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Kıskaç N, Rashidi M, Yıldırım G, Çelik A, Hacıoğlu B, Genç A, Çakmak S, Şahin BS. Profile, reasons for hospitalization and nursing diagnoses of refugee-native patients admitted to internal medicine clinic-an evaluation from nursing perspective. Int J Equity Health 2024; 23:95. [PMID: 38725035 PMCID: PMC11084015 DOI: 10.1186/s12939-024-02190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
PURPOSE The study aims to evaluate the hospitalization diagnoses and nursing diagnoses of the refugee and local population hospitalized in internal medicine clinics, which are especially important in the early diagnosis, treatment, and rehabilitation of chronic diseases, and to emphasize their importance in nursing care. METHODS The study was carried out in a descriptive retrospective design. The files of 3563 patients admitted to the internal medicine clinic of a training and research hospital in Türkiye in 2022 were evaluated. SPSS 26.0 program was used for data analysis. RESULTS In the study, 95.3% of hospitalizations were native and 4.7% were refugee patients. It was determined that refugee patients admitted to the internal medicine service had a lower mean age compared to the native population (p < 0.05), but there was no difference in the duration of hospitalization (p > 0.05). When the medical diagnoses of hospitalization were examined, it was determined that the highest number of hospitalizations in the native and refugee populations were for bacterial infections in both genders. In nursing diagnoses, it was determined that both populations and genders were diagnosed with infection risk by the medical diagnoses of the patients. CONCLUSION As a result of the study, it was observed that the duration of hospitalization, reasons for hospitalization, and nursing diagnoses of local and refugee patients were similar. In addition, it was determined that the patients' medical hospitalization diagnoses and nursing diagnoses were compatible.
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Affiliation(s)
- Neşe Kıskaç
- Faculty of Health Sciences, Department of Nursing, Istanbul Gelişim University, Istanbul, Türkiye.
| | - Mahruk Rashidi
- Faculty of Health Sciences, Department of Nursing, Istanbul Gelişim University, Istanbul, Türkiye
| | - Gülay Yıldırım
- Department of Nursing, Trakya University, Keşan Hakkı Yörük School of Health, Edirne, Türkiye
| | - Abdulkadir Çelik
- Haseki Training and Research Hospital, Department of Internal Medicine, Health Sciences University, Istanbul, Türkiye
| | - Burcu Hacıoğlu
- Haseki Training and Research Hospital, Department of Internal Medicine, Health Sciences University, Istanbul, Türkiye
| | - Aslı Genç
- School of Nursing, Department of Nursing, Ufuk University, Istanbul, Türkiye
| | - Sultan Çakmak
- Faculty of Health Sciences, Department of Nursing, Istanbul Gelişim University, Istanbul, Türkiye
| | - Buse Saygın Şahin
- Istanbul University- Cerrahpasa/ Institute of Graduate Studies / Mental Health and Diseases Nursing PhD Program, Istanbul, Türkiye
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Emecen AN, Kıran P, Çağlayan D. Influential Factors of Tuberculosis Notification Rates in Turkey: A Provincial-Level Spatial Analysis. THORACIC RESEARCH AND PRACTICE 2024; 25:68-74. [PMID: 38454202 PMCID: PMC11114173 DOI: 10.5152/thoracrespract.2024.23109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/07/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The total annual count of reported tuberculosis (TB) cases continues to decline throughout Turkey. Recognizing the regions with high and low burdens and revealing the factors affecting TB notification rates may play a role in guiding national control programs. This study aimed to analyze the spatial distribution of TB notification rates from 2005 to 2018 and evaluate the factors contributing to TB rates. MATERIAL AND METHODS In this ecological study, we used freely available open data from the Internet. We employed global and local spatial autocorrelation analysis to identify the spatial distribution and the clusters with low and high burdens. We conducted an ordinary least square regression model, spatial lag model, and spatial error model. The best-fitting model was selected via model parameters. RESULTS Throughout the study period, the provinces in West Marmara Region (Edirne, Kırklareli, Tekirdağ, Çanakkale) were consistently in a high-burden cluster. In univariate ordinary least square regression, population density, the proportion of contacts screened for TB, the proportion of TB contacts who received prophylaxis, TB dispensary count, mean particulate matter 10 levels, and gross domestic product were found to be positively associated with TB notification rate. The best-fitting multivariate spatial lag model revealed that the proportion of contacts screened for TB (β, z-value: 0.89, 2.21) positively affected TB notification rate. CONCLUSION The high TB burden in West Marmara Region should warn policymakers to maintain a focused approach to controlling TB in this area. This study showed the importance of contact tracing efforts to prevent the underdetection of TB cases.
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Affiliation(s)
- Ahmet Naci Emecen
- Dokuz Eylül University Research and Application Hospital, İzmir, Turkey
| | - Pınar Kıran
- Department of Public Health, Epidemiology Subsection, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Derya Çağlayan
- Department of Public Health, Epidemiology Subsection, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Ergönül Ö, Keske Ş, Ksinzik A, Güldan M, Özbek L, Azap A, Şimşek-Yavuz S, Can F, Sakarya S. The challenges in the monitoring of infectious diseases after the earthquake in Türkiye in 2023. THE LANCET. INFECTIOUS DISEASES 2023; 23:e482-e488. [PMID: 37419128 DOI: 10.1016/s1473-3099(23)00362-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 07/09/2023]
Abstract
After the devastating earthquake in Türkiye and Syria in February, 2023, the long-term failure to meet the need for shelter, unfavourable living conditions in tent settlements, poor access to clean drinking water, water suitable for personal hygiene, and sanitary facilities, as well as interruptions in provision of primary health-care services, have emerged as the most important risk factors contributing to the spread of infectious diseases. 3 months after the earthquake, most of these problems persist in Türkiye. Data on the control of infectious diseases are scarce according to the reports prepared by medical specialist associations based on observations of health-care providers working in the region and statements made by the local health authorities. According to these unsystematised data, and considering the conditions in the region, faecal-oral transmissible gastrointestinal infections, as well as respiratory and vector-borne infections, are the main challenges. Vaccine-preventable diseases, such as measles, varicella, meningitis, and polio can be spread in temporary shelters due to interrupted vaccine services and crowded living conditions. In addition to controlling risk factors for infectious diseases, sharing data on the status and control of infectious diseases in the region with the community, health-care providers, and relevant expert groups should be a priority to improve the understanding of the effects of interventions and prepare for possible infectious disease outbreaks.
