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2.
PLoS Negl Trop Dis ; 13(12): e0007827, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31830034

RESUMO

BACKGROUND: Cutaneous leishmaniasis (CL) has historically been reported from Syria. Since 2011, the country has been affected by a war, which has impacted health and health services. Over the same period, an increase in the number of cases of CL has been reported from several areas across the country and by a number of authors. This study aims to provide the first quantitative evidence of the epidemiological evolution of CL in Syria during the war. MATERIALS AND METHODS: Data on number of CL cases for the period 2011-2018 were extracted from three different surveillance systems: the Ministry of Health (MoH) routine surveillance system, the MoH/WHO sentinel-syndromic Early Warning Alert and Response System (EWARS), and surveillance data collected by the international nongovernmental organization (NGO) the MENTOR Initiative. Data were cleaned and merged to generate the best possible estimates on number of CL cases; incidence of CL was also calculated based on data on resident population. Data reported from the years preceding the conflict (2007-2010) were also added to the analysis for comparative purposes. RESULTS: The analysis of data from the three available sources over the period considered indicates that number of reported cases progressively grew from prewar levels to reach a peak in 2015, decreased in 2016, remained stable in 2017, and increased again in 2018. Such a trend was mirrored by changes in incidence of infection. Some governorates, which used to report low numbers of CL cases, started recording higher number of cases after the onset of the war. CONCLUSION: The war coincided with a major rise in reported number of CL cases and incidence of infection, although an increasing trend was already appreciable before its onset.


Assuntos
Conflitos Armados , Leishmaniose Cutânea/epidemiologia , Humanos , Incidência , Prevalência , Síria/epidemiologia
5.
BMC Health Serv Res ; 19(1): 549, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382956

RESUMO

BACKGROUND: The awareness of diabetes mellitus (DM) and its complications, especially diabetic retinopathy (DR), is the key to reducing their burden. This study aimed to assess both the awareness of diabetic outpatients and their action towards periodic eye exam, and to determine the causes of non-compliance amongst patients who were aware. Because the Syrian Crisis affected all aspects of Syrians' life, the study aimed to determine the crisis' effects on patients' care-seeking behavior. Our study was the first step in paving the way of prevention strategies. METHODS: This observational cross-section study was conducted on 260 patients with DM who were visiting the four main hospitals in the Syrian capital, Damascus between August and November 2017. RESULTS: The mean (±SD) age of participants was 54.3(±12.8) years. Females were more than half (56.2%). The majority were from areas outside Damascus (72.3%). The mean (±SD) DM duration was 10.6 (±7.1) years. Almost all patients (93.8%) thought that DM could affect the eye. 67.3% believed that it could cause blindness. 86.9% of the patients conceived that DM patients should visit an ophthalmologist regularly. 37% did not visit any ophthalmologists at all, while 63% reported they had visited their ophthalmologists. Only 21.5% had a regular eye exam. Gender, educational level, economic status, province, and family history of DM had statistically an insignificant relation with an ophthalmologist visit. The preponderance of the patients who haven't visited regularly did not appreciate the necessity of regular eye exam. Diabetic neuropathy was the most common complication of DM that patients were aware of (92%) and suffered from (56.5%). Meanwhile, regarding the effects of the Syrian Crisis: 41.2% of diabetic patients had stopped their medications for at least one month, mainly because the drugs were unavailable (74.7% of them), as some drug companies had been destroyed. Half of the patients had struggled to reach a medical care center. Half of the patients had been displaced, two-third of them were from outside Damascus. CONCLUSION: A screening program for DR should be initiated. Also, awareness about DM and its complications, especially DR, should be raised through doctors and media.


