Background The national severe acute respiratory illness (SARI) surveillance system in Yemen was established in 2010 to monitor SARI occurrence in humans and provide a foundation for detecting SARI outbreaks. Objective To ensure that the objectives of national surveillance are being met, this study aimed to examine the level of usefulness and the performance of the SARI surveillance system in Yemen. Methods The updated Centers for Disease Control and Prevention guidelines were used for the purposes of our evaluation. Related documents and reports were reviewed. Data were collected from 4 central-level managers and stakeholders and from 10 focal points at 4 sentinel sites by using a semistructured questionnaire. For each attribute, percent scores were calculated and ranked as follows: very poor (≤20%), poor (20%-40%), average (40%-60%), good (60%-80%), and excellent (>80%). Results As rated by the evaluators, the SARI surveillance system achieved its objectives. The system’s flexibility (percent score: 86%) and acceptability (percent score: 82%) were rated as “excellent,” and simplicity (percent score: 74%) and stability (percent score: 75%) were rated as “good.” The percent score for timeliness was 23% in 2018, which indicated poor timeliness. The overall data quality percent score of the SARI system was 98.5%. Despite its many strengths, the SARI system has some weaknesses. For example, it depends on irregular external financial support. Conclusions The SARI surveillance system was useful in estimating morbidity and mortality, monitoring the trends of the disease, and promoting research for informing prevention and control measures. The overall performance of the SARI surveillance system was good. We recommend expanding the system by promoting private health facilities’ (eg, private hospitals and private health centers) engagement in SARI surveillance, establishing an electronic database at central and peripheral sites, and providing the National Central Public Health Laboratory with the reagents needed for disease confirmation.
BACKGROUND Noncommunicable diseases (NCDs) kill 41 million people each year, accounting for 71% of all deaths globally. The burden of NCDs is rising faster in developing countries of the Middle East than in other regions. The morbidity and mortality of NCDs are still not well-studied in Yemen. OBJECTIVE The aim of this study was to describe the epidemiology of NCDs in Sana’a City, Yemen, for 2017. METHODS Raw data of a house-to-house survey that was conducted by the Ministry of Public Health and Population in 2017 were analyzed. Data were collected from household heads who were asked if any household member had one of the following five NCDs: hypertension (HTN), diabetes (DM), bronchial asthma (BA), mental disorders (MD), and epilepsy. Data were entered and analyzed using Epi info 7.2. For calculations of prevalence, 2017 projections from the 2004 census were used. RESULTS A total of 241,310 households were surveyed (1,592,646 household members), 59,061 (24.48%) of which included 70,178 members who had at least one NCD. The overall prevalence of NCDs was 4.4%. The disease-specific prevalence was as follows: HTN, 2.3%; DM, 2.2%; BA, 0.4%; MD, 0.27; and epilepsy, 0.19%. The overall NCD prevalence was significantly higher among females than males (5.1% vs 3.8%; odds ratio [OR] 1.35, 95% CI 1.33-1.35), which was also the case for the prevalence of HTN (3.1% vs 1.6%; OR 1.94, 95% CI 1.90-1.98), DM (2.3% vs 2.1%; OR 1.11, 95% CI 1.09-1.13), and BA (0.5% vs 0.3%; OR 1.56, 95% CI 1.49-1.65). In contrast, the prevalence of MD was significantly higher among males than females (0.35% vs 0.16%; OR 2.2, 95% CI 2.06-2.31). The prevalence of NCDs progressively increased with age. Nearly 18% of patients had more than one NCD; 35.2% of the patients with HTN also had DM. CONCLUSIONS One-quarter of the surveyed households had at least one member with one or more of the five NCDs and the overall prevalence of NCDs was 4.4%. These data reflect only the tip of the iceberg as the findings are based on self-reported diagnosed cases rather than standardized measures. More attention to NCDs, strengthened health care provision, the ability to obtain high-reliability data, an NCDs stepwise survey, and establishing an NCDs surveillance system are recommended.
