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Mohamed Ali MM, Alemary F, Alrtail A, Rzeg MM, Albakush AM, Ghenghesh KS. High isolation rates of multidrug-resistant bacteria from water and carpets of mosques. Libyan J Med 2014; 9:25415. [PMID: 25128691 PMCID: PMC4134672 DOI: 10.3402/ljm.v9.25415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 07/20/2014] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE There is little information regarding the isolation of antimicrobial-resistant potentially pathogenic bacteria from water and carpets of mosques worldwide. The objective of the present investigation is to determine the bacteriological quality of water and carpets of mosques in Elkhomes city in Libya. METHODS Potentially pathogenic bacteria were isolated from water samples (n=44) and dust samples from carpets (n=50) of 50 mosques in Elkhomes city, Libya, using standard bacteriological procedures. Susceptibility of isolated bacteria to antimicrobial agents was determined by the disc-diffusion method. RESULTS Of the water samples examined, 12 (27.3%) were positive for Escherichia coli, 10 (22.7%) for Klebsiella spp., and 15 (34.1%) for other enteric bacteria. Of the dust samples of carpets examined, 6 (12%) were positive for E. coli, 33 (66%) for Klebsiella spp., and 30 (60%) for Staphylococcus spp. Multidrug resistance (MDR, resistance to three or more antimicrobial groups) was found among 48.7% (19/37) and 46.9% (30/64) of the examined enterobacteria from water and carpets, respectively, and among 66.7% (20/30) of Staphylococcus spp. from carpets. In addition, methicillin-resistant Staphylococcus aureus (MRSA) was isolated from a carpet of one mosque. CONCLUSION Presence of multidrug-resistant potentially pathogenic bacteria in examined water and carpets indicate that mosques as communal environments may play a role in the spread of multidrug-resistant bacteria in the community and pose a serious health risk to worshipers.
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Bodalal Z, Azzuz R, Bendardaf R. Cancers in Eastern Libya: First results from Benghazi Medical Center. World J Gastroenterol 2014; 20:6293-6301. [PMID: 24876750 PMCID: PMC4033467 DOI: 10.3748/wjg.v20.i20.6293] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 12/26/2013] [Accepted: 02/20/2014] [Indexed: 02/07/2023] Open
Abstract
AIM: To study the pattern of cancer incidence and determine the incidence rates in Eastern Libya (for the first time in a decade).
METHODS: A hospital-based registry of cancer patients was formed using records from the primary oncology center in eastern Libya - focusing on those diagnosed in the year 2012.
RESULTS: The most common malignancies in men were cancers of the colon (22.3%, n = 90), lung (20.3%, n = 82), prostate (16.1%, n = 65), pancreas (4.2%, n = 17) and liver (4.2%, n = 17). For women, they were found to be cancers of the breast (41.5%, n = 213), colon (16.4%, n = 84), uterus (8%, n = 41), ovary (5.5%, n = 28) and pancreas (3.1%, n = 16). Additionally age-standardized rates (ASR) were determined for Libya. The different cities and towns in eastern Libya were compared for any variation. The city of Beida in particular was found to have a remarkably high incidence of gastric cancer. The different findings were discussed and comparisons were made with past literature as well as the incidence rates for neighbouring countries. The incidence rates given for the eastern region showed differences from previously reported values (i.e., the rate of colon cancer was the highest in North Africa whereas other malignancies occurred less frequently). Potential explanations for the urban-rural difference as well as the difference in incidence rates were put forth. The significance of this study is that it establishes a baseline of cancer incidence which should be the backbone for any future national cancer plan in Libya.
CONCLUSION: Proper surveillance programs need to be in place and healthcare policy should be adjusted to take into account the more prevalent and pressing cancers in society.