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Affiliation(s)
- Önder Ergönül
- Koç University İşbank Center for Infectious Diseases (KUISCID), Istanbul, Türkiye; Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Türkiye.
| | - Şiran Keske
- Koç University İşbank Center for Infectious Diseases (KUISCID), Istanbul, Türkiye; Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Türkiye
| | - Apolina Ksinzik
- Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Türkiye; Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Mustafa Güldan
- Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Türkiye
| | - Laşin Özbek
- Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Türkiye
| | - Alpay Azap
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Medical Faculty, Ankara, Türkiye
| | - Serap Şimşek-Yavuz
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Medical Faculty, Istanbul, Türkiye
| | - Füsun Can
- Koç University İşbank Center for Infectious Diseases (KUISCID), Istanbul, Türkiye; Department of Medical Microbiology, Koç University School of Medicine, Istanbul, Türkiye
| | - Sibel Sakarya
- Koç University İşbank Center for Infectious Diseases (KUISCID), Istanbul, Türkiye; Department of Public Health, Koç University School of Medicine, Istanbul, Türkiye
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Tunalı V, Özbilgin A. Knock, knock, knocking on Europe 's door: Threat of leishmaniasis in Europe with a focus on Turkey. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2023; 4:100150. [PMID: 37941928 PMCID: PMC10628545 DOI: 10.1016/j.crpvbd.2023.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023]
Abstract
Leishmaniasis epidemiology is currently undergoing substantial transformations in both Turkey and Europe, signifying potential implications for public health. This review analyzes the evolving patterns within Turkey and their potential ramifications for Europe. Within Turkey, the dynamics of leishmaniasis are undergoing noteworthy alterations, manifesting in a rise in cutaneous leishmaniasis (CL) cases and the emergence of Leishmania major and Leishmania donovani. These transformations are predominantly driven by factors such as the distribution of vectors, human activities, climate fluctuations, and migration. Across Europe, particularly in countries within the Mediterranean basin, leishmaniasis is endemic, primarily attributed to Leishmania infantum. Recent evidence suggests a resurgence of the disease even in previously non-endemic areas, propelled by climate change, urbanization, and migration. The changing landscape of leishmaniasis in Turkey carries direct implications for Europe. The presence and distribution of Leishmania tropica, L. major, and L. donovani raise concerns regarding cross-border transmission. Turkey's strategic position along migration routes further compounds the risk, alongside the facilitative effects of climate change and host mobility. Embracing a One Health approach with public awareness campaigns should be a priority. To ensure the protection of public health in Europe, it is imperative to adopt a proactive approach by establishing robust surveillance mechanisms, implementing preventive measures, and cultivating collaboration with Turkey. The invaluable experience, strategic geographical location, and well-established infrastructure of Turkey make this collaboration crucial in effectively addressing the evolving dynamics of leishmaniasis and its potential impacts on Europe.
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Affiliation(s)
- Varol Tunalı
- Celal Bayar University Faculty of Medicine, Department of Parasitology, Manisa, Turkey
- Eşrefpaşa Municipality Hospital, Department of Emergency Medicine, Izmir, Turkey
| | - Ahmet Özbilgin
- Celal Bayar University Faculty of Medicine, Department of Parasitology, Manisa, Turkey
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Karami M, Gorgani-Firouzjaee T, Chehrazi M. Prevalence of cutaneous Leishmaniasis in the Middle East: a systematic review and meta-analysis. Pathog Glob Health 2023; 117:356-365. [PMID: 36222473 PMCID: PMC10177677 DOI: 10.1080/20477724.2022.2133452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Cutaneous leishmaniasis (CL), caused by an obligate intracellular protozoan parasite from the genus Leishmania, imposing a significant burden on underdeveloped countries especially those located in the Middle East. Four electronic databases were searched to evaluate the prevalence of CL in the Middle East. The random effects model (95% confidence intervals (CI)) were applied to determine the overall and subgroup pooled prevalence. Heterogeneity was assessed by Cochran's Q test and I2 statistics. Among 2424 peer-reviewed papers, 37 datasets from 34 studies were included in the current meta-analysis. 285560 individuals were assessed across 9 Middle Eastern countries. The pooled prevalence of CL was estimated at 12% (95% CI 9-15 %; 10718/285560). The highest prevalence rate was observed in Syria (39%, 37-42%), and the lowest one was found in Iraq and Lebanon (0%, 0-1%). The prevalence of CL in studies that applied LST assays had the highest rate (48%, 17-80%). The infection rate in males was similar to females (7%, 4-10%). The prevalence of infection in individuals living in urban areas was higher than in rural areas (14%, 10-19%). The prevalence of CL in the age group 0-15 years was higher than in individuals 16-40 and >40 years (9%, 6-13%). Most of the lesions were found on the face, and single lesions were more prevalent than two and three ones. In conclusion, the occurrence of CL was considerable in Middle Eastern countries. Therefore, more efforts should be made to precisely report the CL in this region for developing appropriate preventive and controlling strategies. .
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Affiliation(s)
- Mohsen Karami
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Tahmineh Gorgani-Firouzjaee
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Health Science, Babol University of Medical Sciences, Babol, Iran
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Cutaneous Leishmaniasis: A 2022 Updated Narrative Review into Diagnosis and Management Developments. Am J Clin Dermatol 2022; 23:823-840. [PMID: 36103050 PMCID: PMC9472198 DOI: 10.1007/s40257-022-00726-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 01/10/2023]
Abstract
This review is an update of an earlier narrative review published in 2015 on developments in the clinical management of cutaneous leishmaniasis (CL) including diagnosis, treatment, prevention and control measurements. CL is a vector-borne infection caused by the protozoan parasite Leishmania. The vector is the female sandfly. Globally, CL affects 12 million cases and annually 2 million new cases occur. CL is endemic in almost 100 countries and the total risk population is approximately 350 million people. WHO lists CL an emerging and uncontrolled disease and a neglected tropical disease. Local experience-based evidence remains the mainstay for the management of CL. Whereas intralesional therapeutic options are the first treatment option for most CL patients, those with mucocutaneous and disseminated involvement require a systemic therapeutic approach. Moreover, different Leishmania species can vary in their treatment outcomes. Therefore, species determination is critical for optimal CL clinical management. New DNA techniques allow for relatively easy Leishmania species determination, yet they are not easily implemented in resource-limited settings. There is a desperate need for novel, less toxic, and less painful treatment options, especially for children with CL. Yet, the large and well conducted studies required to provide the necessary evidence are lacking. To further control and potentially eliminate CL, we urgently need to improve vector control, and diagnostics, and we require efficient and safe vaccines. Alas, since CL primarily affects poor people, biotechnical companies dedicate little investment into the research programs that could lead to diagnostic, pharmaceutical, and vaccine innovations.
