Public Health 2 الصحة العامة
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- Item"Assessing Antibiotic Prescriptions and Incidence of Urinary Tract Infection in Pregnant Women Attending Primary Health Care in Nablus City – Palestine "(Al-Quds University, 2025-08-12) Lara Zahi Adel Khatatba; لارا زاهي عادل خطاطبةUrinary tract infections (UTIs) are a common complication during pregnancy, with up to 20% of pregnant women affected. Empirical antibiotic prescribing is frequent, yet often lacks microbiological confirmation, which contributes to the rising incidence of antimicrobial resistance (AMR). In Palestine, limited data exist on the appropriateness of antibiotic use and resistance patterns among pregnant women. Aim: This study aims to assess the appropriateness of existing antibiotic prescribing practices for UTIs among pregnant women within Nablus's primary healthcare system. It also seeks to identify the prevalence of recurrent and antibiotic-resistant UTIs. Methodology: A prospective cohort study was conducted between December 2024 and May 2025 in primary healthcare clinics in Nablus, Palestine. A total of 485 pregnant women were enrolled. Data were collected using structured questionnaires and laboratory analyses, including urine cultures and antibiotic susceptibility testing. Antibiotic prescriptions were evaluated against international guidelines, particularly those from the American College of Obstetricians and Gynecologists (ACOG). Results: Among participants who underwent urine culture (n = 279), 115 (41.2%) had culture-confirmed UTIs. Escherichia coli (38.3%) and Staphylococcus aureus (22.6%) were the most commonly isolated pathogens. Multidrug resistance was observed in 52% of isolates. Empirical antibiotic treatment was common (55.5%), while 77.3% of prescribed antibiotics followed appropriate dosing and duration, with only 22.7% aligned with ACOG-recommended first-line therapies for pregnancy. Among the 120 participants followed for 90 days, recurrent UTI was identified in 18 cases (15%). However, recurrence was not significantly associated with age, income, parity, trimester, or history of abortion. Conclusions: Although empirical prescribing practices generally met standards for dosage and duration, antibiotic selection often diverged from first-line recommendations. The high rate of multidrug resistance underscores the urgent need for improved diagnostic practices and adherence to evidence-based guidelines. Strengthening antimicrobial stewardship in antenatal care is essential to improving maternal outcomes and reducing AMR in resource-limited settings. Keywords: Antibiotic prescribing, Antibiotic stewardship, Antimicrobial resistance, Asymptomatic bacteriuria, Escherichia coli, Multidrug resistance, Palestine, Pregnancy, Primary health care, Urinary tract infection
- ItemPrevalence of Vulvovaginal Candidiasis among Pregnant Women Attending an Antenatal Clinics in East Jerusalem(Al-Quds University, 2025-01-08) Halema Mahmoud Ata Durgham; حليمة محمود عطا ضرغامCandida is the most prevalent opportunistic and pathogenic fungus in humans. Vulvovaginal candidiasis (VVC) is the second most common vaginal infection among women of reproductive age. It impacts 75% of women at least once during their lifetime, with 50% encountering a recurrence. The prevalence of Candida spp. rises from 10 to 17% in non pregnant women to 35% during pregnancy. In Palestine, there is a lack of documented data concerning Candida infections. Methods: A case-control study evaluated the prevalence of vulvovaginal candidiasis (VVC) among pregnant women at RCSH Jerusalem, identified associated risk factors, and isolated Candida species, regardless of clinical manifestations. Between July 2023 and July 2024, there were 240 VVC-pregnant women, comprising 115 cases and 125 controls. Data were analyzed utilizing descriptive and inferential statistics through SPSS. Results: The study found a higher prevalence of candidiasis in the case group (50.4%). From 115 case samples, 58 pregnant women had Candida. Seven species were found in these samples. C. albicans (33%), C. tropicalis (26%), C. glabrata (10%), C. kefyr (10%), C. krusei (9%), C. utilis (7%) and C. dubliniensis (5%). The study found significant factors associated with candidiasis, including pregnancy-related factors, clinical history, and behavioral practices. Symptoms include vaginal discharge, itching, burning, and dysuria. Understanding these associations is crucial for prevention and management. Conclusions: This study highlights the prevalence and risk factors of candidiasis, emphasizing the importance of precise diagnosis and treatment. It suggests that demographic surveys may not be as effective as specialized therapies. Future research should explore complex connections between risk factors and candidiasis. Keywords: VVC, Pregnant women, Prevalence, Candida.