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Ben Khaial F, Bodalal Z, Elramli A, Elkhwsky F, Eltaguri A, Bendardaf R. Cervical cancer in north-eastern Libya: 2000-2008. J OBSTET GYNAECOL 2014; 34:523-6. [PMID: 24800833 DOI: 10.3109/01443615.2014.914478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Libya is a country with a low population, listed under the EMRO. Using registers and patient records from a major primary oncology clinic, data was gathered from Libyan cervical cancer patients and various parameters were studied across 9 years. Out of 4,090 female cancer cases during the study period, 1.8% were cervical cancer (n = 74). The average age of presentation was 53 years, with most of the cases (60%, n = 44) being premenopausal. Approximately 65% (n = 48) of cervical cancer patients are diagnosed at later stages (i.e. stages III and IV). The majority of these cases are squamous cell carcinoma (83.8%, n = 62), while 16.2% (n = 12) were found to be adenocarcinoma. Patients with squamous cell carcinoma presented at later stages more often than those with adenocarcinoma. Human papilloma virus was strongly implicated in cervical cancer, with 94% (n = 63) of those who were tested being positive for HPV-16 (82.5%, n = 52) and HPV-18 (12.7%, n = 8). Diagnosis was most frequently made through biopsy (97.3%, n = 72) as opposed to Pap smears (2.7%, n = 2). Most Libyan patients were put through chemotherapy (75%, n = 55) and triple therapy (surgery with combined chemotherapy and radiotherapy) was the most common (38%, n = 28) modality of treatment. Comparisons were made between Libya and other nations, either in the developed world or neighbouring countries. The major problem of cervical cancer in Libya is delayed presentation and hence, all the recommendations focus on increased awareness for the populace, implementation of a national cancer control plan and a national screening programme.
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Peeran SW, Altaher OB, Peeran SA, Alsaid FM, Mugrabi MH, Ahmed AM, Grain A. Oral health in Libya: addressing the future challenges. Libyan J Med 2014; 9:23564. [PMID: 24666627 PMCID: PMC3965712 DOI: 10.3402/ljm.v9.23564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 02/03/2014] [Indexed: 12/03/2022] Open
Abstract
Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health-related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management.
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Al-Tarshihi MI, Al-Basheer M. The falling bullets: post- Libyan revolution celebratory stray bullet injuries. Eur J Trauma Emerg Surg 2014; 40:83-5. [PMID: 26815781 DOI: 10.1007/s00068-013-0323-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 08/12/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report our experience with the post-Libyan revolution celebratory stray bullet injuries by falling bullets. METHODS This descriptive study was carried out during the period from November 2011 to February 2012 at the military Jordanian field hospital in Benghazi-Libya. Twenty-three patients who were injured by falling bullets were enrolled in this study. Intentional and direct bullet injuries due to conflicts were excluded. Demographic data, injured body part, place of injury, timing of intervention, hospital stay, and fatality were described and analyzed. RESULTS Children less than 14 years of age constituted 65.2 % (n = 15) of the falling bullets victims. Injured body parts were upper and lower limbs (12, 52.2 %), chest (8, 34.8 %), head and neck (2, 8.7 %), and abdomen (1, 4.3 %). Three (13.0 %) patients were diagnosed to have stray bullet injury by radiological investigations without a clinical suspicion. Two (8.7 %) fatalities were reported. CONCLUSION Celebratory stray bullet injuries are an unusual form of injury not infrequently seen in some parts of the world. Lower limb and chest injuries especially among children are most commonly reported. Focus on prevention through education and weapon use regulations carries the best chance of reducing these injuries.
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Hosni M, Maghrbi AE. Ectoparasites infestation of free-ranging hedgehog (Etelerix algirus) in north western Libya. Open Vet J 2014; 4:12-5. [PMID: 26623333 PMCID: PMC4629589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 01/26/2014] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to assess the prevalence of ectoparasites in hedgehogs (Etelerix algirus) in north western region of Libya. Seventy hedgehogs were sampled, and 39 (55.7%) were infested with external parasites. A total of 44 ticks, 491 fleas were collected from the infested hedgehogs and four species of ectoparasites were identified, one mite (Sarcoptes scabiei), one tick (Rhipicephalus appendiculatus) and two fleas (Xenopsylla cheopis and Ctenocephalides canis). For ectoparasites, 10/39 (25.6%) were infested by S. scabiei, 8/39 (20.5%) by Rh. appendiculatus and 11/39 (28.2%) by fleas. The prevalence of mixed infestation with S. scabiei and C. canis was 3(7.7%), Rh. appendiculatus and C. canis was 2 (5.1%) and infestation by two species of fleas was 5 (12.8%). The overall mixed infestation was 10 (25.6%). We concluded that the hedgehogs may play an important role in spreading external parasites and transmission of diseases from one region to another and from wildlife animals to domestic animals and human.
