Background:Depression and anxiety are prevalent comorbidities and a major concern for patients with tuberculosis. They are associated with low quality-of-life, poor treatment adherence and increased risk of mortality and morbidity. Aim:To assess the prevalence of depression and anxiety and their predictors among pulmonary tuberculosis patients in Tigray, Northern Ethiopia. Methods:Between January and April 2025, we interviewed 360 patients aged ≥ 18 years, who were confirmed to have pulmonary tuberculosis and had been receiving treatment and follow-up for at least 2 weeks in 10 outpatient tuberculosis clinics in Tigray, Ethiopia. We used the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 for data collection, and used SPSS version 29 to analyse the data. Binary logistic regression model was used to identify the predictors of depression and anxiety. Results:P revalence of depression among the patients was 56.7% while prevalence of anxiety was 54.2%. Multivariable regression analysis revealed that smoking, alcohol consumption, adverse drug effects, and perceived stigma were significant risk factors for depression, while treatment support was a protective factor. Smoking, adverse drug effects, HIV/AIDS coinfection, and perceived stigma were significant risk factors for anxiety. Conclusion:The prevalence of depression and anxiety among patients with pulmonary tuberculosis in this study was significantly higher than in other studies. Therefore, there is a need to encourage tuberculosis patients with the identified risk factors to undergo screening for depression and anxiety and to incorporate psychological interventions into their treatment plan.
Laboratory biosafety and biosecurity have long been regarded as highly technical disciplines focused on containment practices and the safe handling of infectious agents. Their purpose is to protect laboratory personnel, communities, and the environment from accidental exposure, loss, theft, misuse, or intentional release. That framing is no longer sufficient. A biological incident that begins in one laboratory can rapidly become a national emergency, cross borders and threaten global health security.
Background:Cardiovascular disease is a leading cause of death globally and a major public health challenge in Islamic Republic of Iran. Risk estimation can help identify high-risk groups and guide prevention. Aim:To estimate the cardiovascular disease mortality risk over a 10-year period among adults aged 30-70 years in Yazd Province, Islamic Republic of Iran. Methods:In 2023, we obtained health data for 2090 adults (809 men and 1281 women) aged 30-70 years in Yazd Province, Islamic Republic of Iran, from the Ministry of Health and Medical Education. We estimated the 10-year risk of cardiovascular disease mortality, using the Framingham risk model, and used independent t test and chi-square test to assess the differences between groups. P < 0.05 was considered statistically significant. Results:Men had higher systolic blood pressure and smoking prevalence than women, while women had higher total cholesterol (P < 0.001). Men had higher estimated 10-year cardiovascular disease mortality risk than women. Low risk was more common among women than men (95.9% versus 58.6%). Moderate risk was more common among men than among women (29.6% versus 3.3%), as was high risk (11.8% versus 0.8%). Conclusion:The observed differences in cardiovascular disease mortality risk factors among the study population indicate the need for preventive measures tailored to the men and women groups. Prevention should focus on smoking, blood pressure control and cholesterol management.
Background:Crimean-Congo haemorrhagic fever is a life-threatening vector-borne disease prevalent in many parts of the world. Aim:To analyse and document the trend of Crimean-Congo haemorrhagic fever cases and fatality in Sistan and Baluchestan Province of Islamic Republic of Iran from 2018 to 2024. Methods:Data on suspected cases of Crimean-Congo haemorrhagic fever for 2018-2024 were collected from the Communicable Disease Center of Zahedan University of Medical Sciences, Islamic Republic of Iran, and analysed using SPSS 27 and Stata 17. Results:Of the 433 registered cases, 91 were confirmed and 16 were probable. Fatality rate was 11%. The highest number of cases was reported in 2019 (n = 167) and the lowest was in 2024 (n = 15), indicating a decreasing trend. The number of cases was higher during the winter months (P < 0.001). Conclusion:Although there is a decreasing trend in the incidence of Crimean-Congo haemorrhagic fever in Sistan and Baluchestan Province, Islamic Republic of Iran, targeted interventions are needed to strengthen prevention, diagnosis and treatment, especially during the winter months.
