This week in the BMJ
Volume 333, Number 7573, Issue of 21 Oct 2006Health burden of genetic disorders is high in the Arab world
Health burden of genetic disorders is high in the Arab world
Better prevention and control of genetic disorders is needed in Arab countries to reduce the high rates of infant mortality and morbidity and intellectual and physical handicap they cause. In their clinical review Al-Gazali and colleagues (p 831) suggest that consanguinity and large family size are mainly responsible for the high frequency of genetic disorders in these countries and that the barriers to developing effective services are not just financial but cultural, legal, and religious as well. Some countries have set up cost effective programmes for specific disorders that may lead to the development of similar services in other Arab countries.
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Neurological presentation of malaria in Yemen has poor prognosis
Malaria is a serious burden on health services in Yemen; it accounts for 17% of paediatric hospital admissions, and more than half of cases are classified as severe falciparum malaria. A two site observational study by Al-Taiar and colleagues (p 827) found that female sex, history of fits, Blantyre coma score < 2, and hyperlactataemia were associated with poor prognosis. Of the 26 children who died, 22 presented with neurological signs; this is in contrast to Africa, where severe anaemia and respiratory distress are better predictors of fatal outcome.
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Child mortality is high in Eastern Mediterranean countries
Fifteen per cent of deaths in children under 5 around the globe occur in the Eastern Mediterranean Region and half could be prevented by cost effective evidence based interventions. In an analysis of regional data Bhutta and colleagues (p 839) show that almost 90% of deaths occur in just seven of the 22 countries in the region, and that despite a drop in death rates in the 1970s to the 1990s, mortality is rising again. They argue that an absence of political will rather than a lack of knowledge accounts for this failure to improve the outlook for the region's children.
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Learning more about responding to conflict and disaster
Past, present, and potential natural disasters, conflicts, and humanitarian crises in the Eastern Mediterranean Region highlight the need for investment in disaster planning and response services. In a collection of articles (p 843) authors with front line experience show that the poor and marginalised bear the brunt of both natural and man made disasters. The articles comment on the challenges faced by humanitarian and emergency agencies and proffer suggestions—ranging from practical to political—on how their interventions might be improved and the impact of future disasters mitigated.
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Sexual and reproductive health of young Arab people needs to be improved
Cultural taboos limit young Arab people's access to information and sexual and reproductive health services say DeJong and El-Khoury (p 849). Health services generally fail to recognise the needs of the young, and unmarried people are largely excluded from surveys of sexual and reproductive health. Signs that young people are getting the information they need from online services are encouraging. Hopefully more open discussion will follow and lead to provision of appropriate accessible services that build on the small scale programmes that already exist.
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