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1. The burden of metabolic risk factors in North Africa and the Middle East, 1990–2019: findings from the Global Burden of Disease StudyResearch in context

Author

Mohammad-Reza Malekpour, Mohsen Abbasi-Kangevari, Seyyed-Hadi Ghamari, Javad Khanali, Mahsa Heidari-Foroozan, Sahar Saeedi Moghaddam, Mohammadreza Azangou-Khyavy, Sahba Rezazadeh-Khadem, Negar Rezaei, Parnian Shobeiri, Zahra Esfahani, Nazila Rezaei, Ali H. Mokdad, Mohsen Naghavi, Bagher Larijani, Farshad Farzadfar, Amirali Aali, Sherief Abd-Elsalam, Meriem Abdoun, Abdorrahim Absalan, Eman Abu-Gharbieh, Niveen ME. Abu-Rmeileh, Ahmed Abu-Zaid, Ali Ahmadi, Sepideh Ahmadi, Ayman Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Mostafa Akbarzadeh-Khiavi, Hanadi Al Hamad, Tariq A. Alalwan, Khalid F. Alhabib, Yousef Alimohamadi, Vahid Alipour, Syed Mohamed Aljunid, Mahmoud A. Alomari, Saleh A. Alqahatni, Rajaa M. Al-Raddadi, Javad Javad Aminian Dehkordi, Mehrdad Amir-Behghadami, Sohrab Amiri, Davood Anvari, Jalal Arabloo, Judie Arulappan, Ashokan Arumugam, Zahra Aryan, Mohammad Athar, Seyyed Shamsadin Athari, Abolfazl Avan, Sina Azadnajafabad, Samad Azari, Hosein Azizi, Nayereh Baghcheghi, Nader Bagheri, Sara Bagherieh, Ovidiu Constantin Baltatu, Akshaya Srikanth Bhagavathula, Vijayalakshmi S. Bhojaraja, Souad Bouaoud, Muhammad Hammad Butt, Luciana Aparecida Campos, Abdulaal Chitheer, Reza Darvishi Cheshmeh Soltani, Aso Mohammad Darwesh, Shirin Djalalinia, Milad Dodangeh, Maysaa El Sayed Zaki, Iffat Elbarazi, Muhammed Elhadi, Waseem El-Huneidi, Rana Ezzeddini, Mohammad Fareed, Hossein Farrokhpour, Ali Fatehizadeh, Yaseen Galali, Amir Ghaderi, Mansour Ghafourifard, Mohammad Ghasemi Nour, Ahmad Ghashghaee, Maryam Gholamalizadeh, Pouya Goleij, Mohamad Golitaleb, Parham Habibzadeh, Nima Hafezi-Nejad, Rabih Halwani, Hamidreza Hasani, Maryam Hashemian, Amr Hassan, Soheil Hassanipour, Hadi Hassankhani, Kamal Hezam, Reza Homayounfar, Seyed Kianoosh Hosseini, Kaveh Hosseini, Mehdi Hosseinzadeh, Soodabeh Hoveidamanesh, Jalil Jaafari, Haitham Jahrami, Elham Jamshidi, Tahereh Javaheri, Sathish Kumar Jayapal, Ali Kabir, Amirali Karimi, Neda Kaydi, Mohammad Keykhaei, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Moien A.B. Khan, Kashif Ullah Khan, Yusra H. Khan, Moawiah Mohammad Khatatbeh, Farzad Kompani, Hamid Reza Koohestani, Mohammed Kuddus, Savita Lasrado, Sang-woong Lee, Soleiman Mahjoub, Ata Mahmoodpoor, Elham Mahmoudi, Elaheh Malakan Rad, Narges Malih, Ahmad Azam Malik, Tauqeer Hussain Mallhi, Yosef Manla, Borhan Mansouri, Mohammad Ali Mansournia, Parham Mardi, Abdoljalal Marjani, Sahar Masoudi, Entezar Mehrabi Nasab, Ritesh G. Menezes, Vildan Mevsim, Yousef Mohammad, Mokhtar Mohammadi, Esmaeil Mohammadi, Noushin Mohammadifard, Arif Mohammed, Sara Momtazmanesh, Fateme Montazeri, Maryam Moradi, Maziar Moradi-Lakeh, Negar Morovatdar, Christopher J.L. Murray, Zuhair S. Natto, Seyed Aria Nejadghaderi, Ali Nowroozi, Morteza Oladnabi, Ahmed Omar Bali, Emad Omer, Hamidreza Pazoki Toroudi, Raffaele Pezzani, Ashkan Pourabhari Langroudi, Sima Rafiei, Mehran Rahimi, Vafa Rahimi-Movaghar, Shayan Rahmani, Amir Masoud Rahmani, Vahid Rahmanian, Chythra R. Rao, Sina Rashedi, Mohammad-Mahdi Rashidi, Reza Rawassizadeh, Elrashdy Moustafa Mohamed Redwan, Malihe Rezaee, Maryam Rezaei, Seyed Mohammad Riahi, Gholamreza Roshandel, Aly Saad, Maha Mohamed Saber-Ayad, Siamak Sabour, Leila Sabzmakan, Basema Saddik, Erfan Sadeghi, Saeid Sadeghian, Amirhossein Sahebkar, Morteza Saki, Saina Salahi, Sarvenaz Salahi, Amir Salek Farrokhi, Marwa Rashad Salem, Hamideh Salimzadeh, Abdallah M. Samy, Nizal Sarrafzadegan, Brijesh Sathian, Melika Shafeghat, Syed Mahboob Shah, Jaffer Shah, Ataollah Shahbandi, Fariba Shahraki-Sanavi, Mehran Shams-Beyranvand, Mohd Shanawaz, Kiomars Sharafi, Javad Sharifi-Rad, Jeevan K. Shetty, Zahra Shokri Varniab, Seyed Afshin Shorofi, Soraya Siabani, Mohammad Sadegh Soltani-Zangbar, Seidamir Pasha Tabaeian, Seyed-Amir Tabatabaeizadeh, Mohammad Tabish, Majid Taheri, Yasaman Taheri Abkenar, Moslem Taheri Soodejani, Amir Taherkhani, Arash Tehrani-Banihashemi, Mohamad-Hani Temsah, Bereket M. Tigabu, Alireza Vakilian, Siavash Vaziri, Bay Vo, Fereshteh Yazdanpanah, Arzu Yigit, Vahit Yiğit, Mazyar Zahir, Burhan Abdullah Zaman, Maryam Zamanian, Moein Zangiabadian, Iman Zare, and Zahra Zareshahrabadi

