Public Health 2 الصحة العامة
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- 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.
- ItemManagement and Prevention of Animal Bites in West Bank.(Al-Quds University, 2025-02-25) Yaser Ahmad Khalil AL-Nawaja; ياسر احمد خليل النواجعهBackground:Animal bites are direct injuries sustained by a person exposed to an animal attack, causing injury to the body that is primarily characterized by skin lacerations or severe injuries, the animal bites are ordinary injuries, considering as one of the frequent reasons for receiving primary care and referring to emergency centers. Annually, 330,000 emergency visits are associated with bites in the United States(Darvishi et al., 2023). Methodology: A quantitative, retrospective cohort study was conducted in the West Bank Governmental Preventive Medicine Department (PMD) in Palestine from 2020 to 2023 to estimate the prevalence rate of animal bites and their prevention and management. Result: The majority of the population wears males totalling 2522 individuals (82.34%), while 541 individuals (17.66%) wear females, with the age average of the population being 21.37 years. The distribution of bite incidents by place reveals that the majority occurred in rural areas, with 53.09%. The data showed that dogs were responsible for most bites, accounting for 87.33%. Also, related to the number of bites, 71.43% experienced a single bite, while 28.57% were exposed to multiple bites. The nature of the wound showed that most wounds were classified as mild at 64.68%, and the distribution of bite locations on the body showed that the upper limbs were the most commonly affected area at 50.73%. In 2020, there were 636 cases, this number rose to 645 cases in 2021 and increased to 857 cases in 2022. The highest number of cases was recorded in 2023, with 925 cases. Only 5.06% of patients received rabies immunoglobulin (RIG), 50.05% received the rabies vaccine, 37.84% received the Tetanus-toxoid vaccine, and 69.54% of patients received antibiotic treatment. Conclusion: The animal bite prevalence rate has been significantly increasing over the years.
- ItemKnowledge, Attitude, and practice of management of upper respiratory tract infections in children under five years old of age among healthcare professionals in primary health care of southern Palestine(Al-Quds University, 2025-01-05) Marwa Khalid Al sarasra; مروه خالد محمد الصراصرهBackground: One of the current challenges to global public health is antimicrobial resistance (AMR). AMR has spread as a direct result of increased antibiotic use in agriculture, animals, and humans. Antibiotics are frequently used to treat upper respiratory tract infections (URIs), even when they are not necessary, as is the case with viral infections and self-limited illnesses, which account for the majority of URI occurrences. Evaluating doctors' perspectives, practices, and expertise about prescribing antibiotics to children with acute URIs may help manage the problem of antibiotic misuse. Aim: This study aims to evaluate the problem in the community and provide information for the construction of appropriate programs to optimize the prescription of antibiotics. Methodology: This cross-sectional study is intended for primary care physicians in Palestine who treat acute upper respiratory tract infections (URIs). Physicians' knowledge, attitudes, and practices were evaluated using a self-administered questionnaire. The questionnaire also contained four clinical scenarios that addressed different URI possibilities to evaluate antibiotic prescription trends in typical cases. Results: The majority of the 100 physicians in this study were general practitioners, with an average age of 36.8±7.6. The average number of right answers for the 18 knowledge questions was 14.9±2.5, indicating that they had good knowledge. Their mean attitude scores for prescribing antibiotics inappropriately were low, with ignorance receiving the highest score (4.2 ± 0.56). 52% of participants prescribed antibiotics if the child's fever lasted more than five days, and 22% did so if the child had a yellowish or greenish nasal discharge, according to the prescribing practice for URIs in unusual circumstances. Of the 400 clinical scenarios, 207 (51.75%) included prescriptions for antibiotics, and 32.82% of those prescriptions were appropriate. Conclusion: In Palestine's primary healthcare system, physicians who treat acute URIs are wellversed in antibiotic use and resistance, and they exhibit a positive attitude towards the responsible use of antibiotics. More research is needed to examine the reasons that contribute to incorrect antibiotic prescribing practices and non-adherence to guidelines, even if the percentage of inappropriate prescriptions in clinical scenarios is slightly high. Establishing a national antibiotic stewardship program is also crucial to enhancing antibiotic prescription practices and addressing issues with antibiotic resistance.
