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A comparative study of tobacco control scale score in the Eastern Mediterranean Region countries 东地中海地区国家烟草控制量表评分比较研究
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.120
Elnaz Saeedi, Sepideh Abdi, Amir Reza Dardashti, Pedram Fattahi, Negar Taheri, F. Lotfi, Saeed Nemati, M. V. Rajabpour
Background: The tobacco control scale (TCS) score is used widely in European countries to evaluate the adoption of antitobacco policies by countries, however, data on the adoption of tobacco control programmes in the Eastern Mediterranean Region (EMR) are limited to a 2009 survey. Aim: To compare the TCS score for measuring national tobacco control programmes in the EMR countries in 2009 and 2021. Methods: This cross-sectional survey compared data from 21 EMR countries on 6 major indicators, including the price of cigarettes, tobacco smoke-free public places, national budget for tobacco control activities, ban on tobacco advertising, health warning labels on tobacco packets, and support for treatment of tobacco dependence. The TCS scores at the country level in 2009 were extracted from a previous study. We then calculated the TCS score in 2021 for the same countries using the WHO report on the global tobacco epidemic 2021 and the World Bank data for 2020. Results: The average TCS score (standard deviation) for EMR countries increased from 29.7 (16.8) in 2009 to 40.7 (17.3) in 2021. The highest TCS score (83.0) was reported in Islamic Republic of Iran, followed by Yemen (72.8) and Lebanon (62.0). Five countries (Djibouti, Syrian Arab Republic, Tunisia, Bahrain, and Oman) scored less than 30. Health warning labels, smoke-free public places, and tobacco control budgets as a percentage of Gross Domestic Product per capita had all increased, but tobacco prices and cessation treatments did not improve over the past decade. Conclusion: Tobacco control policies have been implemented and improved in most EMR countries, but there is room for further improvement. Tobacco pricing and taxation, national tobacco control program budgets, and cessation treatments require more attention.
背景:欧洲国家广泛使用烟草控制量表(TCS)评分来评估各国采取反烟草政策的情况,但有关东地中海地区(EMR)采取烟草控制计划的数据仅限于 2009 年的一项调查。目的:比较 2009 年和 2021 年衡量东地中海地区国家烟草控制计划的 TCS 分数。方法:这项横断面调查比较了 21 个地中海区域国家在 6 个主要指标上的数据,包括香烟价格、无烟公共场所、国家烟草控制活动预算、烟草广告禁令、烟草包装上的健康警示标签以及对烟草依赖治疗的支持。我们从之前的一项研究中提取了 2009 年国家层面的 TCS 分数。然后,我们利用世界卫生组织 2021 年全球烟草流行报告和世界银行 2020 年的数据,计算了相同国家 2021 年的 TCS 分数。结果:环境监测和报告国家的平均总烟草控制分数(标准偏差)从 2009 年的 29.7(16.8)上升到 2021 年的 40.7(17.3)。据报告,伊朗伊斯兰共和国的总关键控制点得分最高(83.0),其次是也门(72.8)和黎巴嫩(62.0)。五个国家(吉布提、阿拉伯叙利亚共和国、突尼斯、巴林和阿曼)的得分低于 30 分。健康警示标签、无烟公共场所和烟草控制预算占人均国内生产总值的比例都有所提高,但烟草价格和戒烟治疗在过去十年中并没有改善。结论:烟草控制政策已在大多数环境监测和报告国家得到实施和改善,但仍有进一步改进的空间。烟草定价和税收、国家烟草控制项目预算以及戒烟治疗需要得到更多关注。
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引用次数: 0
Prevalence, socio-demographic and economic determinants of violence against ever-married women in Morocco 摩洛哥针对已婚妇女的暴力行为的发生率、社会人口和经济决定因素
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.122
Abdelghani Asraoui, C. Khassouani, A. Soulaymani
Background: Violence against women is a public health issue worldwide, affecting the physical and mental wellbeing of women, children and families. Aim: To determine the socio-demographic and economic factors contributing to violence against women in Morocco and offer recommendations for the prevention and reduction of violence. Methods: Data for this study was obtained from the 2018 National Population and Family Health Survey. We applied the Chi-square test and t-test to study the possible associations between some socio-demographic and economic variables and violence against women. We performed a logistic regression to indicate the simultaneous association of the variables. Results: Among 9969 ever-married women aged 15–49, 15.0% [CI (95%): 14.3-15.7%] had suffered an act of violence in the