Diseases In Jordan Research Articles

Prevalence, Predictors and Reasons for Discharge Against Medical Advice Among Patients With Chronic Disease During COVID-19.

Discharge against medical advice (DAMA) is used in healthcare facilities in a situation where patients refuse care or decide to leave the hospital before the treating physician recommends discharge. Previous studies have found DAMA to be prevalent among patients with various chronic conditions. The study had four objectives. The study aimed to investigate: (1) the prevalence of DAMA during COVID-19 (2020-2021) among Jordanian patients with chronic diseases, (2) the association between DAMA and sociodemographic and clinical characteristics of patients with chronic diseases, (3) the predictors of DAMA and (4) the reasons behind DAMA at the patient, hospital and environmental levels. A descriptive cross-sectional correlational design was used in the study. A convenience sampling approach was used to collect data from 1576 patients with chronic diseases from 3 private hospitals. The study found that the prevalence rate of DAMA was 33.3%. There was a significant association between the sociodemographic and clinical characteristics of patients with chronic diseases and DAMA. Health insurance found to be the strongest predictor of DAMA. Finally, the study found that patient, hospital and environmental-related factors had a low impact on DAMA. DAMA is prevalent among patients with chronic diseases in Jordan during COVID-19 pandemic. The current study's findings can serve as an empirical basis for planning and implementing DAMA prevention programs and/or establishing or revising policies for the target population.

Prevalence Rates of Tuberculosis, Human Immunodeficiency Virus, and Hepatitis B and C among Migrant Workers in Jordan.

Migration across national borders is an influential factor of consideration in the control of infectious diseases. Therefore, including migrants in surveillance and screening programs as well as linkage to care is mandatory to meet the public health targets of countries and regions. This study aimed to determine the prevalence of tuberculosis (TB), human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among migrant workers applying for work permits in Jordan during the period 2018-2020. The findings of this study are expected to guide health policy to prevent the spread of infectious diseases in Jordan. During the period 2018-2020, 439,622 migrant workers underwent routine testing for TB, HIV, and hepatitis B and C. Demographic, laboratory, and clinical data for those migrants were retrieved from the Directorate of Chest Diseases and Immigrants Health records. The overall prevalence of the mentioned diseases as well as by subgroups was calculated. The prevalence rates of TB and HIV among migrants were 54 per 100,000 migrants (11 per 100,000 male migrants and 138 per 100,000 female migrants, P < 0.001) and 21 per 100,000 (11 per 100,000 male migrants and 41 per 100,000 female migrants, P < 0.001), respectively. The prevalence of hepatitis B was 10 per 1000 migrants (12 per 1000 male migrants and 7 per 1000 female migrants, P < 0.001) and the prevalence of hepatitis C was 37 per 1000 (51 per 1000 male migrants and 10 per 1000 female migrants, P < 0.001). The prevalence of all studied conditions varied significantly according to gender, age, occupation, and country of origin. The prevalence rates of TB, HIV, HBV, and HCV were generally higher among migrants than Jordanians. Evidence-based health policies need to be drafted that aim to address migrant workers health care to ensure the lowest possible risk from infectious diseases to the people of Jordan is maintained. The study findings can inform the formulation of immigration and public health policies, including screening requirements for migrant workers, health insurance provisions, labor regulations, and support services for those with these conditions.

The burden of Cardiovascular diseases in Jordan: a longitudinal analysis from the global burden of disease study, 1990–2019