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Mahimbo A, Kang M, Sestakova L, Smith M, Dawson A. Factors influencing refugees' willingness to accept COVID-19 vaccines in Greater Sydney: a qualitative study. Aust N Z J Public Health 2022; 46:502-510. [PMID: 35555951 PMCID: PMC9347689 DOI: 10.1111/1753-6405.13252] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Achieving high vaccination coverage is a critical strategy to reducing the spread of COVID-19 infection. This study, undertaken before the Delta variant outbreak, aimed to understand potential drivers and barriers influencing COVID-19 vaccine uptake for refugees. METHODS Four focus group interviews were conducted with 37 refugees from four language groups (Arabic, Dari, Dinka and Karen). Data were analysed thematically. RESULTS Willingness to accept COVID-19 vaccines was associated with participants' perceptions of disease severity, and benefits such as increased immunity against COVID-19 disease and prevention of the spread of the disease. Cues for increasing individual willingness to get vaccinated included obtaining information from trusted sources and community engagement. By contrast, information gaps on vaccines compounded by misinformation on social media contributed to a reluctance to be vaccinated. CONCLUSION As this study was conducted before the Delta variant outbreak, participants' stance on COVID-19 vaccines may have changed. However, addressing vaccine literacy needs for this group remains an on-going priority. Health promotion initiatives must be tailored to the different socio-cultural contexts of each community. IMPLICATIONS FOR PUBLIC HEALTH Engagement with refugee populations is critical for optimising access and uptake of vaccines to protect health, prevent death and ensure that control of the pandemic is equitable. This may also provide valuable public health lessons for other marginalised populations.
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Affiliation(s)
- Abela Mahimbo
- School of Public Health, University of Technology Sydney, New South Wales,Correspondence to: Dr Abela Mahimbo, School of Public Health, Faculty of Health, University of Technology Sydney, Building 10, Level 8, Room 221, 235‐253 Jones St, Ultimo, NSW, 2007
| | - Melissa Kang
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales
| | | | | | - Angela Dawson
- School of Public Health, University of Technology Sydney, New South Wales
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Ekezie W, Awwad S, Krauchenberg A, Karara N, Dembiński Ł, Grossman Z, del Torso S, Dornbusch HJ, Neves A, Copley S, Mazur A, Hadjipanayis A, Grechukha Y, Nohynek H, Damnjanović K, Lazić M, Papaevangelou V, Lapii F, Stein-Zamir C, Rath B. Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10071038. [PMID: 35891201 PMCID: PMC9324407 DOI: 10.3390/vaccines10071038] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/30/2022] [Accepted: 06/14/2022] [Indexed: 01/27/2023] Open
Abstract
Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.
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Affiliation(s)
- Winifred Ekezie
- Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany; (W.E.); (S.A.)
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- College of Life Sciences, University of Leicester, Leicester LE5 4PW, UK
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
| | - Samy Awwad
- Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany; (W.E.); (S.A.)
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
- Stanford University, Palo Alto, CA 94305, USA
| | - Arja Krauchenberg
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
- European Parents Association, 1000 Brussels, Belgium
| | - Nora Karara
- Young European Academy of Paediatrics, 1000 Brussels, Belgium;
- Evangelical Hospital Queen Elisabeth Herzberge, 10365 Berlin, Germany
| | - Łukasz Dembiński
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Zachi Grossman
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Stefano del Torso
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Hans Juergen Dornbusch
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Ana Neves
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Sian Copley
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Artur Mazur
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Adamos Hadjipanayis
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Yevgenii Grechukha
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland;
| | - Kaja Damnjanović
- Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia;
| | - Milica Lazić
- Faculty of Philosophy, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Vana Papaevangelou
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | - Fedir Lapii
- European Academy of Paediatrics, 1000 Brussels, Belgium; (Ł.D.); (Z.G.); (S.d.T.); (H.J.D.); (A.N.); (S.C.); (A.M.); (A.H.); (Y.G.); (V.P.); (F.L.)
| | | | - Barbara Rath
- Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany; (W.E.); (S.A.)
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- ImmuHubs Consortium, Coordinating Entity: Vienna Vaccine Safety Initiative e.V., 10437 Berlin, Germany;
- Correspondence:
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Güven Gökmen T, Yakici G, Kalayci Y, Turut N, Meral Ocal M, Haligür M, Günaydin E, Köksal F. Molecular characterization of Mycobacterium bovis strains isolated from cattle and humans by spoligotyping and 24-locus MIRU-VNTR, and prevalence of positive IGRA in slaughterhouse workers in Southern Turkey. IRANIAN JOURNAL OF VETERINARY RESEARCH 2022; 23:210-218. [PMID: 36425601 PMCID: PMC9681978 DOI: 10.22099/ijvr.2022.42580.6186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/09/2022] [Accepted: 06/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mycobacterium bovis is a zoonotic member of the Mycobacterium tuberculosis complex with a wide range of hosts, mainly cattle. Molecular epidemiological studies should be conducted to determine the transmission route, zoonotic risk factors, and phylogenetic relationships of M. bovis strains. Aims: This study aimed to characterize bovine and human M. bovis isolates by molecular methods. METHODS Molecular characterization and clonal relationship of strains isolated from tissue and organ samples of 76 cattle with positive tuberculin tests were collected from a slaughterhouse, and four M. bovis strains isolated from clinical materials of patients with suspected pulmonary TB isolates were analyzed using 24-locus MIRU-VNTR and spoligotyping methods. QuantiFERON-TB Gold Plus (QFT-Plus; Qiagen) was used to determine the prevalence of latent TB infection among 21 slaughterhouse personnel including 7 veterinarians, 12 butchers, 1 caretaker, and 1 veterinary technician. RESULTS SB0288/SIT685 type was detected in both cattle and humans by the spoligotyping method. When evaluating MIRU-VNTR, the presence of a 100% compatible pattern between human and bovine isolates was not detected, but some human samples were found to be 91.6% similar to a bovine sample. In addition, 21 slaughterhouse workers were screened with the interferon gamma-released assay (IGRA) and a 23.8% positivity was detected. CONCLUSION Clonal similarity was determined between the bovine and human isolates using the MIRU-VNTR and spoligotyping methods and IGRA positivity in the occupational group suggested that M. bovis might be associated with pulmonary tuberculosis in humans.
