatized.


Asunto(s)
Cuidados Posteriores , Creación de Capacidad , Participación de la Comunidad , Equipos y Suministros/provisión & distribución , Abortivos no Esteroideos/uso terapéutico , Aborto Inducido , República Democrática del Congo , Dilatación y Legrado Uterino , Urgencias Médicas , Servicios de Planificación Familiar , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Misoprostol/uso terapéutico , Embarazo , Mejoramiento de la Calidad , Calidad de la Atención de Salud , Sistemas de Socorro , Somalia , Legrado por Aspiración , Yemen
15.
J Contemp Dent Pract ; 20(4): 428-433, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-31308272

RESUMEN

AIMS: To investigate the relationship between tooth loss, age, gender, and its correlation with several local habits that affect oral health, especially the khat, and Shammah use. MATERIALS AND METHODS: The current study included 580 participants. They were divided into five age groups15-24, 25-34, 35-44, 45-54, and 55-64-years-old. Clinical and radiographic examinations were done for each subject. Reasons for teeth loss, age, gender, khat chewing, Shammah use, smoking, and use of oral hygiene aids were recorded. The data were statically analyzed using Chi-square tests of the statistical package for social sciences (SPSS) program. The p value < 0.05 were considered statistically significant. RESULTS: Caries was the most cause of tooth loss in the young age groups 15-34 years-old and was significantly more common compared to the older groups (p < 0.001). The periodontal diseases increased with age and progressively became the main cause of tooth loss of 100% in the 55-64 years-old group. Orthodontic reasons for tooth extractions were limited to the young age group 15-24 years old. Third molars were the highest extracted teeth in the maxillary arch, while the first molars were the highest in the mandibular arch. Anterior teeth were the lowest extracted teeth ranging from 9; 1.6% in maxillary teeth and 9-29; 1.6-5% in the mandibular teeth. CONCLUSION: This study highlights the importance of local habitual use of khat 52.9% and Shammah 8.1% besides smoking in tooth loss. Caries was the main cause of tooth loss in the young age groups, followed by the periodontal disease in the older age. Molars were frequently extracted followed by maxillary first premolars. CLINICAL SIGNIFICANCE: Limited number of epidemiological surveys were carried out in Taiz Governorate to investigate the reasons of tooth loss and its relationship with social habits like Khat chewing, Shammah use, smoking, using of Miswake and toothbrush. The results of this study will guide us to develop a preventive program which may minimize tooth loss and its adverse effects.


Asunto(s)
Caries Dental , Enfermedades Periodontales , Pérdida de Diente , Adolescente , Adulto , Anciano , Hábitos , Humanos , Persona de Mediana Edad , Factores de Riesgo , Extracción Dental , Yemen , Adulto Joven
16.
Gulf J Oncolog ; 1(30): 61-66, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31242984

RESUMEN

OBJECTIVE: To describe the histological patterns, and to evaluate the long-term outcomes of non surgical treatment of nasopharyngeal carcinoma (NPC) in patients registered at Hadhramout National Cancer Centre (HNCC) in Mukalla City, in Hadhramout Province, Yemen. METHODS: Non-randomized descriptive cancer registrybased study of patients with different WHO types of nasopharyngeal cancer and different non surgical treatment modality. Data was obtained from the medical records of patients seen and followed-up at HNCC. Data was collected using Can-Reg 10 computerized program and statistical analysis done using SPSS version-17 software program. RESULTS: The study included 109 patients with NPC, males were 71(65.14%) and females were 38(34.86%), with a male to female ratio of 2:1. The mean age was 43 (range10-89 years). The majority of the patients were from Hadhramout 85(77.98%), while 24(22.2%) patients were from outside Hadhramout. The most common type of NPC seen according WHO classification was type III 82(75.24%) patients, followed by type II 15(13.76%) patients, and lastly type I 12(11%). The type III tumors of nasopharynx was the predominant type seen in younger patients. Cervical nodal metastasis was found in 86(78.9%) patients, N0 neck was observed in 23(21.1%) patients. The highest annual incidence was observed in 2011 and 2012; fourteen females and 31 males. Patients who underwent curative radiotherapy were 14(12.85%), chemotherapy were 33(30.28%), and concurrent chemoradiotherapy were 62 (56.88%) as initial cancer treatment. Deaths during follow-up period due to local recurrences of NPCs after radiotherapy, chemotherapy and chemoradiotherapy were 1(0.92%), 5(4.59%), 11(10%) respectively. The period of follow-up was 72 months. Two patients were lost from follow-up. CONCLUSION: Our results reveal that WHO-NPC type III is the most common type seen in patients, and the predominant type in young males who presented from Hadhramout regions. Treatment outcome was best in irradiated group followed by chemoradiotherapy and lastly chemotherapy.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioradioterapia/mortalidad , Neoplasias Nasofaríngeas/mortalidad , Radioterapia Conformacional/mortalidad , Sistema de Registros/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Cisplatino/administración & dosificación , Docetaxel/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Nasofaríngeas/patología , Neoplasias Nasofaríngeas/terapia , Pronóstico , Tasa de Supervivencia , Yemen , Adulto Joven
17.
Lancet ; 393(10186): 2121, 2019 05 25.
Artículo en Inglés | MEDLINE | ID: mdl-31226045

