Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit最新文献

Background: Optometry regulation and practice vary by country in the Eastern Mediterranean Region, therefore, understanding the disparities is crucial for optimizing eye care services in the region.

Aim: To evaluate the professional regulations, clinical practices and barriers to providing specialized optometry services in the Eastern Mediterranean Region.

Methods: Between April and September 2024, this cross-sectional survey collected data on professional regulations, clinical practices and barriers to specialized optometry services from 383 optometrists in the Eastern Mediterranean Region countries that recognize optometry as a profession. The data were analysed using SPSS version 29 and descriptive analysis was conducted.

Results: Eighty percent of the respondents said there was national legislation and mandatory registration to obtain a practicing license in their countries. Almost all the optometrists said they had authority to prescribe spectacles (97.9%) and dispense contact lenses (94.3%), while only 29.2% said they were licensed to prescribe therapeutic drugs. Almost all the respondents (95.6%) assessed visual acuity, while only 18.1% performed contact tonometry. Insufficient training (33.6%) and lack of equipment (29.3%) were the main barriers to providing specialized optometry services.

Conclusion: There are significant variations in the scope of optometry practice in the Eastern Mediterranean Region countries and optometrists primarily provide basic eye care services. There is a need to widen the scope of optometry practice in the region and provide more comprehensive training and equipment support to enable optometrists to meet the diverse and evolving eye care needs.

Background: Mobile health clinics play a vital role in achieving Universal Health Coverage, particularly in disaster-prone areas. However, little is known about patients' satisfaction with their use in Oman.

Aim: To investigate satisfaction with mobile health clinic services during health emergencies in Oman.

Methods: This cross-sectional survey collected data from 180 individuals aged ≥ 16 years in Balad Seet and Yasab on the use of mobile health clinics during natural disasters between July 2022 and April 2024 in Oman. We used the patient satisfaction questionnaire short form to evaluate patients' satisfaction with services across 7 domains and used χ² test to analyse the association between categorical variables and satisfaction.

Results: Almost all (90.6%) the study participants said they were satisfied with the mobile health clinic services. There were significant associations between sociodemographic characteristics and participant satisfaction levels between Balad Seet and Yasab. Participants from Balad Seet reported consistently higher satisfaction levels than those from Yasab, across all domains.

Conclusion: This study highlights the potential of mobile health clinics for providing services in remote areas and during health emergencies in Oman and the potential contribution to achieving Universal Health Coverage and Oman's Vision 2040 health agenda.

Background: Diabetes management requires lifelong medical and medication supervision. The war in Gaza has worsened essential care for diabetes patients, disrupting access to treatment and medications and causing non-adherence.

Aim: To evaluate the effects of the October 2023 war on diabetes treatment and medication compliance in Gaza.

Methods: Between February and May 2024, this cross-sectional study collected data from 278 diabetes patients residing in Rafah, Gaza Strip. It analysed the impact of the war on access to care and medications and medication adherence.

Results: Access to health care facility had decreased from 90% before the October 2023 war to 22% at the time of the study, and medication adherence had decreased from 85% to 45%. Financial constraints severely impacted medication affordability (55% significantly, 37% moderately, 7% lightly, and only 1% not at all) and medication adherence (65% due to mild constraint, 40% due to moderate constraint and 15% due to high constraint).

Conclusion: Findings from this study indicate the need for accelerated assistance to rehabilitate health infrastructure and services in Gaza to guarantee continuous care for diabetic patients and patients suffering from other chronic diseases.

Background: The October 2023 war in Gaza triggered a humanitarian crisis. It disrupted access to food and nutrition services, thus worsening food insecurity and increasing malnutrition risks.

Aim: To document the experience of United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) in providing emergency nutrition services in Gaza during the conflict.

Methods: Through partnership with the United Nations Children's Fund and other partners, UNRWA tracked emergency nutrition interventions in Gaza, including piloting and scaling middle upper arm circumference (MUAC) screening for under-5 children, capacity building for staff providing nutrition services and modifying food parcels to meet nutrition needs within the context of the war.

Results: Between January and September 2024, UNRWA distributed food parcels to nearly 1.15 million people in Gaza, conducted 87 551 MUAC screenings for children aged 6-59 months and referred 6398 malnourished cases (MUAC < 12.5 cm) for treatment. UNRWA trained 110 physicians, nurses and midwives to provide nutrition interventions.

