Background/Objectives: Nasopharyngeal cancer (NPC) is prevalent in Southeast Asia, Southern China and North Africa. Up to 46% of NPC patients undergoing cisplatin chemoradiation treatment experience irreversible hearing loss. Prestin is a motor protein in the outer hair cells of the cochlea, and animal studies have shown that blood prestin levels are elevated following cisplatin induced hearing loss. We investigated whether rising serum prestin levels can predict sensorineural hearing loss (SHNL) in NPC patients undergoing induction cisplatin chemotherapy (icCRT). Methods: Serum prestin levels were measured at ten time points during cisplatin chemotherapy. Pure tone audiogram and tinnitus handicap inventory (THI) were measured at baseline and at one and nine months after cisplatin administration. These outcomes were obtained to investigate whether rising prestin levels predict SNHL or worsening THI. Results: Of the 11 patients accrued, there was no association between prestin level and SNHL. An increase in THI was associated with higher prestin levels. There was significant hearing loss at 8 kHz at one (right ear, p = 0.012, left ear, p = 0.043) and nine months (right ear, p = 0.011) after treatment. After completing cisplatin, patients also had increased THI. Conclusions: Prestin was not identified as a biomarker of cisplatin-induced hearing loss in our cohort of NPC patients undergoing icCRT. NPC patients experience worsening of tinnitus with cumulative cisplatin, and hearing loss can persist at nine months post treatment. Future studies should focus on improved novel methods for measuring prestin or other cochlear proteins to better identify potential markers before permanent cisplatin induced hearing loss.

ABSTRACT This special issue introduction explores the global governance of commercial actors in data-intensive health innovation. While commercial entities are foundational to data-intensive health innovation processes and products, their dominance raises critical concerns regarding the distribution of benefits, the accrual of value, and the control of digital infrastructures. The authors define “commercial actors” broadly to include technology companies, venture capital firms, and health organizations engaging in market-driven innovation. Through an analysis of contributions spanning North America, Europe, Africa, and Asia, the introduction explores three key themes: the tension between private and public value, the path-dependent nature of commercialized digital infrastructures, and the necessity for global coordination across fragmented governance layers. After summarizing the contributions to the special issue, the article calls for a multifaceted, ecosystem-based approach to align commercial practices with public safety, ethics, and universal health values.

Cutaneous leishmaniasis (CL) caused by Leishmania major is a zoonotic disease transmitted by phlebotomine sand flies. Identification of reservoir hosts is critical for understanding transmission and guiding control. While Psammomys obesus and Meriones shawi are recognized reservoirs in North Africa, the role of other rodents remains unclear. We experimentally assessed the reservoir potential of Acomys cahirinus seurati from southeastern Algeria. Animals were intradermally infected, and clinical signs and infectiousness to sand flies were monitored. Parasite persistence in skin and visceral tissues was measured by quantitative PCR. All animals developed localized, self-limiting lesions. Seven of sixteen individuals transmitted parasites to Phlebotomus papatasi between 10 and 25 weeks post-infection. Parasites were mostly restricted to the inoculation site, with limited dissemination to contralateral pinnae and hindpaws, and rare presence in spleen or liver. Notably, some animals were infectious without visible lesions, indicating that ulceration is not required for transmission. These findings show that A. cahirinus seurati can maintain L. major infection for up to 6 months and transmit parasites to sand flies, fulfilling key criteria of a reservoir host. Thus, this species may contribute to CL transmission in endemic foci lacking classical reservoirs, emphasizing the need to consider alternative rodent hosts in surveillance and control programs in North Africa.