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Hwisa NT, Katakam P, Chandu BR, Ismael MH, Bader A. Pandemic influenza A (H1N1) vaccination among libyan health care personnel: A cross-sectional retrospective study. J Pharm Bioallied Sci 2014; 6:192-7. [PMID: 25035639 PMCID: PMC4097933 DOI: 10.4103/0975-7406.130958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 08/17/2013] [Accepted: 09/29/2013] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Vaccination rate among health-care personnel's (HCPs) are not promising notwithstanding the World Health Organization campaigns over three decades resulting in compromising patient safety. The H1N1 virus, which caused a world-wide pandemic earlier has now transformed into a seasonal flu virus. AIMS The aim of this study was to analyze the incidence of 2009-10 pandemic influenza A (H1N1) vaccination among Libyan HCPs in four hospitals of Al-Zawia, Libya. MATERIALS AND METHODS A questionnaire, which listed eight sections of parameters distributed among 310 HCPs to assess the vaccination rate and resulting adverse effects. STATISTICAL ANALYSIS The data were analyzed using descriptive statistics, Pearson's χ(2)-test and Student's t-test where appropriate. RESULTS The overall pandemic A (H1N1) vaccination among all HCPs was only 107 (39.9%) out of 268 respondents. The distribution of respondents based on physicians, other staff and sex were found significant (P < 0.05). The common barriers of H1N1 vaccination being lack of awareness fear of adverse effects, allergies and religious beliefs. The major adverse effect observed was erythema in 95.56% of physicians and 87.1% in other staff. About 2% of HCPs have reported arthralgia. No significant differences existed between the responses of general variables and adverse effects. The glycoprotein 120 and squalene were found responsible for the reported adverse effects. 37 (82.22%) vaccinated medical HCPs have advised their patients to get vaccinated. CONCLUSIONS Due to recurrence of H1N1 influenza in recent times, vaccination campaigns should be promoted immediately to address the knowledge gap of HCPs for intervention by regulatory and health organizations in Libya. The health belief model could be applied to improve vaccination among HCPs.
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AlObaidy H. Patterns of inborn errors of metabolism: A 12 year single-center hospital-based study in Libya. Qatar Med J 2013; 2013:57-65. [PMID: 25003067 PMCID: PMC4080488 DOI: 10.5339/qmj.2013.18] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 12/31/2013] [Indexed: 11/22/2022] Open
Abstract
Background: Inborn errors of metabolism (IEM) are mostly transmitted as autosomal recessive disorders and are therefore more frequent in countries with high consanguinity rates such as in the Arab world. Objective: To study the socio-demographic characteristics and the clinical presentation of IEM in Libyan children and to shed light on our experience in dealing with these disorders. Methods: This is a descriptive case series hospital-based study of 107 children attending the Metabolic Unit at El-Khadra Teaching Hospital (MUKH) in Tripoli, Libya. The study took place between January 2001 and December 2012. Information was collected from caregivers and from all available hospital records on the following variables: age, sex, birth order, place of residence, age at onset, presenting complaints and family history of the same illness. Results: During the 12-year study period, there were 55,422 live births at El-Khadra Teaching Hospital and 107 children were diagnosed with 46 different metabolic disorders. A significantly high consanguinity rate was observed (86.9%) among parents of the affected children. Family history of previous affected children was noted in 63.5% of cases. Male to female ratio was 1.18:1. The most frequent IEM cases were amino acids disorders (25%), carbohydrate disorders (14.9%), lysosomal storage diseases (14%), organic aciduria and energy metabolic defects (9.3% each). The main clinical presentations were jaundice, hepatomegaly and seizures. Most children presented between one and six months of age (43.4%); whereas the median age at diagnosis was eight months. Thirty-eight children (35.5%) were born at El-Khadra Hospital with IEM giving a birth prevalence of 1:1458 live births, (1:6158 for aminoaciduria and 1:6927 for carbohydrate disorders). Conclusion: IEM disorders are common in Libya. Efforts to enhance awareness among pediatricians and primary healthcare providers should be supported and encouraged as many diseases are still undiagnosed. It is very important to consider IEM among all children when they present any worrying or suspicious symptoms or signs which do not respond to conventional treatment. Although our findings are preliminary, and probably the first to be conducted in Libya, they suggest ideas for decision makers to plan services including newborn screening programs and country-wide research of IEM diseases.