Assuntos
Retinopatia Diabética/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Assistência Ambulatorial , Conflitos Armados , Conscientização , Cegueira/prevenção & controle , Estudos Transversais , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/epidemiologia , Neuropatias Diabéticas/psicologia , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Diagnóstico Precoce , Feminino , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Fatores Socioeconômicos , Síria/epidemiologia
6.
Hemoglobin ; 43(3): 218-221, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31373517

RESUMO

Hypothyroidism is one of the common endocrine complications described in patients with ß-thalassemia major (ß-TM). Studies have reported its incidence and severity depending on the region, quality of management and treatment protocols. The reported thyroid dysfunction includes overt hypothyroidism, subclinical hypothyroidism and rarely, central hypothyroidism. The main aims of this study were to identify the incidence of hypothyroidism in 82 patients with ß-TM in Syria, and also to evaluate the effect of compliance with deferoxamine (DFO) therapy on the patients' thyroid function. Out of the 82 patients included in this study, 24 had subclinical hypothyroidism (29.27%) and one patient had overt hypothyroidism (1.22%). It was demonstrated by this study that noncompliance with DFO therapy increases the risk of thyroid dysfunction 6.38-times compared to compliance with DFO [risk ratio (RR) = 6.385; 95% confidence interval (95% CI) 2.40-16.95)]. These results emphasize the importance of compliance with chelation therapy to minimize the burden of thyropathy on patients' quality of life, and also augment the rationale for a routine follow-up and endocrine evaluation for early detection and management of these complications.


Assuntos
Sobrecarga de Ferro/epidemiologia , Sobrecarga de Ferro/etiologia , Adesão à Medicação , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/etiologia , Talassemia beta/complicações , Talassemia beta/epidemiologia , Adolescente , Adulto , Biomarcadores , Estudos de Casos e Controles , Criança , Estudos Transversais , Desferroxamina/farmacologia , Desferroxamina/uso terapêutico , Feminino , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/epidemiologia , Hipotireoidismo/etiologia , Quelantes de Ferro/farmacologia , Quelantes de Ferro/uso terapêutico , Sobrecarga de Ferro/diagnóstico , Sobrecarga de Ferro/tratamento farmacológico , Masculino , Cooperação do Paciente , Síria/epidemiologia , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/tratamento farmacológico , Resultado do Tratamento , Adulto Jovem , Talassemia beta/genética
7.
BMC Oral Health ; 19(1): 165, 2019 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-31345205

RESUMO

BACKGROUND: The Syrian crisis has started eight years ago and has, directly and indirectly, affected all the aspects of the Syrians lives. A lot of new war-related factors contributed to change the socio-economic status, the demographical distribution and the ability to access the public health services. Moreover, the crisis created the biggest displacement crisis both inside and outside Syria. Therefore, it is important to study the prevalence of dental caries and oral health in these specific circumstances in order to build a database to assess and compare future results of preventive programs and to assess health and social needs of the communities affected by war or crisis. The aim of this research is to Study the level of oral health among children during the Syrian crisis, as well as the relation between oral health and socioeconomic status (SES). METHODS: A cross-sectional study to assess the oral health of children in Damascus city by using DMFT index and other dental indices. The data were collected from ten randomly selected schools covering all the areas of Damascus city, and the final sample size was 811 children. RESULTS: DMFT index was used to assess the oral health of the children. The average number was (3.36) among all children; 14% of the sample size had a good oral health, while 86% had at least one decayed, missed, or filled tooth. There was also a strong association between SES of the child and the oral health represented as DMFT Index (P = 0.03), Pearson's correlation test displayed an inverse association between the SES and oral health (P = - 0.074). CONCLUSION: This study highlights the impact of the Syrian crisis on the SES of the Syrian children and their oral health. Bad oral health has been recorded and it has a significant relation with the SES of the children.


Assuntos
Cárie Dentária/epidemiologia , Saúde Bucal , Classe Social , Criança , Estudos Transversais , Índice CPO , Cárie Dentária/prevenção & controle , Inquéritos de Saúde Bucal/estatística & dados numéricos , Status Econômico , Feminino , Humanos , Masculino , Higiene Bucal , Prevalência , Síria/epidemiologia
8.
Parasitol Res ; 118(9): 2679-2687, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31289943

