Twenty two years of IDD elimination efforts in Sudan: An alternative approach for national USI legislation is needed

The aims of this paper are (1) to review the progress made in Iodine Deficiency Disorders (IDD) control in Sudan since 1989, and (2) to propose an alternative approach for national USI legislation in Sudan. Although three federal ministerial decrees requiring salt manufactures to fortify all edible salt with Iodine and three states have laws prohibit selling of non-iodized salt in their jurisdictions. But none of these decrees and laws implementation was enforced. Utilization of existing National Standardization and Metrology Law (2008), National Public Health Law (2008), and Food Inspection Law (1973) provide legal frame for this alternative approach. Collaboration between MOH and SSMO to issue a national compulsory salt specification and develop monitoring and surveillance systems is highly recommended Keywords: Sudan, Universal Salt Iodization, Iodine Deficiency Disorders, USI legislation

Publishing in the Digital Era: Open Access Journals Model

The Directory of Open Access Journals (DOAJ) was launched in 2003 at Lund University, Sweden.DOAJ is a membership organization, Publisher, Ordinary Member and Sponsor are the three membership available categories. It is a community-curated list of open access journals and aims to be the starting point for all information searches for quality, peer reviewed open access material. Membership in the DOAJ is a vibrant declaration of intent and proves a commitment to quality, peer-reviewed open access. To support Open Access Journals (OAJ) community, DOAJ is co-author to the Principles of Transparency and Best Practice in Scholarly Publishing (Principles) (https://doaj.org/bestpractice) and DOAJ members are expected to pursue these principles as a condition of membership

The role of family background on adolescent khat chewing behavior in Jazan Region

BACKGROUND: Khat is a well-known natural stimulant from the Catha edulis plant and is widely used in certain Red Sea countries, including Yemen and the province of Jazan in Saudi Arabia. Jazan is located in the southwestern part of the Kingdom of Saudi Arabia adjacent to Yemen, where the practice of khat chewing is deeply rooted throughout the entire population. The main objective of this paper was to assess the association between family background, i.e., parent and sibling khat use, and adolescents' khat chewing behavior in Jazan. Other variables were also tested for association, including parents' education levels, family income, and peer influence. MATERIAL AND METHODS: A cross-sectional study was conducted with a representative sample (n = 4,100) of intermediate and upper secondary school students of Jazan. The participants were selected using a three-stage cluster random sampling. A structured self-administered questionnaire was used for data collection. Descriptive statistics, a chi-squared test, and logistic regression were performed to examine the associations and predictors of khat chewing. RESULTS: A total of 3,923 students of both genders from 72 intermediate and upper secondary schools in Jazan were involved in this study. Of these participants, 42.8% (1,678) were from intermediate schools and 43.8% (1,717) were females. The prevalence of current khat chewing among the students was 20.5% (95% confidence interval (CI) 19.27–21.79) and was significantly higher for males at 33.1% (95% CI 31.16–35.08) than for females, of whom 4.3% (95% CI 3.39–5.31) (P < 0.001) chew khat. The multivariate logistic regression analysis suggests that the most important independent predictors of student khat chewing included the students' smoking status (odds ratio (OR) = 14.03, P < 0.001), a friend using khat (OR = 5.65, P < 0.001), a sister using khat (OR = 2.04, P < 0.05), a father using khat (OR = 1.45, P < 0.001), and a brother using khat (OR = 1.56, P < 0.05). CONCLUSION: The results highlight the significant impact of peer and familial khat abuse in adolescent khat chewing behavior. The findings suggest that khat control programs need to focus on peers and family members to reduce the prevalence of the habit along with its unfavorable consequences

Peace impact on health: population access to iodized salt in south Sudan in post-conflict period