Deverra scoparia (D. scoparia) Coss. & Durieu is an endemic plant from North Africa that is commonly utilized in folk medicine for diabetes treatment. This study aimed to evaluate the in vivo antidiabetic effects of D. scoparia in both normal and STZ-induced diabetic rats. The investigation focused on the impact of an aqueous extract of D. scoparia administered at a dosage of 40 mg/kg on glycemia and lipid profiles in these rats. Additionally, the study included assessments of glycogen content in the liver and skeletal muscles (EDL and soleus), as well as a phytochemical analysis. Both single and repeated oral doses of the aqueous extract (40 mg/kg) resulted in a significant decrease in blood glucose, total cholesterol, and triglyceride levels in diabetic rats. Moreover, this extract improved glucose tolerance and enhanced hepatic glycogen content in the diabetic subjects. Notably, the plant exhibited a rich profile of certain phytochemicals, particularly phenolic acids and flavonoids. The findings of this study clearly indicate that the aqueous extract of D. scoparia possesses substantial antidiabetic activity.

The state of disease research in the Middle East and North Africa from 1980 to 2023

Evaluating digital mental health interventions for Middle East and North Africa children and adolescents affected by armed conflict: A systematic review.

Assessing global patterns and health risks of vegetables as a dietary mercury exposure pathway.

Analysis of Mortality Trajectory Patterns in the Middle East and North Africa: Which Diseases Are the Deadliest?

Durum wheat germplasm response to high temperatures, the role of small HSP26 in the defense response.

Optimal techno-economic and environmental assessment of a standalone solar-powered irrigation system in North Africa based on the nexus approach

Epidemiological trends and sex-specific disparities in stroke incidence, prevalence, years lived with disability (YLDs), and years of life lost (YLLs) across the African Union: insights from the Global Burden of Disease Study (1990-2023).

Few studies have investigated the prevalence of workplace violence (WPV) - defined as any physical or psychological violence experienced in the workplace - in the Middle East and North Africa (MENA) region. We aimed to examine the determinants of WPV and its association with self-reported physical and mental health among employed adults residing in Lebanon. This was a national cross-sectional study among working-age residents of Lebanon recruited through random digit dialling. Data were collected from January to July 2024. The main exposure of interest was WPV, defined as having experienced at least one incident of physical or psychological violence in the past six months. We measured three outcomes - depressive symptoms, anxiety symptoms, and poor physical health - using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Patient-Reported Outcomes Measurement Information System Global Health 1.2 scales, respectively. Adjusted logistic regression models, accounting for covariates identified through directed acyclic graphs, estimated the association between WPV and each outcome, separately. We enrolled 3076 employed participants with a median age of 37 years (interquartile range = 28-46), of whom 30.5% had completed college or postgraduate education and 24.9% were non-Lebanese. Almost 16% of participants experienced at least one form of WPV. Moreover, 33.4%, 25.5%, and 75.7% experienced depressive symptoms, anxiety symptoms, and reported poor physical health, respectively. Being exposed to WPV increased the odds of depressive symptoms (adjusted odds ratio (aOR) = 3.00; 95% confidence interval (CI) = 2.40-3.70), anxiety symptoms (aOR = 3.01; 95% CI = 2.41-3.72), and poor physical health (aOR = 2.82; 95% CI = 2.04-3.98) after adjusting for age, sex, education, nationality, marital status, urbanicity, and job sector. Our findings highlight the extent and effect of WPV among workers in Lebanon and the urgent need to address the matter. Findings offer a basis for developing targeted interventions aimed to support vulnerable workers.

Abstract Survey research on public opinion in the Middle East and North Africa (MENA) has dramatically increased in both quantity and quality over the past generation. However, this has not been matched by discussion about the intellectual assumptions of public opinion research in the region as it expands into non-Western and/or non-democratic settings. To remedy this deficiency, we begin this type of investigation by assessing the resonance of public opinion definitions using data from a nationally representative face-to-face survey conducted in the Arab Gulf state of Qatar. Our results reveal substantial variation in the relative accuracy ascribed to each of five definitions of public opinion proposed in the scholarly literature. We find that the two most salient definitions form a continuum ranging from the textbook definition of public opinion as the aggregation of independent views, to the opposite view of public opinion as discursive societal consensus.