Background:Needlestick and sharps injuries are common occupational hazards among health care workers and may result in exposure to bloodborne pathogens. Aim:To assess reported needlestick and sharps injuries among health care workers at 2 university hospitals in Croatia. Methods:We collated and analysed national surveillance and hospital data of needlestick and sharps injuries among health workers in 2 university hospitals in Croatia for the period 2018-2022. We compared the pre-COVID-19 pandemic period (2018-2019) with the pandemic period (2020-2022) using descriptive statistics and chi-square tests. P < 0.05 was considered statistically significant. Results:Between 2018 and 2022, a total of 3554 needlestick and sharps injuries were reported among the health care workers. Needles accounted for 2373 (68.6%) of 3458 reports with complete data on injury type. Nurses and medical technicians were the most affected group, accounting for 2358 of the national reports (51.4%; 95% confidence interval 49.7-53.0). Injury reports were higher during the COVID-19 pandemic than before the pandemic (1930 vs 1624). The difference between the 2 hospitals was not statistically significant (P = 0.41). Conclusion:Needlestick and sharps injuries remain an important occupational risk among health care workers in Croatia, particularly among nurses and medical technicians. Safer handling of sharps, better reporting compliance and targeted education can help reduce this occupational exposure.
Background:Limited evidence on the socioeconomic inequalities in mortality due to noncommunicable disease hampers the development and implementation of policies to improve health equity in Islamic Republic of Iran. Aim:To assess the socioeconomic inequalities in mortality caused by major noncommunicable diseases across provinces and districts in Islamic Republic of Iran. Methods:We obtained data for all deaths attributed to noncommunicable disease (1 105 000) for the period 2016-2018 across 429 districts in 31 provinces of Islamic Republic of Iran. We also obtained aggregated household income and expenditure data from the statistical centre. We analysed the data with R version 4.5.1, using the index of disparity to measure inequality and regression-based relative index of inequality to measure socioeconomic inequalities in noncommunicable disease mortality. Results:The average noncommunicable disease mortality ranged from 36.02 per 100 000 population in Kohgiluyeh and Boyer-Ahmad to 73.06 per 100 000 in Golestan. The index of disparity was >40% in Chaharmahal and Bakhtiari, Sistan and Baluchestan, and Kohgiluyeh and Boyer-Ahmad, and <20% in Semnan and Qazvin. Cardiovascular disease mortality showed the highest difference between adjacent socioeconomic groups, decreasing from 144.1 to 118.5 per 100 000 population between the first and second groups. Conclusion:Noncommunicable disease mortality varied across provinces and socioeconomic groups, particularly for cardiovascular disease mortality. To reduce inequalities in mortality due to noncommunicable disease within and between the provinces, there is a need to strengthen health inequality monitoring using evidence on the causes of death, risk factors and the social determinants of health.
Background: Hajj is associated with an increased risk of invasive meningococcal disease, because of close contact among large numbers of pilgrims from diverse geographic regions. Aim: To recommend evidence-based vaccination strategies for strengthening the prevention of invasive meningococcal disease during Hajj. Methods: We convened a panel of experts from 4 medical societies to review epidemiologic data, immunisation policies and other evidence on PubMed on meningococcal vaccines, including the quadrivalent conjugate vaccine against serogroups A, C, W and Y and meningococcal serogroup B vaccine (MenB), available in Saudi Arabia. Based on their findings they drafted a consensus statement of recommendations for the prevention of meningococcal disease during Hajj. Results: We found from our review that invasive meningococcal disease remains a significant health risk during Hajj. Based on the findings, we recommend MenB vaccination for adults intending to perform Hajj. Vaccination should specifically target vulnerable populations, particularly people with chronic disease, immunocompromised individuals, those with occupational risk, children aged 2 months to 18 years and adults aged ≥ 60 years. Integration of vaccination into Hajj and Umrah registration systems, clear communication, adverse event monitoring and evaluation of programme impact may support uptake. Conclusion: Adding MenB vaccination to existing quadrivalent meningococcal conjugate vaccine recommendations can strengthen protection and reduce the risk of invasive meningococcal disease outbreaks during Hajj.
Background: Road traffic injuries and deaths remain a major public health concern in Saudi Arabia. Aim: To review the burden and risk factors for road traffic injuries in Saudi Arabia and describe recent government road safety efforts. Methods: We reviewed official government documents and published literature on national trends, risk factors, emergency response and injury patterns of road traffic injuries and road safety efforts by the Government of Saudi Arabia. Results: Between 2013 and 2023, serious road traffic accidents decreased by 46% in Saudi Arabia, fatalities by 44% and injuries by 40% as a result of stricter traffic monitoring and public awareness campaigns. In spite of this progress, the burden remains concentrated among specific population groups and regions. The key challenges include non-compliance to safety measures and non-completion of infrastructure upgrades. Conclusion: Saudi Arabia has achieved measurable reductions in road traffic accidents, injuries and fatalities. However, achieving the Vision 2030 road safety target will require sustained enforcement, safer infrastructure, stronger road safety education, and wider use of data-driven technologies.