BackgroundCardiovascular Disease (CVD) is the leading cause of mortality worldwide. While countries in the Arab world continue to lack public health data and be severely understudied in health research, previous research has shown that compared to 1990, CVDs had a higher burden of disease in the Arab World in 2010. Jordan, a middle-income Arab country, is profiled with unique attributes such as a dual-sector healthcare system, political stability, and its role as a haven for refugees and migrants. These distinctive factors emphasize Jordan’s suitability as a case study. This investigation aims to quantify CVD burden in Jordan and identify risk factors, contributing to a broader understanding of health challenges in the Arab region and beyond.MethodsThe Global Burden of Disease (GBD) dataset was used to estimate prevalence, death, and disability-adjusted life-years (DALYs) as age-standardized rates from 1990 to 2019. We calculated percentage change for nine specific CVDs and reported trends by gender and age groups. Additionally, data on twelve a priori selected behavioral, clinical, and environmental risk factors attributing to overall age-standardized CVDs DALY were reported per 100,00 population.ResultsIn 2019, the age-standardized CVD prevalence, death, and DALYs rates in Jordan were 7980 (95% uncertainty interval [UI] 7629, 8360), 248 (95% UI 211, 288), and 4647 (95% UI 4028, 5388), respectively. Despite an increase in the absolute number of mortality and prevalence, between 1990 and 2019, the age-standardized prevalence, death, and DALYs rates all decreased by 5.5%, 45.1%, and 46.7%, respectively. In 2019, the leading risk factors contributing to overall age-standardized CVDs DALY per 100,000 population were high systolic blood pressure, high BMI, dietary risks, and high LDL cholesterol.ConclusionDespite decreasing burden rate of CVDs in Jordan between 1990 and 2019, CVDs remain the leading cause of mortality in Jordan, with an increase in the total number of prevalence and mortality. Overall, this contributes to increased healthcare costs. Further research is required to quantify the burden of CVDs and understand it better. Intervention measures and policies tailored to specific CVDs should be designed to reduce the burden of CVDs in Jordan.

Forecasting the Spread of Viral Diseases in Jordan Using the SARIMA Statistical Model

Time series models can help predict disease. Incidence data can be used to predict future disease outbreaks. Advances in modeling techniques allow us to compare the predictive capabilities of different time series models. Public health monitoring systems give essential data for accurate forecasting of future epidemics. This paper describes a study that used two types of infectious disease data, namely Mumps and Chickenpox, collected from a Department of Statistics open source data in mainland Jordan, to assess the performance of time series methods, specifically Seasonal Autoregressive Integrated Moving-Average with Exogenous Regressors. The data collected from 2000 to 2023 were used as modeling and forecasting samples, respectively. The performance was evaluated using two metrics: mean absolute error and mean squared error. The statistical models' accuracy in predicting future epidemic illnesses established their use in epidemiological monitoring. The Seasonal Autoregressive Integrated Moving Average with Exogenous Regressors model, which was used to estimate total mumps cases in Jordan, was applied to a real dataset over the years 2000 to 2023. The dataset was separated into three groups: 78% training, 9% validation, and 13% testing. The results showed a mean squared error of 26629 and a mean absolute error of 152. The model predicted that Jordan will have 2341 cases of mumps by 2028.

Prevalence and pathogenicity of fungi associated with grapevine trunk diseases in Jordan

Grapevines (Vitis vinifera) are important fruit producers in Jordan, and grapevine trunk diseases (GTDs) are suspected to cause problems in many Jordanian vineyards. This study aimed to estimate GTDs incidence and severity in selected vineyards, and to isolate and identify the causal agents associated with GTDs in this country. Field surveys were carried out and representative samples of diseased vines showing GTDs symptoms were collected to isolate and identify the causal organisms. Molecular analyses of DNA sequences of the Internal Transcribed Spacer (ITS) regions of fungal ribosomal DNA (rDNA) were used to confirm the morphological identifications of the fungal isolates. GTDs were present in all the surveyed vineyards. Mean GTD incidence was 44% across all the fields evaluated, ranging from 9 to 69% in individual vineyards. Disease severity ranged from 52–74% (mean = 62%) across all vineyards and locations. A total of 325 fungal isolates were recovered from infected grapevines. The most prevalent pathogens identified were those associated with Botryosphaeria dieback, including Diplodia seriata, Lasiodiplodia theobromae and Neofusicoccum parvum, followed by the Esca disease pathogens Phaeoacremonium parasiticum, P. aleophilum, P. rubrigenum, and Fomitiporia spp. Ilyonectria liriodendri and I. spp., known to be associated with black foot of grapevines, were also isolated. Plant pathogens causing vascular wilts and root rots, including Fusarium proliferatum, F. oxysporum, Verticillium spp., and Rhizoctonia solani, were also identified from diseased plant samples, and were found in mixed infections with GTDs pathogens. Most of the identified pathogens, except those associated with vascular wilt and root rot, are reported for the first time in Jordan. Results of this study indicate that GTDs are widespread in Jordan, and that there is urgent need to adopt a “national strategy” for GTD management in this country.

