Knowledge, attitude, perception and practice regarding antimicrobial use in upper respiratory tract infections in Qatar: a systematic review.

OBJECTIVE: To explore the knowledge, attitude, perception and practice towards antimicrobial use in upper respiratory tract infections in patients visiting healthcare settings in Qatar. DESIGN: Systematic review was performed using a predetermined protocol and in accordance with standardized reporting guidelines. MEDLINE, PubMed, EMBASE, Global Health and PsycINFO were searched for relevant published studies using relevant MESH terms and keywords. SETTING: All healthcare settings in Qatar including both inpatient and ambulatory care. PARTICIPANTS: All published articles exploring the antimicrobial use in upper respiratory tract infections at any health setting in Qatar were considered for inclusion in the study. No age, gender or population were excluded. MAIN OUTCOME MEASURES: The outcome of interest was antimicrobial use in upper respiratory tract infections in Qatar. We included all related studies to explore the knowledge, attitude, perception and practice for patients visiting all health care settings. RESULTS: Three articles were included, one in a primary care setting, one in a secondary care setting and one in the private sector. Overprescribing was noted in all settings. Our findings demonstrate low expectations to receive antibiotics, among the Qatari population, in primary care (28.1%). In fact, the majority of patients would be satisfied with reassurance rather than receiving antimicrobials. Many patients were satisfied with explanation from physicians and counselling. Private sector registered high prevalence of antimicrobial misuse for respiratory tract infections in which 85% deemed inappropriate. This finding was also noted at a medical intensive care unit which showed high antimicrobial use (76%) and respiratory tract infections accounted for 57% of prescriptions. CONCLUSION: Studies are needed to determine factors and population-based rates of antimicrobial use in all healthcare settings. There is also a need for interventional programs for both physicians and public on appropriate use of antimicrobials to combat global antimicrobial resistance.

Factors influencing the tobacco control policy process in Egypt and Iran: a scoping review.

INTRODUCTION: Tobacco control policy is essential for addressing the growing tobacco consumption seen in the Eastern Mediterranean Region, the single greatest preventable contributor to the non-communicable disease epidemic. Egypt and Iran have had varied success in using policy to combat this issue. The study aims to identify and compare the factors which have influenced different stages of the policy process - evidence generation, development and implementation. METHODS: A scoping review was conducted with a systematic search of 7 databases which was conducted along with searches of Google Scholar, and the World Health Organisation and Eastern Mediterranean Regional Office websites to identify influencing factors at each stage of the policy process. RESULTS: Twenty-seven relevant articles were identified from the literature search. Factors identified as influencing tobacco control policy in these countries were lobbying by the tobacco industry, the rise of water-pipe smoking, lack of political commitment and the lack of resources to for policy implementation. Iran was found to be leading Egypt on all three areas of the policy process. Implementation was found to be the most pivotal part of the policy process and the area in which Egypt was weakest compared to Iran. CONCLUSION: This study addresses a gap in knowledge concerning tobacco control in the Middle East and has identified multiple factors which are potentially slowing the process of enforcing policy to address tobacco consumption. Iran is the regional leader for tobacco control and it is important for Egypt to assess the transferability of its tactics and immediately start implementing measures to control tobacco use.

Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting.

Influenza surveillance is needed to monitor potential public health threats from the emergence of novel influenza viruses. This study assessed the capacity and performance of the national influenza surveillance system in Afghanistan from 2007 to 2014. Data were collected by review of hospital registers and the National Influenza Centre (NIC) database, interviews with influenza focal points at 9 influenza sentinel surveillance sites and the Centre staff, and observation of the sites. Out of 6900 specimens collected, influenza virus was detected in 253 (3.6%), predominantly H1N1 (63%); most of these cases were detected during the 2009 pandemic. The NIC had the capacity for virus isolation and PCR identification and performed reasonably until 2011 when support of the Naval American Medical Research Unit 3 was withdrawn. The limitations identified in the system indicated the need for: more complete data, improved technical competence and trained human resources, updating of the infrastructure/facilities, and the presence of standard operating procedures throughout surveillance.