Subjects
Global burden of disease, Metabolic risk factors, High systolic blood pressure, High fasting plasma glucose, High body-mass index, High-LDL, Medicine (General), R5-920
Abstract

Summary: Background: The objective of this study is to investigate the trends of exposure and burden attributable to the four main metabolic risk factors, including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body-mass index (BMI), and high low-density lipoproteins cholesterol (LDL) in North Africa and the Middle East from 1990 to 2019. Methods: The data were retrieved from Global Burden of Disease Study 2019. Summary exposure value (SEV) was used for risk factor exposure. Burden attributable to each risk factor was incorporated in the population attributable fraction to estimate the total attributable deaths and disability-adjusted life-years (DALYs). Findings: While age-standardized death rate (ASDR) attributable to high-LDL and high-SBP decreased by 26.5% (18.6–35.2) and 23.4% (15.9–31.5) over 1990–2019, respectively, high-BMI with 5.1% (−9.0–25.9) and high-FPG with 21.4% (7.0–37.4) change, grew in ASDR. Moreover, age-standardized DALY rate attributed to high-LDL and high-SBP declined by 30.2% (20.9–39.0) and 25.2% (16.8–33.9), respectively. The attributable age-standardized DALY rate of high-BMI with 8.3% (−6.5–28.8) and high-FPG with 27.0% (14.3–40.8) increase, had a growing trend. Age-standardized SEVs of high-FPG, high-BMI, high-SBP, and high-LDL increased by 92.4% (82.8–103.3), 76.0% (58.9–99.3), 10.4% (3.8–18.0), and 5.5% (4.3–7.1), respectively. Interpretation: The burden attributed to high-SBP and high-LDL decreased during the 1990–2019 period in the region, while the attributable burden of high-FPG and high-BMI increased. Alarmingly, exposure to all four risk factors increased in the past three decades. There has been significant heterogeneity among the countries in the region regarding the trends of exposure and attributable burden. Urgent action is required at the individual, community, and national levels in terms of introducing effective strategies for prevention and treatment that account for local and socioeconomic factors. Funding: Bill & Melinda Gates Foundation.

Published
2023
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2. Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18: a geospatial modelling study

