1
|
Al-Bataineh R, Al-Hammouri M, Al-Jaraideh W. The accessibility and quality of health services for diabetes mellitus and chronic respiratory disease patients during Covid-19 in Northern Jordan: A mixed method study. PLoS One 2023; 18:e0294655. [PMID: 37972036 PMCID: PMC10653463 DOI: 10.1371/journal.pone.0294655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The catastrophe caused by the Coronavirus disease has affected all services worldwide. A range of policies were introduced to slow the virus spread, which in turn, affected the accessibility and quality of healthcare services. This was a problematic and concerning for patients with chronic diseases, such as patients with diabetes mellitus (DM) and chronic respiratory diseases (CRD), due to their sustained need for ongoing health care. The aims of the study were: 1) assessing the level of both accessibility and quality of healthcare services during the Covid-19 pandemic from the DM and CRD patients' perspectives, 2) assessing the association between the patients' socio-demographics and their perspectives on health services accessibility and quality, and 3) exploring the perspectives of DM and CRD patients on barriers and facilitators of health services accessibility and quality during the era of COVID -19. METHOD Design. A sequential explanatory mixed-method was used in this study. In the quantitative part, a self -administered questionnaire was used to collect data from 300 patients with DM and/or CRD. In the qualitative part, focus group approach was used to collect data from 25 patients. Setting. Public, private and teaching hospitals were involved. Analysis. SPSS Version 25 was used to analyze the quantitative data. Thematic analysis was used to analyze the qualitative data. RESULTS The quantitative findings indicated that almost 99% of the participating patients perceived barriers, ranging from low to high, to accessing health services during COVID-19. Additionally, more than half of the sample perceived low to moderate level of quality of health services. Four themes and nine subthemes related to barriers and facilitators were identified in the qualitative part of the study. CONCLUSION The study revealed that both quality and accessibility of healthcare services for DM and CRD patients were impacted during the era of COVID -19. The findings lay the ground for developing future health programs and establishing or revising policies with the goal of improving healthcare services quality and accessibility for the target population.
Collapse
Affiliation(s)
- Raya Al-Bataineh
- Department of health management and policy, Faculty of Medicine, Jordan university of Science and Technology, Irbid, Jordan
| | - Mohammed Al-Hammouri
- Department of Community and Mental Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Wafa’a Al-Jaraideh
- Department of health management and policy, Faculty of Medicine, Jordan university of Science and Technology, Irbid, Jordan
| |
Collapse
|
2
|
Tariq MNM, Stojanovska L, Dhaheri ASA, Cheikh Ismail L, Apostolopoulos V, Ali HI. Lifestyle Interventions for Prevention and Management of Diet-Linked Non-Communicable Diseases among Adults in Arab Countries. Healthcare (Basel) 2022; 11:healthcare11010045. [PMID: 36611505 PMCID: PMC9819169 DOI: 10.3390/healthcare11010045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
The increased incidences of diet-related non-communicable diseases (NCDs) such as diabetes, obesity, and cardiovascular diseases among adults are becoming the chief public health concern in most Arab countries. Economic expansion has contributed to a nutrition shift from a traditional seasonal diet to Westernized eating habits coupled with a sedentary lifestyle. Despite the rising concern for NCD mortality, public health policies are inadequately addressed. This narrative review aims to discuss the effectiveness of nutritional interventions focusing on diet and physical activity in the management of NCDs among Arab adults. A comprehensive literature search was performed using different database platforms such as Cochrane reviews, Scopus, and PubMed for articles published between 1 December 2012 and 31 December 2021. Fifteen recent research articles addressing NCDs, mainly diabetes and obesity, from different Arab countries were included in this review. Structured lifestyle interventions involving behavioral therapy approaches and personalized goals for diet and physical activity were found to improve specific health outcomes in most studies. Significant improvements in health outcomes were reported for longer-duration interventions with follow-ups. A combination of both online and face-to-face sessions was found to be effective. It is important to identify barriers to physical activity for a culturally acceptable lifestyle intervention and conduct further studies to evaluate interventions for the long-term maintenance of health outcomes.