Middle East respiratory syndrome coronavirus: current knowledge and future considerations.

A literature review of publically available information was undertaken to summarize current understanding and gaps in knowledge about Middle East respiratory syndrome coronavirus (MERS-CoV), including its origin, transmission, effective control measures and management. Major databases were searched and relevant published papers and reports during 2012-2015 were reviewed. Of the 2520 publications initially retrieved, 164 were deemed relevant. The collected results suggest that much remains to be discovered about MERS-CoV. Improved surveillance, epidemiological research and development of new therapies and vaccines are important, and the momentum of recent gains in terms of better understanding of disease patterns should be maintained to enable the global community to answer the remaining questions about this disease.

Middle East respiratory syndrome coronavirus: current knowledge and future considerations

A literature review of publically available information was undertaken to summarize current understanding and gaps in knowledge about Middle East respiratory syndrome coronavirus [MERS-CoV], including its origin, transmission, effective control measures and management. Major databases were searched and relevant published papers and reports during 2012-2015 were reviewed. Of the 2520 publications initially retrieved, 164 were deemed relevant. The collected results suggest that much remains to be discovered about MERS-CoV. Improved surveillance, epidemiological research and development of new therapies and vaccines are important, and the momentum of recent gains in terms of better understanding of disease patterns should be maintained to enable the global community to answer the remaining questions about this disease

Une analyse documentaire des informations publiques disponibles a été entreprise afin de passer en revue les connaissances et les lacunes actuelles sur le coronavirus du syndrome respiratoire du Moyen-Orient [MERS-CoV], notamment sur son origine, la transmission, les mesures de lutte efficaces et la prise en charge. Notre objectif est d'améliorer la compréhension du virus au plan de la santé publique, et d'agir sur l'intervention de santé publique internationale. Nous avons effectué des recherches dans les principales bases de données et avons examiné les articles et rapports publiés pertinents pour la période 2012-2015. Sur les 2 520 articles et rapports publiés initialement sélectionnés, 164 études ont été jugées pertinentes. Les résultats recueillis indiquent qu'il reste encore beaucoup à apprendre sur le MERS-CoV. Il est impératif d'améliorer la surveillance, de procéder à des recherches épidémiologiques et de mettre au point de nouveaux traitements et vaccins. De même, il est nécessaire de maintenir l'élan suscité par les récentes découvertes en matière de compréhension améliorée du tableau épidémiologique, afin de permettre à la communauté mondiale de répondre aux questions jusqu'à présent sans réponse à propos de cette maladie

Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting

Influenza surveillance is needed to monitor potential public health threats from the emergence of novel influenza viruses. This study assessed the capacity and performance of the national influenza surveillance system in Afghanistan from 2007 to 2014. Data were collected by review of hospital registers and the National Influenza Centre [NIC] database, interviews with influenza focal points at 9 influenza sentinel surveillance sites and the Centre staff, and observation of the sites. Out of 6900 specimens collected, influenza virus was detected in 253 [3.6%], predominantly H1N1 [63%]; most of these cases were detected during the 2009 pandemic. The NIC had the capacity for virus isolation and PCR identification and performed reasonably until 2011 when support of the Naval American Medical Research Unit 3 was withdrawn. The limitations identified in the system indicated the need for: more complete data, improved technical competence and trained human resources, updating of the infrastructure/facilities, and the presence of standard operating procedures throughout surveillance

La surveillance de la grippe est nécessaire pour contrôler les menaces de santé publique potentielles au moment de l'émergence de nouveaux virus de la grippe. La présente étude a évalué la capacité et la performance du système national de surveillance de la grippe en Afghanistan de 2007 à 2014. Les données ont été recueillies en examinant les registres des hôpitaux et la base de données du Centre national de la grippe [CNG], en interrogeant les points focaux pour la grippe sur neuf sites de surveillance sentinelle ainsi que le personnel du CNG, et en observant les sites. Sur les 6900 échantillons prélevés, le virus de la grippe a seulement été identifié dans 253 d'entre eux [3,6%] ; il s'agissait essentiellement du H1N1 [63%]. De plus, la majorité de ces cas ont été dépistés au cours de la grippe pandémique de 2009. Le CNG avait la capacité d'isolement et d'identification par PCR du virus. Il a en outre obtenu des résultats satisfaisants jusqu'à ce que la troisième Unité de recherche médicale de la Marine américaine [NAMRU-3] lui retire son soutien en 2011. Les insuffisances identifiées dans le système indiquent la nécessité d'obtenir des données plus complètes, d'améliorer les compétences techniques et d'avoir des ressources humaines formées, de rénover les infrastructures/locaux, et de disposer de modes opératoires normalisés pour l'ensemble du processus de surveillance