Perspective of healthcare providers on assessing the quality and accessibility of health services for chronic diseases in Jordan during Covid-19: a mixed method study

BackgroundHospital services in all parts of the world were severely affected by the crisis caused by the Coronavirus pandemic. This was particularly concerning for patients who suffer from chronic diseases. Aim: This study aimed to: assess the level of quality and accessibility of chronic disease services from the perspectives of healthcare providers, assess the association between healthcare providers’ socio-demographic factors and their perspectives on accessibility and quality level, and explore the providers’ perspectives on the barriers and facilitators of quality and accessibility to chronic disease health services during the COVID -19 pandemic.MethodDesign: An explanatory mixed method design was employed in this study using a questionnaire and focus group discussion approach. The questionnaire consisted of three sections including, demographic, accessibility, and quality. Sample: A convenience sampling approach was used to collect the quantitative from 412 healthcare providers working at public, private, and teaching hospitals. A purposive sample of 12 healthcare providers were interviewed to collect the qualitative data. Analysis: The quantitative data were analyzed using SPSS Statistics Version 25. The qualitative data was analyzed using the thematic analysis approach.ResultsThis study found that the quality and accessibility of chronic disease services in northern Jordan were affected during COVID-19. Quantitative: The majority of the participants reported moderate level of accessibility and quality. Qualitative: Four main and six subthemes were identified: 1) Accessibility barriers including transportation and fear of infection; 2) Accessibility facilitators including availability of Personal Protective Equipment (PPE) and Covid-19 vaccination; 3) Quality barriers including staff shortage; 4) Quality facilitators including safety protocol.ConclusionThe quality and accessibility of chronic disease services were affected due to the healthcare system restating to address the Covid-19 pandemic. Different barriers and facilitators for chronic disease healthcare services accessibility and quality were identified. The findings of this study lay the ground for healthcare decision and policymakers to develop strategies and formulate polices to ensure these patients receive the needed healthcare services, and hence improve their health outcomes.

Profiling Cardiometabolic Health in Jordan: A Call to Action to Improve Cardiovascular Health.

Over the past decades, Jordan has witnessed unprecedented growth in the prevalence of cardiometabolic diseases, with a crude prevalence of 48.2% in 2020, up from 38% in 2009. This is slightly higher than the reported prevalence of 40% in the US population. According to the latest World Health Organization report published in 2020, Jordan's leading cause of mortality iscardiovascular diseases with a cause-specific mortality rate of 18.6%. Since the advancement of the healthcare system in Jordan took place in the early 2000s, Jordan has witnessed a major epidemiologic transition where the burden of infectious disease has decreased, but on the other hand, the burden of cardiometabolic disease has increased as well. For such a country with limited resources and healthcare infrastructure where two-thirds of its population is below the age of 30, this is alarming. This growth can be attributed to a complex interplay between genetic and lifestyle factors. Smoking, physical inactivity, obesity, and unhealthy dietare considered major public health problems in Jordan, as reported in 2007 by the Jordanian Behavioral Risk Factor Surveillance.We attempt to raise awareness through this review article, so healthcare providers in Jordan understand the magnitude of the issue, and appropriate steps are taken to reestablish screening and management guidelines pertaining to cardiometabolic diseases in Jordan.

Applying the Framingham Risk Score for cardiovascular diseases in Jordan: A cross sectional study

Purpose: To assess the protective measures taken by Jordanians to decrease the risk of first cardiovascular event using the Framingham Risk Score classification.Methods: A survey was created using Google forms and disseminated through social media platforms (WhatsApp and Facebook) in order to facilitate contact with multiple sections of the Jordanian population. The questions were designed to measure the objectives of this study and a scale was used to measure the level of application. Demographic parameters were documented. Framingham’s risk Score was observed among patients with a diploma and those with high school or less education (p = 0.043). There was a significant difference in Framingham Risk Score between non-smokers and sometimes smokers.Conclusion: The Framingham Risk Scores reveals that 90 % of individuals have a low risk of getting cardiovascular disease (CVD) in the Jordanian population, 5 % have an intermediate risk, and 5 % have a high risk. This is normal as the age range of participants in the survey was within the 20 to 30 years.