last 12 months preceding the survey (17.0% in urban and 11.9% in rural areas). Violence against women depended significantly on age, age at first marriage, marital status, total children ever born, educational level, wealth index, being a household head, employment status, decision-maker regarding employment, number of marriages ever had, smoking, relationship with the husband, husband's age, husband's educational level, husband’s polygamy, area of residence, and region of residence (P < 0.05). Conclusion: Violence against women has reached endemic proportions in Morocco and this has serious consequences for population health and the country's economy. There is a need to reinforce and better structure public health programmes to sustainably prevent or reduce violence against women in the country. It is also important to take actions to mitigate the risk factors and provide adequate and quality care for victims.
背景:对妇女的暴力行为是世界范围内的一个公共卫生问题,影响着妇女、儿童和家庭的身心健康。目的:确定导致摩洛哥妇女遭受暴力的社会人口和经济因素,并提出预防和减少暴力的建议。研究方法本研究的数据来自 2018 年全国人口和家庭健康调查。我们采用卡方检验和 t 检验来研究一些社会人口和经济变量与暴力侵害妇女行为之间可能存在的关联。我们进行了逻辑回归,以显示变量之间的同步关联。研究结果在 9969 名 15-49 岁的已婚妇女中,15.0% [CI(95%):14.3-15.7%] 在调查前的 12 个月内遭受过暴力行为(城市地区为 17.0%,农村地区为 11.9%)。暴力侵害妇女行为与年龄、初婚年龄、婚姻状况、所生子女总数、教育程度、财富指数、户主、就业状况、就业决策者、婚姻次数、吸烟、与丈夫的关系、丈夫的年龄、丈夫的教育程度、丈夫的一夫多妻制、居住地区和居住区域有很大关系(P < 0.05)。结论在摩洛哥,暴力侵害妇女行为已成为地方病,对人口健康和国家经济造成了严重后果。有必要加强和完善公共卫生计划,以持续预防或减少该国的暴力侵害妇女行为。同样重要的是采取行动,减少风险因素,并为受害者提供适当和优质的护理。
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引用次数: 0
Cross-sectional study of co-occurring addiction problems among high school students in Tunisia 突尼斯高中生同时存在成瘾问题的横断面研究
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.121
Oumayma Mbarki, R. Ghammem, N. Zammit, S. Ben Fredj, J. Maatoug, H. Ghannem
Background: Addictive behaviours are a major public health problem, especially among adolescents, who are susceptible to experiencing multiple co-occurring addictions. Aim: To assess the prevalence of addiction problems and co-occurrences of addictive behaviours (substance abuse, problematic video gaming and social media addiction) and disorders among high school students in Sousse, Tunisia. Methodology: A cross-sectional study was conducted in 2018 in public high schools, in the urban area of Sousse, Tunisia. A structured self-administered questionnaire was used to obtain relevant information from the students. Statistical analysis was performed using SPSS version 10 and confidence intervals of 95% were calculated. Chi-square test was used to compare qualitative variables and multinomial regression was conducted to determine independent factors related to the number of addictive behaviour co-occurrences. Results: Of the 1399 high school students, 60.5% were girls and mean age was 17 ± 2.28 years. Analysis of single addiction problems revealed 20.9% prevalence for all tobacco products, 10.1% for alcohol, 7.0% for all drugs, 36.1% for Facebook, and 35.3% for video games. Analysis of co-occurring addiction problems showed that 46.0% of the study population had 1 addiction problem, 12.2% had 2 addiction problems, 4.5% had 3, and 2.7% had the maximum number of 4 addiction problems. Multinomial regression showed an increase in co-occurrence of addiction problems among boys (aOR = 217.004; P < 0.001), participants who had repeated a school grade (aOR = 0.232; P < 0.001), those who had moderate or severe depression (aOR = 0.232; P < 0.001), and those who were anxious (aOR = 0.335; P = 0.003) and had alexithymia (aOR = 0.361; P = 0.005). Conclusion: The rate of co-occurrent addictions among adolescents in Sousse, Tunisia, is alarming. Problematic use of Facebook, gaming and tobacco use were the most frequent addictive behaviours. There is an urgent need for effective and multisectoral programmes to prevent addictions among children in Tunisia and other countries in the Middle East and North Africa Region.