Tobacco control efforts in the Gulf Cooperation Council countries: achievements and challenges.

This paper reports a review into the current state of tobacco use, governance and national commitment for control, and current intervention frameworks in place to reduce the use of tobacco among the populations of the Gulf Cooperation Council (GCC) member states and Yemen. It further reviews structured policy-oriented interventions (in line with the MPOWER package of 6 evidence-based tobacco control measures) that represent government actions to strengthen, implement and manage tobacco control programmes and to address the growing epidemic of tobacco use. Our findings show that tobacco control in the GCC countries has witnessed real progress over the past decades. These are still early days but they indicate steps in the right direction. Future investment in implementation and enforcement of the Framework Convention on Tobacco Control, production of robust tobacco control legislation and the establishment of universally available tobacco cessation services are essential to sustain and strengthen tobacco control in the GCC region.

Living conditions in Iraq: 10 years after the US-led invasion.

In the early 1980s, Iraq was a middle-income and rapidly developing country with a well-developed health system. A few decades later - after wars, sanctions and a violent sectarian upsurge - child and maternal health indicators have deteriorated, its poverty headcount index is at 22.9% and diseases such as cholera have remerged. Today Iraq is beset by chronic political deadlock and a complexity of economic challenges; accordingly, all aspects of life are suffering, including health. Irrespective of the monumental investment to improve components of the health system, via national and international efforts, the health status of the population can only advance through resounding and synergistic effort in other aspects of life affecting health: the social determinants of health.

Tobacco control efforts in the Gulf Cooperation Council countries: achievements and challenges

This paper reports a review into the current state of tobacco use, governance and national commitment for control, and current intervention frameworks in place to reduce the use of tobacco among the populations of the Gulf Cooperation Council [GCC] member states and Yemen. It further reviews structured policy-oriented interventions [in line with the MPOWER package of 6 evidence-based tobacco control measures] that represent government actions to strengthen,implement and manage tobacco control programmes and to address the growing epidemic of tobacco use. Our findings show that tobacco control in the GCC countries has witnessed real progress over the past decades. These are still early days but they indicate steps in the right direction. Future investment in implementation and enforcement of the Framework Convention on Tobacco Control, production of robust tobacco control legislation and the establishment of universally available tobacco cessation services are essential to sustain and strengthen tobacco control in the GCC region

Le présent article expose un état des lieux de la consommation de tabac, de la gouvernance, de l'engagement national dans la lutte antitabac, et les cadres d'intervention actuellement en place destinés à réduire la consommation de tabac dans les populations des Etats membres du Conseil de Coopération du Golfe et du Yémen. II examine également les interventions structurées pour l'élaboration de politiques [conformément au programme MPOWER qui est compose de six mesures de lutte antitabac fondées sur des données probantes] qui représentent des actions gouvernementales destinées à renforcer, mettre en oeuvre et gérer des programmes de lutte antitabac et à s'attaquer à l'épidémie croissante de tabagisme. Nos résultats révèlent que la lutte antitabac dans les pays membres du Conseil de Coopération du Golfe a réalisé des progrès tangibles au cours des dernières décennies. Toutefois, il ne s'agit que d'un début montrant la voie à suivre. De nouveaux investissements dans la mise en oeuvre et l'application de la Convention-cadre pour la lutte antitabac, la proposition d'une législation antitabac solide et l'offre de services de sevrage tabagique d'accès universel sont essentiels pour appuyer et renforcer la lutte antitabac dans la région du Conseil de Coopération du Golfe