RESUMO

Turkey is one of the leishmaniasis endemic countries, and according to the recent reports, more than 45% of the cases were reported from the Southeastern part of Turkey. The disease is endemic in Syria with annually 25,000 cases, and it is emphasized by WHO that the actual number was estimated to be 2-5-fold higher than the reported numbers. Due to the civil war in Syria, more than seven million people were displaced and migrate to neighboring countries. The population structure of Leishmania tropica was investigated in the present study using clinical samples, which were obtained from Syrian patients residing in Turkey. Previously reported database was used to compare the results obtained in the present study. According to the multilocus microsatellite typing profiles, three populations (Sanliurfa, Mediterranean, and Syrian/Turkish) were identified. Syrian/Turkish population, which is a new structure and identified for the first time in the present study, was comprised of clinical samples obtained from Syrian patients. The newly described population structure was homogeneous and solid comparing to previously identified population structures in Turkey. Further analyses revealed two sub-populations under the main Syrian/Turkish population structure. The findings of the present study revealed that the epidemiological status of leishmaniasis is more complicated than it is estimated. We believe that the data presented here will provide valuable information on the leishmaniasis epidemiology.


Assuntos
Leishmania tropica/isolamento & purificação , Leishmaniose Cutânea/parasitologia , Humanos , Leishmania tropica/classificação , Leishmania tropica/genética , Leishmaniose Cutânea/epidemiologia , Repetições de Microssatélites , Tipagem de Sequências Multilocus , Filogenia , Refugiados/estatística & dados numéricos , Síria/epidemiologia , Turquia/epidemiologia
9.
Am J Trop Med Hyg ; 101(1): 108-112, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31162008

RESUMO

War provides ideal grounds for the outbreak of infectious diseases, and the Syrian war is not an exception to this rule. Following the civil crisis, Syria and refugee camps of neighboring countries witnessed an outbreak of leishmaniasis. We accessed the database of the central leishmaniasis registry in Latakia city and obtained the leishmaniasis data of the period 2008-2016. Our data showed that the years 2013 and 2014 recorded a surge in the number of both cutaneous leishmaniases (CL) and visceral leishmaniasis (VL) cases. This surge coincided with the massive internal displacement waves that struck Latakia governorate during that time. Subsequently, after 2015, the number of recorded CL and VL cases gradually decreased. This drop coincided with a reduced influx of internally displaced persons into Latakia governorate. Our report depicts the effects of the Syrian crisis on the epidemiology of leishmaniasis by outlining the experience of Latakia governorate. Similar results may have occurred in other refugee-hosting Syrian governorates.


Assuntos
Conflitos Armados , Leishmaniose Cutânea/epidemiologia , Leishmaniose Visceral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Cidades , Bases de Dados Factuais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Refugiados , Síria/epidemiologia , Fatores de Tempo , Adulto Jovem
10.
East Mediterr Health J ; 25(3): 189-196, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31054229

RESUMO

Background: Human Development Index (HDI), maternal mortality rate (MMR) and children aged under 5 years mortality rate (U5MR) are fundamental issues, especially in low- and middle-income countries. Aims: The aim of this study was to evaluate the changes in HDI, MMR and U5MR from 1980 to 2010 in certain West Asian countries as well as the relationship between these indexes. Methods: In this ecological study, HDI, MMR and U5MR information from studied countries during 1980 to 2010 was extracted from the gap minder site and then analysed using descriptive and analytical methods, including Spearman correlation. Results: The lowest and highest rates of HDI and MMR in 2010 were seen in the United Arab Emirates and Pakistan (HDI: 0.49, 0.81; MMR: 7.14, 335.45 respectively). HDI is rising in all countries studied, with the highest increase in the Islamic Republic of Iran (0.21). MMR and U5MR saw a decline over the years, with the greatest decrease seen in India, and the lowest and highest child mortality rate in 2010 found in Bahrain and Pakistan (8.3, 91.8 respectively). However, there was a negative relationship between HDI and MMR (r = -0.7, P < 0.001). Conclusions: HDI increased during 1980-2010. The highest rate of HDI decrease was observed in the Islamic Republic of Iran, and the greatest reduction of MMR was seen in India. Also, the highest decrease in U5MR was related to India as well, while MMR and U5MR rate decreased. Hence, improving HDI might have a definite impact on decreasing MMR and U5MR, especially in low- and middle-income countries.