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Affiliation(s)
- T. Güven Gökmen
- Department of Microbiology, Ceyhan Veterinary Faculty, Cukurova University, 01330, Adana, Turkey
| | - G. Yakici
- Tuberculosis Region Laboratory, Tropical Disease and Research Center, Cukurova University, 01330, Adana, Turkey
| | - Y. Kalayci
- Microbiology Laboratory, Adana City Hospital, 01230, Adana, Turkey
| | - N. Turut
- MSc, Microbiology Laboratory, Adana Veterinary Control Institute, 01250, Adana, Turkey
| | - M. Meral Ocal
- Department of Microbiology, Medicine Faculty, Cukurova University, 01330, Adana, Turkey
| | - M. Haligür
- Department of Pathology, Ceyhan Veterinary Faculty, Cukurova University, 01330, Adana, Turkey
| | - E. Günaydin
- Department of Microbiology, Veterinary Faculty, Kastamonu University, 37150, Kastamonu, Turkey
| | - F. Köksal
- Department of Microbiology, Medicine Faculty, Cukurova University, 01330, Adana, Turkey
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Aljadeeah S, Wirtz VJ, Nagel E. Cross-sectional survey to describe medicine use among Syrian asylum seekers and refugees in a German federal state: looking beyond infectious diseases. BMJ Open 2021; 11:e053044. [PMID: 34588262 PMCID: PMC8479972 DOI: 10.1136/bmjopen-2021-053044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aim of our study was to describe medicine use and document self-reported diseases or conditions for which medicines were used among Syrian asylum seekers and refugees (AS&Rs) in the German state of North Rhine-Westphalia (NRW). We examined in this study differences in the use of medicines among different age and sex groups of the study participants. SETTING Fifteen different refugee shared accommodation centres in the greater Cologne area, a community centre with a language school and consultation office, and other places frequented by the Syrian community. PARTICIPANTS Syrian AS&Rs registered in NRW and residing in the city of Cologne or surrounding areas. PRIMARY OUTCOME MEASURES The prevalence of using at least one medicine in the 7 days preceding data collection, and the use of prescribed medicines and self-medication. RESULTS Of the 1641 Syrian AS&Rs who took part in our study, the overall 7-day prevalence of medicine use was 34.9%. Among adults, headache and hypertension were the most common indications that led to medicine use. By dose, hypertension (954 doses) and diabetes (595 doses) were the first and second most frequent indication. Among children, fever and cough were the most common indication; ibuprofen and hederae helicis folium preparations were the most used medicines. Low prevalence was found of medicine use for the treatment of either infectious diseases or mental disorders. CONCLUSION Among the Syrian AS&Rs in NRW who participated in the study, non-communicable diseases (NCDs) were common presumed causes of use of medication among adults. We encourage future studies to pay more attention to NCDs medicine use among AS&Rs. Researchers should also consider reaching AS&Rs who live in private housing and not limit studies only to newly arrived AS&Rs who live in shared accommodation centres.
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Affiliation(s)
- Saleh Aljadeeah
- Institute of Medical Management and Health Science, University of Bayreuth, Bayreuth, Germany
| | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Eckhard Nagel
- Institute of Medical Management and Health Science, University of Bayreuth, Bayreuth, Germany
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11
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Sahin E, Dagli TE, Acarturk C, Sahin Dagli F. Vulnerabilities of Syrian refugee children in Turkey and actions taken for prevention and management in terms of health and wellbeing. CHILD ABUSE & NEGLECT 2021; 119:104628. [PMID: 32739068 PMCID: PMC7388819 DOI: 10.1016/j.chiabu.2020.104628] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 07/05/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The Syrian crisis, which started in March 2011, has resulted in the displacement of 6.3 million refugees predominantly to neighboring countries in addition to the internal displacement of 6.2 million people. Turkey is the country hosting the largest number of refugees in the world with 3.6 million Syrian refugees 46 % of which are under 18 years old. OBJECTIVE The purpose of this article is to conduct a narrative review and analyze the vulnerabilities of refugee children in Turkey from the lens of the Sustainable Development Goals (SDG), more specifically SDG Goal 3: Good Health and Wellbeing, with a specific focus on Syrian refugee children. Moreover, this article explores the actions taken to prevent and mitigate issues that arise from these vulnerabilities. METHOD This narrative review article collected data from various primary and secondary sources on the Turkish refugee framework including national and international legislation, governmental and non-governmental data and reports, and scientific papers. RESULTS Syrian refugee children in Turkey are facing a variety of risks in terms of their health and wellbeing including communicable and non-communicable diseases, post-traumatic stress disorder, depression, family violence, child labor, and child marriage. The measures taken for prevention and response by governmental and non-governmental entities are multilateral and aim to address issues from multiple perspectives including medical, psychosocial, child protection, and legal. CONCLUSIONS The interventions and restructuring of the health system in Turkey contribute to the SDG number 3 for refugee children. The existence of a legal system which enables refugee access to health, protection, and other social services is key to achieve this goal. However, the existing system could be improved especially through solidifying the legal basis and centralizing the implementation for child and refugee protection. The engagement of all stakeholders to improve the health and wellbeing of refugee children remains vital.
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Affiliation(s)
- Ecem Sahin
- Child Protection Centers Support Society, Istanbul, Turkey.
| | - Tolga E Dagli
- Emeritus Prof Department of Pediatric Surgery, Marmara University, Istanbul, Turkey.
| | - Ceren Acarturk
- Department of Psychology, Koc University, Istanbul, Turkey.
| | - Figen Sahin Dagli
- Emeritus Prof Department of Pediatrics, Gazi University, Ankara, Turkey.