Obtaining a better overview of peste des petits ruminants epidemiology in North-East Africa is critical for guiding the ongoing PPR Global Control and Eradication Strategy. This study demonstrated PPRV exposure and potential endemic circulation among small ruminants through the identification and characterization of PPRV strains in lung tissues from slaughtered SR in Sudan. Lung tissues displaying pneumonia, comprising 83 cases (65 sheep and 18 goats), were collected from slaughterhouses in five Sudanese states. An IC-ELISA screening indicated an overall estimated antigenic prevalence of 24.1%, with a significantly higher prevalence in goats (66.7%) compared to sheep (12.3%). Northern Sudan had the highest antigenic prevalence (80%). PPRV-positive samples, confirmed by IC-ELISA and N-gene-based RT-PCR. Sanger sequencing and phylogenetic analysis of PPRV N-gene fragments assigned Sudanese strains to lineage IV genotype, revealing substantial sequence identity (100-96.58%) with strains from North Africa, East Africa, and Europe. The study suggests subclinical PPRV infections or co-infections with other respiratory pathogens affected slaughtered SR, contributing to the observed lung gross pathology. In summary, the endemic transmission of lineage IV PPRV strains in Sudan highlights the need for intensified PPR control strategies at the national level and serves to inform the Global PPR Control initiative led by WOAH/OIE and FAO.

In the Middle East and North Africa (MENA) region, the prevalence of Type 2 Diabetes (T2D) is 17-18%, substantially higher than the ~9-10% reported in Western populations, with some Gulf states approaching 25% in adults. Historically, Arab diets, characterized by high fiber intake from whole grains, legumes, and fermented dairy products, have contrasted markedly with the Western dietary pattern increasingly prevalent among urbanized Arab populations. These nutritional shifts have been associated with changes in gut microbial composition, including lower representation of short-chain fatty acid-producing bacteria and higher abundance of dysbiosis-associated taxa. Concurrently, diet-derived compounds and microbial metabolites have been associated with changes in DNA methylation, histone modifications, and non-coding RNA expression. Epigenome-wide association studies revealed both shared and population-specific methylation signatures in patients with T2D. However, integrated multi-omics studies remain limited in Arab populations, where the disease burden is highest. This review integrates emerging evidence on diet-linked epigenetic alterations, microbiome-associated metabolic pathways, and their intersection in potentially contributing to T2D risk and progression. Given the heterogeneity of T2D across populations, there is a pressing need for culturally contextualized precision medicine frameworks that integrate population-specific diet-microbiome-epigenome dynamics rather than extrapolating findings across populations. Additionally, this review synthesizes evidence that dietary patterns are associated with T2D-relevant pathways through the diet-microbiome-epigenome axis, with emphasis on Arab/MENA populations and Western comparator cohorts.

ABSTRACT This article examines the role Ahmed Sharif as-Sanūsi played in the conflict against Italy, France, and Britain, between 1902 and 1917. It explores his early military experience and the nature of the Sanūsiyya and examines the motives behind the insurgency (1911–1915) and the large-scale uprising of the Sanūsi across North Africa in late 1915 and 1916. His relative obscurity belies his importance for these were campaigns of a wider conflict between the Sanūsi and the Ottomans and their vassals against the encroachment of British, French and Italian colonial forces during the final stages of the ‘scramble for Africa’. Using an ends-ways-means approach, the article finds that while Ahmed Sharif was able to conduct successful irregular warfare against Italian, French and British forces, their alignment and closer active cooperation in the colonial sphere – after Britain occupied Egypt and Italy joined the Entente powers – proved his undoing.

This structured narrative review aimed to synthesize published African cases of cherubism by describing patterns of presentation, diagnosis, management, and genetic investigation. A structured narrative literature review was conducted using PubMed, Scopus, Google Scholar, and African Journals Online. Peer-reviewed case reports and case series describing cherubism in African patients were included. Data extraction followed predefined criteria, capturing demographic features, age at onset and presentation, clinical, radiological and histological findings, management strategies, and the use of molecular genetic testing. Findings were synthesised descriptively. Fourteen studies reporting 20 individual cases from eight African countries were identified, with the majority originating from North Africa. Although symptom onset most commonly occurred in early childhood, the median age at presentation for management was 13.75 years, suggesting delayed access to care. Molecular genetic testing was reported in only two cases, while most diagnoses relied on clinical, radiological, and histopathological features. Surgical intervention was commonly described, with fewer cases managed conservatively. Within the limitations of a structured narrative review based predominantly on published case reports and case series, and constrained by the scarcity of molecularly confirmed cases, the available African literature on cherubism remains limited in scope, geographically skewed, and characterised by incomplete genetic reporting. Recurring features include delayed presentation, reliance on clinical diagnosis, and limited use of molecular testing. These observations reflect gaps in reporting and genetic characterisation rather than population-level patterns, underscoring the need for improved molecular diagnostics, multidisciplinary care, and African registries.