Author

Joseph Jon Frostad, QuynhAnh P Nguyen, Mathew M Baumann, Brigette F Blacker, Laurie B Marczak, Aniruddha Deshpande, Kirsten E Wiens, Kate E LeGrand, Kimberly B Johnson, Mohsen Abbasi-Kangevari, Amir Abdoli, Hassan Abolhassani, Lucas Guimarães Abreu, Michael R M Abrigo, Niveen ME Abu-Rmeileh, Victor Adekanmbi, Anurag Agrawal, Muktar Beshir Ahmed, Ziyad Al-Aly, Fahad Mashhour Alanezi, Jacqueline Elizabeth Alcalde-Rabanal, Vahid Alipour, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Adeladza Kofi Amegah, Saeed Amini, Fatemeh Amiri, Dickson A Amugsi, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Ernoiz Antriyandarti, Davood Anvari, Jalal Arabloo, Morteza Arab-Zozani, Seyyed Shamsadin Athari, Marcel Ausloos, Getinet Ayano, Yared Asmare Aynalem, Samad Azari, Ashish D Badiye, Atif Amin Baig, Kalpana Balakrishnan, Maciej Banach, Sanjay Basu, Neeraj Bedi, Michelle L Bell, Derrick A Bennett, Krittika Bhattacharyya, Zulfiqar A Bhutta, Sadia Bibi, Somayeh Bohlouli, Soufiane Boufous, Nicola Luigi Bragazzi, Dejana Braithwaite, Sharath Burugina Nagaraja, Zahid A Butt, Florentino Luciano Caetano dos Santos, Josip Car, Rosario Cárdenas, Felix Carvalho, Joao Mauricio Castaldelli-Maia, Carlos A Castañeda-Orjuela, Ester Cerin, Soosanna Kumary Chattu, Vijay Kumar Chattu, Pankaj Chaturvedi, Sarika Chaturvedi, Simiao Chen, Dinh-Toi Chu, Sheng-Chia Chung, Saad M A Dahlawi, Giovanni Damiani, Lalit Dandona, Rakhi Dandona, Aso Mohammad Darwesh, Jai K Das, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Diego De Leo, Jan-Walter De Neve, Getu Debalkie Demissie, Edgar Denova-Gutiérrez, Sagnik Dey, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Fariba Dorostkar, Leila Doshmangir, Andre Rodrigues Duraes, Hisham Atan Edinur, Ferry Efendi, Maha El Tantawi, Sharareh Eskandarieh, Ibtihal Fadhil, Nazir Fattahi, Nelsensius Klau Fauk, Seyed-Mohammad Fereshtehnejad, Morenike Oluwatoyin Folayan, Masoud Foroutan, Takeshi Fukumoto, Abhay Motiramji Gaidhane, Mansour Ghafourifard, Ahmad Ghashghaee, Syed Amir Gilani, Tiffany K Gill, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Rajat Das Gupta, Rajeev Gupta, Reyna Alma Gutiérrez, Nima Hafezi-Nejad, Randah R Hamadeh, Ahmed I Hasaballah, Soheil Hassanipour, Khezar Hayat, Behzad Heibati, Reza Heidari-Soureshjani, Nathaniel J Henry, Claudiu Herteliu, Mehdi Hosseinzadeh, Mohamed Hsairi, Guoqing Hu, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chidozie C D Iwu, Jalil Jaafari, Mihajlo Jakovljevic, Tahereh Javaheri, Ravi Prakash Jha, John S Ji, Jost B Jonas, Ali Kabir, Zubair Kabir, Rohollah Kalhor, Naser Kamyari, Tanuj Kanchan, Umesh Kapil, Neeti Kapoor, Gbenga A Kayode, Peter Njenga Keiyoro, Yousef Saleh Khader, Nauman Khalid, Ejaz Ahmad Khan, Maseer Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Mahalaqua Nazli Khatib, Maryam Khayamzadeh, Jagdish Khubchandani, Gyu Ri Kim, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Luke D Knibbs, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Faris Hasan Lami, Qing Lan, Savita Lasrado, Paolo Lauriola, Paul H Lee, Sonia Lewycka, Shanshan Li, Daiane Borges Machado, Phetole Walter Mahasha, Mina Maheri, Azeem Majeed, Afshin Maleki, Reza Malekzadeh, Deborah Carvalho Malta, Borhan Mansouri, Mohammad Ali Mansournia, Natalie Maria Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Benjamin K Mayala, Man Mohan Mehndiratta, Walter Mendoza, Ritesh G Menezes, Endalkachew Worku Mengesha, Tuomo J Meretoja, Tomislav Mestrovic, Irmina Maria Michalek, Erkin M Mirrakhimov, Maryam Mirzaei, Roya Mirzaei, Babak Moazen, Yousef Mohammad, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Ali H Mokdad, Lorenzo Monasta, Maziar Moradi-Lakeh, Paula Moraga, Lidia Morawska, Abbas Mosapour, Simin Mouodi, Amin Mousavi Khaneghah, Satinath Mukhopadhyay, Sandra B Munro, Christopher J L Murray, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Sanjeev Nair, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Ionut Negoi, Henok Biresaw Netsere, Josephine W Ngunjiri, Huong Lan Thi Nguyen, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Ahmed Omar Bali, Obinna E Onwujekwe, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Mahesh P A, Anamika Pandey, Eun-Cheol Park, Eun-Kee Park, Sangram Kishor Patel, Hai Quang Pham, Thomas Pilgrim, Meghdad Pirsaheb, Khem Narayan Pokhrel, Maarten J Postma, Zahiruddin Quazi Syed, Navid Rabiee, Amir Radfar, Fakher Rahim, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Chhabi Lal Ranabhat, Sowmya J Rao, Davide Rasella, Prateek Rastogi, Goura Kishor Rath, David Laith Rawaf, Salman Rawaf, Lal Rawal, Reza Rawassizadeh, Andre M N Renzaho, Bhageerathy Reshmi, Negar Rezaei, Nima Rezaei, Aziz Rezapour, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Morteza Rostamian, Enrico Rubagotti, Godfrey M Rwegerera, Basema Saddik, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Rajesh Sagar, Amirhossein Sahebkar, Biniyam Sahiledengle, Marwa Rashad Salem, Abdallah M Samy, Milena M Santric-Milicevic, Sivan Yegnanarayana Iyer Saraswathy, Brijesh Sathian, Thirunavukkarasu Sathish, David C Schwebel, Sadaf G Sepanlou, Saeed Shahabi, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, Mohammed Shannawaz, Kiomars Sharafi, Aziz Sheikh, Sara Sheikhbahaei, Ranjitha S Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, K M Shivakumar, Soraya Siabani, Tariq Jamal Siddiqi, Balbir Bagicha Singh, Jasvinder A Singh, Yitagesu Sintayehu, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Leo Stockfelt, Mu'awiyyah Babale Sufiyan, Rizwan Suliankatchi Abdulkader, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Amir Taherkhani, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Marcos Roberto Tovani-Palone, Eugenio Traini, Saif Ullah, Bhaskaran Unnikrishnan, Era Upadhyay, Sahel Valadan Tahbaz, Santosh Varughese, Francesco S Violante, Bay Vo, Giang Thu Vu, Yasir Waheed, Yuan-Pang Wang, Catherine A Welgan, Andrea Werdecker, Seyed Hossein Yahyazadeh Jabbari, Sanni Yaya, Vahid Yazdi-Feyzabadi, Mekdes Tigistu Yilma, Naohiro Yonemoto, Mustafa Z Younis, Taraneh Yousefinezhadi, Chuanhua Yu, Yong Yu, Sojib Bin Zaman, Yunquan Zhang, Zhi-Jiang Zhang, Michael Brauer, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation.

