International Journal of Environmental Research and Public Health, 2020
Environmental exposure to dust from quarrying activities could pose health dangers to the populat... more Environmental exposure to dust from quarrying activities could pose health dangers to the population living nearby. This study aimed to investigate the health effects of dust exposure on people living close to quarry sites and compared them with those who live far from the quarry sites. A cross-sectional comparative study was conducted among 79 exposed participants, who lived less than 500 m away from the quarry sites, and 79 control participants who lived more than 500 m away. All participants answered a questionnaire on dust exposure at home and health effects, as well as performed a lung function test in which both reported and measured health effects were investigated. People who live in close proximity to the quarry sites reported exposure to dust at home (98%), land destruction (85%), plant leaves covered with dust (97%), and an inability to grow crops (92%). The exposed group reported significantly higher eye and nasal allergy (22% vs. 3%), eye soreness (18% vs. 1%), and dryn...
Objective: To describe body mass index (BMI), waist circumference and waist-hip ratio in a Palest... more Objective: To describe body mass index (BMI), waist circumference and waist-hip ratio in a Palestinian West Bank village population, and to assess the associations of these variables to blood pressure and serum lipids. Design: Cross-sectional study. Setting: Community-based study in a prototypic semi-rural Palestinian village in the central West Bank. Subjects: All individuals aged 30 – 65 y in the study village were invited for the study and 500 (85%) participated. Main outcome measures: BMI 30 was used as the measure of obesity. Results: The prevalence of ...
Weinvestigated the prevalence of diabetes and associated factors in a cross-sectional survey of a... more Weinvestigated the prevalence of diabetes and associated factors in a cross-sectional survey of an urban Palestinian population of 492 men and women aged 30-65 years. The oral glucose tolerance test was used to diagnose diabetes and impaired glucose tolerance. World Health Organization-recommended survey protocols were followed. Diabetes was found in 12.0% of the survey population [including 9.4% previously diagnosed], and impaired glucose tolerance in 5.9%. Logistic regression analysis controlling for age and sex revealed body mass index, waist-to-hip ratio and family history of diabetes to be significantly independently associated with diabetes.
The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Eg... more The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systemati...
Medical science monitor : international medical journal of experimental and clinical research, 2003
The purpose of this study was to investigate the distribution and association of selected risk fa... more The purpose of this study was to investigate the distribution and association of selected risk factors for diabetes mellitus in a semi-rural Palestinian village. We performed a cross-sectional, population-based study of 500 adults aged 30 to 65 in a semi-rural Palestinian village. The study included two phases: a household survey and an individual assessment utilizing the oral glucose tolerance test OGTT to determine the diabetes status of the participants, anthropometric measurements for body mass index (BMI) and waist-hip ratio (WHR), blood biochemistry measurements for lipids, blood pressure measurement, and a standard questionnaire to assess demographic and other factors. The association between various risk factors and diabetes status was explored by comparing statistical means and proportions and crude and adjusted odds ratios (OR). A multivariate logistic regression using sex and seven factors initially found to be significantly associated with diabetes identified four factor...
