Public Health 2 الصحة العامة
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- ItemDeterminants of healthcare practitioners' adherence to public health directions guidelines regarding notifiable infectious diseases in governmental hospitals in the West Bank(Al-Quds University, 2025-08-09) orouba khader kharbish; عروبه خضر سليمان خربيشInfectious diseases remain one of the most serious challenges facing health systems worldwide. They pose a direct threat to public health and have the potential to spread rapidly and cause epidemics if not controlled early. Most health systems rely on effective surveillance and monitoring systems based on healthcare providers' commitment to promptly reporting these diseases, enabling rapid response and the implementation of the necessary preventive and therapeutic interventions to limit their spread. In Palestine, the Public Health Laws are responsible for monitoring the implementation of reporting policies. This body has developed comprehensive lists of infectious diseases that must be reported and the reporting procedures for each condition, to ensure the health system's readiness to confront any epidemic or health emergencies. Aim: This study aims to assess the determinants of healthcare practitioners' adherence to the Public Health Directorate's guidelines for reporting notifiable infectious diseases in government hospitals in the West Bank. Methodology: A descriptive cross-sectional study design was employed, consisting of 758 male and female healthcare providers working at the AL-watani Hospital/Nablus, Jericho governmental hospital, and Hebron governmental hospital. The study was conducted by filling out a questionnaire in the three previous hospitals. Data collection took place within these facilities using a structured, self-administered questionnaire, which consisted of two sections: the first related to socio-demographic characteristicscomprising 20 variables.The second section consists of nine determinants of healthcare providers’ compliance with public health directives for reporting communicable diseases in governmental hospitals. Results:In this study, (254) questionnaires were distributed, which were selected using a convenience sample method, including (52) electronic questionnaires, and the rest were distributed on paper to the study sample due to the lack of a high response when distributing the electronic questionnaire. The researcher retrieved (238) questionnaires from them, valid for statistical analysis. The results showed that the paragraphs ranged between high and medium with responds rate(94%), as follows: Good adherence to reporting deadlines achieved the highest mean among the dimensions (3.88) at a rate of (77.7%), reflecting a clear awareness of the importance of timely reporting and disease control efforts. - Personal motivation and commitment were high, with an average of (3.87) and a percentage of (73.28), reflecting personal commitment to reporting. - Knowledge and awareness of reporting guidelines were high, with an average of (3.51) and a percentage of (70.12), reflecting staff familiarity with reporting guidelines. - Institutional policies and support received an average rating of 3.32, which corresponds to 66.35%. This suggests that while guidelines and policies are in place, they may not always be comprehensive or backed by sufficient resources. - Barriers to compliance were rated as average. The most prominent barriers were the lack of clear guidelines with a score of (65.21%), time constraints, and lack of knowledge. Peer influence and organizational culture were rated low, with a mean score of 3.09 (61.78%), indicating a greater need to foster a culture of collective compliance within work teams. - Legal and regulatory factors were rated low, with a mean score of 3.28 (65.67%), as respondents acknowledged the importance of legal compliance, but their knowledge of the legal consequences was relatively weak. External influences were rated as moderate, with an average score of 3.21 (64.20%), with a moderate impact of government policies on individual reporting commitment. General compliance was rated as moderate, with an average score of 3.14 (62.75%), reflecting good overall commitment but in need of additional support and motivation. Conclusion: The study results indicate that healthcare providers possess a good level of knowledge regarding infectious disease reporting guidelines and feel personally motivated to report incidents. Additionally, the findings show that providers generally have positive attitudes toward reporting. These results underscore the critical need for enhanced training initiatives and improved administrative frameworks within healthcare facilities. By strengthening support systems and clarifying reporting procedures, healthcare providers can be better empowered to implement best practices, ultimately contributing to more effective disease surveillance and enhanced public health protection. Keywords:Determinants, adherence, healthcare practitioners, Public Health Directorate guidelines, notifiable infectious diseases, government hospitals, West Bank.
