The Journal of the Egyptian Public Health Association最新文献

Background: The Palestinian healthcare system has historically relied on referrals of patients to health facilities across Palestine's borders. Patients referred typically suffered from chronic conditions or congenital anomalies for which the governmental health facilities in Palestine lacked treatment or diagnostic options. The ongoing Israeli genocide on the Palestinian population has destroyed much of the health system and facilities in Gaza and caused tens of thousands of traumatic injuries that need referral abroad, on top of the cohort of patients with chronic conditions and congenital anomalies.

Findings: Statistics published by the WHO-oPt show that 7,841 patients have been allowed medical evacuation and referral from Gaza between the start of the war in October 2023 and 29 September 2025. About two-thirds of all patients (n = 5,000. 63.8%) were medically evacuated before the Israeli military forces occupied the Rafah border crossing with Egypt on 7 May 2024, and 1,702 (21.7%) patients were evacuated between 19 January 2025 and 17 March 2025 as part of the ceasefire agreement. Egypt has received the majority of patients (n = 3,995, 51%) who have been medically evacuated. Excluding the two periods mentioned, a clear Israeli policy emerged since occupying the Rafah border crossing, which weaponized healthcare by preventing patients from Gaza from being medically evacuated to travel abroad to receive life-saving healthcare.

Conclusions: The Israeli policy of weaponizing the referrals and medical evacuations has resulted in excess mortality that merits further research and quantification, as patients succumbed to their medical conditions or injuries while waiting to exit Gaza. Action needs to be taken by host countries to step up their efforts to receive more patients from Gaza and put more pressure on Israel to facilitate the safe evacuation process of these patients.

Background: Microbial communities in aquatic ecosystems are integral to water quality and public health, yet their structure and underlying ecological processes in regions like Egypt remain underexplored. To address this gap, this research explores the structure and dynamics of prokaryotic communities in tap water and groundwater in Cairo, Egypt.

Methods: Using environmental DNA metabarcoding, bioinformatics, and statistical modeling, we investigated microbial composition, pathogen identification, environmental factors, and ecological assembly processes.

Results: The sequence analysis revealed the presence of 6,868 amplicon sequence variants (ASVs), with distinct community structures between groundwater and tap water. Proteobacteria dominated both habitats, with significant habitat-specific variations in Firmicutes, Actinobacteria, Verrucomicrobia, and Bacteroidota. Key genera included Methylobacterium in tap water, and Thauera and Legionella in groundwater, reflecting habitat-specific adaptations. The potential presence of Legionella-detected through 16 S rRNA gene signatures-may indicate conditions that could support organisms associated with diseases such as Legionnaires' disease; however, 16 S-based detection does not confirm viability or infectivity. Similarly, the surrogate presence of taxa such as Streptococcus salivarius, Stenotrophomonas maltophilia, and Acinetobacter baumannii in tap-water samples suggests possible post-treatment contamination or biofilm-associated persistence, warranting further targeted monitoring using methods capable of confirming viability. Ecological assessments indicated that stochastic mechanisms, particularly ecological drift, were the dominant forces shaping microbial community assembly in both water sources, whereas homogeneous selection exerted a moderate influence specifically within groundwater environments. Environmental parameters such as DO%, NO₂-N, and NO₃-N were critical in shaping tap water communities, while NH₄-N and TDS influenced groundwater communities.

Conclusion: This study highlights the distinct microbial dynamics of groundwater and tap water, emphasizing the importance of integrated water quality management strategies to mitigate nutrient pollution, monitor potential pathogen signatures, and protect public health.

Background: The COVID-19 pandemic highlighted critical gaps in mortality surveillance, particularly in low- and middle-income countries (LMICs). This study evaluated the feasibility of using routine mortality data as an early warning system for respiratory outbreaks in Alexandria, Egypt.

