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The Gaza Strip is one of the world’s most fragile states and faces substantial public health and development challenges. Climate change is intensifying existing environmental problems, including increased water stress. We provide the first published assessment of climate impacts on diarrhoeal disease in Gaza and project future health burdens under climate change scenarios. Over 1 million acute diarrhoea cases presenting to health facilities during 2009–2020 were linked to weekly temperature and rainfall data and associations assessed using time-series regression analysis employing distributed lag non-linear models (DLNMs). Models were applied to climate projections to estimate future burdens of diarrhoeal disease under 2 °C and 1.5 °C global warming scenarios. There was a significantly raised risk of diarrhoeal disease associated with both mean weekly temperature above 19 °C and total weekly rainfall below 6 mm in children 0–3 years. A heat effect was also present in subjects aged > 3 years. Annual diarrhoea cases attributable to heat and low rainfall was 2209.0 and 4070.3, respectively, in 0–3-year-olds. In both age-groups, heat-related cases could rise by over 10% under a 2 °C global warming level compared to baseline, but would be limited to below 2% under a 1.5 °C scenario. Mean rises of 0.9% and 2.7% in diarrhoea cases associated with reduced rainfall are projected for the 1.5 °C and 2 °C scenarios, respectively, in 0–3-year-olds. Climate change impacts will add to the considerable development challenges already faced by the people of Gaza. Substantial health gains could be achieved if global warming is limited to 1.5 °C.

Water quality and occurrence of water-borne diseases in the Gaza strip are vivid examples for most developing societies. In recent years, the quality and quantity of groundwater, the only source of waters in the Gaza strip, have deteriorated markedly. A general rundown of the infrastructure and water distribution networks, in particular, the spread of cesspools, excessive use of pesticides and fertilizers, and improper treatment and disposal of wastewater remain major contributing factors to the continued deterioration in the water status in the Gaza strip. Without a doubt, the (Israeli)-Palestinian conflict had a clear negative impact on the water sector in the Gaza strip. Apparently, there is a dire need to adopt the WHO's water safety plan in the management of Gaza's water supply systems from catchment to consumer's tap in order to maintain the sustainability and quality of water resources and prevent outbreaks of waterborne diseases. Therefore, this review has been prepared to highlight the overall picture of the water dilemma in the Gaza strip in the last years and in addition, to identify the sources, sorts, levels, and health risks of consequence to microbial contamination of water. The impact of political conflicts on the water sector in the Gaza strip also was reviewed.

University/college period is one of the stressful stage of life, and depressive symptoms and stress are health problems among students worldwide. Understanding nutrition-mood associations may enable students to make healthier food choices that lead to a healthier life style. The present study investigated the relationship between food consumption and stress and depressive symptoms among university/college students in Gaza strip, Palestine. A cross-sectional survey was undertaken among undergraduates enrolled across 5 universities and 3 colleges in Gaza Strip (n=1409). Self-administered questionnaires included a 12-item food frequency questionnaire; Cohen's Perceived Stress Scale and modified Beck Depression Inventory. Gender and university comparisons were performed. Univariable and multivariable regression analyses were computed for each of the two outcomes; perceived stress and depressive symptoms. In general, females consumed sweets, snacks, fresh fruits and salad/raw vegetables and cooked vegetables more commonly than males, whereas males generally consumed fast food/canned food and cake/cookies, meat/sausage products, fish/sea food, cereal/cereal products and dairy/dairy products more commonly than females with differences across various universities/colleges. Perceived stress and depressive symptoms scores were generally higher among females than males. The univariable analysis showed that significant associations between various food groups and perceived stress and depressive symptoms were more evident for males. In addition, for males, all food groups were negatively associated with perceived stress as well as with depressive symptoms. For females, the exceptions of such negative associations were observed with meat/sausage products, fish/sea food and cereal/cereal products for perceived stress, and only with cereal/cereal products for depressive symptoms. The multivariable analysis indicated that frequent consumption of 'unhealthy' food such as sweets/cookies/snacks/fast food was significantly associated with lower perceived stress among males only. In addition, frequent consumption of 'healthy' foods such as fruits/vegetables was significantly associated with lower depressive symptoms, but for both sexes. In conclusion, university/college students used food whether 'unhealthy' or/and 'healthy' as a coping strategy to reduce tremendous and continuous stress due to the imposed Israeli siege since the year 2006 which affects all aspects of life in Gaza strip.

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Background: One of the most important parameters that affect the development of adolescents is nutrition. Eating practices among adolescents may have long-term impact on their health, Aims: This study aimed to assess whether there is a difference in food intake and physical activity patterns among male and female adolescents (12-19 years old) in the Gaza Strip. Methods: The cross-sectional study was conducted in April 2016 among 378 adolescent students, 205 males, 173 females. Researchers utilized quantitative and qualitative measures by incorporating a face-to-face interview questionnaire with the adolescents and focus group discussions with parents. Results: Over 55% of participants were eating healthy foods with high frequency; the proportion of boys was greater than that of girls (P < 0.05). Around 45% were eating unhealthy foods with high frequency; here the proportion of girls was greater, but the difference was not statistically significant (P > 0.05). In terms of physical activity pattern, more than half of the adolescents were practicing a sedentary lifestyle, girls statistically significantly more than boys (P < 0.001). No statistically significant sex-based association was found between food intake habits and physical activity pattern. Conclusions: Palestinian adolescents of both sexes in the Gaza Strip are practising unhealthy feeding habits coupled with an apparently highly sedentary lifestyle.

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