Published
2022
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3. The range and nature of reproductive health research in the occupied Palestinian territory: a scoping review

Author

Aisha Shalash, Hasan M Alsalman, Alaa Hamed, Mai Abu Helo, Rula Ghandour, Loai Albarqouni, and Niveen ME Abu Rmeileh

Subjects
Scoping review, Reproductive health, Occupied Palestinian territory, Gynecology and obstetrics, RG1-991
Abstract

Abstract Background In order to set research priorities for reproductive health in the occupied Palestinian territory, it is vital to know what current research has been done in the field of reproductive health. The purpose of this scoping review is to examine the range and nature of reproductive health research in the occupied Palestinian territory and to identify research gaps in the existing literature. Methods We searched four databases: EMBASE, PubMed, CINAHL, and Popline. We included studies that: (i) are published (with an abstract); (ii) relevant to reproductive health; (iii) Palestinians living in Palestine; (iv) participants over the age of 15 years; and (v) restricted to human research. Three independent reviewers screened title and abstracts, and extracted data from included articles. We conducted quantitative and qualitative analyses. Results Of 1025 titles and abstracts screened, 145 articles were included. 52 (36%) articles were conducted in community setting and 34 (24%) were conducted in hospitals. There were 5 (3%) experimental studies. 15 articles had more than one main theme; 160 subthemes overall were identified. The most frequently studied theme was labor and delivery (n = 19; 12%). One article discussed adolescent reproductive health and menopause while no articles discussed men’s reproductive health. Conclusions 91% of the research conducted is observational. The focus of reproductive health research was to understand the topic, community and providers’ perceptions and knowledge. Articles related to the quality of services were limited. It is also important to research the reproductive health of women outside of reproductive age, men, and adolescents.

Published
2019
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4. Postpartum Depression: Prevalence, Risk Factors, and Childbirth Experiences in Palestine

Author

Batoul Mattar, Niveen ME Abu-Rmeileh, and Yasmeen Wahdan

Abstract

Background: Worldwide mothers are suffering from postpartum depression (PPD) which impairs mothers' well-being, children, and families, and lead to adverse outcomes for mother and their growing newborns. Low and middle-income countries have a higher prevalence of PPD and limited studies about it. This study will assess the prevalence of PPD among Palestinian women nationally, identify mothers at a higher risk of PPD, and study the correlation between PPD and mistreatment during childbirth. Methods: The study is based on a secondary data analysis from a cross-sectional study in the occupied Palestinian territory (oPt). 745 telephone-based interviews with mothers were done within 2-4 weeks post-childbirth. The Patient Health Questionnaire (PHQ-9) was used as a screening tool for PPD. The Statistical Package for Social Science (SPSS) was used. Results: PPD prevalence among Palestinian mothers is 12.6%, with a higher prevalence among mothers living in the Gaza strip, a politically and economically unstable region in Palestine. Older mothers are two times more likely to develop PPD compared to young mothers. And regarding the correlation between PPD and mistreatment of mothers during childbirth, mothers who experienced disrespectful behaviors (any abuse, negligence, abandonment, ineffective communication, or poor pain management) in childbirth settings are more likely to report PPD than those who were not exposed to any form of disrespect. Conclusion: A high prevalence of postpartum depression was found among Palestinian mothers, especially among mothers who experienced mistreatment in childbirth settings. It is essential to support healthcare providers to improve their practice and attitudes to eliminate mistreatment and abusive behaviors of mothers during childbirth.