Methods: A retrospective time-series analysis of 61,378 deaths (2017-2022) was conducted. Respiratory failure (ICD-10: J96.90) was used as a proxy for COVID-19-related mortality. As population denominators were unavailable at subdistrict level, analyses relied on proportionate mortality, reflecting the pragmatic data scope of the current registry system. Expected deaths were estimated using an exponential smoothing model, and excess mortality was identified when observed deaths exceeded expectations for three or more consecutive months.

Results: Deaths attributed to respiratory failure increased notably during 2020-2021, with sustained excess mortality signals corresponding to pandemic peaks. Mortality among adults aged 70-75 years rose markedly, and total years of life lost during the pandemic reached 41,819 across high-risk age groups (40-70 years).

Conclusions: Routine mortality data can serve as a practical foundation for early detection of respiratory disease outbreaks in resource-limited settings. Future investments should focus on strengthening human resources, expanding digital infrastructure, and improving data standardization to ensure the long-term sustainability and scalability of mortality surveillance systems in LMICs.

The rapid global increase in the older adult population presents unprecedented challenges and opportunities for healthcare systems worldwide. This demographic shift is accompanied by a growing prevalence of chronic conditions such as cardiovascular diseases, diabetes, dementia, and other geriatric syndromes, underscoring the urgent need for innovative, age-sensitive healthcare solutions. Traditional healthcare models often fall short in addressing the complex, multifactorial needs of older adults, highlighting the need for a transformative approach to care delivery and management that integrates personalization, continuity, and technological innovation. This article is a narrative review that synthesizes recent literature published within the last ten years, drawing from PubMed, Scopus, Web of Science, and Google Scholar to explore cutting-edge advancements in geriatric care, with a focus on telemedicine, mobile health (mHealth), artificial intelligence (AI), robotics, and wearable technologies. These innovations offer promising avenues to improve healthcare accessibility, enhance patient outcomes, and alleviate the burden on caregivers. For instance, telemedicine facilitates remote consultations, reducing hospital visits and ensuring continuity of care for individuals in remote or underserved areas. mHealth applications empower older adults to actively manage their health, monitor chronic conditions, and stay connected with caregivers. Robotics and AI-driven systems provide physical support, cognitive stimulation, and personalized care planning, thereby enhancing independence and emotional well-being. However, successfully integrating these technologies into geriatric care requires addressing several challenges, including technical limitations, data privacy concerns, and disparities in digital literacy. A major hurdle lies in ensuring that these solutions are user-friendly and tailored to the diverse physical and cognitive needs of older adults.

Background: Delayed diagnosis and treatment can be detrimental not only to patients but also to the community, as such delays can perpetuate TB transmission. This presents a significant challenge in the ongoing efforts to eliminate TB from the community. The primary objectives of this scoping review were to map out research surrounding delays in TB care across the ten countries with the highest TB burden globally and to identify research gaps in this area.

Methods: The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) were adhered to in reporting this scoping review. Three databases: PubMed, DOAJ, and Scopus, were searched to collect articles published between 2004 and 2024, all in the English language. A total of eighty-one articles were included in this review.

Results: Out of 831 articles, following the eligibility criteria, 81 full-text open-access articles were deemed suitable for review. The findings indicate that delays in TB care are influenced by several factors, including patient-related, household and social, health system, economic, and occupational factors, as well as health-seeking behaviour. Significant variations in delay duration were observed across the reviewed studies. Myanmar recorded the longest median total delay of 170.6 days, while India and China reported median total delays ranging from 8 to 111 days. Due to resource constraints, Mozambique experienced the highest median health system delay of 150 days. There were a very limited number of studies conducted in the Democratic Republic of Congo, the Philippines, and Zambia.

Conclusion: This scoping review found that delays in TB care in high-burden countries are influenced by a combination of patient, social, economic, and health-system factors, with significant differences in delay durations between different countries. These findings underscore the need for stronger health systems, targeted community education to encourage timely care-seeking, and stigma-reduction efforts to minimise delays and support TB elimination goals.