Public Health 2 الصحة العامة
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- ItemFactors determining healthcare worker’s knowledge, attitude and practice regarding hand washing, disinfection and sterilization in Jericho Governorate(Al-Quds University, 2024-08-08) Ahmad Faisal Abdalrhman Mhalees; أحمد فيصل عبد الرحمان محاليسTo ensure patient safety and lower the number of infections in Healthcare-Associated Infections (HAIs) and governmental hospitals, infection prevention and control (IPC) procedures are essential to the provision of healthcare. Basic IPC procedures including hand washing,disinfection, and sterilization greatly reduce the chance of infection transmission in healthcare environments. However, healthcare professionals' knowledge, attitudes, and practices (KAP) have a major impact on how successful these measurements are. The aim of this study is evaluating the factors that influence primary healthcare and governmental hospitals workers' knowledge,attitudes, and practices (KAP) concerning hand washing, disinfection and sterilization within primary healthcare directorate and governmental hospital in the Jericho Governorate. Methodology In a cross-sectional descriptive study, 110 samples of health workers (physicians, nurses,laboratory technicians, radiology technicians, and pharmacists) were included. A convenience sampling technique was used for data collection. All necessary approvals were obtained (Al-Quds University Ethics Committee “IRB” and from the General Administration of Health Education and Scientific Research in the Ministry of Health) before starting to distribute any tool. Descriptive analysis (means and standard deviation) was used using SPSS V26 . The Pearson correlation coefficient was completed, Sidak Post-Hawk test and the one-way ANOVA test were used.Results The results indicated that the level of KAP among healthcare workers in Jericho Governorate regarding hand washing, disinfection, and sterilization is high. The results also indicate a positive relationship between knowledge and both attitude and practice among healthcare workers in Jericho Governorate (r = 0.58).Conclusions The health staff at Jericho Hospital lacks sufficient knowledge in disinfection and sterilization.Therefore, t is important to conduct training and workshops regarding infection control in hospitals in an organized manner.
- ItemEnvironmental and social determinants and risk factors for Cutaneous Leishmaniasis in Palestine: A case- control study in Hebron and Bethlehem Governorates(Al-Quds University, 2024-08-17) Maram Hassan Hamza Almakharzeh; مرام حسن حمزة المخارزةBackground: Cutaneous leishmaniasis is a persistent public health challenge in Palestine, particularly within the Hebron and Bethlehem governorates. This study aims to analyze the epidemiological characteristics of cutaneous leishmaniasis (CL) cases by person, place, and time in Hebron and Bethlehem Districts. Through statistical analysis, it seeks to identify the sociodemographic and environmental risk factors associated with CL transmission in these endemic areas. Additionally, it assesses the relationship between climate factors, particularly rainfall, and CL occurrence over recent years. Finally, the study evaluates the effectiveness of recent preventive measures implemented by municipalities and health authorities in these districts to combat the disease. Methods: A case-control study was conducted with 207 confirmed cases of cutaneous leishmaniasis and 414 controls (1:2 ratio) matched by age, sex, and residential area. Data were gathered through structured interviews and validated questionnaires covering socioeconomic status, housing conditions, environmental exposures, and behavioral factors. Statistical analyses, including chi-square tests, t-tests, and multivariate logistic regression, were used to identify significant risk factors. Results: The spatial distribution of cases revealed that 29.9% were concentrated in Zatara, A’rab ar Rashayida, and Al-dirat, with notable clusters in Wadi Araba, Dimona, Beer Sheba, and Eilat (16.4%), as well as Massafer Bani Na’im (14.5%). Multivariate logistic regression identified several key risk factors for cutaneous leishmaniasis. Household crowding was a significant predictor, with those in overcrowded conditions showing increased odds of infection (OR = 2.10, 95% CI: 1.45–3.05). Poor housing quality, characterized by inadequate sanitation and proximity to areas with high vector activity, further elevated the risk (OR = 2.35, 95% CI: 1.50–3.70). Lower socioeconomic status was strongly associated with higher incidence rates, disproportionately affecting individuals in the lowest income brackets (p < 0.05). Environmental factors, including rainfall and topography, were also significant. The study found that areas with lower annual rainfall (<300 mm) had a higher incidence of cutaneous leishmaniasis, possibly due to the drier conditions favoring the breeding and survival of sandfly vectors (p < 0.05). Topographical analysis revealed that cases were more common in low-lying areas and valleys, which provide suitable microhabitats for sandflies. These areas often have higher humidity levels and vegetation, which can support vector proliferation and increase human exposure risk (OR = 1.90, 95% CI: 1.30–2.80). Behavioral factors, particularly outdoor sleeping habits and insufficient use of protective measures during peak vector activity at night, were significantly correlated with higher infection rates (p < 0.01). Proximity to animal shelters and unprotected agricultural areas increased the likelihood of exposure to sandfly bites, the primary vector for leishmaniasis (OR = 1.85, 95% CI: 1.20–2.85). Educational programs aimed at improving knowledge and practices related to vector protection showed potential as an intervention, indicating that public awareness is critical in mitigating the spread of the disease. Conclusions: The findings underscore the importance of improving socio-economic conditions, enhancing housing and environmental sanitation, and promoting awareness about leishmaniasis to mitigate the disease's spread. Targeted interventions, including the use of insecticide-treated bed nets and better waste management, are recommended to reduce infection rates. Continued surveillance and tailored public health strategies are essential to address the ongoing challenge of leishmaniasis in Palestine.