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12
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COVID-19 barriers and response strategies for refugees and undocumented migrants in Turkey. J Migr Health 2021; 1-2:100012. [PMID: 34405167 PMCID: PMC8352003 DOI: 10.1016/j.jmh.2020.100012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/16/2020] [Accepted: 11/28/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction With more than 40 million confirmed cases of COVID-19 globally, the pandemic is continuing to severely challenge health systems around the world. Countries with high numbers of refugees face an additional burden on COVID-19 preventive and curative services made available and accessible to refugees. Turkey hosts the largest number of refugees globally, with a total of 4 million in 2020. Over 98% of refugees in Turkey reside in urban areas in large, crowded cities such as Istanbul, Gaziantep, and Hatay posing severe challenges for all health responses, including COVID-19. This study provides insights and analysis on the current situation for refugees, migrants under temporary protection and undocumented migrants in Turkey by focusing on the right to health and access to health care under pandemic conditions. Its main aim is to discuss the challenges and opportunities for COVID-19 responses relating to refugees, migrants under temporary protection and undocumented migrants in Turkey. Methods This is a non- systematic and exploratory literature review from academic and grey sources. We reviewed published documents, meeting summaries, media reports/news and policy briefs in Turkish and English on the COVID-19 response in Turkey. Results Since the start of the COVID-19 outbreak in Turkey, the Ministry of Health (MoH) has taken various steps to provide health care for all residents. However, several challenges arise when providing health care to refugees, migrants under temporary protection and other undocumented migrants including language barrier in accessing reliable information and access to health services for existing chronic conditions. Conclusion While refugees, migrants under temporary protection and undocumented migrants have been granted access to services for COVID-19 related health problems, social and cultural barriers remain beyond the current legislation. Solidarity and whole-of-society inclusive approaches should always be the guiding principles in the COVID-19 response.
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13
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Alseed MM, Syed H, Onbasli MC, Yetisen AK, Tasoglu S. Design and Adoption of Low-Cost Point-of-Care Diagnostic Devices: Syrian Case. MICROMACHINES 2021; 12:mi12080882. [PMID: 34442504 PMCID: PMC8401864 DOI: 10.3390/mi12080882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
Civil wars produce immense humanitarian crises, causing millions of individuals to seek refuge in other countries. The rate of disease prevalence has inclined among the refugees, increasing the cost of healthcare. Complex medical conditions and high numbers of patients at healthcare centers overwhelm the healthcare system and delay diagnosis and treatment. Point-of-care (PoC) testing can provide efficient solutions to high equipment cost, late diagnosis, and low accessibility of healthcare services. However, the development of PoC devices in developing countries is challenged by several barriers. Such PoC devices may not be adopted due to prejudices about new technologies and the need for special training to use some of these devices. Here, we investigated the concerns of end users regarding PoC devices by surveying healthcare workers and doctors. The tendency to adopt PoC device changes is based on demographic factors such as work sector, education, and technology experience. The most apparent concern about PoC devices was issues regarding low accuracy, according to the surveyed clinicians.
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Affiliation(s)
- M. Munzer Alseed
- Institute of Biomedical Engineering, Boğaziçi University, Çengelköy, Istanbul 34684, Turkey;
| | - Hamzah Syed
- School of Medicine, Koç University, Sariyer, Istanbul 34450, Turkey;
- Koç University Research Center for Translational Medicine, Koç University, Sariyer, Istanbul 34450, Turkey;
| | - Mehmet Cengiz Onbasli
- Koç University Research Center for Translational Medicine, Koç University, Sariyer, Istanbul 34450, Turkey;
- Department of Electrical and Electronics Engineering, Koç University, Sariyer, Istanbul 34450, Turkey
| | - Ali K. Yetisen
- Department of Chemical Engineering, Imperial College London, London SW7 2AZ, UK;
| | - Savas Tasoglu
- Institute of Biomedical Engineering, Boğaziçi University, Çengelköy, Istanbul 34684, Turkey;
- Koç University Research Center for Translational Medicine, Koç University, Sariyer, Istanbul 34450, Turkey;
- Center for Life Sciences and Technologies, Bogazici University, Bebek, Istanbul 34342, Turkey
- Koç University Arçelik Research Center for Creative Industries (KUAR), Koç University, Sariyer, Istanbul 34450, Turkey
- Department of Mechanical Engineering, Koç University, Sariyer, Istanbul 34450, Turkey
- Correspondence:
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14
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Osman M, Rafei R, Ismail MB, Omari SA, Mallat H, Dabboussi F, Cazer C, Karah N, Abbara A, Hamze M. Antimicrobial resistance in the protracted Syrian conflict: halting a war in the war. Future Microbiol 2021; 16:825-845. [PMID: 34223789 DOI: 10.2217/fmb-2021-0040] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The Syrian conflict has damaged key infrastructure and indirectly affected almost all parts of the Middle East and Europe, with no end in sight. Exhausting conditions created by the Syrian crisis and related massive displacement promote the emergence of numerous public health problems that fuel antimicrobial resistance (AMR) development. Here, we explore the current situation of the Syrian displaced population, and AMR inside Syria and among refugees in host countries. We then suggest a roadmap of selected key interventions and strategies to address the threat of AMR in the context of the Syrian crisis. These recommendations are intended to urge health policy-makers in governments and international health organizations to optimize and push for implementing an effective policy taking into consideration the current obstacles.