- ItemEvaluating Strategies of Healthcare-Associated Infection Prevention and Control in Hebron City Hospitals -Palestine(Al-Quds University, 2025-02-25) Saleh Salama Abu Shameh; صالح سلامة صلاح أبو شامةBackground: Infections acquired during medical treatment for another medical condition are known as healthcare associated infections. Healthcare institutions such as hospitals, ambulatory surgery centers, end-stage renal disease facilities, and long-term care facilities are all susceptible to healthcare associated infections and its infections that show symptoms for the first time 48 hours or more after being admitted to the hospital or within 30 days after medical attention. Aim: This study aimed to evaluate healthcare workers in Hebron City – Palestine from various professions and institution types' attitudes toward evaluating strategies of healthcare-associated infection prevention and control. Methodology: The google form survey was distributed to 185 questionnaires were distributed, n= 178 participants completed the questionnaires, a response rate of 96%. 178 healthcare professionals from government, private, and non-governmental organizations, including physicians (n = 27), radiologists (n = 9), lab technicians (n = 26), nurses (n = 80), and other paramedical staff (n = 36). Chi-square analysis was used to compare the results by age group, kind of institution, and type of occupation in order to assess variability, In additional two statistical tests were used. First, the two independent samples (t-test) were used to compare the means of General Policy Compliance scores between two distinct groups (for example, comparing male vs. female participants). Second, the one-way analysis of variance (ANOVA) was used to compare the means of General Policy Compliance scores across more than two groups Results: Healthcare professionals demonstrated insufficient awareness regarding various aspects of infection prevention and control, including institution-specific concerns, reporting and surveillance protocols, and their preparedness to implement policies and respond to outbreaks. Evidence indicates that nurses and other staff members in private hospitals possess more experience in these areas compared to their counterparts in other healthcare settings. When asked whether essential tools for preventing healthcare-associated infections, such as hand sanitizers, masks, protective equipment, soap, and disinfectants, were available, 92.7% (n=165) of participants responded affirmatively. Additionally, 89.3% (n=159) of respondents confirmed the presence of measures within their organization to prevent healthcare-associated infections. However, 75.3% (n=134) of participants identified violations of infection control policies, rules, and guidelines as the most frequent cause of infection transmission in hospitals, with 70.8% (n=126) agreeing. Furthermore, 41% (n=73) of respondents noted that the most common type of infection reported to the Ministry of Health was "all types of infections, whether hospital-associated or not." Conclusions: The findings of this study highlight significant gaps in healthcare workers' awareness and preparedness regarding infection prevention and control, particularly in relation to institution-specific protocols, reporting systems, and outbreak response. While the availability of essential infection control tools is generally high, violations of infection control policies remain a major concern, contributing to the transmission of healthcare-associated infections. The study underscores the importance of strengthening training programs, reinforcing adherence to infection control guidelines, and enhancing the overall preparedness of healthcare workers to effectively mitigate the risks of healthcare-associated infections across various healthcare settings. Additionally, there is a need for continued monitoring and improvement of infection prevention strategies to ensure better outcomes for patients and healthcare workers alike.
- ItemBrucellosis Knowledge, Attitude and Practice among Local Dairy Producers and Consumers in Hebron City(Al-Quds University, 2024-12-15) Iyad Zyad Sadi Abu Irmeila; اياد زياد سعدي أبو ارميلهBackground: Dairy products consumers and producers play an important role in preventing brucellosis among families, so special attention should be given to these two groups including their knowledge, attitude and practice reflected to the disease in how to prevent brucellosis, to enable them planning for the control measures known to be effective against the spread of the Brucellaspecies such as proper boiling of milk and its products. Aim: To evaluate brucellosis KAP level among consumers and community dairy products producers in the city of Hebron. Material and Methods: This study was carried out in Hebron targeting adult residents who are milk products consumers and who are attending at the MOH primary health care clinics as well as community dairy milk products producers in the city. This research comprised two studies: across-sectional study focusing on dairy product consumers and a qualitative study centered on dairy milk producers, Data was collected in this study using two questionnaires; the first is a quantitative researcher-assisted questionnaire filled out by dairy products consumers targeting their demographics and KAP level for brucellosis and its prevention, and the second questionnaire was a qualitative questionnaire that targeted community dairy products producers which contained three main questions with prop questions (sub questions for more details) in-between which was conducted through face-to-face interviews with the participants ,data were analyzed and processed through SPSS, descriptive statistics was obtained and correlations and associations were identified with KAP level and regression analysis was done to find final associations with KAP. Results: In the quantitative part of the study a total of 370 subjects were sampled and filled the questionnaire in 14 clinics, and in the qualitative part seven interviews were conducted with dairy milk products producers, In the quantitative part 64% of respondents were above the age of 40 years, 52% of them were males , 88.9% were married and 77.6% have income below 3000 shekels,23.8% reported history of previous brucellosis infection in the family, 10.5% only reported having herds in their surroundings, and 47.8% have chronic diseases such as Hypertension or Diabetes Mellitus, The KAP level knowledge score was 69%, attitude score was 4.21, and practice score was 84%. In the qualitative part, seven interviews were done and results showed that the age of respondents was between 30-70 years old, 62%(5 out of 8 producers) have high school education, 75%(6 out of 8 producers) of those interviewed had this work inherited from their ancestors, only 25% (2 out of 8 producers) had learned how to produce safeproducts ,and 50% (4 out of 8 producers) of them don’t have work License from the MOH. Regarding the production process, we found that regular methodsto produce dairy products don’t include boiling milk, i.e. the milk doesn't reach 70°C, only 30°C, and the manufacturers rely on vaccinated herds, although 75% (6 out of 8 producers) of those interviewed said that boiling milk and cheese is very important. Conclusions: This is a one-of-a-kind study of the knowledge and attitude and practice of participants in the community using qualitative and quantitative tools to measure KAP level and to study risk factors affecting KAP level, socioeconomic determinants, and general knowledge, practice and attitude. Recommendations: Increase community awareness for prevention and control of Brucellosis, and consumption of pasteurized milk and dairy products. Increase coordination between Ministry of Health and Ministry of Agriculture / Veterinary services concerning brucellosis prevention and control.