Ahmed Mandil

Geohelminthic infections associated with raw wastewater reuse for agricultural purposes in Beni-Mellal, Morocco

This study was undertaken to determine the possible risk associated with raw wastewater use for agricultural purposes, particularly, the transmission of geohelminthic infections among children of five regions in Beni-Mellal, Morocco. In a randomly selected sample of 1343 children, 740 of them were from five communities using raw wastewater for agriculture, and 603 were from four control communities that do not practice wastewater irrigation. A questionnaire-interview with children and parents was used to collect data on possible demographic, hygiene and behavioral-contact risk factors such as sex, age, family size, parental education, parental occupation, source of water, toilet in house, hand-washing, contact with wastewater and contact with wastewater irrigated land. Ascariasis prevalence was found to be approximately five times higher among children in wastewater-impacted regions compared to control regions. Contact with wastewater and wastewater irrigated land and public water supply were found to be associated with higher infection rates. Trichuris rates did not show a statistically significant difference between the wastewater-impacted and the control regions. In conclusion, raw wastewater use in Beni-Mellal can lead to a high risk of geohelminthic infections. Adequate treatment of wastewater and public health education are highly recommended.

The effectiveness of breath carbon monoxide analyzer in screening for environmental tobacco smoke exposure in Saudi pregnant women

BACKGROUND: Exposure to environmental tobacco smoke (ETS) has harmful effects on the pregnancy outcomes similar to those observed in actively smoking pregnant women. The aim of this study was to estimate the sensitivity and specificity of the breath carbon monoxide (BCO) analysis in the assessment of smoking status among Saudi pregnant women, including ETS exposure compared to self-reported tobacco smoke exposure. METHODS: A cross-sectional design was used during January 2012, 560 pregnant women, irrespective of their gestational age, agreed to undergo BCO testing and completed the data collection sheet for the study. Sensitivity, specificity, positive and negative predictive values were calculated to compare the BCO test with self-reported exposure to ETS. RESULTS: Of the study population 151 (27%) women self-reported ETS exposure during the index pregnancy, 409 (73%) self-reported non-exposure. Sensitivity of the test was 32.5% (95% CI; 25.2-40.3%), the Specificity was much higher at 69.2% (95% CI; 64.4-73.5%), the positive predictive value was 28% (95% CI, 21.9-35.1%), and the negative predictive value was 73.5% (95% CI; 68.9-77.7%). CONCLUSION: The BCO test is an ineffective tool to detect the level of ETS exposure among Saudi pregnant women.

Non-Communicable Disease Risk Factors among Employees and Their Families of a Saudi University: An Epidemiological Study

Objectives To assess the prevalence of noncommunicable disease (NCD) risk factors among Saudi university employees and their families; to estimate the cardiovascular risk (CVR) amongst the study population in the following 10years. Methods The NCD risk factors prevalence was estimated using a cross-sectional approach for a sample of employees and their families aged ≥ 18 years old, in a Saudi university (Riyadh in Kingdom of Saudi Arabia; KSA). WHO STEPwise standardized tools were used to estimate NCD risk factors and the Framingham Coronary Heart Risk Score calculator was used to calculate the CVR. Results Five thousand and two hundred subjects were invited, of whom 4,500 participated in the study, providing a response rate of 87%. The mean age of participants was 39.3±13.4 years. The majority of participants reported low fruit/vegetables consumption (88%), and physically inactive (77%). More than two thirds of the cohort was found to be either overweight or obese (72%), where 36% were obese, and 59% had abdominal obesity. Of the total cohort, 22–37% were found to suffer from dyslipidaemia, 22% either diabetes or hypertension, with rather low reported current tobacco use (12%). One quarter of participants was estimated to have >10% risk to develop cardiovascular disease within the following 10-years. Conclusion The prevalence of NCD risk factors was found to be substantially high among the university employees and their families in this study.

Effect of public knowledge, attitudes, and behavior on willingness to undergo colorectal cancer screening using the health belief model.

Background/Aims: Success of colorectal cancer (CRC) screening is dependent in part on the proportion of uptake by the targeted population. We aimed in this study to identify factors that were associated with willingness to undergo CRC screening based on the health belief model (HBM). Patients and Methods: This was a cross-sectional study among citizens of Riyadh, Saudi Arabia. Demographic data collected included gender, age, education, marital status, employment status, a history of CRC in the family or knowing a friend with CRC, as well as income. A questionnaire was developed in Arabic based on the HBM and included enquiries on knowledge about CRC symptoms and risk factors, types of CRC screening tests, perceived risk of CRC, previously undergoing CRC screening, intent to undergo CRC screening, perceived barriers to CRC screening, perceived severity of CRC, as well as attitudes toward CRC and its screening. Results: Five hundred participants were included. The mean age was 41.0 years (SD 10.7). Males were 50% and only 6.7% of those between 50 and 55 years of age had undergone CRC screening. Of those surveyed, 70.7% were willing to undergo CRC screening. Also, 70.5% thought that CRC is curable, 73.3% believed it was preventable, whereas 56.7% thought it was a fatal disease. Neither gender, level of education, occupation, income, marital status, nor general knowledge about CRC was found to be associated with the willingness to undergo CRC screening. Recognizing that colonoscopy was a screening test (OR 1.55, 95% CI; 1.04–2.29) was associated with a strong desire to undergo CRC screening while choosing a stool-based test was associated with not willing to undergo CRC screening (OR 0.59, 95%CI; 0.38–0.91). Conclusion: We found that the majority of those interviewed were willing to undergo CRC screening and identified a number of barriers as well as potential areas that could be targeted in the promotion of CRC screening uptake if such a national program were to be implemented.