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Affiliation(s)
- Marwan Osman
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Department of Population Medicine & Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA
| | - Rayane Rafei
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Mohamad Bachar Ismail
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Faculty of Sciences, Lebanese University, Tripoli, Lebanon
| | - Sarah Al Omari
- Department of Epidemiology & Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hassan Mallat
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Casey Cazer
- Department of Population Medicine & Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA
| | - Nabil Karah
- Department of Molecular Biology, Umeå Centre for Microbial Research, Umeå University, Umeå, Sweden
| | - Aula Abbara
- Department of Infection, Imperial College, London, UK
| | - Monzer Hamze
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
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15
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Badur S, Öztürk S, Ozakay A, Khalaf M, Saha D, Van Damme P. A review of the experience of childhood hepatitis A vaccination in Saudi Arabia and Turkey: implications for hepatitis A control and prevention in the Middle East and North African region. Hum Vaccin Immunother 2021; 17:3710-3728. [PMID: 34213403 DOI: 10.1080/21645515.2021.1920871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In most countries of the Middle East and Northern African (MENA) region, a high hepatitis A virus (HAV) endemicity has been documented. Few others, such as Saudi Arabia and Turkey, are transitioning from high to intermediate endemicity. There is a paucity of recently published HAV disease burden that could be useful to inform or strengthen relevant national hepatitis A vaccination policy and other prevention strategies in the region. This review summarizes information on HAV epidemiology before and after the implementation of a childhood hepatitis A vaccination program in Saudi Arabia and Turkey. In both countries, a clear shift in the age of first HAV exposure has been documented, with more homogeneous trends across regions in Saudi Arabia compared to Turkey. Utilizing the experience of Saudi Arabia and Turkey with hepatitis A vaccination, countries in the region are encouraged to foster discussions on potential vaccination strategies suitable for their own setting.
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Affiliation(s)
- Selim Badur
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | - Serdar Öztürk
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | - Alev Ozakay
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | | | - Debasish Saha
- Medical & Clinical Emerging Markets, GSK, Wavre, Belgium
| | - Pierre Van Damme
- Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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16
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Erdinc FS, Dokuzoguz B, Unal S, Komur S, Inkaya AC, Inan D, Karaoglan I, Deveci A, Celen MK, Kose S, Erben N, Senturk GC, Heper Y, Kutlu SS, Hatipoglu CA, Sumer S, Kandemir B, Sirmatel F, Bayindir Y, Yilmaz E, Ersoy Y, Kazak E, Yildirmak MT, Kayaaslan B, Ozden K, Sener A, Kara A, Gunal O, Birengel S, Akbulut A, Yetkin F, Cuvalci NO, Sargin F, Pullukcu H, Gokengin D, Multicentric Hiv Study Group. Temporal Trends in the Epidemiology of HIV in Turkey. Curr HIV Res 2021; 18:258-266. [PMID: 32342820 DOI: 10.2174/1570162x18666200427223823] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the temporal trends of HIV epidemiology in Turkey from 2011 to 2016. METHODS Thirty-four teams from 28 centers at 17 different cities participated in this retrospective study. Participating centers were asked to complete a structured form containing questions about epidemiologic, demographic and clinical characteristics of patients presented with new HIV diagnosis between 2011 and 2016. Demographic data from all centers (complete or partial) were included in the analyses. For the cascade of care analysis, 15 centers that provided full data from 2011 to 2016 were included. Overall and annual distributions of the data were calculated as percentages and the Chi square test was used to determine temporal changes. RESULTS A total of 2,953 patients between 2011 and 2016 were included. Overall male to female ratio was 5:1 with a significant increase in the number of male cases from 2011 to 2016 (p<0.001). The highest prevalence was among those aged 25-34 years followed by the 35-44 age bracket. The most common reason for HIV testing was illness (35%). While the frequency of sex among men who have sex with men increased from 16% to 30.6% (p<0.001) over the study period, heterosexual intercourse (53%) was found to be the most common transmission route. Overall, 29% of the cases presented with a CD4 count of >500 cells/mm3 while 46.7% presented with a CD4 T cell count of <350 cells/mm3. Among newly diagnosed cases, 79% were retained in care, and all such cases initiated ART with 73% achieving viral suppression after six months of antiretroviral therapy. CONCLUSION The epidemiologic profile of HIV infected individuals is changing rapidly in Turkey with an increasing trend in the number of newly diagnosed people disclosing themselves as MSM. New diagnoses were mostly at a young age. The late diagnosis was found to be a challenging issue. Despite the unavailability of data for the first 90, Turkey is close to the last two steps of 90-90-90 targets.
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Affiliation(s)
- F S Erdinc
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - B Dokuzoguz
- Ankara Numune Training and Researh Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - S Unal
- Hacettepe Universitesi Hastaneleri, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - S Komur
- Cukurova University, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkey
| | - A C Inkaya
- Ankara Numune Training and Researh Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - D Inan
- Akdeniz University, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - I Karaoglan
- Gaziantep University, Department of Infectious Diseases and Clinical Microbiology, Gaziantep, Turkey
| | - A Deveci
- Ondokuz Mayis University, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
| | - M K Celen
- Dicle University, Department of Infectious Diseases and Clinical Microbiology, Diyarbakır, Turkey
| | - S Kose
- Izmir Tepecik Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey
| | - N Erben
- Eskisehir Osmangazi University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Eskisehir, Turkey
| | - G C Senturk
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Y Heper
- Uludag University, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - S S Kutlu
- Pamukkale University, Department of Infectious Diseases and Clinical Microbiology, Denizli, Turkey
| | - C A Hatipoglu
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - S Sumer
- Selcuk University, Department of Infectious Diseases and Clinical Microbiology, Konya, Turkey
| | - B Kandemir
- Necmettin Erbakan University, Meram Medical Faculty Hospital, Department of Infectious Diseases and Clinical Microbiology, Konya, Turkey
| | - F Sirmatel
- Abant Izzet Baysal University, Department of Infectious Diseases and Clinical Microbiology, Bolu, Turkey
| | - Y Bayindir
- Inonu University, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
| | - E Yilmaz
- Uludag University, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - Y Ersoy
- Inonu University, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
| | - E Kazak
- Uludag University, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - M T Yildirmak
- Okmeydani Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - B Kayaaslan
- Yildirim Beyazit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - K Ozden
- Ataturk University, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey
| | - A Sener
- Canakkale Onsekiz Mart University, Department of Infectious Diseases and Clinical Microbiology, Canakkale, Turkey
| | - A Kara
- Hacettepe University Ihsan Dogramaci Children's Hospital, Department of Infectious Diseases, Ankara, Turkey
| | - O Gunal
- Samsun Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
| | - S Birengel
- Ankara University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - A Akbulut
- Firat University, Department of Infectious Diseases and Clinical Microbiology, Elazig, Turkey
| | - F Yetkin
- Inonu University, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
| | - N O Cuvalci
- Antalya Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - F Sargin
- Medeniyet University Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Pullukcu
- Ege University, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - D Gokengin
- Ege University, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
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Yenilmez E, Kakalicoglu D, Bozkurt F, Filiz M, Akkol Camurcu A, Damar Midik EO, Berk Cam H, Arkali E, Bilgic Atli S, Sahin A, Yorulmaz Goktas S, Erkan H, Ceylan MR, Kacar Eker M, Kaya H, Karacaer Z, Tural E, Dokmetas İ, Gorenek L, Kose S. Fever of unknown origin (FUO) on a land on cross-roads between Asia and Europa; a multicentre study from Turkey. Int J Clin Pract 2021; 75:e14138. [PMID: 33683769 DOI: 10.1111/ijcp.14138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/27/2020] [Accepted: 03/04/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO aetiology and factors influencing the final diagnosis of FUO in Turkey. METHODS A total of 214 patients with FUO between the years 2015 and 2019 from 13 tertiary training and research hospitals were retrospectively evaluated. RESULTS The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult-onset still's disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The aetiological spectrum did not differ in elderly people (P < .05). Infections were less frequent in Western (34.62%) compared with Eastern regions of Turkey (60.71%) (P < .001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed aetiology was significantly higher in elderly people (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (P: .004, OR: 3.07, 95% Cl: 1.39 to 6.71). CONCLUSIONS Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumours and lymphomas, AOSD and thyroiditis are the other common diseases. The aetiological spectrum did not differ in elderly people, on the other hand, infections were more common in Eastern Turkey. A considerable amount of aetiology remained undiagnosed despite the state-of-the-art technology in healthcare services.