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Hajjaji IM, Sherif I, Elazrag A, Jaber S, Chakkarwar PN, Eltabal S. Clinical experience with biphasic insulin aspart in people with type 2 diabetes: Results from the Libya cohort of the A1chieve study. Indian J Endocrinol Metab 2013; 17:S435-S436. [PMID: 24404475 PMCID: PMC3872883 DOI: 10.4103/2230-8210.122062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. MATERIALS AND METHODS Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled in biphasic insulin aspart sub group from Libya. RESULTS A total of 179 patients were enrolled in the biphasic insulin aspart subgroup. All the patients were prior insulin users. At baseline glycaemic control was poor (mean HbA1c: 9.3%). After 24 weeks of treatment there was an improvement in HbA1c (-0.9%). Hypoglycaemic events reduced from 7.2 events/patient-year to 3.7 events/patient-year in 24 weeks. SADRs did not occur in any of the study patients. CONCLUSION Starting or switching to biphasic insulin aspart was associated with improvement in glycaemic control with a low rate of hypoglycaemia.
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El Oakley RM, Ghrew MH, Aboutwerat AA, Alageli NA, Neami KA, Kerwat RM, Elfituri AA, Ziglam HM, Saifenasser AM, Bahron AM, Aburawi EH, Sagar SA, Tajoury AE, Benamer HTS. Consultation on the Libyan health systems: towards patient-centred services. Libyan J Med 2013. [PMID: 23359277 DOI: 10.3402/ljm.v3408i3400.20233.10.3402/ljm.v8i0.20233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century.
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Bodalal Z, Mansor S. Gunshot injuries in Benghazi- Libya in 2011: the Libyan conflict and beyond. Surgeon 2013; 11:258-63. [PMID: 23743179 DOI: 10.1016/j.surge.2013.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/02/2013] [Accepted: 05/12/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since independence, Libya has never experienced personal ownership of arms. That changed during the Libyan conflict where weapons became widespread in the society. As a result gunshot injuries became a concern for surgeons at our principal surgical hospital (Al-Jalaa). This study aims at analyzing the gunshot injuries that took place during 2011 and highlighting the peculiarities in the Libyan scenario. METHODS Patient records were obtained and gunshot injuries were analyzed for various parameters. Statistical analyses were made taking into consideration situations faced by neighbouring countries. RESULTS In 2011, 1761 patients were admitted with over 95% being male and over 97% were Libyan. The average age of a GSI patient was 28.32 ± 10.01 years. Patients aged 18-35 formed over 70% of the cases with half of all cases being treated by the orthopedics department. Sixty-eight percent of cases were injured in the extremities followed by chest (12.5%) and abdomen injuries (7.8%). The mortality rate for GSI's was found to be 5.6% overall with young age, site of injury (i.e. chest and head) and cause of injury (i.e. war or civilian fighting) being important risk factors. CONCLUSIONS Taking into consideration the difficult operating conditions and limited resources, surgeons at our hospital were able to maintain a low mortality rate. Disarmament needs to begin as soon as possible because these injuries will continue to occur so long firearms are available in society.
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Ghenghesh KS, Rahouma A, Tawil K, Zorgani A, Franka E. Antimicrobial resistance in Libya: 1970-2011. Libyan J Med 2013; 8:20567. [PMID: 23537612 PMCID: PMC3610430 DOI: 10.3402/ljm.v8i0.20567] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 03/04/2013] [Indexed: 11/18/2022] Open
Abstract
Resistance to antimicrobial agents is a major health problem that affects the whole world. Providing information on the past state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Information was obtained mainly from Highwire Press (including PubMed) search for the period 1970-2011 using the terms 'antibiotic resistance in Libya', 'antimicrobial resistance in Libya', 'tuberculosis in Libya', and 'primary and acquired resistance in Libya' in title and abstract. From 1970 to 2011 little data was available on antimicrobial resistance in Libya due to lack of surveillance and few published studies. Available data shows high resistance rates for Salmonella species in the late 1970s and has remained high to the present day. High prevalence rates (54-68%) of methicillin-resistant Staphylococcus aureus (MRSA) were reported in the last decade among S. aureus from patients with burns and surgical wound infections. No reports were found of vancomycin-resistant S. aureus (VRSA) or vancomycin-intermediate-resistant S. aureus (VISA) using standard methods from Libya up to the end of 2011. Reported rates of primary (i.e. new cases) and acquired (i.e. retreatment cases) multidrug-resistant tuberculosis (MDR-TB) from the eastern region of Libya in 1971 were 16.6 and 33.3% and in 1976 were 8.6 and 14.7%, in western regions in 1984-1986 were 11 and 21.5% and in the whole country in 2011 were estimated at 3.4 and 29%, respectively. The problem of antibiotic resistance is very serious in Libya. The health authorities in particular and society in general should address this problem urgently. Establishing monitoring systems based on the routine testing of antimicrobial sensitivity and education of healthcare workers, pharmacists, and the community on the health risks associated with the problem and benefits of prudent use of antimicrobials are some steps that can be taken to tackle the problem in the future.