Patterns of tobacco consumption in food facilities in Riyadh, Saudi Arabia

AIM: This study aimed at assessing prevailing patterns and risk factors of tobacco consumption among clients, food handlers and employers of food facilities, in Riyadh, Saudi Arabia. METHODS: A cross-sectional approach to a representative sample of food facilities in Riyadh was used. A sample of 3000 participants included clients (75%); food handlers/hospitality workers (20 %) and employers (5 %). Participants were reached at restaurants, food courts or cafes. A modified version of the WHO-CDC-Global Youth Tobacco Survey questionnaire was used for data collection. RESULTS: The prevalence of tobacco use at food facilities was found to be 40.3 %, of which 74% were customers, 18.8% were food handlers and 7.2% were managers. The consumption of tobacco was higher at restaurants (39.9%), but lowest at food courts of shopping malls. Water pipe (55.3%) was the main consumption type, followed by cigarettes (42.6%) and chewing tobacco (2.1%). Multivariate analysis showed that gender (male), marital status (single), and type of food facility (Estaraha and café/coffee shop) were independent risk factors associated with tobacco use at food facilities. CONCLUSION: Tobacco use is very common in food facilities in Riyadh as reflected by results of our study, especially among single males Saudis. We should build on success encountered in banning smoking in airports, airplanes, shopping malls, market places, educational institutions and healthcare facilities, extending the ban to include food facilities as well. This is important for the health of non-smokers as well as smokers themselves.

Health research institutional mapping: an Eastern Mediterranean Regional perspective

Background Research-conducive environments are mandatory for planning, implementing and translating research findings into evidence-informed health policies. Aim This study aimed at comprehensive situation analysis of health research institutions in the Region. Methods We collected data on: institutional characteristics, research scope, capacity building, ethics, governance and resources. Results We contacted 575 institutions, of which, 223 (38.8%) responded, indicating that they conducted population research (82%). Reported studies were mostly in medicine, public health and epidemiology, while reported capacity building mainly focused on scientific writing (20.6%), research proposal writing (18%) and quantitative research methods (17%). Most institutions reported having collaborating partners (82%) - predominantly national (77%). Sixty-four percent of institutions received their own funding, with 48% reporting always having access to national databases. Conclusion Governments in the Eastern Mediterranean Region and international funding agencies are called upon to support health research production through increasing allocated support and capacity building in health research.

The integration and management of noncommunicable diseases in primary health care

1Division of Noncommunicable Diseases and Mental Health, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt. 2Division of Information, Evidence and Research, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt. 3Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon. 4Research Division, Dasman Diabetes Institute, Dasman, Kuwait. 5Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

Social Disapproval and Reasons Behind Tobacco Use as Perceived by Pregnant Women

Background : Societal perception of smokers, and reasons behind them smoking both reflect acceptance or rejection of smoking behaviour and can reframe tobacco prevention and/or cessation programs to be more effective in tobacco control. This study aimed at targeting the social unacceptability of smoking amongst Saudi females and considering their opinions of the reasons behind smoking amongst both genders. Methodology : We followed a cross-sectional approach towards data collection from a sample of pregnant women seen at the antenatal clinic at King Khalid University hospital, irrespective of their gestational age. The data was collected using a pretested, anonymous, self administered questionnaire. Results : 1208 pregnant women were included in our study. Their mean age was 29 + 6 years, and their mean gestational age was 29.6 + 7 weeks. Most women (88%) either agreed or strongly agreed that exposure to smoking may harm the foetus, and only 3.5% of them would accept to smoke if they were offered a cigarette by their husbands. The top reported reasons for smoking amongst males and females were: association with tobacco using friend, reduction of stress, and manifestation of masculinity or gender equality. Pregnant women were not impressed by smokers, and as less than 1% of them considered them attractive and about 25% of them believed male and female smokers feel insecure. Conclusion : The social disapproval of smoking behaviour in this study was prominent especially towards female smokers. Reasons behind smoking are still blamed on friends, family members and peer pressure. Such results are important in shaping tobacco prevention and control programs