ABSTRACT Background Cardiovascular diseases and diabetes mellitus present an increasing challenge... more ABSTRACT Background Cardiovascular diseases and diabetes mellitus present an increasing challenge for health care in the occupied Palestinian territory (oPt). Effective access to health care is a core prerequisite to the effective management of the two diseases. A main goal for policy makers is to improve access for patients to the services they need. However, improvement of access needs a thorough understanding of the barriers to health care encountered by patients. The aim in this study was to show the main barriers to health-care access that are reported by patients with cardiovascular diseases and diabetes mellitus attending clinics in Ramallah, West Bank, oPt. Methods A qualitative method based on theory developed from data generated during field research was used to develop a framework of patients’ perceptions of access to health care and management of illness. Data were gathered as part of a larger project (Mediterranean Studies of Cardiovascular disease and Hyperglycaemia: Analytical Modelling of Population Socio-economic transitions) from four clinics selected to represent the main health-care providers in the oPt: an outpatient cardiology clinic (urban setting) and three primary health-care clinics (rural and refugee-camp settings). 40 patients had exit interviews and 16 had in-depth interviews; 12 in-depth interviews were done with patients’ family members, and eight in-depth interviews with the clinic staff. Findings Factors that are related to patients and systems interact to form barriers or facilitators to health care and effective illness management, and were noted in all three themes that became apparent from the interviews: availability (central physical location and distance from home, patient’s waiting time, availability of the needed drugs and laboratory tests, and the presence of specialist staff); affordability of drugs that were not provided at the local formulary and thus were not provided to patients free of charge, and needed laboratory tests that were not available at the centre; patients’ acceptability of or satisfaction with care (previous social ties between patients and providers; sense of belonging to or ownership of the centre; patients’ views of the importance of seeking care; and patients’ expectations of what providers should inform them about and how they should deal with their illness). The last theme became apparent differently between primary and secondary health-care centres—patients at the primary health-care centres expressed higher satisfaction than for secondary health care, determined by strong social ties and a sense of belonging to the providers and the health-care centre. Interpretation For patients, health services are not only places for the provision of health care, albeit varied, but they are also sites of social relations. Patients’ perceptions of their access to health care differ, dependent on their socioeconomic, political, and cultural influences, and should also be taken into serious consideration in future policy development. Funding European Commission. Contributors All authors contributed to the data analysis and preparation of this Abstract. Conflicts of interest We declare that we have no conflicts of interest. Acknowledgments We thank all the commentators who participated in The Lancet–Palestinian Health Alliance writers’ workshop, Birzeit University, Ramallah, West Bank, oPt, March 2–3, 2011.
Scandinavian Journal of Clinical & Laboratory Investigation, 2000
This paper aims to evaluate the utility of a single glucometer fasting capillary blood glucose (F... more This paper aims to evaluate the utility of a single glucometer fasting capillary blood glucose (FCBG) measurement in determining the prevalence of diabetes mellitus in a homogeneous adult population. FCBG measurements were compared with results of the oral glucose tolerance test (OGTT) in 445 subjects aged 30-65 years in an urban cross-sectional study in Old Ramallah. Prevalence of diabetes, sensitivity, specificity and predictive values were calculated at different cut-off levels of FCBG, using OGTT as the reference. The prevalence of OGTT-diagnosed diabetes was 2.7%, while it varied considerably using different cut-off levels of FCBG. The sensitivity of a single glucometer (Exac Tech II) measurement of FCBG at the cut-off level of 6.7 mmol 1(-1) was 33.3%, with a specificity of 98.8%. Using the cut-off level of 6.1 mmol 1(-1) as suggested by the 1998 provisional report of a WHO consultation, the sensitivity increased to 41.7%. At a cut-off level of 5.6 mmol 1(-1), a sensitivity of 66.6% was reached, but the specificity decreased slightly. It can be concluded that a single glucometer measurement of FCBG in an adult population is not useful in determining the prevalence of diabetes mellitus.
This paper presents evidence from research into health system challenges of cardiovascular diseas... more This paper presents evidence from research into health system challenges of cardiovascular disease (CVD) and diabetes in four Eastern Mediterranean countries: the occupied Palestinian territory, Syria, Tunisia and Turkey. We address two questions. How has the health system in each country been conceptualised and organised to manage the provision of care for those with CVD or diabetes? And what were key concerns about the institutional ability to address this challenge? Research took place from 2009 to 2010, shortly before the political upheavals in the region, and notably in Syria and Tunisia. Data collection involved a review of key documents, interviews with key informants and brief data collection in clinics. In analysing the data, we adopted the analytical schema proposed by Walt and Gilson, distinguishing content, actors, context and process. Key findings from each country highlighted concerns about fragmented provision and a lack of coordination. Specific concerns included: the lack of patient referral pathways, functioning health information systems and investment in staff. Regarding issues underlying these 'visible' problems in managing these diseases, we highlight implications of the wider systemic pressure for reform of health-sector finance in each country, based on neoliberal models.