背景:成瘾行为是一个重大的公共卫生问题,尤其是在青少年中,他们很容易同时出现多种成瘾行为。目的:评估突尼斯苏塞高中生中成瘾问题的发生率以及成瘾行为(药物滥用、问题视频游戏和社交媒体成瘾)和障碍的共存情况。研究方法:2018 年在突尼斯苏塞市区的公立高中开展了一项横断面研究。采用结构化自填问卷的方式从学生中获取相关信息。使用 SPSS 10 版本进行了统计分析,并计算了 95% 的置信区间。采用卡方检验比较定性变量,并进行多项式回归以确定与成瘾行为共现次数相关的独立因素。研究结果在 1399 名高中生中,60.5% 为女生,平均年龄为 17±2.28 岁。对单一成瘾问题的分析显示,所有烟草制品的成瘾率为 20.9%,酒精成瘾率为 10.1%,所有毒品成瘾率为 7.0%,Facebook成瘾率为 36.1%,电子游戏成瘾率为 35.3%。对并发成瘾问题的分析表明,46.0%的研究人群有 1 种成瘾问题,12.2%的人有 2 种成瘾问题,4.5%的人有 3 种成瘾问题,2.7%的人最多有 4 种成瘾问题。多项式回归结果显示,男生(aOR = 217.004;P < 0.001)、留级生(aOR = 0.232;P < 0.001)、中度或重度抑郁症患者(aOR = 0.232;P < 0.001)、焦虑症患者(aOR = 0.335;P = 0.003)和情感淡漠患者(aOR = 0.361;P = 0.005)同时出现成瘾问题的比例增加。结论突尼斯苏塞青少年的并发成瘾率令人担忧。有问题地使用 Facebook、玩游戏和吸烟是最常见的成瘾行为。突尼斯和中东及北非地区的其他国家迫切需要有效的多部门计划来预防儿童成瘾。
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引用次数: 0
Population-based cross-sectional study of sex-specific dose-response associations between night sleep duration and hypertension in Islamic Republic of Iran 关于伊朗伊斯兰共和国夜间睡眠时间与高血压之间性别特异性剂量-反应关系的人群横断面研究
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.119
S. Asgari, A. Najafi, K. Sadeghniiat-haghighi, Farid Najafi, R. Safari-Faramani, Atefeh Behkar, S. Akbarpour
Background: Several studies have suggested that sleep disorders have adverse effects on blood pressure. However, the findings remain controversial and only a few studies have investigated the association between sleep duration and hypertension among all age and sex subgroups. Aim: To evaluate the dose-response association between sleep duration and blood pressure in the Iranian population using the Ravansar non-communicable disease cohort study. Methods: This was a cross-sectional study of 9865 participants aged 35–65 years from the 2014–2017 Ravansar noncommunicable disease cohort study. Night sleep duration was classified as ≤5 hours, 6 hours, 7 hours, 8 hours, 9 hours, and ≥10 hours. The association between self-reported sleep duration and hypertension was examined using multivariable logistic regression in STATA version 14. Restricted cubic spline analysis showed the dose-response association between sleep duration and hypertension. Results: The age-adjusted prevalence of hypertension was 16.50% among men, 24.20% among women and 20.50% in the total population. Compared with reference sleep duration (7 hours) in the total population, the multivariable odds ratio [OR (95% CI)] for hypertension was 0.70 (0.55–0.88) for the group with 9 hours sleep duration and 0.90 (0.74–1.09) for the group with ≤5 hours sleep duration. Among pre-menopausal women, we observed an inverse association between 9 hours sleep duration and hypertension [0.62 (0.42–0.90)]. The age-adjusted cubic spline suggested a linear inverse association between sleep duration and prevalence of hypertension among men and the total population and a non-linear association among women. Conclusion: Longer sleep duration (from 9 hours) had a negative association with hypertension. Further studies are needed to identify the risk factors associated with sleep duration and hypertension among the general population in the Islamic Republic of Iran.