Collapse
Affiliation(s)
- Maryam Naveed Muhammad Tariq
- Department of Nutrition & Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates
| | - Lily Stojanovska
- Department of Nutrition & Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
| | - Ayesha S. Al Dhaheri
- Department of Nutrition & Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX1 2JD, UK
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
| | - Habiba I. Ali
- Department of Nutrition & Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates
- Correspondence: ; Tel.: +971-03-713-6556
| |
Collapse
|
3
|
Schmid B, Ansbro É, Raju E, Willis R, Shabila N, Perel P. Models of care for non-communicable diseases for displaced populations in Iraq: a scoping review. Confl Health 2022; 16:40. [PMID: 35841046 PMCID: PMC9283558 DOI: 10.1186/s13031-022-00474-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022] Open
Abstract
Non-communicable diseases (NCDs) are the leading cause of death and disability globally. Their importance in humanitarian settings is increasingly recognised, but evidence about how best to address NCDs in these setting is limited. This scoping review aimed to explore models of NCD care for displaced populations in Iraq, in order to build evidence to design context adapted models of care. A search of key databases (Medline, Embase, Scopus, EconLit, Global Health, Web of Science, and the Iraqi Academic Scientific Journals) was conducted and complemented with grey literature and snowballing searches. Documents were included if they referred to models of NCD care for displaced populations. We synthesised the data using a conceptual model of care framework. The findings were reported according to the PRISMA guidelines for scoping reviews. We identified 4036 documents of which 22 were eligible for inclusion. Only six documents were peer-reviewed studies with most being internal reports, commentaries, or press releases. Of the 14 documents that reported on their methods, most applied quantitative approaches (n = 7), followed by mixed-methods (n = 5) and qualitative approaches (n = 2). Only one document reported on outcome data and none applied longitudinal study designs. Documents generally described individual framework dimensions, mostly centring around medicines, facility-based services, and selected access dimensions. Most dimensions had few or no references. The most common model for displaced populations in Iraq was primary-level centred care that complemented or supported existing—mostly tertiary—public health system structures. Additionally, private facilities played an important role and were frequently accessed by displaced populations in most settings. Quality of care, particularly patient-perceived quality, emerged as a critical factor for designing context-adapted models of NCD care. This review also identified a strong regionality of NCD care, particularly in terms of access rates and barriers. We concluded that there is a scarcity of evidence on the effectiveness of models of NCD care for displaced populations in Iraq, calling for capacity building initiatives focused on implementation research and evaluation.
Collapse
Affiliation(s)
- Benjamin Schmid
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK. .,Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Éimhín Ansbro
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK.,Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Emmanuel Raju
- Global Health Section and Copenhagen Centre for Disaster Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Unit for Environmental Sciences and Management, African Centre for Disaster Studies, North-West University, Potchefstroom, South Africa
| | - Ruth Willis
- Research Fellow in Social Science, Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Nazar Shabila
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
| | - Pablo Perel
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK.,Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| |
Collapse
|
4
|
Murtagh E, Shalash A, Martin R, Abu Rmeileh N. Measurement and prevalence of adult physical activity levels in Arab countries. Public Health 2021; 198:129-140. [PMID: 34418764 DOI: 10.1016/j.puhe.2021.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/14/2021] [Accepted: 07/09/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study aims to examine the reported prevalence of sufficient physical activity among adults in Arab countries and to determine the use of validated instruments for assessing physical activity. STUDY DESIGN This is a systematic literature review. METHODS This review follows recommendations outlined in the Meta-Analysis of Observational Studies in Epidemiology guidelines. The protocol for this study was preregistered with PROSPERO. Cross-sectional, cohort and intervention studies with a minimum of 300 adults aged ≥18 years assessing physical activity using a questionnaire or other self-report measure in the Arabic language were identified from seven electronic databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, SPORTDiscu and PubMed). Databases were searched from 1st January 2008 to 17th September 2018. Descriptive analysis was performed using frequency and percentages. The prevalence of physical activity was calculated as the average prevalence for the reported percentages from the studies with similar tools. RESULTS Fifty studies involving 298,242 participants were included in this review. The mean (range) sample size was 5964.8.1 (323-197,681). Data were collected from participants in 16 of the 22 Arab countries. Great variation exists across the studies in determining whether adults were sufficiently active or not. Twenty studies reported usable data from the Global Physical Activity Questionnaire and the International Physical Activity Questionnaire (moderate & high categories). In these studies, prevalence of physical activity ranged from 34.2 to 96.9%. It was not possible to compare the other studies owing to variation in instruments used to assess physical activity and in the case definition used for 'physically active'. CONCLUSIONS This study highlights the need for wider reporting of physical activity and the adoption of valid and reliable instruments to support the development of evidence-informed policy and programmes at both country and regional level. International tools need to be correctly validated, or context-specific tools must be developed to accurately measure physical activity.