Aim To determine the population access to salt/iodized salt during and after the armed conflict in south Sudan and to illustrate geographical variations in population consumption of iodized salt in south Sudan after the armed conflict. Methods The sources of data for the conflict period were the 2004 Toward a Baseline: Best Estimates of Social Indicators for Southern Sudan study report and the 2000 Multiple Indicators Cluster Survey, and for the post-conflict period the 2005 Sudan Household Health Survey (SHHS) data set. Results After peace agreement, population access to salt increased by 6.8% (Z = 5.488, P < 0.001) and the consumption of iodized salt increased by 32.9% (Z = 24.668, P < 0.001). More than 73% of families were using iodized salt but geographical differences existed between states. Conclusion Peace had positive impact on population access to iodized salt in south Sudan. Public health authorities in south Sudan need to establish quality monitoring and surveillance systems to track progress toward Universal Salt Iodization goal defined by the World Health Organization, United Nations Children’s Fund, and the International Council for the Control of Iodine Deficiency Disorders

Evaluation of the learning environment and the perceived weakness of the curriculum: student perspective

Background: Educational environment has been shown to have influence on learning outcome and affects student achievement, satisfaction, and success. The study was conducted to assess medical students’ perception of their learning environment and to explore areas of weakness within the educational environment.Methods: A mixed method of study, was performed using non-probability sampling at the Faculty of Medicine, Gezira University (FMUG), Sudan. An updated Arabic Dundee Ready Education Environment Measure (DREEM) was developed and administered to 854 students during the academic year 2016-2017.Results: Seventy five percent of students completed the inventory (638/854) and Sixty four percent (546/854) responded to the open-ended question providing comments and suggestions. The overall reliability coefficient alpha in this study was 0.914. The global score for this study was found positive (122/200). Students were most satisfied with the learning aspects, academic environment, and academic self-perception. However, they were unsatisfied with their teaching and social atmosphere (inadequate social support for stressed students, substandard teaching, overemphasised factual learning, unpleasant accommodation). The qualitative content analysis was performed and emerged with four themes: the physical environment, a number of students, pedagogical approaches and faculty-student communication.Conclusions: The study suggested the overall students’ perceptions of the educational environment in the FMUG were on the positive side. However, certain specific elements of the learning environment and educational programme need to be critically investigated and remedied. The updated Arabic DREAM can be used reliably in the context of medical education in Arabic speaking countries

Iodized Salt Consumption in Sudan: Present Status and Future Directions

Iodine Deficiency Disorders (IDD) Control Programme in Sudan adopted salt iodization as the long-term strategy in 1994. In 2000, it was found that less than 1% of households were using adequately-iodized salt. The objectives of this study were to: (i) study the coverage and variation of different geographical regions of Sudan regarding access to and use of iodized salt, (ii) explore the possible factors which influence the use of iodized salt, (iii) develop recommendations to help in the implementation of the Universal Salt Iodization (USI) strategy in Sudan. This paper is based on the Sudan Household Health Survey (SHHS) dataset. A total sample of 24,507 households was surveyed, and 18,786 cooking salt samples were tested for iodine levels with rapid salt-testing kits. Nationally, the percentage of households using adequately-iodized salt increased from less than 1% in 2000 to 14.4%, with wide variations between states. Access to iodized salt ranged from 96.9% in Central Equatoria to 0.4% in Gezira state. Population coverage with iodized salt in Sudan remains very low. The awareness and political support for USI programme is very weak. National legislation banning the sale of non-iodized salt does not exist. Utilization of the already-existing laws, like the National Standardization and Metrology Law (2008), to develop a compulsory national salt specification, will accelerate the USI in Sudan

Prevalence and Risk Factors for Brucellosis in Jazan Province, Saudi Arabia

Purpose: Brucellosis is responsible for considerable public health issues involving economic losses due to abortion, loss of milk production and infertility in adult males. The purpose of this study was to determine the sero-prevalence of brucellosis in Jazan Province, Saudi Arabia and assess the possible risk factors.Methods: An observational cross-sectional study was conducted in three geographical areas of Jazan Province, Saudi Arabia. The study sample included 400 participants from randomly selected primary health care centres. A standardised questionnaire was used to collect information on demographics and risk factors for brucellosis. A 5 ml blood sample was collected from each study participant. The SPSS statistical program was utilised for data analysis.Results: The overall sero-prevalence of brucellosis in Jazan Province was 13.4 % and was higher among participants ≥ 40 years old (20 %) than those &lt; 40 years (12 %). Prevalence was significantly higher among rural (39.3 %; 95 % confidence interval [CI], 29.8 – 49.7) than urban populations (4.6 %; 95 % CI, 2.7 – 7.9), in Saudis (14.5 %; 95 % CI, 11.1 – 18.8) than non-Saudis (3.0 %; 95 % CI, 7.0 – 15.3) and in males (16.4 %; 95 % CI, 12.2 – 21.6) than females (7.1 %; 95 % CI, 3.7 – 13.4).Conclusion: These results indicate the need for a vaccination program in Jazan Province and for public awareness campaign activities to combat and eradicate the disease.Keywords: Sero-prevalence, Brucellosis, Milk, Vaccination, Public awareness campaig

