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East Mediterr Health J. 2019;25(1):3–4. https://doi.org/10.26719/2019.25.1.3

Copyright © World Health Organization (WHO) 2019. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

¹Summary report on the Interregional meeting on leishmaniasis among neighbouring endemic countries in the Eastern Mediterranean, African and European regions, Amman, Jordan, 23–25 September 2018 (http://applications.emro.who.int/docs/IC_Meet_Rep_2019_EN_22325.pdf).

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This issue of the Eastern Mediterranean Health Journal covers a spectrum of public health research throughout the Region, much of which has direct relevance with the work of the World Health Organization. From industrial environmental health to vector control disease surveillance, the public health issues that currently afflict the Region are not necessarily unique, but certainly highlight areas of research that can have a particular urgency when considering the specific challenges faced by populations throughout the Middle East and North Africa.

Chemical accidents have the potential for immense destruction not only through potential loss of life, but also through the degradation of the environment and contamination of air, water and thus agriculture. As low and middle-income countries are keen to industrialize and look to raise their standard of living, so must legal oversight and processes to ensure environmental health considerations are met. The Islamic Republic of Iran has witnessed a number of industrial chemical incidents that have raised the need for urgent review of current legislation and enforcement, as highlighted in the research article “Industrial chemical accidents: a growing health hazard in the Islamic Republic of Iran” (1) and examination of the application of International Health Regulations.

Keeping with the theme of efficiency and effective oversight, this issue also examines research on proposed conceptual integrated models in the adoption of electronic medical records, and thus seek to promote quality of healthcare services, as discussed in the research article “Determining factors in applying electronic medical records in healthcare” (2).

Common to many of the countries of the Eastern Mediterranean Region is the issue of air quality and prevalence of tobacco use that has led to increasing rates of chronic obstructive pulmonary disease (COPD). Considered an environmental health concern, whether highlighting industrial air pollution or substance use, the article “The global prevalence of chronic obstructive pulmonary disease: a systematic review and meta-analysis” (3) synthesizes worldwide published data to assess its geographical extent and gender balance: interestingly the Americas reported the highest rates of COPD and a higher diagnosis in males.

However, environmental health is not limited to industrial pollution or chemical hazards; the combination of working life and cultural or religious observance can also have environmental health implications not necessarily foreseen in the natural world. Such is the area of research in the article “Effect of fasting during Ramadan on heat parameters in the Middle East” (4), examining how some religious practices may potentially have adverse effects on outdoor workers if robust workplace measures are not enforced in high-temperature environments to prevent heat exhaustion.

Mobile populations, either as migrants or tourists, may present a challenge to the effective control of infectious diseases. The travel industry is one area that has grown exponentially in the Gulf States with its rapidly rising standard of living, yet awareness of the importance of travel health is lagging. From vaccinations to effective prevention of transmissible infections, the article “Knowledge, attitudes and practices of travel medicine among primary care physicians in Oman: the need for intervention” (5) researched just how developed travel medicines are in the Sultanate and where weaknesses lie in travel health awareness and promotion.

Following the theme of communicable disease prevention, this issue also includes a timely update on the management of Zika virus transmission outlined in the short research communication “Enhancing surveillance for early detection of Zika virus infection: strategies for the countries of the Eastern Mediterranean Region” (6). Currently the Region has not had any reported cases of the Zika virus despite the presence of its vector: Aedes mosquitoes. Maintaining this Zika-free status for the Region is a priority for the WHO Regional Office for the Eastern Mediterranean, and here the considerations are put forward for enhanced surveillance using a combination of syndromic and event-based surveillance approaches within the existing system in operation.

Quality assessment of health service providers and hospital healthcare are two areas examined in this issue and draw attention to the necessity of effective healthcare. The research article “National quality assessment questionnaire for physiotherapy centres: a pilot study in Lebanon” (7) highlights the importance of responsive quality control tools for physiotherapy centres that often come under the private sector. Such tools can also form part of the accreditation of such health service providers, not only to ensure required staff qualification levels, but also to address the problem of infection due to below standard levels of hygiene.

Moreover, a hospital environment would appear to be the ideal environment for early diagnosis and management of paediatric illnesses, yet as the research article “Nutritional risk screening of hospitalized children aged < 3 years” (8) highlights, it can be surprisingly difficult to identify malnutrition in such hospital settings. This research draws attention to the need for effective screening tools for children vulnerable to malnutrition, ensuring prompt interventions that may contribute to overall improvements in patient care, as well as shortening the hospitalization period.

Finally, a WHO event summary of the “interregional meeting on leishmaniasis” (9) held in September 20181 draws attention to the fact that almost 70% of the total number of cutaneous leishmaniasis cases reported worldwide have been from the Region; the implementation of effective control measures remains an important challenge for the Organization.

Looking forward, February issue of the EMHJ will cover a wide spectrum of public health topics, including a review of family planning policies in the WHO Eastern Mediterranean Region; inequalities in access to hospitals; antenatal care among Palestinian refugees in Jordan; and tobacco and waterpipe use among Saudi university students.

References

1. Fatemi F; Ardalan A; Mansouri N; Aguirre B; Mohammdfam I. Industrial chemical accidents: a growing health hazard in the Islamic Republic of Iran. East Mediterr Health J. 2019;25(1):5–11. https://doi.org/10.26719/2019.25.1.5
2. Abou Haidar M; Khalife K; Abou Abbas L; Nasser Z; Tannous JC; Yammine J. National quality assessment questionnaire for physiotherapy centres: a pilot study in Lebanon. East Mediterr Health J. 2019;25(1):12-17. https://doi.org/10.26719/emhj.18.008
3. Shaaban S; Nassar M; El-Gendy Y; El-Shaer B. Nutritional risk screening of hospitalized children aged < 3 years. East Mediterr Health J. 2019;25(1):18–23. https://doi.org/10.26719/emhj.18.019
4. Abdekhoda M; Dehnad A; Zarei J. Determinant factors in applying electronic medical records in healthcare. East Mediterr Health J. 2019;25(1):24-33. https://doi.org/10.26719/emhj.18.007
5. Manjunath G; Aravindhakshan R; Varghese S. Effect of fasting during Ramadan on thermal stress parameters. East Mediterr Health J. 2019;25(1):34–39. https://doi.org/10.26719/emhj.18.013
6. Kurup PJ; Al Abri SS; Al Ajmi F; Khamis HA; Singh J. Knowledge, attitude and practice of travel medicine among primary care physicians in Oman: the need for intervention. East Mediterr Health J. 2019;25(1):40-46. https://doi.org/10.26719/emhj.18.027
7. Varmaghani M; Dehghani M; Heidari E; Sharifi F; Moghaddam SS; Farzadfar F. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2019;25(1):47–57. https://doi.org/10.26719/emhj.18.014
8. Obtel M; Malik MR; Tran Minh TM; Muhavani Buliva E; Ali Elkhobby A; Salim SA; et al. Enhancing surveillance for early detection of Zika virus infection: strategies for the countries of Eastern Mediterranean Region. East Mediterr Health J. 2019;25(1):58–65.https://doi.org/10.26719/emhj.18.011
9. Leishmaniasis among neighbouring endemic countries in the Eastern Mediterranean, African and European regions. East Mediterr Health J. 2019;25(1):66-68 https://doi.org/10.26719/2019.25.1.66