International Journal of Environmental Research and Public Health, 2020
Environmental exposure to dust from quarrying activities could pose health dangers to the populat... more Environmental exposure to dust from quarrying activities could pose health dangers to the population living nearby. This study aimed to investigate the health effects of dust exposure on people living close to quarry sites and compared them with those who live far from the quarry sites. A cross-sectional comparative study was conducted among 79 exposed participants, who lived less than 500 m away from the quarry sites, and 79 control participants who lived more than 500 m away. All participants answered a questionnaire on dust exposure at home and health effects, as well as performed a lung function test in which both reported and measured health effects were investigated. People who live in close proximity to the quarry sites reported exposure to dust at home (98%), land destruction (85%), plant leaves covered with dust (97%), and an inability to grow crops (92%). The exposed group reported significantly higher eye and nasal allergy (22% vs. 3%), eye soreness (18% vs. 1%), and dryn...
Objective: To describe body mass index (BMI), waist circumference and waist-hip ratio in a Palest... more Objective: To describe body mass index (BMI), waist circumference and waist-hip ratio in a Palestinian West Bank village population, and to assess the associations of these variables to blood pressure and serum lipids. Design: Cross-sectional study. Setting: Community-based study in a prototypic semi-rural Palestinian village in the central West Bank. Subjects: All individuals aged 30 – 65 y in the study village were invited for the study and 500 (85%) participated. Main outcome measures: BMI 30 was used as the measure of obesity. Results: The prevalence of ...
Weinvestigated the prevalence of diabetes and associated factors in a cross-sectional survey of a... more Weinvestigated the prevalence of diabetes and associated factors in a cross-sectional survey of an urban Palestinian population of 492 men and women aged 30-65 years. The oral glucose tolerance test was used to diagnose diabetes and impaired glucose tolerance. World Health Organization-recommended survey protocols were followed. Diabetes was found in 12.0% of the survey population [including 9.4% previously diagnosed], and impaired glucose tolerance in 5.9%. Logistic regression analysis controlling for age and sex revealed body mass index, waist-to-hip ratio and family history of diabetes to be significantly independently associated with diabetes.
The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Eg... more The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systemati...
Medical science monitor : international medical journal of experimental and clinical research, 2003
The purpose of this study was to investigate the distribution and association of selected risk fa... more The purpose of this study was to investigate the distribution and association of selected risk factors for diabetes mellitus in a semi-rural Palestinian village. We performed a cross-sectional, population-based study of 500 adults aged 30 to 65 in a semi-rural Palestinian village. The study included two phases: a household survey and an individual assessment utilizing the oral glucose tolerance test OGTT to determine the diabetes status of the participants, anthropometric measurements for body mass index (BMI) and waist-hip ratio (WHR), blood biochemistry measurements for lipids, blood pressure measurement, and a standard questionnaire to assess demographic and other factors. The association between various risk factors and diabetes status was explored by comparing statistical means and proportions and crude and adjusted odds ratios (OR). A multivariate logistic regression using sex and seven factors initially found to be significantly associated with diabetes identified four factor...
