North Africa Countries Research Articles

Need for neurorehabilitation in the Middle East and North Africa from 1990 to 2021: an analysis based on the global burden of disease study.

This study will present the burden of diseases needing neurorehabilitation in Middle East and North Africa (MENA) countries and describe their epidemiology across age and sex groups. This study was conducted based on the Global Burden of Disease (GBD) 2021 findings. The authors used years of healthy life lost due to disability (YLD) as a proxy for the need for neurorehabilitation, and extracted the YLD rates and counts for neonatal encephalopathy due to birth asphyxia and trauma, stroke, neural tube defects, Parkinson's disease (PD), motor neuron disease, multiple sclerosis (MS), tension-type headache, other neurological disorders (except migraine, dementia, and epilepsy), head injuries, spinal injuries, nerve injury, and asphyxiation across age groups, sexes, and MENA countries. YLD rates of disorders needing neurorehabilitation in 1990 and 2021 were 408.08 and 496.19 per 100 000 people, respectively, indicating a 21.59% rise in YLD. Stroke had the highest YLD rates in both 1990 (150.19 per 100 000) and 2021 (192.75 per 100 000). Syria, Saudi Arabia, and the United Arab Emirates had the highest YLD rates for conditions needing neurorehabilitation. Considering the growing demand for neurorehabilitation with the aging of populations and the historical shortage of rehabilitation services in the region, the gap between the demand and supply may further increase in the coming years, leading to consequences for people living with neurological conditions in the region.

The Influence of Open Access on Institutional Scientific Research Output in MENA Countries: A Comparative Analysis

The release of scientific research has substantial consequences for both the research and the institution in which it was carried out. The selection of publishing methods for scientific articles, such as journal type, quartile, indexed databases, and publishing models, plays a crucial role. Various publishing models exist, including platinum, gold, and green open access. In this study, we examine the implications of open access publishing on reputable journals for Middle East and North Africa (MENA) countries. Additionally, we explore the correlation between open access publishing and MENA country classification according to the World Bank. Bibliometric data from Scopus database are used, focusing on researchers from each MENA country. The World Bank determines if a country is low, middle, or high income. The total number of published documents and open access publications are also considered. The study investigates how open access publishing affects university and research center rankings within MENA countries, utilizing Scopus database information. This encompasses the number of open access documents indexed in Scopus and citations from MENA countries. Multiple ranking systems, such as 2024-QS World University Ranking (QSWUR) and 2023-Scimago Institutions Ranking, are assessed. Findings reveal that open access articles contribute to 72% to 95% of citations received by institutions in MENA countries, highlighting the influence of this publishing model. Additionally, the percentage of open access publishing ranges from 32% in low-income countries to 56% in other MENA countries. The study also demonstrates that MENA countries with higher numbers of open access publications are more likely to have institutions ranked in prestigious systems such as QS World University Ranking and Scimago Institutions. It is discovered that the average percentage of citations received from open access publications indexed in Scopus for MENA countries is 82%, indicating the significant impact of open access publishing on academic citations in these nations. We believe that the procedures done in this study for MENA countries can be generalized further for global countries.

Evaluating the Impact of Chinese FDI in the Energy Sector on Green GDP Growth: A Spatial Econometric Analysis of MENA Countries

This study analyzes the impact of Chinese foreign direct investment (FDI) in the energy sector on the green GDP (GGDP) growth of seven Middle East and North Africa (MENA) countries based on data from 2009 to 2019. Using panel regression analysis, the study focuses on the effects of FDI, economic development level, population size, energy consumption structure, environmental regulation intensity, government fiscal expenditure, and the KOF Economic Globalization Index on GGDP growth. By comparing fixed-effects and random-effects models and applying the Hausman test to select the most appropriate model, the research indicates that the random-effects model is the most suitable. The results show that FDI, economic development level, and population size have significant positive effects on GGDP, while shifts in energy consumption structure also promote sustainable economic growth. In contrast, environmental regulation intensity and the globalization index have no significant impact on GGDP, suggesting that GGDP growth in MENA countries relies more on internal economic policies and the efficiency of resource allocation.