背景:多项研究表明,睡眠障碍会对血压产生不利影响。然而,这些研究结果仍存在争议,只有少数研究调查了所有年龄和性别亚群的睡眠时间与高血压之间的关系。目的:利用 Ravansar 非传染性疾病队列研究,评估伊朗人群睡眠时间与血压之间的剂量-反应关系。研究方法这是一项横断面研究,研究对象是 2014-2017 年 Ravansar 非传染性疾病队列研究中 9865 名 35-65 岁的参与者。夜间睡眠时间分为≤5小时、6小时、7小时、8小时、9小时和≥10小时。使用 STATA 14 版的多变量逻辑回归分析了自我报告的睡眠时间与高血压之间的关系。限制立方样条分析显示了睡眠时间与高血压之间的剂量反应关系。结果显示经年龄调整后,男性高血压患病率为 16.50%,女性为 24.20%,总人口为 20.50%。与总人口的参考睡眠时间(7 小时)相比,睡眠时间为 9 小时的人群患高血压的多变量几率[OR(95% CI)]为 0.70(0.55-0.88),睡眠时间≤5 小时的人群患高血压的多变量几率[OR(0.74-1.09)]为 0.90(0.74-1.09)。在绝经前妇女中,我们观察到 9 小时睡眠时间与高血压呈反向关系[0.62(0.42-0.90)]。经年龄调整的三次样条曲线表明,在男性和总人口中,睡眠时间与高血压患病率之间呈线性反比关系,而在女性中则呈非线性关系。结论较长的睡眠时间(9 小时以上)与高血压呈负相关。还需要进一步研究,以确定伊朗伊斯兰共和国普通人群中与睡眠时间和高血压相关的风险因素。
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引用次数: 0
Regional expert meeting on policy action for healthy diets, with a focus on the Gulf Cooperation Council countries 关于健康饮食政策行动的地区专家会议,重点是海湾合作委员会国家
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/2023.29.12.995
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引用次数: 0
Epidemiology of obesity and control interventions in Saudi Arabia 沙特阿拉伯的肥胖症流行病学和控制干预措施
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.086
Rasha A. Almubark, Saleh A. Alqahtani
Background: Prevalence estimates for overweight and obesity in the Gulf Cooperation Council countries, including Saudi Arabia, have increased over the last 4 decades. Although the World Health Organization encourages countries to implement initiatives aimed at controlling obesity, limited research has been published on the impact of such initiatives in Saudi Arabia. Aims: To assess the epidemiology of overweight and obesity in Saudi Arabia, describe and evaluate the effectiveness of past and current interventions, and recommend actions for prevention and control. Methods: A narrative review of data from the Global Health Observatory was used to determine yearly estimates of prevalence of overweight and obesity in Saudi Arabia from 1975 to 2016. Large-scale interventions aimed at controlling obesity and its risk factors in Saudi Arabia were identified and summarized. Results: Prevalence estimates of overweight and obesity among men and women in Saudi Arabia continued to increase from 1990 to 2019. Prevalence among adults was more than 60% and among children and adolescents it was 20–60%, suggesting a continuing trend. Interventions were identified but their impact on the prevention and control of obesity and its risk factors was unclear. Conclusion: Prevalence estimates of overweight and obesity have been steadily increasing in Saudi Arabia since 1975. Integrated, “whole-of-community” approach, with continuous evaluation, is needed to achieve sustainable prevention and control of obesity in the country.