Background Noncommunicable diseases (NCDs) kill 41 million people each year, accounting for 71% of all deaths globally. The burden of NCDs is rising faster in developing countries of the Middle East than in other regions. The morbidity and mortality of NCDs are still not well-studied in Yemen. Objective The aim of this study was to describe the epidemiology of NCDs in Sana’a City, Yemen, for 2017. Methods Raw data of a house-to-house survey that was conducted by the Ministry of Public Health and Population in 2017 were analyzed. Data were collected from household heads who were asked if any household member had one of the following five NCDs: hypertension (HTN), diabetes (DM), bronchial asthma (BA), mental disorders (MD), and epilepsy. Data were entered and analyzed using Epi info 7.2. For calculations of prevalence, 2017 projections from the 2004 census were used. Results A total of 241,310 households were surveyed (1,592,646 household members), 59,061 (24.48%) of which included 70,178 members who had at least one NCD. The overall prevalence of NCDs was 4.4%. The disease-specific prevalence was as follows: HTN, 2.3%; DM, 2.2%; BA, 0.4%; MD, 0.27; and epilepsy, 0.19%. The overall NCD prevalence was significantly higher among females than males (5.1% vs 3.8%; odds ratio [OR] 1.35, 95% CI 1.33-1.35), which was also the case for the prevalence of HTN (3.1% vs 1.6%; OR 1.94, 95% CI 1.90-1.98), DM (2.3% vs 2.1%; OR 1.11, 95% CI 1.09-1.13), and BA (0.5% vs 0.3%; OR 1.56, 95% CI 1.49-1.65). In contrast, the prevalence of MD was significantly higher among males than females (0.35% vs 0.16%; OR 2.2, 95% CI 2.06-2.31). The prevalence of NCDs progressively increased with age. Nearly 18% of patients had more than one NCD; 35.2% of the patients with HTN also had DM. Conclusions One-quarter of the surveyed households had at least one member with one or more of the five NCDs and the overall prevalence of NCDs was 4.4%. These data reflect only the tip of the iceberg as the findings are based on self-reported diagnosed cases rather than standardized measures. More attention to NCDs, strengthened health care provision, the ability to obtain high-reliability data, an NCDs stepwise survey, and establishing an NCDs surveillance system are recommended.
BACKGROUND The national Severe Acute Respiratory Illness surveillance system in Yemen was established in 2010 to monitor SARI occurrence in humans and provide a foundation for detecting SARI outbreaks. OBJECTIVE To ensure that the objectives of the national surveillance are being met, this study aimed to determine the level of usefulness and assess the performance of the SARI surveillance system in Yemen. METHODS The updated Centers for Disease Control and Prevention (CDC) guidelines were used for the purpose of evaluation. Related documents and reports were reviewed. Data were collected from four central-level managers and stakeholders, and from ten focal points at four Sentinel sites using semi-structured questionnaire. For each attribute, the score percent was calculated and ranked as the following: very poor (≤ 20 %), poor (>20-≤ 40%), average (>40-≤ 60%), good (>60-≤80 %) and excellent (>80 %). RESULTS As rated by the evaluators, SARI surveillance system achieved its targets. The system attributes flexibility (percent score: 86%) and acceptability (percent score: 82%) were rated as excellent, and simplicity (percent score: 74%) and stability (percent score: 75%) were rated as good. The percent score of timeliness was 23% in 2018, indicating poor timeliness. The overall data quality percent score of SARI system was 98.5%. Despite its many strengths, the SARI system has some weakness in that it depends on irregular external financial support. CONCLUSIONS Overall, the SARI surveillance system was useful in estimating morbidity and mortality, monitoring the trend of disease, stimulating researches to inform prevention and control measures. SARI surveillance system was excellent in flexibility, acceptability and data quality. Its simplicity and stability were good; its timeliness was poor. It is recommended to expand the system and engage private sites in SARI surveillance, establish an electronic database at central and peripheral levels, and provide the lab with the reagents needed for confirmation.
case in viral encephalitis caused by HSV and VZV. The outcomes beyond hospital discharge of four patients at 6-month period and seven patients after 12 months were very promising with complete recovery (6/11, 55%) and recovery with minor sequelae (5/11, 45%).Conclusion: Anti-NMDAR encephalitis is an important differential diagnosis of encephalitis. Discrimination of autoimmune cause and viral etiologies of encephalitis is crucial to guide prompt antiviral or immune suppression therapies, that improves the clinical outcomes of the patients.