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Abdellatif MZM, El-Mabrouk K, Ewis AA. An epidemiological study of cutaneous leishmaniasis in Al-jabal Al-gharbi, Libya. THE KOREAN JOURNAL OF PARASITOLOGY 2013; 51:75-84. [PMID: 23467624 PMCID: PMC3587753 DOI: 10.3347/kjp.2013.51.1.75] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 08/17/2012] [Accepted: 09/07/2012] [Indexed: 11/23/2022]
Abstract
Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.
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El Oakley RM, Ghrew MH, Aboutwerat AA, Alageli NA, Neami KA, Kerwat RM, Elfituri AA, Ziglam HM, Saifenasser AM, Bahron AM, Aburawi EH, Sagar SA, Tajoury AE, Benamer HTS. Consultation on the Libyan health systems: towards patient-centred services. Libyan J Med 2013; 8:20233. [PMID: 23359277 PMCID: PMC3556564 DOI: 10.3402/ljm.v8i0.20233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 12/21/2012] [Indexed: 11/14/2022] Open
Abstract
The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century.
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Sharif M, Farhat M, Kraim E, Altrabulsi N, Kammon A, Dayhum A, Eldaghayes I. Ovine paratuberculosis: a confirmed case of Johne's disease in Libya. Open Vet J 2013; 3:131-4. [PMID: 26623326 PMCID: PMC4629618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 10/27/2013] [Indexed: 10/25/2022] Open
Abstract
Paratuberculosis (Johne's disease) was suspected in a herd of approximately 300 sheep after weight loss and scouring had increased in adult animals despite repeated treatment with anthelmintics, antibiotics, multivitamins and minerals. The herd is located near Tarhouna city. Herd history revealed that a total of 60 ewes showed clinical symptoms and deaths during the last two years. The last case that we attended was submitted to the National Center of Animal Health (NCAH) for a detailed laboratory examination. Gross pathological and histological examination of tissue samples revealed results that were highly comparable with Johne's disease. A definitive diagnosis was made only by histopathological identification of Mycobacterium paratuberculosis in the intestines using Ziehl-Neelsen stain. This is the first documented case of M. paratuberculosis in sheep in Libya.
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Hosni M, Maghrbi AE, Ganghish K. Occurrence of Trichinella spp. in wild animals in northwestern Libya. Open Vet J 2013; 3:85-8. [PMID: 26623318 PMCID: PMC4629619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 06/29/2013] [Indexed: 10/25/2022] Open
Abstract
The present study determined the occurrence of Trichinella spp. in captured and some perished wildlife animals which included 70 hedgehogs, 19 red foxes, 13 common jackals and 8 crested porcupines in northwestern Libya. Muscle samples of these animals were examined by trichinoscopy. Trichinella larvae were detected only in 4 (5.7%) of the hedgehogs (Erinaceus algirus) and 2 (10.5%) of the red foxes (Vulpes vulpes). Larvae were found in the muscles of the diaphragm, abdomen, tongue, forelimb, hindlimb and intercostal muscles. Examination of tissue sections revealed the presence of numerous cysts within the muscle fibers containing one or more coiled or elongated larvae. Inflammatory cell infiltration was observed around the cysts especially at their poles. Results indicated the importance of wild animals as reservoirs of Trichinella larvae and their role in the transmission of the disease to other wild and domestic animals as well as humans.