- ItemDeterminants of Preterm Birth among Women at Al Makassed hospital in Jerusalem: a retrospective case control study between 2013-2016(Al-Quds University, 2024-08-18) Suha A. Abu Asal; سها عبد الفتاح محمد أبو عسلBackground: Preterm birth, defined as delivery before 37 weeks of gestation, poses significant health risks for newborns. Globally, an estimated 1 in 10 babies are born preterm), impacting roughly 13.4 million newborns annually. These premature births can lead to a variety of developmental issues. Studies suggest that around 20% of children born preterm worldwide experience long-term health problems, including learning disabilities, vision or hearing impairments, and chronic health conditions. The situation in Palestine, according to Palestinian Central Bureau of Statistics (PCBS) estimated at around 8.8 in west bank and 23% of their deliveries result in preterm births. (UNICEF State of Palestine,2015). These preterm infants also face similar developmental outcomes, with about 55% experiencing some form of long-term disability, highlighting the urgent need for enhanced prenatal and postnatal care to improve outcomes for these vulnerable populations. Study problem and justification: Existing researchers discussed various risk factors, including maternal age, obstetric history, complications, and medical conditions. However, nuanced examinations are needed to understand the complex interplay of maternal, fetal and socio-demographic factors, with disparities observed globally and within specific regions. In the Palestinian context, particularly in Jerusalem, introduces unique challenges influenced by socioeconomic and political factors, impacting maternal health and access to quality healthcare. Specific risk factors for preterm birth in different Palestinian regions include multiple pregnancies, previous preterm births, and inadequate antenatal care, emphasizing the need for targeted interventions . Aim & Hypothesis: The purpose of this study is to investigate the determinants of preterm birth and possible risk factors among Palestinian women at Almakassed hospital in Jerusalem aged 18-40 years old in 2013-2016. The objectives are to identify the main characteristics of mothers who gave premature babies, to investigate the risk factors of Preterm birth, maternal, fetal factors, impact of sociodemographic status, to identify the prevalent long-term developmental outcomes in preterm infants. XI Study methodology: Retrospective Case-control design: In a case-control design, (in this case, preterm birth) of (case) and a control group of (controls) without the outcome:(Have full term), matched for residence and age. Statistical Analysis: Data analyses were performed by using version 28 of the Statistical Package for Social Sciences (SPSS). Descriptive and inferential techniques were used to answer research questions. Ethical Considerations: this study was submitted to Al Quds University-SPH graduate studies committee. Approval was obtained from Al- Quds University. Approval from Al- Makassed hospital was obtained. Approval from each participant was obtained to be involved in the study, and Al- Makassed hospital approval was obtained. Ethical codes compatible with requirements of Helsinki committee were respected including (confidentiality, anonymity, right to reject participation, the right to be informed about results, and that the data was used for scientific purposes only and that names were not used neither in analysis or reporting). Each participant was asked with phone call a verbal consent form declaring their wailings to participate in this study. Results: This study involved 978 women, socio-demographic characteristics, maternal, fetal factors and health care were examined to determine their impact on gestational age at delivery. The study found statistically significant differences in gestational age at delivery based on several factors, firstly the maternal factors There was a significant positive relationship between gestational age and the number of parties. There was no significant difference in gestational age between women with and without a history of abortion. Significant differences in gestational age were observed based on pregnancy methods. Medical comorbidities and a history of preterm delivery were associated with significantly lower gestational ages, while cervical incompetence showed no significant difference. For fetal factors, chronicity type significantly affected gestational age. Among sociodemographic factors, significant differences were noted between tobacco exposed and whom not and education levels but not across different age categories, regarding healthcare factors, more frequent prenatal care is positively correlated with longer pregnancies. Also This study examined developmental outcomes among preterm infants, revealing a notable prevalence of complications. Developmental complications were present in 55.0% of preterm