Purpose This study aims to explore the interplay between corruption, information and communication technology (ICT) and bilateral trade flows in the Middle East and North Africa (MENA), distinguishing between oil and non-oil exporters. It examines whether ICT amplifies governance benefits on the bilateral trade and reduces transaction costs under weak institutions. Design/methodology/approach An augmented gravity model is estimated using Poisson pseudo-maximum likelihood (PPML) to account for zero trade flows and heteroskedasticity. The model tests direct and interactive effects of corruption and ICT, using a MENA panel data set and addressing endogeneity and unobserved heterogeneity. Findings Corruption significantly depresses bilateral trade, with stronger effects among oil exporters. ICT has mixed direct effects, sometimes hindering trade in non-oil economies but supporting oil–non-oil linkages. Interaction terms show ICT enhances the trade-promoting role of corruption control, especially on the exporter side. Coordinated ICT–governance strategies are vital. Practical implications Policies should combine anti-corruption reforms with ICT-based trade facilitation, such as blockchain and e-government tools. Originality/value To the best of the authors’ knowledge, this is among the first region-specific analyses of the corruption–ICT–trade nexus in MENA, highlighting oil versus non-oil asymmetries and exporter/importer differences.

We describe a close relative of Spinosaurus aegyptiacus, the sail-backed, fish-eating giant from nearshore deposits of northern Africa. Spinosaurus mirabilis sp. nov., discovered in the central Sahara alongside long-necked dinosaurs in a riparian habitat, is distinguished by a scimitar-shaped bony crest projecting far above its skull roof. We discern three discrete phases in spinosaurid evolution. During the first phase with roots in the Jurassic, an elongate fish-snaring skull emerged that soon was modified along divergent paths. During a second Early Cretaceous phase, spinosaurids became the dominant predators in circum-Tethyan habitats. The final phase began just before the Late Cretaceous during the opening of the Atlantic Ocean, when spinosaurines attained maximum body size as shallow water ambush specialists limited geographically to northern Africa and South America.

This study assessed the prevalence and clinical characteristics of Behçet's disease (BD) in the Middle East and North Africa (MENA) region, providing updated pooled estimates and identifying gaps in current epidemiological knowledge. We conducted a systematic review and meta-analysis of studies reporting the prevalence, epidemiology, or clinical features of BD in the MENA region, published in PubMed, MEDLINE, and Web of Science databases from 2014 onward. The eligible studies had observational designs and diagnoses based on internationally validated criteria. The study quality was assessed using the AXIS and MINORS tools. Pooled prevalence estimates and clinical feature proportions were calculated with 95% confidence intervals (CI); heterogeneity was quantified using I2. Ten studies (sample size, 31-5218) from seven countries were included. The reported prevalence ranged from 0.06% in Turkey to 0.66% in Jordan. The pooled prevalence was 0.003 (300/100,000 population; 95% CI 0.001-0.005; p = 0.004) with a high heterogeneity (I2 = 87.3%). No significant sex difference was observed in disease risk (odds ratio 1.55, 95% CI 0.59-4.05; p = 0.374). The pooled prevalence of major clinical features showed oral ulcers, genital ulcers, ocular involvement, and positive pathergy tests in 98.7%, 73.7%, 36.6%, and 54.6% of patients, respectively. BD prevalence in the MENA region remains among the highest worldwide. Clinical manifestations are consistent with global patterns but show regional variability, highlighting the need for standardized reporting, consistent epidemiological methodologies, and targeted strategies to support early diagnosis and recognition of the disease.