&lt;i&gt;Rhizoctonia solani&lt;/i&gt; AG-3PT is the major pathogen associated with potato stem canker and black scurf in Jordan

&lt;abstract&gt; &lt;p&gt;&lt;italic&gt;Rhizoctonia solani&lt;/italic&gt; (teleomorph: &lt;italic&gt;Thanatephorus cucumeris&lt;/italic&gt;) is a global soil-borne pathogen that severely harms potato crops, leading to significant product losses. Black scurf and stem canker are two manifestations caused by this pathogen, with variable intensity based on the distinctive anastomosis group endemic to the region. During the growing season of 2017 (March and April), 57 different fungus isolates were collected from potato crops farmed in the Jordan Valley. The identity of all the isolates was confirmed by sequencing the internal transcribed spacer (ITS) of the ribosomal DNA gene, and the hyphal interactions were also performed with &lt;italic&gt;R. solani&lt;/italic&gt; isolates. The sequences were deposited in GenBank, where accession numbers were obtained. 21 of the isolates were AG-3PT &lt;italic&gt;R. solani&lt;/italic&gt;, with 98–99% identity to reference strains. Somatic compatibility was determined by hyphal interactions, which showed pairing compatibility among the isolates. Around 86.7% of the pairings were somatically incompatible, indicating a high level of genetic diversity among the isolates, while only 13.3% of the pairings were somatically compatible. Testing for pathogenicity revealed that AG-3PT affected the stems of solanaceous plants, including potatoes, and the roots of other plant species. Based on the findings of this study, &lt;italic&gt;R. solani&lt;/italic&gt; AG-3PT was the primary pathogen associated with potato stem canker and black scurf diseases in Jordan. To our knowledge, this is the first report on this pathogen's isolation and identification in Jordan.&lt;/p&gt; &lt;/abstract&gt;

Utilizing telehealth intervention to support patients with cardiovascular diseases in Jordan: A qualitative study

IntroductionTelemedicine is one of the new technological solutions used to facilitate treatment and intervention in patients with Cardiovascular Diseases (CVD). Nevertheless, the utilization of telehealth in Jordan is under-researched. PurposeTo explore the perspectives and experiences of patients with cardiovascular disease (CVD) and healthcare providers on how telehealth can help manage critical and long-term CVD health problems. MethodA qualitative, descriptive approach was employed, whereby individual interviews were conducted with 12 healthcare providers and 12 cardiac patients from Abdali and Prince Hamzah Hospitals in Jordan. The derived data were analyzed using thematic analysis, according to the method expounded by Braun and Clarke (2014). ResultsThe analysis of collected data revealed that telehealth deployment exhibited several advantages from the participants' perspectives, these can be divided into the following six themes: mitigating associated risks, qualified and friendly staff, streamlined work processes, effective and structured services, accessibility and privacy of patient information, affordable and convenient services. ConclusionThe current study suggests that telehealth can be helpful and convenient in many aspects of the health care services for patients with CVD, mainly during the crucial times of the COVID pandemic. With this study, stakeholders and Jordanian managers can better understand the telehealth advantages. This will enable them to improve the quality of care in their health organizations in the future.

Depression and adherence to healthy lifestyle behaviors among patients with coronary artery diseases in Jordan

BackgroundIt is well-established in the literature that coronary artery disease (CAD) is a risk factor for depression and that depressive symptoms inversely affect the development and progression of CAD. No published studies have examined the relationship between depression and adherence to healthy lifestyle behaviors among patients with CAD in Jordan. Therefore, the purpose of this study is to investigate the impact of depression on adherence to healthy lifestyle behaviors among CAD patients in Jordan. MethodsA correlational, cross-sectional study of convenience sample of 130 patients with CAD was conducted from out-patient cardiac clinics in a university-affiliated hospital and government-operated hospital in Northern Jordan. Data were collected using self-administered questionnaires on depression and adherence to healthy lifestyle behaviors among CAD patients. ResultsOur data showed that 41% of the participants were non-adherent to healthy lifestyle behaviors, especially in the areas of physical activity (6.2%), maintaining a healthy diet (24.6%), and weight loss (26.15%). Gender, smoking status, and number of cardiac catheterization procedures were found to be significant predictors of patient adherence to healthy lifestyle behaviors. Although depressive symptoms were present in 56.9 % of the participants, depression was not found to be a significant predictor of adherence to healthy lifestyle behaviors among our sample. ConclusionThere was no significant relationship between depression and adherence to healthy lifestyle behaviors among CAD patients in Jordan. Physical activity, maintaining a healthy diet, and weight loss were the least lifestyle behaviors that were adopted, while quitting smoking and medication compliance were the most adopted behaviors among the patients. Our study provides valuable data regarding the levels and predictors of adherence to healthy lifestyle behaviors among CAD patients with CADs. Implications for future research and practice are addressed.

