Assessment of Temporary Community-Based Health Care Facilities During Arbaeenia Mass Gathering at Karbala, Iraq: Cross-Sectional Survey Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Arbaeenia mass gathering (MG) in Karbala, Iraq, is becoming one of the largest MGs in the world. The health care infrastructure in Iraq is inadequately prepared to serve the health needs of the millions of pilgrims.

Objective

This study aimed to describe the temporary health care facilities installed and run by the local community to provide health care services to Arbaeenia pilgrims in Karbala, Iraq.

Methods

A survey was conducted in all community-based health care facilities located along part of Najaf to Karbala road within Karbala governorate. A structured questionnaire was answered through an interview with the workers and direct observation. Data were collected on staff profile, type of services provided, use of basic infection control measures, medical equipment, drugs and supplies, and the most commonly encountered medical problems.

Results

The total number of health care facilities was 120, staffed by 659 workers. Only 18 (15.0%, 18/120) facilities were licensed, and 44.1% (53/120) of the workers were health professionals. The health care workers provided different services including dispensing drugs (370/1692, 21.87%), measuring blood pressure and blood sugar (350/1692, 20.69%), and caring for wounds and injuries (319/1692, 18.85%). Around 97% (116/120) health facilities provided services for musculoskeletal disorders and only 16.7% (20/120) provided services for injuries. The drugs available in the clinic were analgesics, drugs for gastrointestinal and respiratory diseases, and antibiotics, with an availability range of 13.3% to 100.0%. Infection control practices for individual protection, environmental sanitation, and medical waste disposal were available in a range of 18.1% to 100.0%.

Conclusions

Community-based health care facilities experienced a profound shortage of trained human resources and medical supplies. They can significantly contribute to health services if they are adequately equipped and follow standardized operation procedures.

Related collections

Most cited references 19

Record: found
Abstract: found
Article: found

Is Open Access

Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: A Cross Sectional Study

Aref A Bin Abdulhak, Mohamad Altannir, Mohammed Almansor … (2011)

Background Antibiotics sales without medical prescriptions are increasingly recognized as sources of antimicrobial misuse that can exacerbate the global burden of antibiotic resistance. We aimed to determine the percentage of pharmacies who sell antibiotics without medical prescriptions, examining the potential associated risks of such practice in Riyadh, Saudi Arabia, by simulation of different clinical scenarios. Methods A cross sectional study of a quasi-random sample of pharmacies stratified by the five regions of Riyadh. Each pharmacy was visited once by two investigators who simulated having a relative with a specific clinical illness (sore throat, acute bronchitis, otitis media, acute sinusitis, diarrhea, and urinary tract infection (UTI) in childbearing aged women). Results A total of 327 pharmacies were visited. Antibiotics were dispensed without a medical prescription in 244 (77.6%) of 327, of which 231 (95%) were dispensed without a patient request. Simulated cases of sore throat and diarrhea resulted in an antibiotic being dispensed in (90%) of encounters, followed by UTI (75%), acute bronchitis (73%), otitis media (51%) and acute sinusitis (40%). Metronidazole (89%) and ciprofloxacin (86%) were commonly given for diarrhea and UTI, respectively, whereas amoxicillin/clavulanate was dispensed (51%) for the other simulated cases. None of the pharmacists asked about antibiotic allergy history or provided information about drug interactions. Only 23% asked about pregnancy status when dispensing antibiotics for UTI-simulated cases. Conclusions We observed that an antibiotic could be obtained in Riyadh without a medical prescription or an evidence-based indication with associated potential clinical risks. Strict enforcement and adherence to existing regulations are warranted.

0 comments Cited 89 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Taking forward a ‘One Health’ approach for turning the tide against the Middle East respiratory syndrome coronavirus and other zoonotic pathogens with epidemic potential

Alimuddin Zumla, Osman Dar, Richard Kock … (2016)

Highlights • The appearance, disappearance, and re-emergence of pathogens of humans with epidemic potential and high mortality rates have threatened global health security for centuries. • Global public health authorities should have been better prepared for the recent Ebola virus disease (EVD) epidemic in West Africa. • The current Zika virus outbreak is diverting the attention of public authorities and governments from other important infectious diseases that continue to threaten global public health security; one such disease lurking in the background is the Middle East respiratory syndrome (MERS). • The emergence of the MERS coronavirus (MERS-CoV) in 2012 was the second time (after severe acute respiratory syndrome coronavirus (SARS-CoV)) that a new coronavirus, highly pathogenic for humans, emerged in the 21st century. Whilst most MERS cases have been reported from the Middle East, MERS cases have been reported from 27 countries in all continents. • MERS-CoV has been found in camel populations of Eastern Africa and the Middle East, and with millions of pilgrims visiting Saudi Arabia and returning home every year, the movement of MERS-CoV to new locations presents a real threat to global health security. • With animal, human, and environmental factors playing a critical role in its evolution, MERS-CoV represents a classical zoonosis. • A serious and more collaborative and coordinated MERS-CoV response plan is required to better define MERS-CoV epidemiology, transmission dynamics, molecular evolution, optimal treatment and prevention measures, and development of vaccines for humans and camels. • The ‘One Health’ concept focuses on the relationship and interconnectedness between humans, animals, and the environment, and recognizes that the health and wellbeing of humans is intimately connected to the health of animals and their environment (and vice versa). • A ‘One Health’ approach is ideally suited to the MERS-CoV situation and requires close cooperation between those who provide human health, animal health, and promote environmental and ecosystems health. • Critical to the establishment of a ‘One Health’ platform is the creation of a multidisciplinary team with a range of expertise to learn more about zoonotic spread between animals, humans, and the environment, and to monitor, respond to, and prevent major outbreaks conductive sociopolitical and economic framework for action. • The persistence of MERS-CoV 4 years since its first discovery has created major opportunities for Saudi Arabia or one of the other Middle Eastern countries to take leadership of the ‘One Health’ approach to tackling new emerging and re-emerging infectious diseases with epidemic potential in their region. • Parallel initiatives across Africa and the tropics could be harmonized to create regional networks that can serve as a repository for expert ‘One Health’ advice on safe and sustainable agricultural systems, especially for livestock, in support of human development.