Renewable energy, energy efficiency, and economic complexity in the middle East and North Africa: A panel data analysis

This paper aims to investigate how economic complexity and structural transformation affect energy security. This study differs from previous research by focusing on energy efficiency and renewable energy transition as indicators of energy security. The employed methods include econometric techniques such as Panel-Corrected Standard Errors, Driscoll and Kraay's Spatial Correlation Consistent (SCC) method, and Generalized Least Squares, covering data from the Middle East and North Africa (MENA) countries between 1990 and 2017. The results show that economic complexity has a negative effect on energy efficiency but a positive impact on renewable energy. However, economic growth positively affects energy efficiency but negatively influences renewable energy. These results imply that economic complexity is energy-intensive but green, whereas economic growth is energy-saving but brown. The comparative analysis reveals that the negative effects of economic complexity and growth are larger than their positive effects, highlighting the necessity of restructuring economic activities and sectors. Accordingly, decision-makers should encourage the utilization of more energy-efficient technologies in economic activities and production, while promoting renewable energy consumption to enhance energy security in the MENA region.

The spatial relationship between leishmaniases and sand flies in Europe and neighboring countries

BackgroundLeishmania infantum is endemic in Europe (and elsewhere) while L. donovani s.s., L. tropica and L. major are not but are present in neighboring countries in North Africa, the Middle East, (the Asian part of) Turkey and the Southern Caucasus. Lists of sand fly vector species in the scientific literature vary with the criteria for vector incrimination, and criteria vary because, for some, evidence is difficult to generate. With minimal criteria, about 20 sand fly species are proven or suspected vectors of L. infantum in Europe and neighboring countries, while for L. tropica and L. major, there are seven and four proven or suspected vector species, respectively, in this area. For L. donovani s.s., present in Cyprus, the Middle East and (the Asian part of) Turkey, no local vectors have been incriminated so far. The aim was to assess the degree of spatial agreement between Leishmania spp. and various vectors species and their relative contribution to the explained variation.MethodsWe used multivariate regression modeling to analyze the spatial relationship between autochthonous Leishmania spp. and clinical forms in humans and animals and 14 Phlebotomus spp. in Europe and neighboring countries.ResultsThere was only fair agreement between parasite and vector distributions. The most parsimonious models describing the distribution of Leishmania spp. and clinical forms included three to six sand fly species and explained between 12% (L. infantum) and 37% (L. donovani) of the observed variation. Selected models included confirmed and suspected vector species as well as unexpected species.ConclusionsThe relatively low agreement between Leishmania and vector distributions highlights the need to improve leishmaniasis reporting and vector surveillance in areas where no information is available, both for a better understanding of the epidemiology of infection in endemic areas and to monitor possible spread of infection into non-endemic areas. While some of the unexpected sand fly-Leishmania spp. statistical associations might be spurious, for others, the existence of sporadic or recent reports of infections warrants further vector competence studies that consider strain variation.Graphical

Epidemiological Aspects of Road Accidents in the Middle East and North Africa (MENA) Countries from 1990 to 2019

Background: Road accidents are a major public health concern globally and are expected to become the fifth leading cause of death worldwide by 2030. Objectives: This study aimed to compare the consequences of road accidents in the Middle East and North Africa (MENA) region by analyzing data from 21 countries and approximately 400 million people Methods: The data used was from the Global Burden of Diseases (GBD) in 2019, which defines traffic accidents as deaths resulting from external injury causes based on the international classification of diseases (ICD). Results: Road traffic injuries (RTIs) in the MENA region have decreased from 1990 to 2019. Motor vehicles have the highest death rate from RTIs at 15.32 per 100,000, followed by pedestrians at 8.37 per 100,000, motorcyclists at 2.16 per 100,000, and cyclists at 0.35 per 100,000. Saudi Arabia (46.7 per 100,000) and Oman (25.5 per 100,000) have the highest death rates for motor vehicle-related road injuries, while Oman (17.7 per 100,000) and Yemen (12.95 per 100,000) have the highest rates for pedestrian-related road injuries. Conclusions: Given the significant impact of road accidents in the countries of the region, it is crucial to address this issue through various measures. These should include training initiatives, preventive measures, and a review of traffic laws and regulations.