Situating zoonotic diseases in peacebuilding and development theories: Prioritizing zoonoses in Jordan.

Zoonotic diseases are projected to be a serious public threat in the coming decades. In 2016, the World Health Organization (WHO) recommended that Jordan prioritize their list of zoonoses, partially in response to the influx of Syrian refugees. We write this paper to expand the One Health framework by situating zoonotic diseases in peacebuilding and development theories in order to prioritize zoonotic diseases in Jordan. We employ an explanatory sequential mixed methods approach to create a modified version of the Center for Disease Control's (CDC) One Health Zoonotic Disease Prioritization (OHZDP) tool. We use an integrative literature review to develop a list of zoonoses to be prioritized. We expand the One Health framework by arguing health inequity is a form of violence, and thus promotion of health equity is a form of peacebuilding. We undertake thematic and statistical analyses to assess the 12 previously published OHZDP tools to evaluate necessity for change to the process given COVID-19 and the refugee situation in Jordan. In these analyses we use drivers of health indicators as measurements for peacebuilding and development, given these drivers are related to health inequities, to guide weighting of the criteria in our tool for Jordan. We apply our modified OHZDP tool to prioritize our disease list. We find it necessary to give socioeconomic factors greater consideration and to distribute weighting more evenly among all criteria within the tool when prioritizing zoonotic diseases in better reflect the Jordanian context and incorporate the refugee population. We find the priority zoonoses within Jordan to be bovine tuberculosis, brucellosis, and COVID-19, with most having a disproportionately negative impact on refugees. In Jordan's case, zoonotic diseases represent an area where promoting social equity for individuals is essential to the larger society. In this sense managing zoonoses is an area uniquely suited for peacebuilding.

Resilience of patients with coronary heart diseases in Jordan: A cross-sectional study

ObjectivesThis study aimed to assess the level of resilience and related factors among patients with coronary heart disease. MethodsA cross-sectional was used to determine the factors associated with the level of resilience. A convenience sampling technique was used to recruit 134 patients with coronary heart disease who attended the out-patients cardiology clinics at two leading public hospitals in Jordan from July to September 2017. The Connor-Davidson Resilience Scale (CD-RISC) was used to collect the data via a face-to-face structured interview. Mann-Whitney U test and Kruskal Wallis test were used to analyze the data. ResultsThe results showed a moderate level of resilience among patients with coronary heart diseases. Patients who reported having no history of a cardiac procedure reported a higher total resilience score (69.50 [63.25, 75.00] vs. 65.50 [58.00, 72.00]) and a higher score in dimension 1,“personal competence, high standards, and tenacity” than their counterparts (22.00 [18.50, 26.00] vs. 21.00 [15.75, 23.00]) (P < 0.05). Dimension 3 “positive acceptance of change and secure relationships” score was higher for employed patients than retired patients (15.00 [14.00, 16.00] vs. 14.00 [12.00, 15.00]) (P < 0.05). However, no significant associations were found between other socio-demographic characteristics and resilience levels across the five dimensions. ConclusionIdentifying the resilience level and related factors among patients with cardiac problems should be integrated into the comprehensive plan of care to improve patient quality of life, enhance effective coping strategies, improve mental health and well-being, and prevent further disease complications.

The Association Between e-Health Literacy and Willingness to Deprescribe Among Patients with Chronic Diseases: A Cross-Sectional Study from Jordan.