Published
2023

5. Exploring women's experiences during childbirth in health facilities during COVID-19 pandemic in occupied palestinian territory: a cross-sectional community survey

Author

Niveen ME Abu-Rmeileh, Yasmeen Wahdan, Hedieh Mehrtash, Khitam Abu Hamad, Arein Awad, and Ӧzge Tunçalp

Subjects
Obstetrics and Gynecology
Abstract

Introduction This study aims to assess the prevalence of mistreatment during childbirth in the occupied Palestinian territory and to explore factors associated with mistreatment. Methods A cross-sectional study of women who gave birth in the West Bank and Gaza Strip health facilities. The survey was administered over the phone to women up to 8 weeks post-partum. Data collection took place between July 2020 and March 2021. Results A total of 745 women participated in the study, 36·25% were from the Gaza Strip and 63·75% from the West Bank. The prevalence of mistreatment was 18·8% in which women reported any verbal abuse, physical abuse, or stigma or discrimination during childbirth, with verbal abuse as the most common form of mistreatment reported. Physical abuse was more likely to be reported by women with no labour companion with them (OR: 3·11, 95%CI: 1·24 − 7·99). Verbal abuse was more likely to be reported by women with less than three live births (OR: 1·71, 95%CI: 1·06 − 2·76, women with no birth companion (OR: 2·72, 95%CI: 1·36 − 3·80) and more likely to be reported if curtains wre not used (OR: 2·55, 95%CI: 1·33 − 4·88). Women with less education were more likely to report long waiting times or delays in receiving services compared to women with higher education (OR: 1·40, 95%CI: 1·06 − 2·10). Conclusion For the first time using the World Health Organisation (WHO) tool in the Eastern Mediterranean region, the study findings, show the occurrence of mistreatment and identify areas to be strengthened to ensure that all women have a respectful childbirth experience within health facilities.

Published
2022

6. Gender differences in the price elasticity of demand for waterpipe and cigarette smoking in Lebanon, Jordan and Palestine: a volumetric choice experiment

Author

Sameera Awawda, Ali Chalak, Yousef Khader, Aya Mostafa, Ruba Abla, Rima Nakkash, Mohammed Jawad, Ramzi G Salloum, and Niveen ME Abu-Rmeileh

Subjects
Adult, Male, Jordan, Adolescent, Commerce, Water Pipe Smoking, Tobacco Products, General Medicine, Taxes, Elasticity, Arabs, Cigarette Smoking, Sex Factors, Tobacco, Humans, Female, Lebanon
Abstract

ObjectivesThis study assessed the extent to which the elasticity of cigarette and waterpipe tobacco products differs between men and women. We also explored the levels of substitution and complementarity in tobacco products among men and women.SettingThe study examines tobacco elasticities in three Arab countries: Lebanon, Jordan and the West Bank of Palestine.ParticipantsWe used data from nationally representative surveys of adults aged ≥18 years in Lebanon (n=1680), Jordan (n=1925) and Palestine (n=1679). The proportion of women was 50.0% of the sample in Lebanon and Palestine, and 44.6% in Jordan.Primary and secondary outcome measuresA zero-inflated Poisson regression model estimated own-price and cross-price elasticities for two variations of cigarettes and five variations of waterpipe tobacco products. Elasticities were measured based on eight scenarios of prices.ResultsDemand for waterpipe tobacco products was elastic for both men and women. The cross-price elasticities in the three countries indicate the existence of substitution between cigarettes and waterpipe products and by different varieties within each of the two tobacco products. Gender differences varied across the three countries whereby higher cross-price elasticities were observed for women in Jordan and Palestine. For example, the price elasticity for discount waterpipe was −1.4 and −0.6 for women and men in Jordan, respectively.ConclusionsResults on the elasticity of demand for tobacco products and the existence of substitution between tobacco products reveal the higher responsiveness of men and women to changes in tobacco prices. This should be taken into consideration in tobacco control strategies particularly when reducing tobacco consumption via taxation policies.