Measuring progress towards universal health coverage in 22 Middle East and North African countries

PurposeMonitoring progress towards universal health coverage (UHC) has become increasingly important, especially given the centrality of UHC in achieving the sustainable development goals. We sought to estimate the progress towards UHC in the 22 Middle East and North Africa (MENA) countries. MethodsEmploying the Joint World Bank and World Health Organization Framework for Monitoring UHC, we estimated the UHC index for MENA countries using both service coverage and financial protection indicators. We also explored the correlation between the UHC index with government expenditure/investment in health. ResultsThe 2021 UHC index ranged from 48.2 (Somalia) to 90.3 (United Arab Emirates) with a mean, median, and standard deviation of 74.9, 77.4, and 11.1, respectively, with significant differences between low-income and high-income countries. Service coverage lags behind financial protection in most MENA countries. There is a significant positive relationship between UHC and government health spending/investments. ConclusionThe majority of MENA countries are yet to achieve UHC. There is a need to expand healthcare services, especially PHC services, and adopt strategies that address concerns related to financial protection.

Fostering decent jobs, formalising informal employment and spurring job mobility in MENA countries

AbstractLongstanding evidence in Middle East and North Africa (MENA) countries shows a high prevalence of unemployment and informality among a large fraction of population, and at the same time gender disparities in labour force participation and occupational mobility. Why is there such persistent labour‐market segmentation? What is the impact and potential of various formalisation policies? An overview of the informal economy across three middle‐income MENA countries (Egypt, Jordan and Tunisia) is provided with respect to taxonomy, coverage and drivers. Transition matrices and multinomial logistic regressions are applied to longitudinal microdata from Labour‐Market Panel Surveys, focusing on workers' occupational mobility in relation to their previous status, age cohort, gender and other demographics. Persistent segmentation and low occupational mobility in all countries suggest that informal employment is not driven by choice on the labour supply side but by structural constraints on the demand side. Existing formalisation policies based on distinct stick and carrot strategies, and targeting of existing businesses and workers achieve rather modest impacts. One recommendation to supplement policies for decent jobs creation is to promote social and solidarity enterprises and extend microfinance to informal enterprises.

Assessment of ochratoxin A occurrence in poultry feed in eastern Algeria

ABSTRACT This study investigated the prevalence of the mycotoxin Ochratoxin A in poultry feed samples from Eastern Algeria, an important poultry production region. Ochratoxin A, produced by Aspergillus and Penicillium fungi, can contaminate feed, leading to toxicity issues for poultry and human beings consuming contaminated products. Analysis of 42 feed samples using the Enzyme-Linked Immunosorbent Assay (ELISA), found 62% contained detectable ochratoxin A levels exceeding the concentration of 1.50 ng g−1, varying between 2.23 ng g−1 and 3.23 ng g−1 with an average of 2.59 ng g−1. Although the widespread prevalence is below current regulatory limits, there is a need for continued monitoring to prevent contamination and toxin transfer to poultry meat and eggs. The study recommends expanding testing to more regions and implementing Ochratoxin A surveillance. This is a feed – and food – safety issue on a large scale, with implications for other countries in North Africa.

Social unrest and bank liquidity creation: evidence from MENA banks

PurposeA host of studies have assessed the determinants of bank liquidity creation, highlighting the relevance of macroeconomic and microeconomic factors. However, whether and how social unrest impacts bank liquidity creation remains a moot issue. To inform this debate, this study aims to exploit bank-level data for Middle East and North Africa (MENA) countries covering the period 2010–2019 to assess the interlinkage between social unrest and bank liquidity creation.Design/methodology/approachIn view of the staggered inception of social unrest across MENA countries, the author uses a difference-in-differences specification to tease out the causal impact.FindingsThe findings reveal that the Arab Spring improves liquidity creation after onboarding after confounding factors. This impact differs across conventional and Islamic banks and differs across asset side (market) and liability side (funding) liquidity creation. The evidence also underscores the positive real effects of such liquidity creation on real economic output.Originality/valueThis is one of the early studies exploiting a large sample of MENA banks to examine this issue in a systematic manner.