Collapse
Affiliation(s)
- E Murtagh
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Ireland.
| | - A Shalash
- Institute of Community and Public Health, Birzeit University, Palestine; School of Medicine, University of Limerick, Ireland
| | - R Martin
- Mary Immaculate College, Limerick, Ireland
| | - N Abu Rmeileh
- Institute of Community and Public Health, Birzeit University, Palestine
| |
Collapse
|
5
|
El-Saadani S, Saleh M, Ibrahim SA. Quantifying non-communicable diseases' burden in Egypt using State-Space model. PLoS One 2021; 16:e0245642. [PMID: 34375334 PMCID: PMC8354445 DOI: 10.1371/journal.pone.0245642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022] Open
Abstract
The study aimed to model and quantify the health burden induced by four non-communicable diseases (NCDs) in Egypt, the first to be conducted in the context of a less developing county. The study used the State-Space model and adopted two Bayesian methods: Particle Filter and Particle Independent Metropolis-Hastings to model and estimate the NCDs’ health burden trajectories. We drew on time-series data of the International Health Metric Evaluation, the Central Agency for Public Mobilization and Statistics (CAPMAS) Annual Bulletin of Health Services Statistics, the World Bank, and WHO data. Both Bayesian methods showed that the burden trajectories are on the rise. Most of the findings agreed with our assumptions and are in line with the literature. Previous year burden strongly predicts the burden of the current year. High prevalence of the risk factors, disease prevalence, and the disease’s severity level all increase illness burden. Years of life lost due to death has high loadings in most of the diseases. Contrary to the study assumption, results found a negative relationship between disease burden and health services utilization which can be attributed to the lack of full health insurance coverage and the pattern of health care seeking behavior in Egypt. Our study highlights that Particle Independent Metropolis-Hastings is sufficient in estimating the parameters of the study model, in the case of time-constant parameters. The study recommends using state Space models with Bayesian estimation approaches with time-series data in public health and epidemiology research.
Collapse
Affiliation(s)
- Somaya El-Saadani
- Department of Biostatistics and Demography,Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
- * E-mail:
| | - Mohamed Saleh
- Faculty of Computers and Artificial Intelligence, Cairo University, Cairo, Egypt
| | - Sarah A. Ibrahim
- Department of Biostatistics and Demography,Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| |
Collapse
|
6
|
Tobacco Research in the Eastern Mediterranean Region: A Scoping Review of Published Studies from Seven Countries. J Community Health 2021; 46:225-231. [PMID: 32474805 DOI: 10.1007/s10900-020-00850-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
While surveillance on a global scale has been showing a decline in tobacco smoking in the past decade, rates in the Eastern Mediterranean Region (EMR) remained stable with some countries showing rising trends. This study aimed to analyze the landscape of tobacco research in the EMR, present data on publication trends, and identify research gaps and opportunities to guide future tobacco research in the region. We conducted a scoping review of tobacco research in seven countries from January 2000 to December 2013. Three hundred and forty eight studies were identified, the majority of which were published in international journals and in English language. There was an increase in publications over time, with a significant positive linear trend (p = 0.03). Descriptive cross-sectional and case-control studies were the most common study designs (67.0%), and only 8% were longitudinal studies. Papers that reported, in part or solely, on waterpipe tobacco smoking (WTS) constituted 25.6% of the total publication pool. Tobacco consumption was treated as an exposure variable in half of the papers and mostly in relation to cancer and cardiovascular diseases, as an outcome measure in 37.7%, and as a confounding variable in 14.7% of the papers. Studies that examined associations of tobacco with other behaviors (5.3%) were lacking. The scarcity of high-evidence tobacco research in the EMR, together with the relatively deficient data on WTS and associations with other factors warrant the need for discussions on research priority setting and guidance on funding allocations in the region.