Conclusion: Coordination with other partners enabled UNRWA to provide emergency nutrition services during the conflict in Gaza despite the infrastructure damage, resource constraints and operational disruptions. Sustained, flexible and well-coordinated nutrition interventions are needed in Gaza and similar conflict zones to prevent severe acute malnutrition, impaired child growth and development, and child mortality.

Background: Treating cases that require different surgical specialties requires high-level interdisciplinary coordination, and prioritization of the patient's needs, which is nearly impossible in a war zone.

Aim: To document the case of a woman who was diagnosed with multiple fractures from an explosive injury sustained during the October 2023 war in Gaza.

Methods: The woman underwent 3 surgical operations, internal fixation for the rib fracture, internal fixation of the left humerus, and fixation of the mandible fracture. She was hospitalized for nearly one month in 2 admission intervals-14 days at the surgical department and 16 days at the intensive care unit.

Result: After prolonged interdisciplinary management, recurrent admissions and multiple operations, the patient recovered significantly well.

Conclusion: This case highlights the significance of a multidisciplinary approach to managing these types of injuries, and how a severe polytrauma patient can recover when provided with appropriate care in spite of the conflict.

Background: Due to war, paediatric cancer patients from Gaza face several healthcare challenges, including frequent treatment disruptions, limited medication supplies, poor infrastructure, psychosocial burden, and war-related trauma.

Aim: To assess the psychosocial status of paediatric cancer patients from Gaza treated at King Hussein Cancer Center (KHCC), Jordan.

Methods: Using the psychosocial assessment tool, psychologist observations and caregiver reports, we collected data from 23 paediatric cancer patients aged 1-18 years, from Gaza, who received treatment at KHCC between November 2023 and April 2024. We conducted a retrospective thematic analysis of the data using Braun and Clarke's six-step process.

Results: About half (52%) of the children had leukaemia, while others presented with sarcomas, lymphoma and other tumours. The patients reported emotional stress and sadness due to the war, separation from family, loss, or displacement, reflecting significant mental health challenges. They exhibited symptoms such as fatigue and poor appetite and expressed heightened fear and anxiety regarding their hospital stay and medical treatment. Strong family support was key in helping the children cope, for those who had immediate family members with them.

Conclusion: This study highlights the complex health challenges that paediatric cancer patients from Gaza face and the need for integrated care to improve their physical and psychosocial wellbeing.

Background: The October 2023 war in Gaza has impacted the health system and increased the economic burden in Gaza.

Aim: To assess the effects of the war in Gaza on health care costs and access to services.

Methods: Between February and May 2024, this cross-sectional survey collected data from 658 individuals in Gaza on health care costs, obstacles to access and the effectiveness of health care services. Data analysis was conducted using SPSS version 25 and the relationships between the variables were determined using the chi-square test. Associations were considered statistically significant at P < 0.05.

Results: Seventy percent of the study participants reported increased health care costs because of the war; 40% relied on personal savings and 25% on aid to cover their medical expenses. The main barriers to accessing medications were shortages (70%), high prices (60%) and poor distribution (50%). Higher income levels were correlated with reduced barriers to access (P < 0.01) and higher education levels were associated with greater satisfaction with services (P = 0.02).

Conclusion: The war has disrupted the healthcare system in Gaza, seriously affecting the cost, access and quality of services. In addition to a permanent ceasefire, targeted actions are needed to lessen the economic burden on the population and improve service delivery.

Background: Children with kidney failure in Gaza are particularly vulnerable because of the conflict.

Aim: To document the condition of children with kidney disease in Gaza and the impact of the October 2023 war on their health.

Methods: We report the experience of children with kidney disease in Gaza, including those supported by Children Not Numbers.

Results: Of the 45 children who lived with kidney failure in Gaza, Children Not Numbers supported 18. Six of those supported by Children Not Numbers were on haemodialysis and had significant electrolyte abnormalities. Ten of the children, among those not supported by Children Not Numbers, died of kidney failure due to inadequate access to dialysis.

Conclusion: Children with kidney failure in Gaza currently have suboptimal access to dialysis and transplant, thus reducing their chances of survival. Urgent actions are needed to enable them to access life-sustaining treatment and care.