Prevalence and Risk Factors of Hepatitis B Virus among Pregnant Women in Jazan Region- Kingdom of Saudi Arabia

Background: Hepatitis B virus is one of the major etiological agents for parenterally acquired hepatitis. Viral hepatitis during pregnancy is associated with high risk of maternal complications. This study was conducted to determine the prevalence of HBV infection in pregnant women, and to find out its associated risk factors in Jazan region south KSA. Patients &amp; Methods: A random sample of 537 pregnant females who attended Jazan general hospital and randomly selected primary health care centers in Jazan region - before 38 weeks of gestation - constituted the target population of the present study. All women were screened for HBsAgd by using HBsAg Rapid Test Device (ACON). Results: The overall prevalence of HBV virus among the women was found to be 4.1% (95% CI: 2.7 - 6.1). The prevalence of HBV according to age showed that women less than 20 years are free of HBV, whereas for other age groups HBV prevalence is found to increase with increase in age. Regarding the associated risk factors, women  with  history of hospitalization, and  jaundices showed a significant association with anti- HBV seropositive. Dental histories, blood transfusion and history of surgery did not prove significant association with  HBV. Conclusion: Prevalence of Hepatitis B virus infection in pregnant ladies was 4.1%. Past history of hospitalization and jaundices are important risk factors for transmission of infection. The study suggests expansion of the Hepatitis B vaccination program to reduce the risk of HBV among pregnant women. Key words: Hepatitis B virus, Pregnancy, Prevalence, Risk factors

Effect of Healthy Lifestyle Interventions in Schools of Jazan City, Kingdom of Saudi Arabia: A Quasi-experimental Study

Background Unhealthy dietary habits and lifestyle among adolescents is considered as a risk factor for nutrition-related diseases in adulthood. The objective of this study was to investigate the effectiveness of a healthy lifestyle intervention—including physical activity (PA) and eating habits (EH)—among female students in Jizan City, southwest Kingdom of Saudi Arabia (KSA). Methods A representative sample of 565 school students aged 12–15 years was randomly selected from four schools in Jizan, KSA. The PA and EH were assessed using a validated self-administered questionnaire. A pre-post quasi-experimental study was implemented in three phases. Results Following the intervention, the school children in the intervention groups showed a significant improvement in their EH and PA. These improvements were documented in increased physical walking measured by the number of students walking daily, the number of days walked, and the time spent on vigorous activities (54.11 ± 54.89 to 63.24 ± 76.16). Fruits and vegetables had a similar consumption frequency in both the intervention and control groups. The snacks were frequently consumed among intervention group with a significant increase in the mean number from 1.64 ± 0.93 to 1.96 ± 1.13 (p = 0.000) and fast food were less frequently consumed among intervention group than the control group (p = 0.000). The prevalence of obesity in the intervention group was reduced from 16.3% to 12.9%, while it was significantly increased from 17.6% to 19.0% in the control group (p = 0.0148). Weight decreased by 0.37 kg in the intervention group, while it increased by 0.07 kg in the control group, but with no statistically significant increase. Conclusion: In conclusion, healthy lifestyle interventions can improve short- and long-term outcomes in school children. When examining the health benefits of healthy lifestyle, the importance of dietary and PA behaviors should be considered. Keywords:&nbsp; lifestyle, dietary habits, physical activity, chronic diseases, Jazan-KSA &nbsp