Oil Price Shochs'S Asymmetric Responses on Food Inflation in Middle East and North Africa Countries in the time of Ukraine-Russia Crisis

Oil Price Shochs'S Asymmetric Responses on Food Inflation in Middle East and North Africa Countries in the time of Ukraine-Russia Crisis

Enhancing employability through university-industry linkages: Omani engineering students’ perspectives of the Eidaad internship programme

Like many Middle East and North Africa countries, one of the main socio-economic challenges facing Oman is the creation of meaningful graduate employment opportunities. A combination of factors that include the gap between the expertise and skills acquired in higher education and workforce requirements means many students struggle to find suitable jobs upon graduation. Consequently, providing quality education and developing national talents are key objectives of the country’s Vision 2040 development roadmap. Higher levels of cooperation between tertiary institutions and industry within the framework of government policy are necessary to achieve these outcomes. This study explores undergraduate engineering student perceptions of one example of this collaboration – the Eidaad internship programme. To better understand interns’ perceptions of the programme’s personal and professional benefit across targeted areas and means for further improvement, a three-part on-line questionnaire was administered to current and former programme participants. Results indicate overwhelmingly positive perceptions of the programme, including in terms of enhancing interns’ teamwork skills, workplace participation, communication skills, clarity of career plans and objectives, and so on. Participant suggestions for improvement include the creation of concrete employment pathways and the provision of further on-the-job training opportunities. Implications for the Eidaad and similar internship programmes are discussed.

Development of A Responsible Investment for Low Carbon Economy: Renewable Energy Responsible Investment Index and Conceptual Framework for MENA Region

Responding to climate change creates particular challenges for Middle East and North Africa (MENA) countries in terms of oil output and water scarcity, but also gives potential for new paths to sustainability. The low-carbon energy transition poses critical concerns for MENA oil and gas producers, particularly about the impact on their reliance on hydrocarbon earnings. Without adjustment, this would exacerbate macroeconomic imbalances and possibly jeopardise pre-existing social contracts. Politicians are attempting to promote a variety of renewable energy sources and implementation tactics in order to mitigate the adverse consequences of climate change. As a result, the development of an index capable of effectively measuring and benchmarking the overall sustainability and economics of a country becomes necessary. In reality, the index should be capable of reflecting a near-complete assessment of renewable energy's current and future conditions. Simultaneously, it should be capable of revealing critical ESG and economic aspects of the renewable energy business. The proposal aims to create a composite index, dubbed the Renewable Energy Responsible Investment Index (RERII). It is comprised of 19 nations and 22 distinct metrics. From 2010 to 2019, a trend in RERII is computed. The RERII suggested in this work may be utilised as a screening tool, a decision-making tool, a benchmarking tool, and a tool for guiding sustainable development.

The indirect costs of vaccine-preventable cancer mortality in the Middle East and North Africa (MENA)

Background Infections are responsible for ∼13% of cancer cases worldwide, with human papillomavirus (HPV) and hepatitis B (HBV) among the infections associated with cancer for which vaccines are available. The aim of this study was to estimate the indirect cost of premature mortality related to cancers caused by HPV and HBV in Middle East and North Africa (MENA) countries. Methods The number of deaths and years of life lost (YLL) in 2019 from four HPV-related cancers: cervical cancer, oral cavity cancer, laryngeal cancer, and oropharynx cancer, as well as HBV-related liver cancer were sourced from the Institute for Health Metrics Evaluation (IHME) Global Burden of Disease database. HPV-attributable fractions were applied to deaths and YLL. The human capital approach was used to measure productivity loss, through value of YLL (VYLL), and estimated using gross domestic product per capita (World Bank; in USD). Seventeen countries in the MENA region were included. Four countries in the region were not included due to data availability. Results In 2019, there were 11,645 potentially vaccine-preventable cancer-related deaths across the MENA region. This resulted in an indirect cost of $1,688,821,605, with 76.1% of this accrued in the Middle East ($1,284,923,633). The number of deaths in the Middle East (5,986) were similar to Northern Africa (5,659) but YLL were higher in Northern Africa (179,425) compared to the Middle East (169,207). The highest indirect cost per death occurred in Qatar ($1,378,991), compared to $14,962 in Sudan. Oral cavity cancer had the highest VYLL per death ($186,084). Conclusions There is a high burden of premature mortality and indirect costs of potentially vaccine-preventable cancer-related deaths in the MENA region. Improved vaccination program implementation, increased vaccine coverage of HPV and HBV vaccinations, and continued prioritization of public health measures, such as screening, could effectively reduce premature mortality and associated costs.