Collapse
|
7
|
Mansour R, Naal H, Kishawi T, Achi NE, Hneiny L, Saleh S. Health research capacity building of health workers in fragile and conflict-affected settings: a scoping review of challenges, strengths, and recommendations. Health Res Policy Syst 2021; 19:84. [PMID: 34022883 PMCID: PMC8140497 DOI: 10.1186/s12961-021-00725-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Fragile and conflict-affected settings (FCAS) have a strong need to improve the capacity of local health workers to conduct health research in order to improve health policy and health outcomes. Health research capacity building (HRCB) programmes are ideal to equip health workers with the needed skills and knowledge to design and lead health-related research initiatives. The study aimed to review the characteristics of HRCB studies in FCASs in order to identify their strengths and weaknesses, and to recommend future directions for the field. METHODS We conducted a scoping review and searched four databases for peer-reviewed articles that reported an HRCB initiative targeting health workers in a FCAS and published after 2010. Commentaries and editorials, cross-sectional studies, presentations, and interventions that did not have a capacity building component were excluded. Data on bibliographies of the studies and HRCB interventions and their outcomes were extracted. A descriptive approach was used to report the data, and a thematic approach was used to analyse the qualitative data. RESULTS Out of 8822 articles, a total of 20 were included based on the eligibility criteria. Most of the initiatives centred around topics of health research methodology (70%), targeted an individual-level capacity building angle (95%), and were delivered in university or hospital settings (75%). Ten themes were identified and grouped into three categories. Significant challenges revolved around the lack of local research culture, shortages in logistic capability, interpersonal difficulties, and limited assessment and evaluation of HRCB programmes. Strengths of HRCB interventions included being locally driven, incorporating interactive pedagogies, and promoting multidisciplinary and holistic training. Common recommendations covered by the studies included opportunities to improve the content, logistics, and overarching structural components of HRCB initiatives. CONCLUSION Our findings have important implications on health research policy and related capacity building efforts. Importantly, FCASs should prioritize (1) funding HRCB efforts, (2) strengthening equitable international, regional, and national partnerships, (3) delivering locally led HRCB programmes, (4) ensuring long-term evaluations and implementing programmes at multiple levels of the healthcare system, and (5) adopting engaging and interactive approaches.
Collapse
Affiliation(s)
- Rania Mansour
- Global Health Institute, American University of Beirut, Beirut, 1107 2020 Lebanon
- St. George’s, University of London, London, UK
| | - Hady Naal
- Global Health Institute, American University of Beirut, Beirut, 1107 2020 Lebanon
| | - Tarek Kishawi
- Global Health Institute, American University of Beirut, Beirut, 1107 2020 Lebanon
| | - Nassim El Achi
- Global Health Institute, American University of Beirut, Beirut, 1107 2020 Lebanon
| | - Layal Hneiny
- Saab Medical Library, American University of Beirut, Beirut, Lebanon
| | - Shadi Saleh
- Global Health Institute, American University of Beirut, Beirut, 1107 2020 Lebanon
| |
Collapse
|
8
|
Abstract
Non-communicable diseases (NCD) related to inadequate nutrition are prevalent in economically transitioning countries such as the Arab region. The westernized diet is recognized as a leading trend and the UN General Assembly is focused on the prevention and control of NCD. Due to the rapid transitions in diet and physical inactivity occurring in the Arab region, revising public health dietary strategies, guidelines, and policies to reduce the burden of NCD is needed. This article presents existing literature on food label use in the Arab region as a response to the problem. The primary objective was to locate, review, and summarize peer-reviewed studies on how and why consumers use food labels in Arab countries. An integrative review of the related literature was conducted with no delimiting time frames. The authors applied search strategies to eight academic databases which produced 32 peer-reviewed articles. Seventeen were removed due to inconsistent scope and focus. Awareness of and nutrition knowledge about food labeling emerged as a primary theme. Education, household income, and age were secondary themes and predictor variables. Nutrition food labels as a population-based strategy can influence individual behavior change and potentially improve population health. These outcomes depend on the consumer's ability to understand nutrition labels and properly apply information. Themed recommendations included standardization of food labeling policies, consumer education on food labeling, and public health efforts to develop a detailed understanding of regional populations prior to health promotion strategy development. Enabling informed food selection and reinforcing healthy dietary intake can help prevent NCD and support individual and population health.