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Abrika OSS, Hassali MA, Abduelkarem AR. Importance of social pharmacy education in Libyan pharmacy schools: perspectives from pharmacy practitioners. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2012; 9:6. [PMID: 22451860 PMCID: PMC3309042 DOI: 10.3352/jeehp.2012.9.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 02/26/2012] [Indexed: 05/31/2023]
Abstract
The present study aims to explore the perceptions among pharmacy practitioners in Libya on the importance of social pharmacy education. A qualitative methodology was employed to conduct this study. Using a purposive sampling technique, a total of ten Libyan registered pharmacists were interviewed. Based on the content analysis of the interviews, two major themes emerged, namely the understanding of social pharmacy education and the need for incorporating social pharmacy courses into the pharmacy education curriculum. The majority of the respondents knew about the concept. Of those that had no prior knowledge of this term, half of them expressed interest in knowing more about it. There was a positive perception of introducing social pharmacy into the undergraduate curricula among the respondents, and they believed that it is necessary for future pharmacists to know about social pharmacy components. The findings from the pharmacy practitioners' evaluation suggest the need to incorporate social pharmacy courses into the curricula of all pharmacy schools in Libya.
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Elhwuegi AS, Darez AA, Langa AM, Bashaga NA. Cross-sectional pilot study about the health status of diabetic patients in city of Misurata, Libya. Afr Health Sci 2012; 12:81-86. [PMID: 23066426 PMCID: PMC3462506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Being a leading cause of death worldwide, epidemiological studies about diabetes mellitus have encouraged governments to initiate or improve local diabetes monitoring and prevention strategies. OBJECTIVE The main objective of this study was to examine the profile of diabetic patients in the city of Misurata, the third largest city in Libya. METHODS 260 diabetic cases of both gender randomly selected from the total number of patients admitted to the centre of diabetes and endocrine disorders, Misurata -Libya for the period between January to March 2008. Data collected from patients' files and by directly questioning the patients. SPSS software version 13 was used for the statistical analysis and presentation of the data. RESULTS 87% of all patients were type 2 diabetics, while only 9.9% were type 1. 73% of all patients had family history of diabetes. 52% of all diabetic patients were obese, with more obesity in females (70% of females) than males (33.8% of males). Obesity was more pronounced in type 2 patients (56.8%) than in type 1 patients (11.5%). 38% of all patients were treated with insulin while 35.4% were treated with oral hypoglycemics. Meanwhile 32.6% of type 2 diabetic patients were treated with insulin. Only 9.2% of all patients had fasting blood sugar below 140 mg/dl, whereas 55% had levels in the range of 140-180 mg/dl, while 35.8% had levels above 180 mg/dl. Microvascular complications included retinopathy (16.2% of all patients), neuropathy (11.2%), nephropathy (1.5%) and combination of neuropathy and retinopathy (6.5%). CONCLUSION High percentage of risk factors including obesity, family history of diabetes, hypertension and microvascular complications requires a Libyan national policy for the surveillance, prevention and control of diabetes and its complications.
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Salamat A, Esriti A, Ehtuish A, El-Ogbi S. Libyan cochlear implant programme: achievements, difficulties, and future goals. Libyan J Med 2011; 6:LJM-6-5930. [PMID: 21694783 PMCID: PMC3118784 DOI: 10.3402/ljm.v6i0.5930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 04/24/2011] [Indexed: 11/20/2022] Open
Abstract
Cochlear implantation has become established worldwide as a safe and effective method of auditory rehabilitation of selected severely and profound deaf children and adults. Over 100,000 patients have received cochlear implants worldwide with the paediatric population proving to be the main beneficiaries. The Libyan cochlear implant programme was set up in 2004. Data relating to the patients who received cochlear implantation at Tripoli Medical Centre between October 2007 and February 2010 were analysed. Implant operations were performed on 37 patients. All patients received Med-El SONATATI100 devices. Thirty-four (91.9%) of these patients were children, whilst three (8.1%) were adults. Combined, congenital hearing loss (56.8%) and perinatal/neonatal (29.7%) were the two main aetiological factors in children. Seventeen patients (45.9%) had a positive family history of deafness. Sixteen patients (43.2%) were born to blood-related parents. The overall rate of minor and major complications was 16.2%, which is comparable to previous studies.