Asunto(s)
Esperanza , Femenino , Humanos , Yemen
18.
BMC Res Notes ; 12(1): 339, 2019 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-31200755

RESUMEN

OBJECTIVES: Streptococcus pyogenes is the most frequent cause of pharyngitis and skin infections in children. It is also the causative agent of dangerous immune-complications such as rheumatic fever and rheumatic heart disease which are common in Yemen. The aim of this study was to determine the throat carriage rate of Streptococcus pyogenes among asymptomatic school children in Sana'a city. RESULTS: A cross-sectional study was conducted from December to March of years 2012-2016. A total of 813 asymptomatic school children whose antistreptolysin O test was negative were included. The mean age of the students was 10.5 ± 2.8 years with a range from 5 to 15 years old. Throat swab and blood sample were taking from each student. One hundred and four (12.8%) healthy students were found to be Streptococcus pyogenes carriers. Pharyngeal Streptococcus pyogenes carriage rate was statistically insignificant among different age groups. However, it was found to be more common among females (66, 15%) than males (38, 10%) with statistically significant difference (χ2 = 4.52, P = 0.04). This study showed a high asymptomatic carriage rate of Streptococcus pyogenes in the throat of healthy school children in Sana'a city, Yemen.


Asunto(s)
Faringitis/microbiología , Faringe/microbiología , Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/fisiología , Adolescente , Portador Sano/epidemiología , Portador Sano/microbiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Faringitis/complicaciones , Faringitis/epidemiología , Prevalencia , Instituciones Académicas , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/epidemiología , Yemen/epidemiología
19.
Sultan Qaboos Univ Med J ; 19(1): e26-e31, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31198592

RESUMEN

Objectives: There has been an increasing need for reliable chronological age (CA) estimation in several aspects, including orthodontic treatment needs and legal, civil and forensic purposes. This study aimed to assess the validity of the Demirjian and Fishman methods in predicting the CA of Yemeni children. Methods: This descriptive cross-sectional study was conducted at seven schools in Sana'a, Yemen, between December 2016 and December 2017. One orthopantomograph and one left hand-wrist X-ray were obtained for each child to calculate the dental age (DA) and skeletal age (SA) which were correlated and compared with the CA. Results: A total of 358 Yemeni children aged 8-16 years were included in this study. The mean CA, DA and SA were 12.00 ± 2.25, 11.34 ± 2.42 and 12.39 ± 1.65 years, respectively. The Demirjian method significantly underestimated the CA by 0.58 ± 1.25 years in the total sample and 0.73 ± 1.30 and 0.40 ± 1.17 years in males and females, respectively (P <0.001). The Fishman method significantly underestimated the CA by 0.23 ± 1.19 and 0.44 ± 1.26 years in the total sample and in males, respectively (P ≤0.02). The Fishman method insignificantly underestimated the females CA by 0.02 ± 1.08 years (P = 0.898). Conclusions: Yemeni CA is highly correlated to DA and SA estimated by the Demirjian and Fishman methods, respectively. The Fishman method was more accurate amongst Yemeni females. Results showed that Yemeni children are delayed in dental development and skeletal maturity.


Asunto(s)
Factores de Edad , Predicción/métodos , Adolescente , Determinación de la Edad por los Dientes/métodos , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Análisis de Regresión , Yemen
20.
Artículo en Inglés | MEDLINE | ID: mdl-31035515

RESUMEN

The present study examined maternal religiosity as an underlying cultural factor in the effect of harsh physical parenting on child behavioral problems. Data was collected via a discipline observational task, religiosity-based vignettes, and a questionnaire in a group of 62 mothers and their children in slum areas in Yemen. Moderation and mediation models were tested, where the role of maternal religiosity as a predictor and a moderator in the association between harsh physical parenting and child behavioral problems was explored. Findings showed no direct association between harsh physical parenting, maternal religiosity, and child behavioral problems. However, maternal religiosity was found to significantly moderate the relationship between harsh physical parenting and child behavioral problems such that the positive association between harsh physical parenting and child behavior problems was stronger when parents were more religious. Implications of the moderating role of maternal religiosity on the association between harsh physical parenting and child behavioral problems are discussed.


Asunto(s)
Madres , Responsabilidad Parental , Problema de Conducta , Religión , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Religión y Psicología , Encuestas y Cuestionarios , Yemen
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