Background:Evidence on the patterns and sociodemographic characteristics of suspected child abuse and neglect in Oman remains limited, particularly outside the national capital region. Aim:To assess the patterns and sociodemographic characteristics of suspected child abuse and neglect cases at a regional hospital in Oman. Methods:We collated and analysed data on suspected child abuse and neglect cases among children aged 0-18 years from Rustaq Hospital, Oman, for the period August 2020 to August 2023. Descriptive statistics and chi-square tests were used to assess associations between abuse type, age, sex and parental marital status. P < 0.05 was considered statistically significant. Results:Neglect was most frequently reported (58.2%) among the 256 suspected cases, especially among children aged 0-4 years. Physical and sexual abuse were more frequent among older children, and emotional abuse among children from single-parent households. Neglect was higher among boys than girls (69.2% vs 48.9%; P = 0.001), while sexual abuse was more common among girls (34.5% vs 11.1%; P < 0.001). Overall, abuse type was significantly associated with age, sex and parental marital status. Conclusion:Age, sex and parental marital status were associated with patterns of suspected child abuse and neglect in this regional hospital. Strengthening early detection, family support and targeted prevention may help improve child protection in this setting.
Meningitis remains a persistent public health threat in the WHO Eastern Mediterranean Region (EMR), despite the availability of effective vaccines. The launch of the Regional Framework for Implementing the Defeating Meningitis by 2030 Global Road Map, aligned with the World Health Assembly Resolution WHA73.9, offers EMR Member States an evidence‑informed blueprint to accelerate actions towards achieving the set targets.
Background:Reports of fatal adverse reactions to ceftriaxone sodium have raised serious safety concerns in Syrian Arab Republic, yet evidence describing fatal outcomes remains limited. Aim:To describe and characterise fatal adverse reactions associated with ceftriaxone sodium administration in Syrian Arab Republic. Methods:We conducted a retrospective analysis of 14 fatal cases of ceftriaxone-associated adverse reactions reported to the national pharmacovigilance system in Syrian Arab Republic from 2018 to 2023. Results:Fourteen ceftriaxone sodium-associated fatal ADR cases were identified, including one maternal-foetal case, accounting for 15 deaths. Most fatalities resulted from immediate anaphylactic reactions following intravenous or intramuscular administration. Fatal outcomes included maternal-foetal death, Stevens-Johnson syndrome with multiorgan failure and anaphylaxis occurring during an intradermal allergy test. Conclusion:Fatal adverse reactions to ceftriaxone were predominantly rapid and unpredictable, underscoring the need for careful allergy assessment, close patient monitoring and adherence to safe administration practices.
Background:Evidence on antibiotic use among internally displaced persons in conflict-affected Northwest Syria remains scarce. Aim:To assess knowledge, attitudes and practices regarding antibiotic use among internally displaced persons in Northwest Syria. Methods:We collected data from 630 individuals, aged ≥ 18 years, living in 12 internally displaced persons camps, in April 2022, through face-to-face interviews, using a WHO-validated questionnaire adapted for Syrian context. We analysed the data using SPSS version 26 and conducted univariate and multivariate logistic regression to assess associations between respondent characteristics and key outcomes. P < 0.05 was considered statistically significant. Results:Of the 630 participants (58.1% female; median age 38 years), 66.5% had received at least one antibiotic prescription in the past year. Females were more likely than males (odds ratio 2.89; 95% confidence interval 1.10-7.40; P = 0.02), and single participants less likely than married participants (OR = 0.29; 95% CI: 0.10-0.84, P = 0.02), to have used a prescribed antibiotic. Antibiotic misuse was common: 62.2% used antibiotics without a prescription, 51.6% used antibiotics prescribed for others and 39.4% did not complete their recommended dosage. The proportion of participants who obtained antibiotics without prescription increased from 64.8% before to 79.0% after displacement (P < 0.001). Of the participants, 69.8% had sufficient knowledge of, and 59.2% had positive attitude towards, antibiotic use. Conclusion:Although most participants reported having sufficient knowledge of antibiotics, misconceptions and inappropriate use were common. Targeted and evidence-based interventions are needed to improve antibiotic use practices and to support antimicrobial stewardship among internally displaced persons in Northwest Syria and other similar settings.