Collapse
|
9
|
Zyoud SH. The Arab region's contribution to global COVID-19 research: Bibliometric and visualization analysis. Global Health 2021; 17:31. [PMID: 33766073 PMCID: PMC7993895 DOI: 10.1186/s12992-021-00690-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/18/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND At the global level and in the Arab world, particularly in low-income countries, COVID-19 remains a major public health issue. As demonstrated by an incredible number of COVID-19-related publications, the research science community responded rapidly. Therefore, this study was intended to assess the growing contribution of the Arab world to global research on COVID-19. METHODS For the period between December 2019 and March 2021, the search for publications was conducted via the Scopus database using terms linked to COVID-19. VOSviewer 1.6.16 software was applied to generate a network map to assess hot topics in this area and determine the collaboration patterns between different countries. Furthermore, the research output of Arab countries was adjusted in relation to population size and gross domestic product (GDP). RESULTS A total of 143,975 publications reflecting the global overall COVID-19 research output were retrieved. By restricting analysis to the publications published by the Arab countries, the research production was 6131 documents, representing 4.26% of the global research output regarding COVID-19. Of all these publications, 3990 (65.08%) were original journal articles, 980 (15.98%) were review articles, 514 (8.38%) were letters and 647 (10.55%) were others, such as editorials or notes. The highest number of COVID-19 publications was published by Saudi Arabia (n = 2186, 35.65%), followed by Egypt (n = 1281, 20.78%) and the United Arab Emirates (UAE), (n = 719, 11.73%). After standardization by population size and GDP, Saudi Arabia, UAE and Lebanon had the highest publication productivity. The collaborations were mostly with researchers from the United States (n = 968), followed by the United Kingdom (n = 661). The main research lines identified in COVID-19 from the Arab world are related to: public health and epidemiology; immunological and pharmaceutical research; signs, symptoms and clinical diagnosis; and virus detection. CONCLUSIONS A novel analysis of the latest Arab COVID-19-related studies is discussed in the current study and how these findings are connected to global production. Continuing and improving future collaboration between developing and developed countries will also help to facilitate the sharing of responsibilities for COVID-19 in research results and the implementation of policies for COVID-19.
Collapse
Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839, Palestine.
| |
Collapse
|
10
|
Akkawi A, Khabsa J, Noubani A, Jamali S, Sibai AM, Lotfi T. Non-communicable diseases research output in the Eastern Mediterranean region: an overview of systematic reviews. BMC Med Res Methodol 2020; 20:68. [PMID: 32192439 PMCID: PMC7082905 DOI: 10.1186/s12874-020-00924-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/13/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Rates of non-communicable diseases (NCDs) are rapidly rising in the Eastern Mediterranean Region (EMR). Systematic reviews satisfy the demand from practitioners and policy makers for prompt comprehensive evidence. The aim of this study is to review trends in NCD systematic reviews research output and quality by time and place, describe design and focus, and examine gaps in knowledge produced. METHODS Using the Montori et al. systematic reviews filter, MeSH and keywords were applied to search Medline Ovid, Cochrane Central and Epistemonikos for publications from 1996 until 2015 in the 22 countries of the EMR. The 'Measurement Tool to Assess Systematic Reviews', AMSTAR, was used to assess the methodological quality of the papers. RESULTS Our search yielded 2439 papers for abstract and title screening, and 89 papers for full text screening. A total of 39 (43.8%) studies included meta-analysis. Most of the papers were judged as being of low AMSTAR quality (83.2%), and only one paper was judged as being of high AMSTAR quality. Whilst annual number of papers increased over the years, the growth was mainly attributed to an increase in low-quality publications approaching in 2015 over four times the number of medium-quality publications. Reviews were significantly more likely to be characterized by higher AMSTAR scores (±SD) when meta-analysis was performed compared to when meta-analysis was not performed (3.4 ± 1.5 vs 2.6 ± 2.0; p-value = 0.034); and when critical appraisal of the included studies was conducted (4.3 ± 2.3 vs 2.5 ± 1.5; p-value = 0.004). Most of the reviews focused on cancer and diabetes as an outcome (25.8% and 24.7%, respectively), and on smoking, dietary habits and physical activity as exposures (15.7%, 12.4%, 9.0%, respectively). There was a blatant deficit in reviews examining associations between behaviors and physiologic factors, notably metabolic conditions. CONCLUSIONS Systematic reviews research in the EMR region are overwhelmingly of low quality, with gaps in the literature for studies on cardiovascular disease and on associations between behavioral factors and intermediary physiologic parameters. This study raises awareness of the need for high-quality evidence guided by locally driven research agenda responsive to emerging needs in countries of the EMR.