Published
2022

7. Injury burden in individuals aged 50 years or older in the Eastern Mediterranean region, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

Author

Samar Al-Hajj, Sarah H Farran, Abla Mehio Sibai, Randah R Hamadeh, Vafa Rahimi-Movaghar, Rajaa M Al-Raddadi, Farideh Sadeghian, Zahra Ghodsi, Wael Alhajyaseen, Niveen ME Abu-Rmeileh, Behzad Abbasi, Mohsen Abbasi-Kangevari, Amir Abdoli, Salam Abdulqadir Abdulrahman, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Muhammad Sohail Afzal, Bahman Ahadinezhad, Sajjad Ahmad, Ali Ahmadi, Ali Ahmed, Haroon Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Hanadi Al Hamad, Fahad Mashhour Alanezi, Turki M Alanzi, Suliman A Alghnam, Fadwa Naji Alhalaiqa, Beriwan Abdulqadir Ali, Liaqat Ali, Yousef Alimohamadi, Cyrus Alinia, Syed Mohamed Aljunid, Sami Almustanyir, Tarek Tawfik Amin, Saeed Amini, Sohrab Amiri, Mohammad Hosein Amirzade-Iranaq, Ali Arash Anoushirvani, Alireza Ansari-Moghaddam, Davood Anvari, Muhammad Aqeel, Jalal Arabloo, Morteza Arab-Zozani, Judie Arulappan, Armin Aryannejad, Saeed Asgary, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Zahra Azadmanjir, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ahmed Y Y Azzam, Sara Bagherieh, Mohammad Hossein Bakhshaei, Abdul-Monim Mohammad Batiha, Neeraj Bedi, Akshaya Srikanth Bhagavathula, Zulfiqar A Bhutta, Sadia Bibi, Ali Bijani, Nadeem Shafique Butt, Zahra Chegini, Omar B Da'ar, Saad M A Dahlawi, Sajad Delavari, Mostafa Dianatinasab, Mojtaba Didehdar, Shirin Djalalinia, Saeid Doaei, Milad Dodangeh, Fatemeh Eghbalian, Elham Ehsani-Chimeh, Iman El Sayed, Maysaa El Sayed Zaki, Hala Rashad Elhabashy, Muhammed Elhadi, Sharareh Eskandarieh, Azin Etemadimanesh, Mohamad Ezati Asar, Shahab Falahi, Farshad Farzadfar, Ali Fatehizadeh, Hamed Fattahi, Masoud Foroutan, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Reza Ghanbari, Reza Ghanei Gheshlagh, Ahmad Ghashghaee, Maryam Gholamalizadeh, Alireza Ghorbani, Syed Amir Gilani, Kimiya Gohari, Pouya Goleij, Michal Grivna, Mohammed Ibrahim Mohialdeen Gubari, Rasool Haddadi, Nima Hafezi-Nejad, Arvin Haj-Mirzaian, Rabih Halwani, Sajid Hameed, Asif Hanif, Ahmed I Hasaballah, Amr Hassan, Hossein Hassanian-Moghaddam, Soheil Hassanipour, Hadi Hassankhani, Khezar Hayat, Mohammad Heidari, Mohammad-Salar Hosseini, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Soodabeh Hoveidamanesh, Huda Abu-Saad Huijer, Behzad Imani, Seyed Sina Naghibi Irvani, Roxana Jabbarinejad, Mohammad Ali Jahani, Mahsa Jalili, Amirreza Javadi Mamaghani, Seyed Ali Jeddi, Farahnaz Joukar, Ali Kabir, Laleh R Kalankesh, Leila R Kalankesh, Rohollah Kalhor, Aziz Kamran, Leila Keikavoosi-Arani, Mohammad Keykhaei, Yousef Saleh Khader, Rovshan Khalilov, Mohammad Khammarnia, Ejaz Ahmad Khan, Maseer Khan, Moien AB Khan, Javad Khanali, Hamid Reza Khayat Kashani, Omid Khosravizadeh, Ali-Asghar Kolahi, Hamid Reza Koohestani, Sogol Koolaji, Faris Hasan Lami, Savita Lasrado, Farzan Madadizadeh, Muhammed Magdy Abd El Razek, Mahdi Mahdavi, Soleiman Mahjoub, Ata Mahmoodpoor, Razzagh Mahmoudi, Alaa Makki, Mohammad-Reza Malekpour, Reza Malekzadeh, Narges Malih, Ahmad Azam Malik, Fariborz Mansour-Ghanaei, Borhan Mansouri, Mohammad Ali Mansournia, Seyedeh Zahra Masoumi, Entezar Mehrabi Nasab, Ritesh G Menezes, Mohamed Kamal Mesregah, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-Aghazadeh-Attari, Esmaeil Mohammadi, Heidar Mohammadi, Mokhtar Mohammadi, Seyyede Momeneh Mohammadi, Abdollah Mohammadian-Hafshejani, Teroj Abdulrahman Mohammed, Jalal Moludi, Sara Momtazmanesh, Maryam Moradi, Masoud Moradi, Farhad Moradpour, Rahmatollah Moradzadeh, Nazanin Mortazavi, Seyede Salehe Mortazavi, Houshang Najafi, Zhila Najafpour, Zuhair S Natto, Javad Nazari, Hasti Nouraei, Fatemeh Nouri, Hassan Okati-Aliabad, Ahmed Omar Bali, Emad Omer, Fatemeh Pashazadeh Kan, Hamidreza Pazoki Toroudi, Zahra Zahid Piracha, AliMohammad Pourbagher-Shahri, Naeimeh Pourtaheri, Mohammad Rabiee, Navid Rabiee, Saber Raeghi, Hassan Rafieemehr, Sima Rafiei, Fakher Rahim, Shahram Rahimi-Dehgolan, Amir Masoud Rahmani, Vahid Rahmanian, Kiana Ramezanzadeh, Chythra R Rao, Vahid Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Azad Rasul, Reza Rawassizadeh, Seyed-Mansoor Rayegani, Nazila Rezaei, Negar Rezaei, Saeid Rezaei, Zahed Rezaei, Mohsen Rezaeian, Forouzan Rezapur-Shahkolai, Sahba Rezazadeh-Khadem, Mohammad Saadati, Siamak Sabour, Basema Saddik, Umar Saeed, Sahar Saeedi Moghaddam, Hamid Safarpour, Mahdi Safdarian, Amirhossein Sahebkar, Payman Salamati, Marwa Rashad Salem, Abdallah M Samy, Nima Sanadgol, Muhammad Arif Nadeem Saqib, Yaser Sarikhani, Arash Sarveazad, Brijesh Sathian, Mehdi Sayyah, Sadaf G Sepanlou, Saeed Shahabi, Masood Ali Shaikh, Elaheh Shaker, Mehran Shams-Beyranvand, Sakineh Sharifian, Mohsen Shati, Hatem Samir Shehata, Ali Sheidaei, Sara Sheikhbahaei, Rahim Ali Sheikhi, Parnian Shobeiri, Soraya Siabani, Gholam Reza Sivandzadeh, Ahmad Sofi-Mahmudi, Ahmad Sohrabi, Seidamir Pasha Tabaeian, Mohammadreza Tabary, Elnaz Tabibian, Ensiyeh Taheri, Majid Taheri, Arash Tehrani-Banihashemi, Amir Tiyuri, Seyed Abolfazl Tohidast, Saif Ullah, Parviz Vahedi, Sahel Valadan Tahbaz, Rohollah Valizadeh, Mehdi Varmaghani, Bay Vo, Yasir Waheed, Seyed Hossein Yahyazadeh Jabbari, Fereshteh Yazdanpanah, Zabihollah Yousefi, Hossein Yusefi, Telma Zahirian Moghadam, Hamed Zandian, Iman Zare, Arash Ziapour, and Ali H Mokdad