背景:过去 40 年来,包括沙特阿拉伯在内的海湾合作委员会国家的超重和肥胖发病率有所上升。尽管世界卫生组织鼓励各国实施旨在控制肥胖的措施,但有关此类措施在沙特阿拉伯的影响的研究成果却十分有限。目的:评估沙特阿拉伯超重和肥胖的流行病学,描述和评估过去和当前干预措施的效果,并提出预防和控制行动建议。方法:对来自全球健康观察站的数据进行叙述性回顾,以确定 1975 年至 2016 年沙特阿拉伯超重和肥胖症流行率的年度估计值。确定并总结了沙特阿拉伯旨在控制肥胖及其风险因素的大规模干预措施。结果:从 1990 年到 2019 年,沙特阿拉伯男性和女性超重和肥胖的流行率持续上升。成年人中的患病率超过 60%,儿童和青少年中的患病率为 20-60%,表明这一趋势仍在继续。干预措施已经确定,但其对预防和控制肥胖及其风险因素的影响尚不明确。结论自 1975 年以来,沙特阿拉伯超重和肥胖的流行率一直在稳步上升。要在该国实现肥胖症的可持续预防和控制,需要采取 "全社区 "综合方法,并进行持续评估。
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引用次数: 0
Strengthening dengue control in Pakistan 加强巴基斯坦的登革热控制
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.099
Maheen Saleem, A. Sheikh, Hina Nawaz, Gati Ara
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引用次数: 0
Translating political commitments into actions to enhance Universal Health Coverage in the Eastern Mediterranean Region 将政治承诺转化为加强东地中海地区全民医保的行动
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.112
A. Mataria, Reza Majdzadeh, Deena Al Asfoor, Hassan Salah, Zafar Mirza
Background: Many countries in the Eastern Mediterranean Region (EMR) have developed packages of services for achieving Universal Health Coverage (UHC), however, policymakers, especially in resource-constrained countries, still face challenges in delivering equitable, efficient and sustainable health services. Aims: To provide guidance for EMR countries and develop packages of services for UHC. Methods: We used information gathered from narrative reviews, national experiences and expert consultations to develop step-by-step guidance for the development of national packages of services for the achievement of UHC by countries in the EMR. Results: The processes used to develop packages of services varied between EMR countries and these processes may not have involved all relevant stakeholders. We highlight in this paper the iterative processes, including several phases and steps, to be used by EMR countries for developing packages of services for UHC. These processes also make provision for continuous monitoring and revision to make necessary improvements as morbidity patterns evolve. Conclusion: Developing a package of services for the achievement of UHC is a significant milestone for EMR countries and it is central to shaping the healthcare system for effective delivery of services.
背景:东地中海地区(EMR)的许多国家已经制定了实现全民健康保险(UHC)的一揽子服务,但是,决策者,尤其是资源有限的国家的决策者,在提供公平、高效和可持续的医疗服务方面仍然面临挑战。目的:为东地中海区域国家提供指导,并为实现全民健康覆盖制定一揽子服务计划。方法:我们利用从叙述性综述、国家经验和专家咨询中收集到的信息,为制定国家一揽子服务计划提供分步指导,以帮助教育、医疗和卫生改革国家实现全民健康目标。结果:在制定一揽子服务的过程中,欧洲监测报告国家之间的做法各不相同,而且这些过程可能没有让所有相关利益方参与进来。我们在本文中强调了迭代过程,包括几个阶段和步骤,供环境监测与报告国家用于制定实现全民保健的一揽子服务。这些过程还规定了持续监测和修订,以便随着发病率模式的变化做出必要的改进。结论:为实现全民健康保险而制定一揽子服务计划,对于环境监测和报告国家来说是一个重要的里程碑,也是塑造医疗保健系统以有效提供服务的核心。
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引用次数: 0
Gaza disaster: we need a permanent ceasefire, now! 加沙灾难:我们现在就需要永久停火!