0 comments Cited 62 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Impact of Over-the-Counter Restrictions on Antibiotic Consumption in Brazil and Mexico

Yared Santa-Ana-Tellez, Aukje Mantel-Teeuwisse, Anahi Dreser … (2013)

Background In Latin American countries over-the-counter (OTC) dispensing of antibiotics is common. In 2010, both Mexico and Brazil implemented policies to enforce existing laws of restricting consumption of antibiotics only to patients presenting a prescription. The objective of the present study is therefore to evaluate the impact of OTC restrictions (2010) on antibiotics consumption in Brazil and Mexico. Methods and Findings Retail quarterly sales data in kilograms of oral and injectable antibiotics between January 2007 and June 2012 for Brazil and Mexico were obtained from IMS Health. The unit of analysis for antibiotics consumption was the defined daily dose per 1,000 inhabitants per day (DDD/TID) according to the WHO ATC classification system. Interrupted time series analysis was conducted using antihypertensives as reference group to account for changes occurring independently of the OTC restrictions directed at antibiotics. To reduce the effect of (a) seasonality and (b) autocorrelation, dummy variables and Prais-Winsten regression were used respectively. Between 2007 and 2012 total antibiotic usage increased in Brazil (from 5.7 to 8.5 DDD/TID, +49.3%) and decreased in Mexico (10.5 to 7.5 DDD/TID, −29.2%). Interrupted time series analysis showed a change in level of consumption of −1.35 DDD/TID (p<0.01) for Brazil and −1.17 DDD/TID (p<0.00) for Mexico. In Brazil the penicillins, sulfonamides and macrolides consumption had a decrease in level after the intervention of 0.64 DDD/TID (p = 0.02), 0.41 (p = 0.02) and 0.47 (p = 0.01) respectively. While in Mexico it was found that only penicillins and sulfonamides had significant changes in level of −0.86 DDD/TID (p<0.00) and −0.17 DDD/TID (p = 0.07). Conclusions Despite different overall usage patterns of antibiotics in Brazil and Mexico, the effect of the OTC restrictions on antibiotics usage was similar. In Brazil the trend of increased usage of antibiotics was tempered after the OTC restrictions; in Mexico the trend of decreased usage was boosted.

0 comments Cited 52 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Faris Lami:

ORCID: https://orcid.org/0000-0002-3673-3818

Department of Community and family MedicineCollege of MedicineUniversity of BaghdadBab Al Muadham, RusafaBaghdad, 00964Iraq964 +9647901402692farislami@yahoo.com

Journal

Journal ID (nlm-ta): JMIR Public Health Surveill

Journal ID (iso-abbrev): JMIR Public Health Surveill

Journal ID (publisher-id): JPH

Title: JMIR Public Health and Surveillance

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2369-2960

Publication date Collection: Jul-Sep 2019

Publication date (Electronic): 4 October 2019

Volume: 5

Issue: 4

Electronic Location Identifier: e10905

Affiliations

[1 ] Department of Community and Family Medicine College of Medicine University of Baghdad Baghdad Iraq

[2 ] Karbala Directorate of Health Iraq Ministry of Health Karbala Iraq

[3 ] Private Practitioner Amman Jordan

Author notes

Corresponding Author: Faris Hasan Lami farislami@ 123456yahoo.com

Author information

Faris Lami https://orcid.org/0000-0002-3673-3818

Inam Hameed https://orcid.org/0000-0001-6784-0555

Ali Arbaji https://orcid.org/0000-0002-2812-5142

Article

Publisher ID: v5i4e10905

DOI: 10.2196/10905

PMC ID: 6800459

PubMed ID: 31588911

SO-VID: c865e313-3a2c-47b1-afa7-4c2ce372fc94

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.

History

Date received : 28 April 2018

Date revision requested : 11 October 2018

Date revision received : 5 December 2018

Date accepted : 14 December 2018

Comments

Comment on this article

scite_

Cited by 3

See all cited by

Most referenced authors 245

See all reference authors

Submit your digital health research with an established publisher
- celebrating 25 years of open access