Collapse
Affiliation(s)
- Alaa Akkawi
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Aya Noubani
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Sarah Jamali
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abla M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| | - Tamara Lotfi
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
11
|
Phillimore P, Sibai AM, Rizk A, Maziak W, Unal B, Abu Rmeileh N, Ben Romdhane H, Fouad FM, Khader Y, Bennett K, Zaman S, Mataria A, Ghandour R, Kılıç B, Ben Mansour N, Fadhil I, O'Flaherty M, Capewell S, Critchley JA. Context-led capacity building in time of crisis: fostering non-communicable diseases (NCD) research skills in the Mediterranean Middle East and North Africa. Glob Health Action 2019; 12:1569838. [PMID: 30721116 PMCID: PMC6366406 DOI: 10.1080/16549716.2019.1569838] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: This paper examines one EC-funded multinational project (RESCAP-MED), with a focus on research capacity building (RCB) concerning non-communicable diseases (NCDs) in the Mediterranean Middle East and North Africa. By the project’s end (2015), the entire region was engulfed in crisis. Objective: Designed before this crisis developed in 2011, the primary purpose of RESCAP-MED was to foster methodological skills needed to conduct multi-disciplinary research on NCDs and their social determinants. RESCAP-MED also sought to consolidate regional networks for future collaboration, and to boost existing regional policy engagement in the region on the NCD challenge. This analysis examines the scope and sustainability of RCB conducted in a context of intensifying political turmoil. Methods: RESCAP-MED linked two sets of activities. The first was a framework for training early- and mid-career researchers through discipline-based and writing workshops, plus short fellowships for sustained mentoring. The second integrated public-facing activities designed to raise the profile of the NCD burden in the region, and its implications for policymakers at national level. Key to this were two conferences to showcase regional research on NCDs, and the development of an e-learning resource (NETPH). Results: Seven discipline-based workshops (with 113 participants) and 6 workshops to develop writing skills (84 participants) were held, with 18 fellowship visits. The 2 symposia in Istanbul and Beirut attracted 280 participants. Yet the developing political crisis tagged each activity with a series of logistical challenges, none of which was initially envisaged. The immediacy of the crisis inevitably deflected from policy attention to the challenges of NCDs. Conclusions: This programme to strengthen research capacity for one priority area of global public health took place as a narrow window of political opportunity was closing. The key lessons concern issues of sustainability and the paramount importance of responsively shaping a context-driven RCB.