- ItemPrevalence and Risk Factors of Bloodborne Diseases Among Blood Donors in the West Bank (2020–2024)(Al-Quds University, 2025-08-09) Nour Hassan Mohammad Al-Nawawreh; نور حسان محمد النواورةBlood banks are essential components of the health care system, and patients needing blood transfusions rely on blood donors. However, blood can carry risks for donors, families, recipients, and the community. Bloodborne diseases such as hepatitis B, C, HIV, and syphilis are among the common infections transmitted through various methods. These infections often do not show symptoms in donors, making them a hidden threat to recipients and public health. blood-borne diseases are a significant concern when it comes to blood transfusions. Because of that, blood banks and health departments often do screenings to catch any infections early.Every year, millions of people globally face the risk of catching infections that can be spread through blood transfusions. However, there is limited research on the prevalence of these conditions among blood donors in Palestine. Methodology: A retrospective cohort study was conducted at the Governmental Preventive Medicine Department (PMD) in the West Bank, Palestine, from 2020 to 2024, to assess the prevalence of blood-borne diseases among blood donors and analyze associated risk factors. Result: From 2020 to 2024, a total of 259,998 blood donors were screened, of whom 808 (0.31%) tested positive for blood-borne infections. The prevalence rates were 0.025% for HBV, 0.0053 for HCV,0.006% for HIV and 0% for syphilis. HBV was the most common infection (81% of cases), followed by HCV (17%) and HIV (2%). Male donors and those residing in urban areas were more likely to be infected. The most affected age group for HBV was 34–41 years, while for both HCV and HIV, it was 26–33 years. Statistical analysis revealed a significant association between infection type and both age group (p < 0.001) and sex (p = 0.003). Notably, unprotected sexual contact accounted for 94% of HIV cases, and HBV vaccination coverage among donors remained low at 13.3%. Conclusion:The study showed that blood donors in the West Bank had unexpectedly low rates of HBV, HCV, and HIV, with no reported cases of syphilis. Notably, men, urban residents, and middle-aged donors were more likely to carry infections. The main modes of transmission for these diseases appear to be through unsafe blood transfusion practices and unprotected sexual activity. Overall, there is room for improvement in vaccination coverage for adults over 33 years of age, safety procedure enhancements, and regular follow-up checks to ensure long-term safety. Keywords:Blood-borne Diseases, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV), Syphilis, Blood Donors, Prevalence, Risk Factors. تُعدّ بنوك الدم من المكونات الأساسية لنظام الرعاية الصحية، ويعتمد المرضى الذين يحتاجون إلى نقل الدم على المتبرعين بالدم. ومع ذلك، قد يُشكّل الدم خطرًا على المتبرعين والعائلات والمتلقين والمجتمع. تُعدّ الأمراض المنقولة بالدم، مثل التهاب الكبد الوبائي ب، ج، وفيروس نقص المناعة البشرية، والزهري، من بين الأمراض الشائعة التي تنتقل عبر طرق مُختلفة. غالبًا ما لا تظهر هذه العدوى أعراضًا لدى المتبرعين، مما يجعلها تهديدًا خفيًا للمتلقين والصحة العامة. تُشكّل الأمراض المنقولة بالدم مصدر قلق كبير عندما يتعلق الأمر بنقل الدم. ولذلك، غالبًا ما تُجري بنوك الدم والدوائر الصحية فحوصات للكشف المُبكر عن أي عدوى. يواجه ملايين الأشخاص حول العالم كل عام خطر الإصابة بالعدوى التي يُمكن أن تنتشر عن طريق نقل الدم. ومع ذلك، لا توجد أبحاث كافية حول انتشار هذه الحالات بين المتبرعين بالدم في فلسطين. المنهجية: تم إجراء دراسة جماعية استعادية في دائرة الطب الوقائي الحكومية في الضفة الغربية – فلسطين، خلال الفترة من عام 2020 إلى عام 2024، بهدف تحديد مدى انتشار الأمراض المنقولة بالدم بين المتبرعين بالدم وتحليل العوامل الديموغرافية والسلوكية والطبية المرتبطة بها. النتائج: بلغ إجمالي عدد المتبرعين من عام 2020 إلى عام 2024، 259,998 متبرعًا، منهم 808 مصابين بأمراض منقولة بالدم. وبلغت نسب انتشار فيروس التهاب الكبد ب، وفيروس التهاب الكبد ج، وفيروس نقص المناعة البشرية، والزهري 0.025%، و0.053%، و0.007%، و0% للزهري على التوالي. وكانت العدوى الأكثر شيوعًا هي فيروس التهاب الكبد ب (81%)، يليه فيروس التهاب الكبد ج (17%)، ثم فيروس نقص المناعة البشرية (2%). وكان الرجال وسكان المناطق الحضرية أكثر عرضة للإصابة بالعدوى. أما بالنسبة لفيروس التهاب الكبد ب، فقد كانت الفئة العمرية الأكثر شيوعًا بين المتبرعين 34-41 عامًا، بينما كانت الفئة العمرية الأكثر شيوعًا لفيروس التهاب الكبد ج (26-33 عامًا)، وفيروس نقص المناعة البشرية (26-33 عامًا). وقد وُجدت صلة قوية بين نوع العدوى والفئة العمرية (p < 0.001) والجنس (p = 0.003). كان الاتصال الجنسي غير الآمن سببًا في 94% من حالات الإصابة بفيروس نقص المناعة البشرية، مع انخفاض معدل التطعيم ضد فيروس التهاب الكبد ب (13.3%). الاستنتاج: أظهرت الدراسة أن معدلات الإصابة بفيروس التهاب الكبد ب وفيروس التهاب الكبد ج وفيروس نقص المناعة البشرية لدى المتبرعين بالدم في الضفة الغربية منخفضة بشكل مفاجئ، ولم تُبلّغ عن أي حالات إصابة بمرض الزهري. ومن المثير للاهتمام أن الرجال وسكان المدن والمتبرعين في منتصف العمر كانوا أكثر عرضة للإصابة بالعدوى. ويبدو أن الطرق الرئيسية لانتشار هذه الأمراض هي من خلال التعامل غير الآمن مع الدم وممارسة الجنس غير الآمن. وبشكل عام، يبدو أن هناك مجالًا للتحسين في جهود التطعيم للبالغين الذين تزيد أعمارهم عن 33 عامًا، وإجراءات السلامة، وفحوصات المتابعة لتعزيز السلامة العامة. الكلمات المفتاحية: الأمراض المنقولة عن طريق الدم، فيروس التهاب الكبد B (HBV)، فيروس التهاب الكبد C (HCV)، فيروس نقص المناعة البشرية (HIV)، الزهري، المتبرعون بالدم، الانتشار، عوامل الخطورة.
- 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.