Subjects
Aged, 80 and over, Male, Health (social science), Traffic Safety, Injury prevention, Road Safety, Middle Aged, Global Burden of Disease, Older population, Psychiatry and Mental health, Life Expectancy, Socioeconomic Factors, Risk Factors, Humans, Female, Quality-Adjusted Life Years, Geriatrics and Gerontology, Family Practice, Aged
Abstract

BackgroundInjury poses a major threat to health and longevity in adults aged 50 years or older. The increased life expectancy in the Eastern Mediterranean region warrants a further understanding of the ageing population's inevitable changing health demands and challenges. We aimed to examine injury-related morbidity and mortality among adults aged 50 years or older in 22 Eastern Mediterranean countries. MethodsDrawing on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we categorised the population into adults aged 50–69 years and adults aged 70 years and older. We examined estimates for transport injuries, self-harm injuries, and unintentional injuries for both age groups, with sex differences reported, and analysed the percentage changes from 1990 to 2019. We reported injury-related mortality rates and disability-adjusted life-years (DALYs). The Socio-demographic Index (SDI) and the Healthcare Access and Quality (HAQ) Index were used to better understand the association of socioeconomic factors and health-care system performance, respectively, with injuries and health status in older people. Healthy life expectancy (HALE) was compared with injury-related deaths and DALYs and to the SDI and HAQ Index to understand the effect of injuries on healthy ageing. Finally, risk factors for injury deaths between 1990 and 2019 were assessed. 95% uncertainty intervals (UIs) are given for all estimates. FindingsEstimated injury mortality rates in the Eastern Mediterranean region exceeded the global rates in 2019, with higher injury mortality rates in males than in females for both age groups. Transport injuries were the leading cause of deaths in adults aged 50–69 years (43·0 [95% UI 31·0–51·8] per 100 000 population) and in adults aged 70 years or older (66·2 [52·5–75·5] per 100 000 population), closely followed by conflict and terrorism for both age groups (10·2 [9·3–11·3] deaths per 100 000 population for 50–69 years and 45·7 [41·5–50·3] deaths per 100 000 population for ≥70 years). The highest annual percentage change in mortality rates due to injury was observed in Afghanistan among people aged 70 years or older (400·4% increase; mortality rate 1109·7 [1017·7–1214·7] per 100 000 population). The leading cause of DALYs was transport injuries for people aged 50–69 years (1798·8 [1394·1–2116·0] per 100 000 population) and unintentional injuries for those aged 70 years or older (2013·2 [1682·2–2408·7] per 100 000 population). The estimates for HALE at 50 years and at 70 years in the Eastern Mediterranean region were lower than global estimates. Eastern Mediterranean countries with the lowest SDIs and HAQ Index values had high prevalence of injury DALYs and ranked the lowest for HALE at 50 years of age and HALE at 70 years. The leading injury mortality risk factors were occupational exposure in people aged 50–69 years and low bone mineral density in those aged 70 years or older. InterpretationInjuries still pose a real threat to people aged 50 years or older living in the Eastern Mediterranean region, mainly due to transport and violence-related injuries. Dedicated efforts should be implemented to devise injury prevention strategies that are appropriate for older adults and cost-effective injury programmes tailored to the needs and resources of local health-care systems, and to curtail injury-associated risk and promote healthy ageing. FundingBill & Melinda Gates Foundation. We acknowledge the Bill & Melinda Gates Foundation for funding this study.