Peritrochanteric fracture among adult are very rare among adults, which needs to be reduced fractures and fixed appropriately for optimum outcome. Comminuted unstable peritrochanteric fractures are challenging injuries that can cause many complications. The current study presented a novel technique for reduction and fixation using a proximal femur locking plate and augmented by long distal tibia medial locked plate, which was placed anteriorly. As we know there is a lack of scientific literatures studied this augmented method as primary method of fixation. A 25-year-old male patient was brought to the emergency department having left hip pain and he was unable to bear his body weight since 12 hours after sustaining a high velocity gunshot injury to his left hip. Physical examination revealed stable hemodynamically status. Upon local physical examination of his affected limb revealed external rotation deformity and shortening of the limb approximately 2cm than healthy contra-lateral limb as shown in figure no.(1). There were two penetrated wounds, the first wound was in anteromedial proximal thigh 3cm length * 2 cm width, second wound was 10cm length *3cm width in posterolateral proximal thig. Neurovascular examination was normal. Past medical history was irrelevant and no any medical comorbidities. Laboratory tests revealed WBC and CRP within normal range. Imaging including pelvic, hip and lower limb x-rays and CT-scan showed complex comminuted peritrochanteric femoral fracture with comminution of greater trochanters. Because of lack of precise classification grade for this pattern of fracture, we diagnosed the fracture "open complex comminuted peritrochanteric femur fracture". Due to the instability and complexity of the fracture, several discussions were conducted to figure out what the best strategy available for definitive fixation. The preoperative plan was to remove the external fixator and perform the internal fixation at the same sitting using a proximal femur locking plate and augmented by anteriorly placed long distal tibia medial locking plate. Postoperative follow up period was uneventful. At eight months postoperatively, patient was able to walk without any walk assist such crutches and patient return to his preinjury condition. Peritrochanteric femur fracture is rare, specifically in young adult. The complex peritrochanteric fracture is challenging fracture pattern which may associated with high complications such as nonunion, delayed union, malunion and implant failure. The optimal surgical treatment is controversial. We consider that treatment of this kind of fracture with augmented locking implants allowed achieving satisfactory reduction with stable fixation that permitted patient's early functional rehabilitation which were the main goal of management.
BACKGROUND Noncommunicable diseases (NCDs) kill 41 million people each year, accounting for 71% of all deaths globally. The burden of NCDs is rising faster in developing countries of the Middle East than in other regions. The morbidity and mortality of NCDs are still not well-studied in Yemen. OBJECTIVE The aim of this study was to describe the epidemiology of NCDs in Sana’a City, Yemen, for 2017. METHODS Raw data of a house-to-house survey that was conducted by the Ministry of Public Health and Population in 2017 were analyzed. Data were collected from household heads who were asked if any household member had one of the following five NCDs: hypertension (HTN), diabetes (DM), bronchial asthma (BA), mental disorders (MD), and epilepsy. Data were entered and analyzed using Epi info 7.2. For calculations of prevalence, 2017 projections from the 2004 census were used. RESULTS A total of 241,310 households were surveyed (1,592,646 household members), 59,061 (24.48%) of which included 70,178 members who had at least one NCD. The overall prevalence of NCDs was 4.4%. The disease-specific prevalence was as follows: HTN, 2.3%; DM, 2.2%; BA, 0.4%; MD, 0.27; and epilepsy, 0.19%. The overall NCD prevalence was significantly higher among females than males (5.1% vs 3.8%; odds ratio [OR] 1.35, 95% CI 1.33-1.35), which was also the case for the prevalence of HTN (3.1% vs 1.6%; OR 1.94, 95% CI 1.90-1.98), DM (2.3% vs 2.1%; OR 1.11, 95% CI 1.09-1.13), and BA (0.5% vs 0.3%; OR 1.56, 95% CI 1.49-1.65). In contrast, the prevalence of MD was significantly higher among males than females (0.35% vs 0.16%; OR 2.2, 95% CI 2.06-2.31). The prevalence of NCDs progressively increased with age. Nearly 18% of patients had more than one NCD; 35.2% of the patients with HTN also had DM. CONCLUSIONS One-quarter of the surveyed households had at least one member with one or more of the five NCDs and the overall prevalence of NCDs was 4.4%. These data reflect only the tip of the iceberg as the findings are based on self-reported diagnosed cases rather than standardized measures. More attention to NCDs, strengthened health care provision, the ability to obtain high-reliability data, an NCDs stepwise survey, and establishing an NCDs surveillance system are recommended.
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