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Affiliation(s)
- Ercan Yenilmez
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Deniz Kakalicoglu
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Fatma Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Mine Filiz
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Aysegul Akkol Camurcu
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Elif Ozge Damar Midik
- Department of Infectious Diseases and Clinical Microbiology, Kartal Lutfi Kirdar City Hospital, University of Health Sciences, Uskudar, Turkey
| | - Hande Berk Cam
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Eren Arkali
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, University of Health Sciences, Konak, Turkey
| | - Seval Bilgic Atli
- Department of Infectious Diseases and Clinical Microbiology, Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Ahmet Sahin
- Department of Infectious Diseases and Clinical Microbiology, Mehmet Akif Inan Training and Research Hospital, University of Health Sciences, Sanliurfa, Turkey
| | - Sibel Yorulmaz Goktas
- Department of Infectious Diseases and Clinical Microbiology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Halil Erkan
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, University of Health Sciences, Konak, Turkey
| | - Mehmet Resat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Merve Kacar Eker
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Hava Kaya
- Department of Infectious Diseases and Clinical Microbiology, Adana City Hospital, University of Health Sciences, Adana, Turkey
| | - Zehra Karacaer
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ersin Tural
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - İlyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Levent Gorenek
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, University of Health Sciences, Konak, Turkey
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18
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Childhood tuberculosis in a reference children's hospital after admission of refugees. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.848937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Kurtuluş Ş, Can R, Sak ZHA. New perspective on rise of tuberculosis cases: communal living. Cent Eur J Public Health 2020; 28:302-305. [PMID: 33338367 DOI: 10.21101/cejph.a6016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 10/16/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Forced migration caused by wars has led to regression in health parameters, including tuberculosis. This study aims to determine the relationship between living area, family type and the number of contacts among refugees and Turkish citizens diagnosed with tuberculosis. METHOD This study was designed using retrospective file scanning. A total of 194 patients with diagnosed TB were included in this study. In addition, patients' addresses were visited and their family lifestyles and living areas were recorded. RESULTS Of 194 patients in the age range of 1-72 years (mean = 31.15, SD = 15.16), 98 patients were refugees. The number of contacts among refugees was 549, and their total living area was 7,740 m2. A total of 57 refugees lived in a communal living situation, and their average living area was significantly lower than that of Turkish citizens. Statistical significance was observed between family lifestyle and habitats. This was found due to the difference between nuclear families and communal living situations. CONCLUSION Tuberculosis was found to infect more people in war-related living conditions. This situation is caused by communal living, which refers to people who are not blood relatives living together; this is new information. Communal life should be taken into account in the contact examination of refugees for tuberculosis, and the obstacles to reach health services for refugees living outside of camps should be examined.
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Affiliation(s)
- Şerif Kurtuluş
- Department of Chest Diseases, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Remziye Can
- Mustafa Kemal Ataturk Vocational and Technical Anatolian High School, Eskisehir, Turkey
| | - Zafer Hasan Ali Sak
- Department of Chest Diseases, Faculty of Medicine, Harran University, Sanliurfa, Turkey
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Heterogeneity in social and epidemiological factors determines the risk of measles outbreaks. Proc Natl Acad Sci U S A 2020; 117:30118-30125. [PMID: 33203683 DOI: 10.1073/pnas.1920986117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Political and environmental factors-e.g., regional conflicts and global warming-increase large-scale migrations, posing extraordinary societal challenges to policymakers of destination countries. A common concern is that such a massive arrival of people-often from a country with a disrupted healthcare system-can increase the risk of vaccine-preventable disease outbreaks like measles. We analyze human flows of 3.5 million (M) Syrian refugees in Turkey inferred from massive mobile-phone data to verify this concern. We use multilayer modeling of interdependent social and epidemic dynamics to demonstrate that the risk of disease reemergence in Turkey, the main host country, can be dramatically reduced by 75 to 90% when the mixing of Turkish and Syrian populations is high. Our results suggest that maximizing the dispersal of refugees in the recipient population contributes to impede the spread of sustained measles epidemics, rather than favoring it. Targeted vaccination campaigns and policies enhancing social integration of refugees are the most effective strategies to reduce epidemic risks for all citizens.