infants, reflecting the significant impact of premature birth on developmental XII outcomes. Intracranial hemorrhage affected 28.2% of infants. Respiratory complications were observed in 49.7% of the infants, Nephrological complications were less common, affecting 12.1%. Retinopathy was seen in 36.8% of the infants. Conclusion: This study investigated the determinants of preterm birth and associated risk factors among Palestinian women aged 18-40 years and its impact on child development at Al Makassed Hospital in Jerusalem from 2013 to 2016. Key findings indicate significant relationships between various socio-demographic, medical, and healthcare factors and gestational age at delivery. These findings emphasize the multifaceted nature of preterm birth determinants, suggesting that improving prenatal care access and addressing socio-demographic and medical risk factors could mitigate the incidence of preterm births and enhance child development outcomes in this population. These findings underscore the substantial risks faced by preterm infants, including neurological, respiratory, renal, and visual complications.
- ItemPsychosocial Challenges, Coping Strategies and Access to Support for Women with Breast Cancer in the Gaza Strip(Al-Quds University, 2024-04-20) Ayda Ahmad Mohammad AL-Hadad; عايدة أحمد محمد الحدادBreast cancer represents 11.7% of all cancer cases worldwide and 18% in in the Gaza Strip. In addition to being a common bodily health problem, cancer is also associated with psychosocial problems such as depression, anxiety. Universally, there is growing evidence around the challenges and support for women with breast cancer. The study is conducted to explore key psychosocial and mental health challenges facing women with BC, appraise their coping strategies, and to ascertain formal and informal support accessible to them. Methods A cross sectional design was used, in which data have been triangulated, quantitatively and qualitatively. The quantitative part is conducted through an interviewed questionnaire with 330 women diagnosed with breast cancer and focused on exploring the challenges they are facing and the support provided to them. The qualitative part looked in-depth to the lived experiences of women with breast cancer, their perspectives were explored through four focus group discussions with 25 participants. Quantitative data was analyzed using the SPSS and open coding thematic analysis technique was used for analyzing qualitative materials. Findings Findings revealed that 35.6% of the participants were 51-60 years old, nearly half of them from Gaza City, 76% were married, 93.3% were housewives and 53.8% reported that their monthly household income is less than 1000 ILS. With regard to the staging of BC, nearly a quarter (24%) were stage I and 36.8% were stage II. As reported by women, 60% took more than 4 weeks to initiate treatment after confirming their diagnosis. Chemotherapy was received by 83% of women, surgery was done for 84%, hormonal therapy was received by 71%, while 68.4% of participants received radiotherapy. Participants scores on mental health scales show that anxiety was more prominent (76% with moderate and severe) than depression (29% moderate and severe) or stress (9% moderate or severe). When asked how BC affected them, 31% reported that cancer reduced their activity level and negatively affected their psychosocial status (26.7%).Findings show that among the five social support dimensions, positive social interaction was the most common dimension, while tangible support (provision of practical resources and material aid) was the least common. Women used different strategies to cope with their disease, the most frequent coping strategies were praying or meditating (75.5%), followed by trying to find comfort in religion or spiritual beliefs (55.2 %).Inferential analysis showed that younger women (less than 40 years), recently diagnosed (one year and less) and women diagnosed at stage of III and IV were facing more challenges than their counterparts from other groups in reporting higher scores of depression, anxiety and stress, and had higher scores of avoidant coping strategies when compared to other women. Women who had mastectomy, reported higher scores in the challenges they face, depression, anxiety and stress, and received more social and formal support compared to women who had breast conservative surgery, but these variances are not statistically significant.Conclusions and recommendations The study concluded numerous challenges that are facing women throughout their course of disease, which found to be adversely affecting their mental health outcomes and points out to the necessity of addressing these challenges. Breast cancer management is not only medical rather, it requires multi-modal interventions including intensive psychosocial support and social protection which needs to be integrated as a crucial component of care.