Assuntos
Mortalidade da Criança , Países em Desenvolvimento/estatística & dados numéricos , Desenvolvimento Econômico , Indicadores Básicos de Saúde , Mortalidade Materna , Barein/epidemiologia , Pré-Escolar , Nível de Saúde , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Irã (Geográfico)/epidemiologia , Jordânia/epidemiologia , Kuweit/epidemiologia , Paquistão/epidemiologia , Catar/epidemiologia , Arábia Saudita/epidemiologia , Fatores Socioeconômicos , Síria/epidemiologia , Emirados Árabes Unidos/epidemiologia
11.
BMC Public Health ; 19(1): 637, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31126261

RESUMO

BACKGROUND: The scarcity of evidence-based research on non-communicable diseases (NCDs) among Syrian refugees has hampered efforts to address the high burden of these diseases in host countries. The objective of this study is to examine published research on NCDs among Syrian refugees in order to inform future research, practice, programs, and policy. . METHODS: Using the scoping review framework proposed by Arksey et al., 17 different databases were searched to identify studies reporting on NCDs among Syrian refugees. The number of relevant documents found was 34, with the earliest going back to 2013-2 years after the beginning of the Syrian conflict. RESULTS: The majority of these documents were descriptive in nature and only two studies addressed the effectiveness of interventions in the management of NCDs. No studies investigated the prevention of these diseases. Furthermore, only 7 studies addressed the host community and only one research article, conducted in Lebanon, included subjects from the host community. The increasing number of documents over the past 5 years illustrates a growing interest in studying NCDs among Syrian refugees. Examination of the papers showed high prevalence of NCDs among Syrian refugees as well as unmet healthcare needs. CONCLUSION: The findings of this review highlighted the dire need for further research on the burden of NCDs among Syrian refugees. Future studies should diversify research design to include interventions, address the host community in addition to the refugees, tackle prevention as well as treatment of NCDs, and explore strategies to enhance the resilience of the host country's health system while ensuring quality of care for NCDs. The increasing momentum for research found in this review presents an opportunity to fill current knowledge gaps, which could result in preventing, controlling and ultimately reducing the burden of NCDs among Syrian refugees and their host communities.


Assuntos
Efeitos Psicossociais da Doença , Doenças não Transmissíveis/epidemiologia , Refugiados/estatística & dados numéricos , Humanos , Prevalência , Síria/epidemiologia
12.
Acta Trop ; 194: 169-171, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30974096

RESUMO

INTRODUCTION: Old World cutaneous leishmaniasis (CL) is one of the most prevalent vector-borne diseases within the World Health Organization's Eastern Mediterranean Region. The conflict in the Syrian Arab Republic generated large population movements and raised concerns about spreading of CL to countries where Syrians have relocated, including Jordan. METHODS: A review of electronic and paper-based registries of CL cases in Jordan was conducted to assess burden of disease and associated socio-demographic factors. RESULTS: Increasing numbers of CL cases have been reported in Jordan between 2010 and 2016 (from 140 to 281), paralleled by significant increases in incidence rate (from 2.09 per 100 000 person-years, 95% CI (1.77-2.47), to 2.87 per 100 000 person-year, 95% CI (2.55-3.22), p = 0.002) and in the proportion of cases who are Syrian (from 8.6%-55.2%, p < 0.001). Syrian refugees have higher odds of presenting with leishmaniasis than Jordanian nationals (adjusted OR 7.1, 95% CI (6.3-8.0), p = 0.000). CONCLUSIONS: Presence of large numbers of Syrian refugees within Jordan has so far not contributed to increased risk of developing CL for Jordanians, however surveillance, diagnosis and case management for CL should be reinforced to meet the increased burden. Electronic surveillance can help identify priority populations and areas for interventions.