The mediating effect of bank risk on the relationship between diversification strategies and discretionary loan loss provisions

Purpose This study aims to investigate the effect of income and asset diversification on earnings management using discretionary loan loss provisions (LLP) in banks, and the role of risk level in mediating this effect. Design/methodology/approach A sample of banks operating in Middle East and North Africa countries was used to test the mediation model of Baron and Kenny (1986) with different measures of diversification and risk. Findings The results show that bank income and asset diversification have unique and combined effects on earnings management. The results also support the idea that a risk-mediating effect contributes to explaining this relationship among banks. Specifically, bank diversification strategies positively affect LLP-based earnings management by increasing bank risk. This result is relevant for conventional banks. However, only a direct and positive effect of diversification strategies on LLP-based earnings management can be observed in Islamic banks, and the indirect effect is not supported. Originality/value This study extends previous research by examining the unique and combined effects of income and asset diversification strategies on earnings management in the banking sector. Specifically, it provides new evidence that diversification strategies increase LLP-based earnings management, both directly and indirectly, through bank risk.

What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries? A systematic review

BackgroundAs many patients are spending their last days in critical care units, it is essential that they receive appropriate end-of -life care. However, cultural differences, ethical dilemmas and preference practices can arise in the intensive care settings during the end of life. Limiting therapy for dying patients in intensive care is a new concept with no legal definition and therefore there may be confusion in interpreting the terms ‘no resuscitation’ and ‘comfort care’ among physicians in Middle East. Therefore, the research question is ‘What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries?’MethodsThe authors conducted a comprehensive systematic literature review using five electronic databases. We identified primary studies from Medline, Embase, CINAHL, Psycinfo and Scopus. The team assessed the full-text papers included in the review for quality using the Joanna Briggs Institute checklist (JBI). We completed the literature search on the first of April 2022 and was not limited to a specific period.ResultsWe identified and included nine relevant studies in the review. We identified five main themes as end-of-life care challenges and/or facilitators: organisational structure and management, (mis)understanding of end-of-life care, spirituality and religious practices for the dying, communication about end-of-life care, and the impact of the ICU environment.ConclusionsThis review has reported challenges and facilitators to providing end-of-life care in ICU and made initial recommendations for improving practice. These are certainly not unique to the Middle East but can be found throughout the international literature. However, the cultural context of Middle East and North Africa countries gives these areas of practice special challenges and opportunities. Further observational research is recommended to confirm or modify the results of this review, and with a view to developing and evaluating comprehensive interventions to promote end-of-life care in ICUs in the Middle East.

Stop, in the Name of COVID! Using Social Media Data to Estimate the Effects of COVID-19-Related Travel Restrictions on Migration

In the wake of the COVID-19 pandemic, the International Organization for Migration has postulated that international migrant stocks fell short of their pre-pandemic projections by nearly 2 million as a result of travel restrictions. However, this decline is not testable with migration data from traditional sources. Key migration stakeholders have called for using data from alternative sources, including social media, to fill these gaps. Building on previous work using social media data to analyze migration responses to external shocks, we test the hypothesis that COVID-related travel restrictions reduced migrant stock relative to expected migration without such restrictions using estimates of migrants drawn from Facebook's advertising platform and dynamic panel models. We focus on four key origin countries in North and West Africa (Côte d'Ivoire, Algeria, Morocco, and Senegal) and on their 23 key destination countries. Between February and June 2020, we estimate that a destination country implementing a month-long total entry ban on arrivals from Côte d'Ivoire, Algeria, Morocco, or Senegal might have expected a 3.39% reduction in migrant stock from the restricted country compared with the counterfactual in which no travel restrictions were implemented. However, when broader societal disruptions of the pandemic are accounted for, we estimate that countries implementing travel restrictions might paradoxically have expected an increase in migrant stock. In this context, travel restrictions do not appear to have effectively curbed migration and could have resulted in outcomes opposite their intended effects.