Collapse
Affiliation(s)
- Peter Phillimore
- a School of Geography, Politics & Sociology , Newcastle University , Newcastle , UK
| | - Abla M Sibai
- b Department of Epidemiology & Population Health , American University of Beirut , Beirut , Lebanon
| | - Anthony Rizk
- b Department of Epidemiology & Population Health , American University of Beirut , Beirut , Lebanon
| | - Wasim Maziak
- c Department of Epidemiology , Florida International University, USA; and Syrian Center for Tobacco Studies , Aleppo , Syria
| | - Belgin Unal
- d Department of Public Health , Dokuz Eylul University , Izmir , Turkey
| | - Niveen Abu Rmeileh
- e Institute of Community and Public Health , Birzeit University , Palestine
| | | | - Fouad M Fouad
- g Department of Epidemiology & Population Health American University of Beirut , Lebanon; and Syrian Center for Tobacco Studies , Aleppo , Syria
| | - Yousef Khader
- h Public Health Department , Jordan University of Science and Technology , Irbid , Jordan
| | | | | | - Awad Mataria
- k WHO Regional Office for the Eastern Mediterranean (EMRO) , Cairo , Egypt
| | - Rula Ghandour
- e Institute of Community and Public Health , Birzeit University , Palestine
| | - Bülent Kılıç
- d Department of Public Health , Dokuz Eylul University , Izmir , Turkey
| | | | - Ibtihal Fadhil
- k WHO Regional Office for the Eastern Mediterranean (EMRO) , Cairo , Egypt
| | - Martin O'Flaherty
- m Institute of Psychology, Health & Society , University of Liverpool , Liverpool , UK
| | - Simon Capewell
- m Institute of Psychology, Health & Society , University of Liverpool , Liverpool , UK
| | - Julia A Critchley
- n Population Health Research Institute , St George's, University of London , London , UK
| |
Collapse
|
12
|
Cardiovascular disease research in the Arab world: a scoping review from seven Arab countries (2000-2018). Public Health 2019; 175:36-42. [PMID: 31377691 DOI: 10.1016/j.puhe.2019.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 04/09/2019] [Accepted: 06/12/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The objective of this study is to map cardiovascular disease (CVD) research productivity in Arab countries and identify gaps and opportunities that would inform future research agenda. STUDY DESIGN This is a scoping review. METHODS A review of research output between January 2000 and December 2018 in seven Arab countries, selected to represent various economies and epidemiological transitions, was conducted. Data on quantity and quality, study design, setting and focus were extracted and analysed for trends by time and place. RESULTS Over the study period, a total of 794 articles were published, with an average of 7.3 publications per million population. While time trends showed a 6-fold increase in the number of publications over the study period, a decreasing trend in mean journal impact factor was noted (from 2.3 in 2000 to 1.5 in 2018). Most studies (71%) were observational, 56% were conducted in medical facilities (hospitals or clinics) and most of the experimental studies (10%) were based in laboratory settings. Behavioural risk factors were addressed in 52% of the studies, and there was a dearth of studies examining associations with diet, physical inactivity or family history. CONCLUSIONS Findings from this review indicate gaps in robust methods and pertinent themes in CVD research in the Arab region. Greater attention should be paid to high-quality evidence and implementation research. Also, there is a need for a more targeted CVD research agenda that is responsive to local and regional health burden and needs.
Collapse
|
13
|
Al-Jabi SW. Arab world's growing contribution to global leishmaniasis research (1998-2017): a bibliometric study. BMC Public Health 2019; 19:625. [PMID: 31118003 PMCID: PMC6532175 DOI: 10.1186/s12889-019-6969-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 05/14/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Leishmaniasis is a parasitic disease caused by a protozoan of the Leishmania genus, and is considered a neglected tropical disease. It still remains a main public health concern at global level and in Arab world mainly in low-income countries. Therefore, this study was designed to evaluate the Arab world's growing contribution to global leishmaniasis research. METHODS This study describes a bibliometric review of all leishmaniasis research publications published between January 1998 and December 2017 indexed on the Scopus database. RESULTS The total number of publications published at global level was 17,570 papers, which achieves an average annual productivity of 878.50 papers publications. Brazil was responsible for the greatest output with the total number of publications of 3865 followed by the Unites States (n = 2729), India (n = 2119), the United Kingdom (n = 1363), and Spain (n = 1274). By limiting the analysis to the publications that have been published by Arab world, the research productivity was 993 papers, which represents 5.65% of total research output at global level in research regarding leishmaniasis. Tunisia was responsible for the greatest output from Arab world with the total number of publications of 297 followed by Sudan (n = 192), Saudi Arabia (n = 131), Morocco (n = 119) and Egypt (n = 67). Since 1998, the growth of publications on leishmaniasis fluctuates, overall showing a rising trend in both global and Arab world. There is a highly significant correlation between publication productivity related to leishmaniasis at global level and the Arab world (r = 0.936; p-value< 0.001). Leishmaniasis treatment, intracellular mechanism of infection, and lifecycle of leishmania are the major current hot topics for the research in this subject at global level and the Arab world. CONCLUSIONS The current study presents a novel review of the current Arab leishmaniasis-related research, and how these results are related to worldwide output. In comparison to the global research output, the Arab world produced less leishmaniasis research. The data presented in the current study by this innovative approach may serve relevant researchers to direct the global leishmaniasis research to Arab counties in which leishmaniasis is endemic.