Assuntos
Leishmaniose Cutânea/epidemiologia , Refugiados , Humanos , Incidência , Jordânia/epidemiologia , Razão de Chances , Prevalência , Síria/epidemiologia
13.
Int J Dermatol ; 58(7): 834-843, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30968403

RESUMO

BACKGROUND: Cutaneous leishmaniasis (CL) remains a prioritized neglected tropical disease. CL novel presentations call for updating its features. METHODS: A multiregional cohort of 396 patients with confirmed CL was reviewed. Lesion's clinical stage and eruption type were assigned. Disease was considered as extensive if numerous (≥5), large (>3 cm), disfiguring, threatening vital sensory organs, and/or older than 12 months. Microscopically, Ackerman's inflammatory pattern, Ridley's pattern (RP), and parasitic index (PI) were recorded. Microscopic variables pertaining to the organisms, epidermis, and host's inflammatory response were also assessed. All cases were confirmed and speciated molecularly. RESULTS: In our region, 71.8% of cases showed extensive disease with 15.7% exceeding 12 months duration. Leishmania tropica accounted for 91.3% of cases while Leishmania major constituted 8.7% and presented solely as dry lesions. The dominant inflammatory composite consisted of plasma cells, lymphocytes, and histiocytes. Granulomatous inflammation was present in 55.5%. Most cases showed interface changes (72.7%), spongiosis (75.3%), and marked epidermal hyperplasia (63.9%). Transepidermal elimination of organisms was present in 29.2% of cases. None of traditional classification patterns (clinical stage, microscopic pattern, and RP) showed the predicted linear correlation with lesion age. High and low PI levels correlated with early and healing microscopic patterns, respectively, but did not correlate with the corresponding RPs. PI was bimodal with peaks at 3-6 and 9-12 months. CONCLUSION: Cutaneous leishmaniasis is an evolving disease defying the traditional prediction classifications. Our study sets the ground for adopting updated clinical courses, microscopic presentation, and species mapping.


Assuntos
Carga Global da Doença/tendências , Leishmania major/isolamento & purificação , Leishmania tropica/isolamento & purificação , Leishmaniose Cutânea/epidemiologia , Doenças Negligenciadas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Líbano/epidemiologia , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/parasitologia , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/parasitologia , Paquistão/epidemiologia , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Pele/citologia , Pele/parasitologia , Pele/patologia , Síria/epidemiologia , Adulto Jovem
14.
J Craniofac Surg ; 30(4): 992-995, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30839466

RESUMO

PURPOSE: The aim of this study was to assess the maxillofacial injuries (MFIs) and our surgical approaches in the Syrian Civil War that emerged during the spring of 2011, among Syria's government and Syrians. PATIENTS AND METHODS: The present study is a prospective clinical study of injured patients at Turkey's Border Hospitals during the Syrian Civil Conflict. Patients' data cover to all emergency and plastic surgery hospitals throughout Turkey. We assessed the patients' data according to location of trauma, duration of hospitalization, the severity and etiology of MFIs with the Injury Severity Score. RESULTS: MFIs were found in 112 of the 956 wounded. The injuries occurred in 69 civilians (61.6%) and 43 soldiers (38.3%). The mean age ranged from 8 to 66 (mean: 29,1 ±â€Š12). Eighty-two percent or higher rates of the injuries needed >4 days' hospitalization. We observed the mortality at a rate of 13.3% for the MFIs. Majority of the MFIs were accompanied by >3 concomitant injuries (n = 59; 52.6%). Most of the facial injuries were located at Mandibula (n = 75; 66.9%), Maxilla (n = 69; 61.6%) and orbitofrontal (n = 52; 46.4%) regions. CONCLUSIONS: Severity and incidence of MFIs were extremely high compared with previously published studies of other wars, especially affecting the civilians in the Syrian Civil War. The high rates of LeFort III fractures exhibit its devastating damages on civilians.


