Ebola Treatment and Prevention are not the only Battles: Understanding Ebola-related Fear and Stigma

Although Ebola Virus Disease (EVD) had already taken hundreds of lives in Liberia, Guinea, and Sierra Leone, it was only declared an ‘Public Health Emergency of International Concern’ in early August when the world started to panic from the possibility of EVD getting out of African borders - a fear that was spreading much faster than the virus itself (1,2). The underlying causes of this fear, however, go far behind the uncertainties surrounding EVD’s pathogenesis and could stem from the past (3). The western perception of associating West Africa with deadly diseases such as malaria, yellow fever and EVD, and representing the region as white man’s grave is not just fueled by superstition or ignorance and has roots in history (3,4). For instance, the yellow fever outbreak in Liberia in the 20s that led to the loss of several prominent American and British medical researchers and instructors, has left the West with painful memories of the region (3)

Introducing \"One Health\" as an Overlooked Concept in Iran

‘One Health’ is the “collaborative effort of multiple disciplines —working locally, nationally, and globally—to attain optimal health for people, animals and our environment” (1). The concept of ‘One Health’ is not as new as it may seem at the first glance, as its pioneer supporters used to live in the 19th century. Looking back in history, Louis Pasteur and Robert Koch’s achievements are good examples of practicing ‘One Health’ (2). More recently in 1940s, efforts of Dr. Steele and his peers around the globe in developing the first ‘Veterinary Public Health’ program made rapid advances in the control and prevention of zoonotic diseases, both in the United States and globally (2). The interaction of humankind, environment, and animals has led to a dynamic through which the health of these groups is interrelated

Deadly Professions: Violent Attacks Against Aid-Workers and the Health Implications for Local Populations

War has devastating implications for families, communities, cultures, economies, and state infrastructure. Similarly, the last decade has seen an increase in the number of attacks against health workers in conflict zones and unstable environments. Unfortunately, these attacks have grave consequences for local populations which often rely on foreign aid programs for their health and well-being. As such, this paper will examine why aid-workers have increasingly been targeted for abductions, ambushes, assassinations, and various forms of intimidation. Furthermore, examples of terminated health programs, as well as populations served by current medical and humanitarian interventions, will be provided to impart a sense of magnitude and importance of health programs to the reader. Lastly, suggestions will be presented which could serve to minimize aid-workers’ risk and exposure to acts of violence in the field

Self-perceived Mental Health Status and Uptake of Fecal Occult Blood Test for Colorectal Cancer Screening in Canada: A Cross-Sectional Study

Background: While colorectal cancer (CRC) is one of the most preventable causes of cancer mortality, it is one of the leading causes of cancer death in Canada where CRC screening uptake is suboptimal. Given the increased rate of mortality and morbidity among mental health patients, their condition could be a potential barrier to CRC screening due to greater difficulties in adhering to behaviours related to long-term health goals. Using a population-based study among Canadians, we hypothesize that self-perceived mental health (SPMH) status and fecal occult blood test (FOBT) uptake for the screening of CRC are associated. Methods: The current study is cross-sectional and utilised data from the Canadian Community Health Survey 2011-2012. Multinomial logistic regression analysis was undertaken to assess whether SPMH is independently associated with FOBT uptake among a representative sample of 11386 respondents aged 50-74 years. Results: Nearly half of the respondents reported having ever had FOBT for CRC screening, including 37.28% who have been screened within two years of the survey and 12.41% who had been screened more than two years preceding the survey. Respondents who reported excellent mental health were more likely to have ever been screened two years or more before the survey (adjusted odds ratio [AOR] = 2.08; 95% CI, 1.00-4.43) and to have been screened in the last two years preceding the survey (AOR = 1.53; 95% CI, 0.86-2.71) than those reported poor mental health status. Conclusion: This study supports the association between SPMH status and FOBT uptake for CRC screening. While the efforts to maximize CRC screening uptake should be deployed to all eligible people, those with poor mental health may need more attentio

Deadly professions: violent attacks against aid-workers and the health implications for local populations

War has devastating implications for families, communities, cultures, economies, and state infrastructure. Similarly, the last decade has seen an increase in the number of attacks against health workers in conflict zones and unstable environments. Unfortunately, these attacks have grave consequences for local populations which often rely on foreign aid programs for their health and well-being. As such, this paper will examine why aid-workers have increasingly been targeted for abductions, ambushes, assassinations, and various forms of intimidation. Furthermore, examples of terminated health programs, as well as populations served by current medical and humanitarian interventions, will be provided to impart a sense of magnitude and importance of health programs to the reader. Lastly, suggestions will be presented which could serve to minimize aid-workers’ risk and exposure to acts of violence in the field

Pathways to Addiction: A Gender-Based Study on Drug Use in a Triangular Clinic and Drop-in Center, Kerman, Iran

Background: Addiction is characterized differently among women and men, and they begin using drugs for different reasons and motives. Objectives: The aim of the study was to explore the gendered experiences and patterns of illicit drug use initiation in an Iranian context. Patients and Methods: A total of 29 participants (15 men and 14 women) took part in in-depth interviews conducted at a HIV triangulation clinic (for men and women) and drop-in-center for women in Kerman in 2011. Results: The results of the study suggest that patterns of drug use are different among among Iranian men and women. Men often transit to drug use from cigarette smoking, whereas women’s drug use practices often begins with opium. Unlike women, men who used drugs were often single at their drug use debut. Conclusions: Different patterns of first exposure to drug use among men and women highlight the role of gendered expectations and socio-cultural norms in shaping drug use experiences of people who use drugs and call for gender-specific harm reduction interventions

HIV Modes of Transmission in Sudan in 2014

Background: In Sudan, where studies on HIV dynamics are few, model projections provide an additional source of information for policy-makers to identify data collection priorities and develop prevention programs. In this study, we aimed to estimate the distribution of new HIV infections by mode of exposure and to identify populations who are disproportionately contributing to the total number of new infections in Sudan. Methods: We applied the modes of transmission (MoT) mathematical model in Sudan to estimate the distribution of new HIV infections among the 15-49 age group for 2014, based on the main routes of exposure to HIV. Data for the MoT model were collected through a systematic review of peer-reviewed articles, grey literature, interviews with key participants and focus groups. We used the MoT uncertainty module to represent uncertainty in model projections and created one general model for the whole nation and 5 sub-models for each region (Northern, Central, Eastern, Kurdufan, and Khartoum regions). We also examined how different service coverages could change HIV incidence rates and distributions in Sudan.Results: The model estimated that about 6000 new HIV infections occurred in Sudan in 2014 (95% CI: 4651-7432). Men who had sex with men (MSM) (30.52%), female sex workers (FSW) (16.37%), and FSW’s clients accounted (19.43%) for most of the new HIV cases. FSW accounted for the highest incidence rate in the Central, Kurdufan, and Khartoum regions; and FSW’s clients had the highest incidence rate in the Eastern and Northern regions. The annual incidence rate of HIV in the total adult population was estimated at 330 per 1 000 000 populations. The incidence rate was at its highest in the Eastern region (980 annual infections per 1 000 000 populations). Conclusion: Although the national HIV incidence rate estimate was relatively low compared to that observed in some sub-Saharan African countries with generalized epidemics, a more severe epidemic existed within certain regions and key populations. HIV burden was mostly concentrated among MSM, FSW, and FSW’s clients both nationally and regionally. Thus, the authorities should pay more attention to key populations and Eastern and Northern regions when developing prevention programs. The findings of this study can improve HIV prevention programs in Sudan