- ItemWomen’s Knowledge, Attitudes, and Practices On Preconception Care in the Southern West Bank(Al-Quds University, 2025-07-20) jawad abu khiran; جواد عبد اللطيف حسن أبو خيرانPreconception care (PCC) is a vital public health approach that enhances maternal and neonatal outcomes by addressing health risks before conception. Despite its significance, awareness and utilization of PCC services remain low among women in Palestine. In 2020, only 37.4% of pregnant women were registered for antenatal care in Ministry of Health (MoH) primary healthcare centers, averaging 3.4 visits per pregnancy, which reflects gaps in engagement with reproductive healthcare. Aim: to evaluate the levels of knowledge, attitudes, and practices (KAP) regarding PCC among women of reproductive age in the Southern West Bank. Methodology: A cross-sectional design was utilized. A convenient sampling method was employed to select participants from primary healthcare clinics throughout the Southern West Bank. Data were collected using a structured questionnaire that assessed knowledge, attitudes, and practices related to PCC, along with socio-demographic characteristics. The study involved a sample of 308 women. Statistical analysis was conducted using SPSS software, which included descriptive statistics, and chi-square tests. Results:Findings indicated that 98% of the participants had a high level of awareness regarding the use of folic acid before and during pregnancy. They were aware that neural tube defects are preventable through folic acid intake and that multivitamin use could reduce the risk of birth defects. However, their actual practice of preconception care (PCC) remained limited. Statistically significant associations were found between knowledge levels and education (p < 0.05) and socioeconomic status (p < 0.05). Despite generally positive attitudes toward PCC, engagement in related practices remained low. The study emphasized that education level and income were key predictors of both knowledge and practice. Conclusion and Recommendations: The study revealed a notable gap between knowledge and actual practice regarding PCC among women in the Southern West Bank. While attitudes were positive, practice remained insufficient. Strengthening health education, integrating PCC into routine primary healthcare, and increasing accessibility are essential steps to improve maternal and neonatal health. Health policymakers should develop targeted interventions to address these gaps, including awareness campaigns, training for healthcare providers, and inclusion of PCC in educational materials and clinic outreach efforts. Keywords: Preconception Care, Knowledge, Attitudes, Practice, Reproductive Health.
- ItemKnowledge, Attitudes and Practices about the Risk of Exposed to Radiation among Dental Students in the Gaza Strip Universities(Al-Quds University, 2024-12-18) Wafaa Kamal Abu-Nasser; وفاء كمال محمد أبوناصرBackground: Dental radiography plays a crucial role in modern dental practice, providing essential diagnostic insights. However, it also involves exposure to ionizing radiation, which necessitates stringent adherence to radiation protection protocols to safeguard both patients and dental professionals. Aim: The study aims to assess the knowledge, attitudes, and practices related to radiation safety among dental students in the Gaza strip, , focusing specifically on those enrolled at Al-Azhar University and the University of Palestine. Methods: A descriptive cross-sectional design was employed, using a stratified sample of 264 students from Al-Azhar University and the University of Palestine. Data werecollected through a structured self-administered questionnaire containing 54 items on a five-point Likert scale, addressing the domains of knowledge, attitudes, and practices related to radiation safety. Statistical analyses, including descriptive statistics, chi-square tests, and correlation analyses, were conducted to examine the data collected. Findings: Most participants demonstrated moderate to good knowledge of radiation safety, including awareness of key principles such as hazard symbols and protective measures. However, gaps in understanding international guidelines were noted. While students generally exhibited positive attitudes toward radiation safety, practical compliance varied, with lower use of lead aprons and thyroid collars. Junior students showed better compliance, likely due to recent training and closer supervision, while