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/2023.29.12.919
A. Al-Mandhari, Richard Peeperkorn, Farah Al-Shorbaji, Ali Mohamed Kamil, Richard Brennan
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引用次数: 0
Epidemiology of scorpion stings in the West Bank, occupied Palestinian territory 巴勒斯坦被占领土约旦河西岸的蝎子蜇伤流行病学
IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.26719/emhj.23.118
E. Handal, Mohammad Abu Serhan, M. Qumsiyeh, R. Bani Hani, David A. Warrell, Z. Amr
Background: Scorpionism (scorpion sting envenoming) is an endemic public health concern in many Arab Middle Eastern countries. However, our knowledge of the epidemiology of scorpion stings in the West Bank is limited. Aim: To investigate the epidemiology of scorpion stings in 4 districts of the West Bank over a specified period. Methods: We obtained scorpion sting records from the main hospitals in 4 districts of the West Bank for 2012 and 20142020. A total of 2175 cases were analyzed retrospectively using SPSS version 17. Results: The average age and standard deviation (±SD) for both sexes was 24.7±17.5 years (22.7±16.5 and 27.1±18.4 years for males and females, respectively). The median age was 20 years and 47.2% were children under 18 years. Most cases were reported during the summer months, between June and October, with a peak in July–August. By anatomic site, the right hand was the most commonly stung in both sexes, followed by the right foot. The chest, buttocks and scrotum were the least affected body parts. Clinical data were available for 405 cases, in which pain, vomiting and sweating were the most common symptoms. The overall incidence of stings was 26.32 per 100 000 inhabitants per year over the study period of 8 years (59.21–171.67, 95% CI). Conclusion: Scorpion stings are commonly encountered by adults and children in the West Bank. There is a need for awareness among the West Bank populations on how to avoid being stung, to train medical staff to better manage sting cases, and to evaluate the antivenom currently being used by physicians for scorpion stings.
背景:蝎子中毒(蝎子蜇伤)是许多中东阿拉伯国家普遍存在的公共卫生问题。然而,我们对约旦河西岸蝎子蜇伤流行病学的了解十分有限。目的:调查特定时期内约旦河西岸 4 个地区的蝎子蜇伤流行病学。方法:我们从约旦河西岸 4 个区的主要医院获得了 2012 年和 2014-2020 年的蝎子蜇伤记录。使用 SPSS 17 版对 2175 个病例进行了回顾性分析。结果:男性和女性的平均年龄和标准差(±SD)分别为 24.7±17.5 岁(22.7±16.5 岁和 27.1±18.4)。年龄中位数为20岁,47.2%为18岁以下儿童。大多数病例发生在夏季,即 6 月至 10 月,高峰期在 7 月至 8 月。从解剖部位来看,男女患者最常被蛰的部位都是右手,其次是右脚。胸部、臀部和阴囊是受影响最小的身体部位。有 405 个病例的临床数据,其中疼痛、呕吐和出汗是最常见的症状。在 8 年的研究期间,每 10 万名居民每年被蜇伤的总发病率为 26.32(59.21-171.67,95% CI)。结论蝎子蜇伤是约旦河西岸成人和儿童经常遇到的情况。有必要提高约旦河西岸居民对如何避免被蝎子蛰伤的认识,培训医务人员更好地处理蛰伤病例,并对医生目前用于治疗蝎子蛰伤的抗蛇毒血清进行评估。
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引用次数: 0
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Eastern Mediterranean Health Journal
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