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Elghuel A. The characteristics of adults with upper gastrointestinal bleeding admitted to Tripoli Medical Center: a retrospective case-series analysis. Libyan J Med 2011; 6. [PMID: 21526040 PMCID: PMC3081857 DOI: 10.3402/ljm.v6i0.6283] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 02/06/2011] [Accepted: 02/06/2011] [Indexed: 11/14/2022] Open
Abstract
Background Acute upper gastrointestinal bleeding (UGIB) is a common reason for hospital admissions worldwide. Aetiological causes of UGIB vary according to geographic region and socioeconomic status. However, despite the implementation of early endoscopy as the standard method for the diagnosis and treatment of UGIB, data on the characteristics of patients with UGIB in Libya are still minimal. In this study, we describe patient demographics, aetiological causes for UGIB, and possible risk factors for upper gastrointestinal bleeding in patients admitted to the Gastroenterology Department at Tripoli Medical Center from January 2001 through June 2006. Method This is a retrospective case-series analysis of all adult patients with upper gastrointestinal bleeding admitted to the Gastroenterology Department at TMC. Patients' medical records were individually reviewed and relevant data abstracted. Results A total of 928 cases with diagnoses of UGIB were admitted to Tripoli Medical Center during the study period. Of these cases, 60.3% were males and 39.7% females (3:2) and males were significantly younger than females (49.6 years vs. 53.9 years, p=0.001). The most common cause of UGIB was peptic ulcer (37.1%) of which duodenal ulcer was the most common (30.7% of all UGIB), especially amongst male patients (36.4%). The second most common cause was bleeding due to varices (29.8%), especially amongst females (35.1%). Additionally, smoking and NSAIDs use were reported by 18.6% and 9.7% of cases and both were significantly associated with bleeding due to peptic ulcers. Conclusion This study has investigated the characteristics of adults with UGIB at a tertiary referral center in Libya. The high frequency of bleeding due to varices amongst females mandates further investigations into the possible underlying hepatic causes and their management, and the potential impact on patient outcome and prognosis.
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Rahouma A, Elghamoudi A, Nashnoush H, Belhaj K, Tawil K, Sifaw Ghenghesh K. Isolation of antibiotic-resistant pathogenic and potentially pathogenic bacteria from carpets of mosques in Tripoli, Libya. Libyan J Med 2010; 5. [PMID: 21483559 PMCID: PMC3071171 DOI: 10.3402/ljm.v5i0.5536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 08/19/2010] [Accepted: 08/23/2010] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Isolation of potentially pathogenic bacteria from carpets in hospitals has been reported earlier, but not from carpets in mosques. The aim of the present study is to determine the pathogenic and potentially pathogenic bacteria that may exist on the carpets of mosques in Tripoli, Libya. METHODS Dust samples from carpets were collected from 57 mosques in Tripoli. Samples were examined for pathogenic bacteria using standard bacteriological procedures. Susceptibility of isolated bacteria to antimicrobial agents was determined by the disc-diffusion method. RESULTS Of dust samples examined, Salmonella spp. was detected in two samples (3.5%, 1 in group B and 1 in group C1), Escherichia coli in 16 samples (28.1%), Aeromonas spp. in one sample (1.8%), and Staphylococcus aureus in 12 samples (21.1%). Multiple drug resistance was observed in >16.7% of E. coli and in 25% of S. aureus. CONCLUSION Contamination of carpets in mosques of Tripoli with antibiotic-resistant pathogenic and potentially pathogenic bacteria may pose a health risk to worshipers, particularly, the very young, the old and the immunecompromised. Worshipers are encouraged to use personal praying mats when praying in mosques.