Assuntos
Conflitos Armados , Traumatismos Maxilofaciais/epidemiologia , Militares , Ferimentos Penetrantes/epidemiologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Incidência , Escala de Gravidade do Ferimento , Tempo de Internação , Masculino , Maxila , Traumatismos Maxilofaciais/classificação , Pessoa de Meia-Idade , Estudos Prospectivos , Síria/epidemiologia , Turquia , Ferimentos Penetrantes/classificação , Adulto Jovem
15.
J Pak Med Assoc ; 69(3): 412-414, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30890837

RESUMO

The review aims to examine the emergence and reemergence of infectious diseases in Jordan, in parallel with the Syrian refugee crisis. Qualitative approach has been adopted for systematically examining the outcomes of Syrian Crisis, which resulted with emerging and re-emerging infectious diseases. It has adhered that infectious diseases; including measles, tuberculosis, and Cutaneous Leishmaniasis, have hazardous effects on Syrian refugees along with alarming threats to local population in Jordan. National health policies should be implemented to adhere to the influence of infectious diseases beside the reduction of the extent of infectious diseases in Jordan. In the 21st century, Syrian conflict can be deliberated as one of the biggest humanitarian disasters. In this multifaceted emergency with devastating requirements and limitations, it has been found essential for dominant medical healthcare providers to develop medical strategies that are based on comprehensive understanding of concerned context and the main medical requirements and susceptible groups.


Assuntos
Conflitos Armados , Doenças Transmissíveis Emergentes/epidemiologia , Refugiados/estatística & dados numéricos , Humanos , Jordânia/epidemiologia , Sarampo/epidemiologia , Poliomielite/epidemiologia , Síria/epidemiologia , Tuberculose/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
16.
Glob Health Action ; 12(1): 1585709, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30907275

RESUMO

BACKGROUND: The Syrian conflict has resulted in major humanitarian crises. The risk is particularly high amongst female children who face additional gendered risks, such as harassment and sexual violence, including a rise in prevalence of child marriage. Despite the importance of this topic, current literature remains relatively scarce. OBJECTIVES: This study aims to explore the social and healthcare repercussions of Syrian refugee child marriages in Jordan and Lebanon. METHODS: A systematic review of the literature was carried out to gather evidence, from a total of eight articles. Data analysis was conducted using the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. RESULTS: The findings of this research identify tradition, honour, economics, fear, and protection-related factors as drivers of child marriage of refugees in Jordan and Lebanon. These motives overlap with findings regarding access to reproductive health and reproductive rights. The lack of autonomy of the child to give informed consent is augmented in the context of protracted violence and displacement. CONCLUSION: There is a need for a holistic approach to provide safe spaces, education, and protection to young girls and their families to reduce their acceptance of child marriage.


Assuntos
Casamento/etnologia , Refugiados/estatística & dados numéricos , Altruísmo , Criança , Feminino , Humanos , Jordânia/etnologia , Líbano/etnologia , Direitos Sexuais e Reprodutivos , Síria/epidemiologia
18.
Acta Trop ; 192: 138-143, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30710533

RESUMO

Outbreaks of Cutaneous Leishmaniasis (CL) due to war-related factors have been reported in different areas in Turkey and Syria. CL has become the most serious of the infectious diseases which have been reported in Gaziantep in southeast Turkey, during the last three years due to the influx of Syrian refugees. The present research involves an analytical cross-sectional epidemiological study of CL cases diagnosed in the Gaziantep Leishmaniasis Diagnosis and Treatment Center. The patient demographic data, the location of the lesions, the number of the lesions, the duration of the lesions, and the treatment of the lesions are included. The diagnosis of CL was made by microscopic examination of smears in all cases, and 81.1% (900/1110) of which were found to be positive. Out of 900 CL patients, 93.8% (845/900) were Syrian citizens and 6.2% (55/900) were Turkish citizens. The disease was more frequent in females with 53.5% (482/900) and in the age group between 0-20 years with 68.3% (615/900). Distribution of lesions in the body showed that the face was the most affected location with 37% (333/900), and the generation time of lesions was 0-6 months with 71.2% (641/900). 94.7% (852/900) of the CL patients healed without relapse, and 5.3% (48/900) of the CL patients relapsed. CL patients have re-emerged in Gaziantep, located in the southeast of Turkey, as a result of Syrian refugees. The increase in CL frequency is alarming and requires control and prevention measures in highly infected areas including this region.