Collapse
Affiliation(s)
- Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
| |
Collapse
|
14
|
Review of Non-Communicable Disease Research Activity in Kuwait: Where is the Evidence for the Best Practice? Ann Glob Health 2019; 85. [PMID: 30924616 PMCID: PMC6634600 DOI: 10.5334/aogh.2392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Kuwait, a small country in the Middle East, is now facing rapid development, with non-communicable diseases (NCDs) accounting for the majority of deaths. Objectives: In this study, we review trends in NCD research productivity in Kuwait and examine to what extent it is aligned with disease burden. Methods: Systematic mapping of NCD papers produced between January 2000 and December 2013 yielded 893 publications. These were defined according to study design, study focus, and risk factors examined. Research gaps were assessed by examining disparities between literature produced and cause-specific proportional mortality rates (PMR) and disability-adjusted life years (DALYs). Findings: While annual publication rates increased more than two-fold during the study period, many of the study methodologies were descriptive (58%). Only 2.6% were based on high-evidence interventional studies. Cancer, CVD, and diabetes featured in 38.1%, 15.1%, and 9.2% of the publications, respectively. Compared to PMR and DALYs, there was a surplus of cancer research, most of which were laboratory-based studies (27.6%) or of the case-report/case-series study type (26.5%). Smoking was more likely to be addressed in relation to CVD (32.6%) than diabetes (6.1%) or cancer (2.1%). Physical inactivity was mostly examined in its relation to diabetes (14.6%), with negligible representation in the remaining study focus (range 0.3% to 2.2%). Conclusion: NCD research production in Kuwait is not aligned with disease burden or health priorities. We recommend a coordinated action between funding agencies, universities, and researchers in Kuwait to guide development of a comprehensive research agenda that is responsive to the country’s emerging needs.
Collapse
|
15
|
Albarqouni L, Elessi K, Abu-Rmeileh NME. A comparison between health research output and burden of disease in Arab countries: evidence from Palestine. Health Res Policy Syst 2018; 16:25. [PMID: 29544498 PMCID: PMC5856204 DOI: 10.1186/s12961-018-0302-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 02/28/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Research conducted on conditions responsible for the greatest disease burden should be given the highest priority, particularly in resource-limited settings. The present study aimed to assess the research output in relation to disease burden in Palestine and to identify the conditions which are under- or over-investigated, if any. METHODS We searched PubMed and Scopus for reports of original research relevant to human health or healthcare authored by researchers affiliated with Palestinian institutions and published between January 2000 and December 2015. We categorised the condition studied in included articles using the Global Burden of Disease (GBD) taxonomy. Data regarding burden of disease (percentage of deaths and disability-adjusted life years (DALYs)) was obtained from the Palestine profile in the GBD study. We examined the degree of discordance between the observed number of published articles for each disease/condition with the expected number based on the proportion of disease burden of that disease/condition. RESULTS Our search identified 2469 potentially relevant records, from which 1650 were excluded following the screening of titles and abstracts. Of the remaining 819 full-text articles, we included 511 in our review. Communicable (infectious) diseases (n = 103; 20%) was the condition with the highest number of published studies. However, cancer (n = 15; 3%) and chronic respiratory diseases (n = 15; 3%) were the conditions with the lowest number of published studies. Research output was poorly associated with disease burden, irrespective of whether it was measured in terms of DALYs (rho = -0.116, P = 0.7) or death (rho = 0.217, P = 0.5). Cardiovascular disease, cancer, and maternal and neonatal deaths accounted for more than two-thirds of the total deaths in Palestine (67%), but were infrequently addressed (23%) in published articles. CONCLUSIONS There is evidence of research waste measured by a mismatch between the health burden of certain diseases/conditions and the number of published research reports on those diseases/conditions in Palestine. A national research priority-setting agenda should be developed to meet the local community's need for quality evidence to implement independent and informed health policies.
Collapse
Affiliation(s)
- Loai Albarqouni
- Centre for Research in Evidence Based Practice (CREBP), Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia.
| | - Khamis Elessi
- Evidence-Based Medicine Unit, Faculty of Medicine, Islamic University, Gaza, Palestine
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Ramallah, West Bank, Palestine
| |
Collapse
|