ABSTRACT Background Cardiovascular diseases and diabetes mellitus present an increasing challenge... more ABSTRACT Background Cardiovascular diseases and diabetes mellitus present an increasing challenge for health care in the occupied Palestinian territory (oPt). Effective access to health care is a core prerequisite to the effective management of the two diseases. A main goal for policy makers is to improve access for patients to the services they need. However, improvement of access needs a thorough understanding of the barriers to health care encountered by patients. The aim in this study was to show the main barriers to health-care access that are reported by patients with cardiovascular diseases and diabetes mellitus attending clinics in Ramallah, West Bank, oPt. Methods A qualitative method based on theory developed from data generated during field research was used to develop a framework of patients’ perceptions of access to health care and management of illness. Data were gathered as part of a larger project (Mediterranean Studies of Cardiovascular disease and Hyperglycaemia: Analytical Modelling of Population Socio-economic transitions) from four clinics selected to represent the main health-care providers in the oPt: an outpatient cardiology clinic (urban setting) and three primary health-care clinics (rural and refugee-camp settings). 40 patients had exit interviews and 16 had in-depth interviews; 12 in-depth interviews were done with patients’ family members, and eight in-depth interviews with the clinic staff. Findings Factors that are related to patients and systems interact to form barriers or facilitators to health care and effective illness management, and were noted in all three themes that became apparent from the interviews: availability (central physical location and distance from home, patient’s waiting time, availability of the needed drugs and laboratory tests, and the presence of specialist staff); affordability of drugs that were not provided at the local formulary and thus were not provided to patients free of charge, and needed laboratory tests that were not available at the centre; patients’ acceptability of or satisfaction with care (previous social ties between patients and providers; sense of belonging to or ownership of the centre; patients’ views of the importance of seeking care; and patients’ expectations of what providers should inform them about and how they should deal with their illness). The last theme became apparent differently between primary and secondary health-care centres—patients at the primary health-care centres expressed higher satisfaction than for secondary health care, determined by strong social ties and a sense of belonging to the providers and the health-care centre. Interpretation For patients, health services are not only places for the provision of health care, albeit varied, but they are also sites of social relations. Patients’ perceptions of their access to health care differ, dependent on their socioeconomic, political, and cultural influences, and should also be taken into serious consideration in future policy development. Funding European Commission. Contributors All authors contributed to the data analysis and preparation of this Abstract. Conflicts of interest We declare that we have no conflicts of interest. Acknowledgments We thank all the commentators who participated in The Lancet–Palestinian Health Alliance writers’ workshop, Birzeit University, Ramallah, West Bank, oPt, March 2–3, 2011.
Scandinavian Journal of Clinical & Laboratory Investigation, 2000
This paper aims to evaluate the utility of a single glucometer fasting capillary blood glucose (F... more This paper aims to evaluate the utility of a single glucometer fasting capillary blood glucose (FCBG) measurement in determining the prevalence of diabetes mellitus in a homogeneous adult population. FCBG measurements were compared with results of the oral glucose tolerance test (OGTT) in 445 subjects aged 30-65 years in an urban cross-sectional study in Old Ramallah. Prevalence of diabetes, sensitivity, specificity and predictive values were calculated at different cut-off levels of FCBG, using OGTT as the reference. The prevalence of OGTT-diagnosed diabetes was 2.7%, while it varied considerably using different cut-off levels of FCBG. The sensitivity of a single glucometer (Exac Tech II) measurement of FCBG at the cut-off level of 6.7 mmol 1(-1) was 33.3%, with a specificity of 98.8%. Using the cut-off level of 6.1 mmol 1(-1) as suggested by the 1998 provisional report of a WHO consultation, the sensitivity increased to 41.7%. At a cut-off level of 5.6 mmol 1(-1), a sensitivity of 66.6% was reached, but the specificity decreased slightly. It can be concluded that a single glucometer measurement of FCBG in an adult population is not useful in determining the prevalence of diabetes mellitus.
This paper presents evidence from research into health system challenges of cardiovascular diseas... more This paper presents evidence from research into health system challenges of cardiovascular disease (CVD) and diabetes in four Eastern Mediterranean countries: the occupied Palestinian territory, Syria, Tunisia and Turkey. We address two questions. How has the health system in each country been conceptualised and organised to manage the provision of care for those with CVD or diabetes? And what were key concerns about the institutional ability to address this challenge? Research took place from 2009 to 2010, shortly before the political upheavals in the region, and notably in Syria and Tunisia. Data collection involved a review of key documents, interviews with key informants and brief data collection in clinics. In analysing the data, we adopted the analytical schema proposed by Walt and Gilson, distinguishing content, actors, context and process. Key findings from each country highlighted concerns about fragmented provision and a lack of coordination. Specific concerns included: the lack of patient referral pathways, functioning health information systems and investment in staff. Regarding issues underlying these 'visible' problems in managing these diseases, we highlight implications of the wider systemic pressure for reform of health-sector finance in each country, based on neoliberal models.
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Papers by Abdullatif Husseini