Background: Deprescribing refers to the partnered discontinuation of chronic medications to limit the negative impacts of polypharmacy. Polymedicated patients play a key role in the success of deprescribing efforts. eHealth literacy reflects patients' ability to appraise electronically available health-related information to make informed health care decisions, which partly reflect their desire to deprescribe. Objectives: The current study aimed to explore the relationship between eHealth literacy and willingness to deprescribe among patients with chronic diseases. Additionally, the predictors of willingness to deprescribe were examined. Materials and Methods: This cross-sectional study was conducted among adult patients with chronic diseases in Jordan. An online questionnaire comprising two validated tools, namely the Electronic Health Literacy Scale (eHEALS) and the Revised Patients' Attitudes Toward Deprescribing (rPATD) Questionnaire, was used for data collection. The questionnaire targeted adult patients with chronic medical conditions in Jordan and was posted to social media portals, following a convenience sampling technique. Results: A total of 719 responses were recorded and included in the final analysis. Participants with higher levels of eHealth literacy were more willing to get their medications deprescribed, as indicated by the perceived use of unneeded medications (p = 0.042). Meanwhile, participants with low levels of eHealth literacy were more likely to report fear of missing out on the potential benefits of deprescribed medications (p = 0.003). Other items that were commonly agreed upon by both the low and high eHealth literacy groups, respectively, included desire for dose reduction (p < 0.001, p < 0.001), belief in the lack of effectiveness of some prescribed medications (p < 0.001, p < 0.001), and fear of precipitating side effects (p = 0.001, p = 0.007). Conclusions: The present study highlighted the relationship between eHealth literacy and a number of items reflecting willingness to deprescribe, and these indicators can be used to guide future deprescribing efforts among eligible patients.

Role of community pharmacists in medication management during COVID-19 lockdown

ABSTRACT Preventive and control measures implemented by many countries to mitigate the spread of COVID-19 may negatively impact medication and chronic disease management, which can interfere with achieving patients’ therapeutic goals. This study aims to evaluate the effect of the COVID-19 lockdown on these aspects, while exploring the role of community pharmacists. A cross-sectional study was conducted via a web-based questionnaire that targeted individuals who suffer from chronic diseases in Jordan. Participants were recruited by convenience sampling and were asked to self-report their ability to access medication, and the perceived role of community pharmacists. Among the 431 participants, the mean age ± SD (years) was 53.8 ± 13.7 and 60.1% (n= 259) were females. Participants mainly reported difficulties in accessing medication (n=198, 45.9%), reduced supplies or unavailability of medications (n=213, 49.4%), nonadherence to medications due to lack of access (n=98, 22.7%) and high costs (n=85, 19.7%). Participants avoided follow-ups due to a fear of infection (n=367, 82.5%) or prolonged waiting time in clinics (n=322, 74.7%). An increased reliance on the community pharmacy for medical advice was reported by 39.9% (n=172) of the participants, with half of them (n=217, 50.3%) depending on the pharmacists for advice regarding over-the-counter medications and COVID-19-related information (n=119, 27.6%). There is an urgent need to involve community pharmacists in medication and chronic disease management with a focus on patient adherence to ensure the optimal management of such vulnerable patient groups. Future studies to assess the effect of pharmacists’ contributions towards enhancing medication/disease management are warranted.

Accessibility Difficulties, and Utilization of Healthcare Services Among Jordanian Roma with Chronic Diseases

Purpose: To examine factors that affect healthcare utilization among Roma population with chronic diseases in Jordan. It also explores behavior-seeking health care among them, their characteristics and ability to access healthcare. Design/Methodology/Approach: A cross-sectional descriptive survey performed, data collection done through in-person interviews using a structured questionnaire based on the Canadian Community Health Survey. Andersen’s behavioral model was implemented to examine the influences of predisposing, enabling, need, and outcome factors on healthcare utilization using binary logistic regression, and predictors for accessibility difficulties using multiple linear regression, Findings: 98.8% of the participants stated that they had difficulties in getting the care needed for diagnosis, treatment, or consultation, and 24.8% said that they didn’t utilize healthcare services last year. The number of chronic diseases and satisfaction level with the healthcare services significantly increase utilization, on the other hand; age, health insurance, resident location, number of chronic diseases and their duration as well as satisfaction with the healthcare are significantly affect accessibility difficulties to healthcare services. Practical implications: Provide mobile health units to reach remote settlements, that provide efficient healthcare services that met their health needs, and to be integrated with local health system. Societal implications: Efforts to involve Roma children in education. Establishing vocational training programs ended with employments. Establish sufficient and reasonable housing, to be side by side to the other population. Originality/value: This study is considered as the first to address the Jordanian Roma health status, utilization and accessibility to healthcare services, the end results help in suggesting different approaches to improve health and promote health equity.

Effect of Genetic Testing on Diagnosing Gastrointestinal Pediatric Patients with Previously Undiagnosed Diseases.