senior students may neglect protocols due to increased confidence or familiarity. Risk factors identified include insufficient training, inconsistent use of protective equipment, and misconceptions about radiation exposure risks, which could lead to severe health issues such as DNA damage and cancer. Recommendations: The study recommends placing greater emphasis on radiation safety education within dental programs in Gaza. Incorporating both theoretical and practical training on radiation protection throughout the dental curriculum could significantly enhance adherence to safety protocols, ultimately reducing the risk of radiation exposure for both future dental practitioners and their patients. Continuous and comprehensive radiation safety education should be integrated into the curriculum. Furthermore, implementing ongoing education programs for dental students and interns will help reinforce safety practices, ensuring a safer clinical environment moving forward
- ItemKnowledge, Attitude, and Health Seeking Action Related to Obstetric Danger Signs among Postpartum Women in the Gaza Strip(Al-Quds University, 2024-12-09) Abdelrahman Ihab Jamal Hammouda; عبدالرحمن إيهاب جمال حمودةThe maternal mortality rate (MMR) remains at an unacceptably high level, with many deaths potentially preventable. The study aimed to assess the knowledge, attitudes, and health-seeking actions related to obstetric danger signs (ODS) and associated factors among postpartum women attending postnatal care in the Gaza Strip. Materials and Methods: An analytical cross-sectional study was conducted over 20 months, from March 2023 to October 2024. The study included 383 women who had recently given birth and attended governmental primary health care (PHC) centres for BCG vaccination or postpartum (within 42 days after delivery) care, regardless of the place or outcome of delivery. A convenient sampling technique was used, and governmental PHC centres were conveniently selected, with one from each Gaza Strip governorate. Data was collected using an expert-evaluated, structured interview questionnaire, and its reliability was confirmed using Cronbach’s alpha coefficients (0.952 for Knowledge and 0.724 for attitude). The data were analyzed using the SPSS program. Results: The mean age of participants was 26.3 years, and 56% demonstrated adequate Knowledge of ODS. Additionally, 67.1% exhibited positive attitudes, and 65.4% of women who experienced ODS took appropriate health-seeking actions by visiting a healthcare facility. A significant relationship was found between health-seeking action and women's Knowledge, though there was no significant association with their attitudes. Employed women were 4.5 times more likely to have adequate ODS knowledge than unemployed women (OR = 4.49, CI = 1.494–13.514). Husband’s education level also impacted women’s Knowledge; women whose husbands had secondary education were 3.5 times more likely to have adequate knowledge than those with less-educated husbands (OR = 3.5, P = 0.003, CI = 1.549–7.951), with a stronger association for those whose husbands had higher education (OR = 4.52, P = 0.001, CI = 1.82–11.18). Attending only governmental clinics during antenatal care (ANC) was associated with a 67.2% decrease in the likelihood of being knowledgeable about ODS compared to attending governmental and private clinics (OR = 0.328, CI = 0.152–0.708). The study also identified two factors significantly associated with attitude levels: receiving counselling during ANC visits about the benefits of delivering in a healthcare facility (χ² = 4.733, p = 0.03) and the place of delivery, with women delivering in governmental hospitals more likely to exhibit positive attitudes than those delivering in private hospitals (χ² = 4.951, p = 0.026). Conclusion: This study highlights the critical role of women's knowledge about ODS in seeking appropriate actions during pregnancy, labour, and postpartum. While most women demonstrated adequate knowledge and positive attitudes, significant gaps remain, particularly influenced by factors such as employment status, husband's education, family size, and the location of healthcare facilities accessed during ANC visits. These findings suggest that improving access to comprehensive maternal health education for women and their families, as well as enhancing counselling services, may be key strategies for improving maternal health outcomes and reducing maternal mortality in the Gaza Strip.