Published
2022

8. Induction Of Labor Among Singleton Pregnancies In Six Palestinian Governmental Hospitals: A Population-Based Cohort Study

Author

Sahar, Hassan, Katariina, Laine, Erik, Fosse, Niveen Me, Abu-Rmeileh, Hadil Y, Ali-Masri, Mohammed, Zimmo, Kaled, Zimmo, Åse, Vikanes, and Khaled M, Ismail

Subjects
induction of labor, Palestine, cohort study, childbirth, variations, singleton, Original Research
Abstract

Objective To explore rates and review practices regarding induction of labor (IOL) among singleton pregnancies in Palestine. Design A prospective population-based cohort study. Setting Six secondary and tertiary governmental hospitals located in the two regions of Palestine: West Bank and Gaza. Participants Singleton pregnancies who had IOL in participating units during the study period were included (n=8290). Women having multiple gestations (1004), planned cesarean births (703), those admitted with cervical dilation >6cm (11228), and pregnancies with no record of cervical dilation and/or gestational age on admission (219) were excluded. Primary outcome measure Rates of IOL in participating units and regions. Results There were a total of 33,402 singleton births during the study period with an IOL rate of 24.8%. Rates of IOL significantly varied between units, ranging from 12.9% to 45.6% (P-value

Published
2019

12. A predictive model of waterpipe smoking cessation among women in southern Iran: application of the theory of planned behavior

Author

Sara Dadipoor, Gholamreza Heydari, Niveen ME Abu-Rmeileh, Shokrollah Mohseni, Hadi Eshaghi Sani Kakhaki, Teamur Aghamolaei, and Nahid Shahabi

Subjects
Water-pipe, Smoking cessation, Theory, Predictor, Iran, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Today, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB). Methods This cross-sectional analytical study was conducted in 2021–2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2. Results With an increase in one attitude score, the odds of cessation increased by 31% (p

Published
2023
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14. Gender differences in the price elasticity of demand for waterpipe and cigarette smoking in Lebanon, Jordan and Palestine: a volumetric choice experiment

Author

Ramzi G Salloum, Mohammed Jawad, Aya Mostafa, Yousef Khader, Rima Nakkash, Niveen ME Abu-Rmeileh, Ali Chalak, Ruba Abla, and Sameera Awawda

Subjects
Medicine
Abstract

Objectives This study assessed the extent to which the elasticity of cigarette and waterpipe tobacco products differs between men and women. We also explored the levels of substitution and complementarity in tobacco products among men and women.Setting The study examines tobacco elasticities in three Arab countries: Lebanon, Jordan and the West Bank of Palestine.Participants We used data from nationally representative surveys of adults aged ≥18 years in Lebanon (n=1680), Jordan (n=1925) and Palestine (n=1679). The proportion of women was 50.0% of the sample in Lebanon and Palestine, and 44.6% in Jordan.Primary and secondary outcome measures A zero-inflated Poisson regression model estimated own-price and cross-price elasticities for two variations of cigarettes and five variations of waterpipe tobacco products. Elasticities were measured based on eight scenarios of prices.Results Demand for waterpipe tobacco products was elastic for both men and women. The cross-price elasticities in the three countries indicate the existence of substitution between cigarettes and waterpipe products and by different varieties within each of the two tobacco products. Gender differences varied across the three countries whereby higher cross-price elasticities were observed for women in Jordan and Palestine. For example, the price elasticity for discount waterpipe was −1.4 and −0.6 for women and men in Jordan, respectively.Conclusions Results on the elasticity of demand for tobacco products and the existence of substitution between tobacco products reveal the higher responsiveness of men and women to changes in tobacco prices. This should be taken into consideration in tobacco control strategies particularly when reducing tobacco consumption via taxation policies.

Published
2022
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