PurposeFour consanguineous Jordanian families with affected members of unknown gastrointestinal related diseases were recruited to assess the utility and efficiency of whole exome sequencing (WES) in reaching the definitive diagnosis.Patients and MethodsMembers from four consanguineous Jordanian families were recruited in this study. Laboratory and imaging tests were used for initial diagnosis, followed by performing WES to test all affected members for the detection of causative variants. Sanger sequencing was used for validation.ResultsWe had a 100% success rate identifying each case presented in this study.ConclusionThis is the first study applying a WES testing approach in the diagnosis of pediatric diseases in Jordan. Our results strongly suggest the need to implement WES as an evident diagnostic tool in the clinical setting, as it will subsequently allow for proper disease management and genetic counseling.

Increased Resistance of Fluoroquinolones among H. pylori isolates from Patients with Gastroduodenal Diseases in Jordan

Recently, Helicobacter pylori has been connected to more than 80% of chronic active gastritis and other gastroduodenal diseases worldwide. Treatment of H. pylori is routinely dependent on the use of multiple antimicrobial agents however, recent data showed the emergence of resistance among clinical strains especially against metronidazole and clarithromycin. This study was conducted to investigate the rate of resistance to different antibiotics that are routinely used in the first line and second line therapies including ciprofloxacin and levofloxacin, tetracycline, amoxicillin, clarithromycin and metronidazole among H. pylori strains isolated from patients with gastroduodenal diseases in Jordan. Both antral and corpus mucosal biopsies from the stomach of patients with positive results of H. pylori stool antigen and urease breath tests were used for the isolation of H. pylori on selective culture media. The standard agar diffusion method was performed to determine the sensitivity of H. pylori clinical isolates against ciprofloxacin and levofloxacin according to CLSI. Among 62 H. pylori clinical strains isolated from gastric biopsies, 21% and 11% were resistant to levofloxacin and ciprofloxacin respectively. Resistance to metronidazole and clarithromycin was found in 90% and 11% respectively. No resistance was observed against amoxicillin, tetracycline and gemifloxacin. The following MIC90 (mg/L) of resistant strains results were obtained at neutral pH 7.3, 64 for metronidazole, 2 for clarithromycin, 2 for ciprofloxacin and 1 for levofloxacin. The present study reported the emergence of increased resistance of fluoroquinolones among H. pylori clinical isolates in Jordan. Concern should be taken into consideration when triple and quadruple therapy regimens are applied for the management of H. pylori infections in our region

The range of pathological diagnoses of oral diseases in Jordan: An 11-year-retrospective study

Objectives: The objective of this study is to describe the pattern of oral and maxillofacial diseases in Jordan and to compare it with global trends.Materials and Methods: A retrospective analysis of pathology records in a major university hospital in Jordan was conducted. Age, gender, anatomical site, and pathological diagnosis were assessed.Results: A total of 1062 records were included. There were 525 (49.4%) females and 537 males (50.6%). The mean age of the study sample was 39 ± 18.7 years (range = 2–88 years). Nearly half of the lesions originated from the jaw bones (48.8%, n = 518), followed by oral mucosa (38.3%, n = 407), and gingivae (7.1%, n = 75). Cystic lesions were the most common type of pathologies (35.8%, n = 380), followed by reactive lesions (25.8, n = 274), and tumors (13.9%, n = 148). The most common individual pathologies were radicular cyst (19.8%, n = 210), followed by dentigerous cyst (11.3%, n = 120), and fibroepithelial polyp (8.8%, n = 93).Conclusion: Reactive and cystic lesions are the most common type of diseases encountered in the present study. The pattern of oral and maxillofacial diseases reported here is consistent with global trends.

Social determinants of access to healthcare as indicator of health equity among patients with chronic diseases in Jordan: a cross-sectional study

Background: The study aims to describe and predict the social determinants of accessing healthcare as an indicator of health equity among patients with chronic diseases. Methods: A cross-sectional structured face to face interview survey of 320 patients selected from three hospitals. Hierarchical regression was used to predict the social determinant of accessing healthcare system in Jordan. Results: Seven predictors were statistically significant, R = 0.368, R2 = 0.135, adjusted R2 = 0.116, F(7,309) = 6.91, P < 0.001. The variables predicted approximately 12% of the variance in accessibility scores. The strongest unique predictive contribution was from household income and gender. Higher income and being female predicted higher scores on accessibility. Whereas, faraway distance between place of residency and hospital predicted lower scores on accessibility. Conclusion: There is inequity between patients in accessing public healthcare system in Jordan based on income, gender and place of residency.