- ItemAssociation of GLP-1R Gene Polymorphisms with the risk of Dyslipidemia in Palestinian Patients with Type 2 Diabetes Mellitus(Al-Quds University, 2024-07-11) Maha Rashad Joma AlSharabati; مها رشاد جمعة الشرباتيThe high risk of cardiovascular events in diabetic patients is associated with dyslipidemia, a common concomitant disease of diabetes. Dyslipidemia comprises of a wide range of lipid disorders including over production of lipids or its deficiency. It is characterized by the presence of either elevated low density lipoprotein cholesterol (LDL-C) or elevated high total cholesterol (Hypercholesterolemia) or elevated triglycerides (Hypertriglyceridemia) or decreased high density lipoprotein cholesterol (HDL-C). Several studies have found that dyslipidemia can be associated by single nucleotide variations in specific genes. Therefore, the present study aimed to investigate GLP-1R gene polymorphisms rs10305420 and rs3765467 and its association with the risk of dyslipidemia in Palestinian patients with type 2 diabetes mellitus (T2DM). A cross sectional study was conducted between October 2023 and February 2024 at Jericho health center MOH. Herein, we used next generation sequencing (NGS) to study two single nucleotide polymorphisms (SNPs), rs10305420 and rs3765467 within the GLP-1R gene in one multiplex PCR tube. Bioinformatics analysis was done using free online galaxy program (https://usegalaxy.org.au/). A total of 216 T2DM patients were enrolled in this study and divided into two groups: The control group (patients without dyslipidemia) and case group (patients with dyslipidemia). The control group included patients aged 40 years or older with confirmed T2DM (diagnosed according to WHO criteria) and had no history of dyslipidemia (TC < 200 mg/dl, TG < 150 mg/dl, and no use of lipid‐lowering agents), while the case group included patients who aged 40 years or older with confirmed T2DM and dyslipidemia. Dyslipidemia was defined by TC ≥ 240 mg/dl and/or TG ≥ 150 mg/dl, LDL-C ≥ 140 mg/dl, HDL-C < 40 mg/dl, and/or use of lipid‐lowering drugs. Participants under 40 years old, individuals with confirmed diagnosis of Type 1 Diabetes Mellitus, patients with incomplete medical records, patients with severe comorbidities (e.g., severe liver disease or cancer), and pregnant women were excluded from the study. The results showed higher rates of diabetic neuropathy, retinopathy, and hypertension among patients with dyslipidemia compared to those without dyslipidemia (p < 0.05). However, no statistically significant differences were observed in the prevalence of nephropathy, diabetic foot, or tobacco smoking status between the two groups, whereas female patients were more prevalent in the dyslipidemia group (p = 0.04). The genotype distributions of rs10305420 in the studied groups showed that the most frequent genotype in the dyslipidemia group was CC (27.8%), followed by CT (15.3%) and TT (7.9%). For those without dyslipidemia, the CC, CT, and TT genotypes were 26.4%, 17.6%, and 5.1%, respectively. The study showed no significant difference in the distribution of the rs10305420 genotype between the T2DM patients with and without dyslipidemia. For the second SNP, the GLP-1R rs3765467 polymorphism, almost all samples exhibited the GG genotype. The mean (TC, TG, and LDL) of T2DM patients with dyslipidemia were respectively higher than those without dyslipidemia (178.7± 39.2 vs. 155.5 ± 33.6, p < 0.001), (189.1 ± 140.1 vs. 106.7 ± 40.6, p < 0.001), and (103.1 ± 32.3 vs. 92.9 ± 27.6, p < 0.015). Mean age, BMI, systolic blood presure of T2DM patients with dyslipidemia were higher than those without dyslipidemia. In conclusion, the rs10305420 and rs3765467 polymorphisms in the GLP-1R gene were not significantly associate with dyslipidemia in this population. Further studies with larger sample sizes are needed to confirm these findings.