Assuntos
Doença Crônica/epidemiologia , Migração Humana/estatística & dados numéricos , Leishmaniose Cutânea/epidemiologia , Doenças Negligenciadas/epidemiologia , Refugiados/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Cricetinae , Estudos Transversais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Síria/epidemiologia , Turquia/epidemiologia , Adulto Jovem
19.
Acta Microbiol Immunol Hung ; 66(3): 327-335, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30803254

RESUMO

Escherichia coli and Klebsiella pneumoniae are frequently found resistance to aminoglycosides in Turkey. The aim of this study was to investigate aminoglycoside resistance in clinical isolates of E. coli and K. pneumoniae from Turkey using both phenotypic and genotypic methods and screening for the prevalence of gene coding for common aminoglycoside-modifying enzymes (AMEs) and 16S rRNA methylase genes. A total of 88 consecutive, non-duplicated E. coli (n = 65) and K. pneumoniae (n = 23) isolates showing resistance or intermediate resistance to amikacin and/or gentamicin were collected between October 2013 and May 2015 from clinical samples received at Gaziantep Dr. Ersin Arslan Training and Research Hospital. Seventeen isolates were obtained from Syrian patients. Isolates resistant to any of the two aminoglycosides were tested by PCR for seven AME genes, and 22 isolates with amikacin MIC ≥16 mg/L were also tested for 16S rRNA methylase genes. In E. coli isolates, the most frequent genes were aac(6')-Ib (50 strains; 76.9%) and aac(3)-IIa (40 strains; 70.7%), followed by aph(3')-Ia (5 strains; 7.6%) and ant(2″)-Ia (2 strains; 3.1%). Among the 23 resistant K. pneumoniae isolates, the most prevalent gene was aac(3')-IIa (87.0%) followed by aac(6')-Ib (73.9%) and aph(3')-Ia (8.6%). The rmtC gene was detected in one K. pneumoniae isolate. Resistance to aminoglycosides in clinical isolates of E. coli and K. pneumoniae from our center is predominantly caused by AAC(6')-Ib and AAC(3)-II enzymes, while the occurrence of 16S rRNA methylases is so far limited.


Assuntos
Aminoglicosídeos/farmacologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Escherichia coli/efeitos dos fármacos , Genes Bacterianos , Klebsiella pneumoniae/efeitos dos fármacos , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Genótipo , Técnicas de Genotipagem , Humanos , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Prevalência , Síria/epidemiologia , Turquia/epidemiologia
20.
BMC Oral Health ; 19(1): 16, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30646889

RESUMO

BACKGROUND: There was an immense need for studies evaluating the dental health status in Syrian children, especially under the current circumstances of the Syrian crisis. No contemporary data was available. The aim of this study was to assess the current dental health status in children aged 8 to 12 years in Damascus city. METHODS: The study was a cross-sectional epidemiological school-based oral health survey using stratified random cluster sampling. A total of 1500 children were clinically examined. For each child, personal information together with DMFT and dmft indices were recorded. Statistical analysis was undertaken to investigate the effects of different factors on caries prevalence. ANOVA, and Chi Square tests were both utilised. RESULTS: The caries prevalence for the whole city was at (79.1%). The mean DMFT was (2.03 ± 1.81) and the mean dmft was (2.47 ± 2.94). Of the DMFT index mean value, (91.14%) was for decayed and missing permanent teeth. Of the dmft index mean value, (89.1%) was for decayed and missing deciduous teeth. The most affected teeth were the permanent first molars (1.58 ± 1.51). There is a statistically significant relationship between the used indices means and the children's distribution as to the city's localities. CONCLUSIONS: Dental caries was higher than expected. Health promotion programmes are essential and of critical importance in order to improve the dental health status.


Assuntos
Cárie Dentária/epidemiologia , Saúde Bucal , Higiene Bucal/estatística & dados numéricos , Criança , Estudos Transversais , Índice CPO , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Síria/epidemiologia
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