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Dinleyici EC, Borrow R. Meningococcal infections among refugees and immigrants: silent threats of past, present and future. Hum Vaccin Immunother 2020; 16:2781-2786. [PMID: 32347773 PMCID: PMC7746237 DOI: 10.1080/21645515.2020.1744979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Globally, there is an increasing number of international migrants. The majority are forced displaced refugees and children unaccompanied by a caregiver, and have limited access to essential public health interventions. Routine vaccination might be interrupted or be incomplete due to conflict areas with limited public health services or a long-unplanned journey. Refugees and migrants may bring infectious disease risks to their country of destination and may be exposed to new risk factors during transit or at their destination. There are lessons learned strategies among refugees and asylum seekers in different countries (vaccination campaign during outbreak, maintain vaccination systems for refugees and medical screening and/or vaccination on arrival) against vaccine-preventable diseases – other than meningococcal infections. Since the 1980s, invasive meningococcal disease (IMD) has been reported as a critical healthcare issue in places of humanitarian crisis such as Thailand and African’s meningitis belt. Refugees and migrants are at increased risk of IMD compared with the overall population due to sero-epidemiology in their country of origin, specific characteristics of the IMD, and a number of contacts during the journey. Recently, IMD cases due to serogroups X and W have been reported and are an emerging health threat for persons arriving from Africa to refugee camps in Italy. There have been sporadic case reports of IMD due to serogroup B in Turkey; however, there has not yet been increased disease activity in this population and no outbreaks have been observed. Outbreaks of IMD in refugee camps have been and could be successfully controlled through the implementation of timely and high-coverage vaccination campaigns, and individual cases of IMD can be treated with antibiotics. Research is needed to determine the prevalence of meningococcal carriage and serogroup distribution among refugees and migrants to inform vaccine recommendations. There is no official recommendation for meningococcal vaccination of refugees. Further strategies for prevention and treatment of human immunodeficiency virus, tuberculosis and antibiotic resistance among refugees are directly related to potential prevention methods for IMD. Meningococcal vaccines have been administered only to risk groups in most host countries Thus, further strategies for the definition of new/emerging risk factors for IMD would be helpful to guide vaccine implementation for refugees and immigrants.
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Affiliation(s)
- Ener Cagri Dinleyici
- Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine , Eskisehir, Turkey
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England , Manchester, UK
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22
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Erenoğlu R, Yaman Sözbir Ş. The Effect of Health Education Given to Syrian Refugee Women in Their Own Language on Awareness of Breast and Cervical Cancer, in Turkey: a Randomized Controlled Trial. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:241-247. [PMID: 31414370 DOI: 10.1007/s13187-019-01604-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In general, refugees have an increased cancer burden because of living in difficult conditions and having low income. Refugee women may have difficulty in accessing healthcare services because of the fear of uncertainty, security concerns, language barriers, cultural differences, and economic problems. For this reason, it is thought that health education given to Syrian refugee women by overcoming the language problem (given in their own language-Arabic) increases the awareness of breast and cervical cancer. The aim of this study is to evaluate the effect of health education given to refugee women in their own language on the awareness of breast and cervical cancer. This is a randomized controlled trial with one control and one intervention group. The research sample consisted of 60 Syrian women (30 experiments, 30 controls), at least 18 years old, married, and literate women who were refugees in Hatay/Turkey. The research data were collected via the questionnaire form developed by the researchers. At the beginning of the study, there was no statistically significant difference in terms of age, education, economic status, gravida, and parity among the women in the experimental and control groups (p > 0.05). There was no statistically significant difference between the pre-test mean scores of the experimental and control groups (p > 0.05). However, there was a statistically significant difference between the post-test mean scores of the experimental and control groups (p < 0.005). In this study, it was determined that health education given to refugee women in their own language had a significant effect on breast and cervical cancer awareness. The attitudes and motivations are shaped, not only by personal information but also by the cultural changes within the community.
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Affiliation(s)
- Rabiye Erenoğlu
- Nursing Department, Gyneacology and Obstetric Nursıng Department, Hatay Healthy High School, Mustafa Kemal University, Tayfur Sökmen Campus Alahan, 31060, Antakya, Hatay, Turkey.
| | - Şengül Yaman Sözbir
- Nursing Department, Gynecology and Obstetric Nursing Department, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Muhjazi G, Gabrielli AF, Ruiz-Postigo JA, Atta H, Osman M, Bashour H, Al Tawil A, Husseiny H, Allahham R, Allan R. Cutaneous leishmaniasis in Syria: A review of available data during the war years: 2011-2018. PLoS Negl Trop Dis 2019; 13:e0007827. [PMID: 31830034 PMCID: PMC6907761 DOI: 10.1371/journal.pntd.0007827] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) has historically been reported from Syria. Since 2011, the country has been affected by a war, which has impacted health and health services. Over the same period, an increase in the number of cases of CL has been reported from several areas across the country and by a number of authors. This study aims to provide the first quantitative evidence of the epidemiological evolution of CL in Syria during the war. MATERIALS AND METHODS Data on number of CL cases for the period 2011-2018 were extracted from three different surveillance systems: the Ministry of Health (MoH) routine surveillance system, the MoH/WHO sentinel-syndromic Early Warning Alert and Response System (EWARS), and surveillance data collected by the international nongovernmental organization (NGO) the MENTOR Initiative. Data were cleaned and merged to generate the best possible estimates on number of CL cases; incidence of CL was also calculated based on data on resident population. Data reported from the years preceding the conflict (2007-2010) were also added to the analysis for comparative purposes. RESULTS The analysis of data from the three available sources over the period considered indicates that number of reported cases progressively grew from prewar levels to reach a peak in 2015, decreased in 2016, remained stable in 2017, and increased again in 2018. Such a trend was mirrored by changes in incidence of infection. Some governorates, which used to report low numbers of CL cases, started recording higher number of cases after the onset of the war. CONCLUSION The war coincided with a major rise in reported number of CL cases and incidence of infection, although an increasing trend was already appreciable before its onset.
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Affiliation(s)
- Ghada Muhjazi
- Department of Communicable Disease Prevention and Control, WHO/EMRO Regional Office for the Eastern Mediterranean, Cairo, Egypt
- * E-mail:
| | - Albis Francesco Gabrielli
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - José Antonio Ruiz-Postigo
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Hoda Atta
- Department of Communicable Disease Prevention and Control, WHO/EMRO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Mona Osman
- Department of Communicable Disease Prevention and Control, WHO/EMRO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | | | | | - Hania Husseiny
- Syria WHO Country Office, World Health Organization, Damascus, Syria
| | - Rasmieh Allahham
- Syria WHO Country Office, World Health Organization, Damascus, Syria
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