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Jaraari AM, Jagannadharao P, Patil TN, Hai A, Awamy HA, El Saeity SO, Abdel Kafi EB, El-Hemri MN, Tayesh MF. Quantitative analysis of gallstones in Libyan patients. Libyan J Med 2010; 5:10.4176/091020. [PMID: 21483549 PMCID: PMC3066788 DOI: 10.4176/091020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Accepted: 06/13/2009] [Indexed: 01/28/2023] Open
Abstract
Gallstone disease is one of the major surgical problems in the Libyan population; it is probably related to diet, especially excessive consumption of meat. The study was conducted to determine the composition of gallstones and their possible etiology in a Libyan population. The chemical composition of gallstones from 41 patients (six males and 35 females) was analyzed. The stones were classified into cholesterol, pigment, and mixed stones (MS). Cholesterol stones (CS) showed a significantly higher cholesterol content than pigment stones (PS) (p=0.0085) though not significantly higher than MS. Their phospholipid content and inorganic phosphates were higher than in the other types of stones and oxalate content was significantly elevated in comparison with MS (p=0.0471). In MS, the cholesterol, bile acids, and bilirubin were intermediate between cholesterol and PS, whereas triglycerides were significantly more than PS (p=0.0004). Bilirubin (0.0001) and bile acids (p=0.0009) were significantly higher than CS (p=0.0001). However, they contained the lowest amounts of sodium, potassium, magnesium, and oxalate. In PS, bilirubin (p=0.0001) was significantly higher than both groups. Bile acid content was significantly higher than CS (p=0.0001) but not significantly more than MS. They showed the highest values of calcium, sodium, potassium, magnesium, and chlorides compared to the other types of stones. High levels of cholesterol in stones and dyslipidemia associated with mixed as well as cholesterol gallstones suggest an etiological association and efforts to reduce dietary fat among the Libyan population may lead to decreased cholesterol and mixed gallstones.
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Jaraari AM, Jagannadharao P, Patil TN, Hai A, Awamy HA, El Saeity SO, Abdel Kafi EB, El-Hemri MN, Tayesh MF. Quantitative analysis of gallstones in Libyan patients. Libyan J Med 2010; 5:4627. [PMID: 28156296 PMCID: PMC3066788 DOI: 10.3402/ljm.v5i0.4627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Accepted: 06/13/2009] [Indexed: 02/03/2023] Open
Abstract
Gallstone disease is one of the major surgical problems in the Libyan population; it is probably related to diet, especially excessive consumption of meat. The study was conducted to determine the composition of gallstones and their possible etiology in a Libyan population. The chemical composition of gallstones from 41 patients (six males and 35 females) was analyzed. The stones were classified into cholesterol, pigment, and mixed stones (MS). Cholesterol stones (CS) showed a significantly higher cholesterol content than pigment stones (PS) (p=0.0085) though not significantly higher than MS. Their phospholipid content and inorganic phosphates were higher than in the other types of stones and oxalate content was significantly elevated in comparison with MS (p=0.0471). In MS, the cholesterol, bile acids, and bilirubin were intermediate between cholesterol and PS, whereas triglycerides were significantly more than PS (p=0.0004). Bilirubin (0.0001) and bile acids (p=0.0009) were significantly higher than CS (p=0.0001). However, they contained the lowest amounts of sodium, potassium, magnesium, and oxalate. In PS, bilirubin (p=0.0001) was significantly higher than both groups. Bile acid content was significantly higher than CS (p=0.0001) but not significantly more than MS. They showed the highest values of calcium, sodium, potassium, magnesium, and chlorides compared to the other types of stones. High levels of cholesterol in stones and dyslipidemia associated with mixed as well as cholesterol gallstones suggest an etiological association and efforts to reduce dietary fat among the Libyan population may lead to decreased cholesterol and mixed gallstones.
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Zorgani A, Shawerf O, Tawil K, El-Turki E, Ghenghesh K. Inducible Clindamycin Resistance among Staphylococci Isolated from Burn Patients. Libyan J Med 2009; 4:104-6. [PMID: 21483523 PMCID: PMC3066734 DOI: 10.4176/090128] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Clindamycin has been used successfully to treat pneumonia and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus. However, inducible clindamycin resistance has been described as a cause of treatment failure of such infections. A total of 159 staphylococcal isolates from different clinical specimens from burn patients in Tripoli Burn Center were tested for inducible clindamycin resistance by the disk-diffusion induction test. Inducible clindamycin resistance was detected in 66.2% of 65 methicillin-resistant S. aureus isolates and in none of 55 methicillin-sensitive S. aureus, 10 methicillin-resistant coagulase negative staphylococci and 29 methicllin-sensitive coagulase negative staphylococci isolates. In our setting, clindamycin can be used for the treatment of infections due to staphylococci, but we recommend that staphylococci isolates, particularly methicillin-resistant S. aureus, are tested by the D-test before treatment.
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Mathew B, Daniel R, Bordom J. Kudos to the virus hunters. Libyan J Med 2009; 4:15-6. [PMID: 21483495 PMCID: PMC3066706 DOI: 10.4176/081207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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