Phylogeographic Dynamics of H9N2 Avian Influenza Viruses in Tunisia

Avian influenza virus subtype H9N2 is endemic in commercial poultry in Tunisia. This subtype affects poultry and wild birds in Tunisia and poses a potential zoonotic risk. Tunisian H9N2 strains carry, in their hemagglutinins, the human-like marker 226 L that is most influential in avian-to-human viral transmission. For a better understanding of how ecological aspects of the H9N2 virus and its circulation in poultry, migratory birds and environment shapes the spread of the dissemination of H9N2 in Tunisia, herein, we investigate the epidemiological, evolutionary and zoonotic potential of seven H9N2 poultry isolates and sequence their whole genome. Phylogeographic and phylodymanic analysis were used to examine viral spread within and among wild birds, poultry and environment at geographical scales. Genetic evolution results showed that the eight gene sequences of Tunisian H9N2 AIV were characterized by molecular markers involved with virulence and mammalian infections.The geographical distribution of avian influenza virus appears as a network interconnecting countries in Europe, Asia, North Africa and West Africa. The spatiotemporal dynamics analysis showed that the H9N2 virus was transmitted from Tunisia to neighboring countries notably Libya and Algeria. Interestingly, this study also revealed, for the first time, that there was a virus transmission between Tunisia and Morocco. Bayesian analysis showed exchanges between H9N2 strains of Tunisia and those of the Middle Eastern countries, analysis of host traits showed that duck, wild birds and environment were ancestry related to chicken. The subtypes phylodynamic showed that PB1 segment was under multiple inter-subtype reassortment events with H10N7, H12N5, H5N2 and H6N1 and that PB2 was also a subject of inter-subtype reassortment with H10N4.

PROMISING DEVELOPMENTS AND SCIENTIFIC TECHNOLOGICAL ACHIEVEMENTS IN GEOLOGICAL EXPLORATION IN THE MIDDLE EAST REGION

Technological and economic trends in the development of the oil and gas industry form promising directions for the development of geological research, oil and gas fields development and hydrocarbons production. Currently, in the world oil and gas production practice, there is a tendency to increase the share of involvement in the hard-to-reach and hard-to-recover reserves development, which results in the cost of geological exploration increasing. It is important to minimize these costs by improving existing and developing new technological solutions. Increasing the efficiency and knowledge intensity of new technologies being introduced is the most promising strategy for exploration activities, oil and gas fields development and exploitation.The current conditions for the exit of most foreign companies from the Russian sector of the oil and gas industry, including the search for potential oil locations, require the development or maintenance at the proper level of own innovative and knowledge-intensive solutions that ensure the further systematic development of the geological exploration sector. A potential vector in this direction could be technology transfer from foreign countries, including most of the Middle East and North Africa countries. The innovative activities of up stream in these countries (including in terms of geological exploration) determine the trends in the development of international geological exploration technologies, as well as potential foreign companies for the systematic institutionalization of mutually beneficial relations between Russian and foreign oil businesses.Saudi Arabia, Israel and Iraq companies develop promising innovative solutions for the oil and gas industry exploration sector, including attracting foreign technologies to their market. Saudi Arabian companies are the most active companies with a significant increase in the number of innovative technologies. The main focus of the innovative solutions developed by these companies for the geological exploration sector is: improving methods of laboratory and geophysical research, improving the quality of seismic exploration, as well as introducing mathematical modeling modern trends in geological exploration.

Sleep disorders and associated factors among medical students in the Middle East and North Africa: a systematic review and meta-analysis

Sleep disturbances like poor and insufficient sleep are common among medical students in the Middle East and North Africa (MENA) countries; however, the extent of medically defined sleep disorders (SDs) remains unclear. This meta-analysis determines SD prevalence and identifies associated factors among medical students in the MENA. PubMed, Web of Science, Google Scholar, and reference lists of included studies were searched (latest search: June 2022). Meta-analyses included 22 studies and were performed using random-effect models. Included studies used self-reported screening tools for assessing SDs and then estimated the proportion of participants at high risk of developing a SD. Central disorders of hypersomnolence were the most prevalent SD [prevalencepooled range: 30.9% (Jordan) to 62.5% (Saudi Arabia)], followed by insomnia disorders [prevalencepooled range: 30.4% (Jordan) to 59.1% (Morocco)], circadian rhythm sleep–wake disorders [prevalencepooled range: 13.5% (Jordan) to 22.4% (Saudi Arabia)], sleep-related breathing disorders [prevalencepooled range: 12.2% (Jordan) to 22.5% (Pakistan)], sleep-related movement disorders [prevalencepooled range: 5.9% (Egypt) to 30.6% (Saudi Arabia)], and parasomnias [prevalencepooled range: 5.6% (Jordan) to 17.4% (Saudi Arabia)]. Female sex, studying in the latter academic years, having anxiety, excessive internet use, and poor academic performance were significantly associated with SDs. SDs are prevalent among MENA medical students. Implementing student-centered interventions targeting high risk groups in medical schools should be considered to improve students’ health and wellbeing.