Search Results (1,350)

Using data collected from 294 farm households across Egypt, Morocco, and Tunisia, this study quantifies crop losses due to soil salinity and analyzes the key factors associated with it. Further, it analyzes the factors driving the farmers’ choice of adaptation measures against salinity. Almost 54% of households surveyed reported yield losses due to salinity, with a sizable portion experiencing losses above 20%. In response to salinization, farmers adopted five adaptation practices, including crop rotation, salt stress-tolerant varieties, drainage management, soil amendments, and improved irrigation practices. A generalized linear model is applied to examine the factors explaining crop loss due to salinity. Results show that a higher share of irrigated land correlates with greater salinity-related crop loss, particularly in areas with poor drainage and low water quality. Conversely, farms with good soil quality reported significantly lower losses. Crop losses due to salinity were much lower in quinoa compared to wheat. Farmers who received agricultural training or belonged to cooperatives reported lower losses. A multivariate probit model was employed to understand drivers of adaptive behaviors. The analysis shows credit access, cooperative membership, training, and resource endowments as significant predictors of adaptation choices. The results underscore the importance of expanding credit availability, strengthening farmer organizations, and investing in training for effective salinity management. Full article

Colorectal cancer (CRC) is a significant public health issue, representing one of the greatest causes of both cancer diagnosis and mortality globally. While the incidence is highest in high-income countries, it is rising across the world, including in the Middle East and North Africa (MENA) region. Many countries have implemented national screening programmes to reduce the burden of CRC, utilising mostly stool tests and colonoscopy, but this has yet to occur across most MENA countries. Uptake of screening opportunities is generally poor. System-level barriers to establishing screening programmes include cost constraints and limited screening infrastructure. Patient-level barriers include embarrassment, fear of a cancer diagnosis, and limited awareness/education. Screening programmes across the MENA region would likely reduce the CRC incidence. These barriers must be overcome through patient education and government action to ensure appropriate patient uptake. This study aims to examine CRC screening practices across MENA, identify key barriers, and propose solutions for sustainable CRC management in the region, through a narrative review and expert input from the Middle East and North Africa Colorectal Cancer (MENA-CRC) Screening and Prevention collaborators. Full article

Background/Objectives: Pneumococcal conjugate vaccines (PCVs) have significantly reduced invasive pneumococcal disease (IPD) globally. We conducted a systematic review to assess whether serotype and antimicrobial resistance trends in the Middle East and North Africa (MENA) reflect global patterns post-PCV introduction. Methods: We searched the CINAHL, MEDLINE, PUBMED, EMBASE, Global Health, Global Index Medicus, EBSCO, Scopus, and Cochrane databases for articles published from inception to 24 January 2024. Eligible studies were original articles in English or French, reporting IPD serotype distribution or antimicrobial susceptibility in the MENA region. Risk of bias was assessed using the STROBE checklist. Results: Eighty-nine studies from 18 countries were included. A decline in PCV7 serotypes was observed following the introduction of PCV10 or PCV13, which was more pronounced in PCV10-era studies. Serotype 3 increased post-PCV13 era, while 19A declined only after PCV10. An expansion in PCV20 serotypes and non-vaccine types (NVTs) was noted in PCV13-implementing countries. Antimicrobial resistance data were insufficient to provide a reliable trend. Limitations: There was limited AMR data and variable surveillance quality across countries. Conclusions: PCV introduction resulted in a modest decrease in PCV7 serotypes and a variable impact on PCV13 serotypes. This, along with the increase in PCV20 serotypes, indicates that higher-valency PCVs might provide better serotype coverage in the region. The study highlights the need for more robust surveillance across the region. Registration: CRD42018104529. Full article

Background: Antimicrobial resistance (AMR) is a growing global health threat, with children in low- and middle-income countries bearing a disproportionate burden. Data on resistance patterns and diagnostic practices in pediatric populations remain limited. This study evaluated diagnostic utilization and AMR among children hospitalized with bacterial infections at a national referral hospital in Kenya. Methods: We conducted a retrospective cohort study of pediatric inpatients (0–12 years) admitted with bacterial infections between 2017 and 2021. Patient records were identified using ICD-10 codes and reviewed for diagnostic testing and antimicrobial susceptibility. Descriptive statistics were conducted to show infection counts, diagnostic testing, and resistance outcomes. Results: Among 1608 patients, 1009/1608 (63%) were infants under one year. Culture was conducted in 640/1608 (40%) and antimicrobial sensitivity testing in 111/640 (17%) patients. Gastroenteritis (46%) was the most common infection and blood the most frequently collected specimen (31%). Of 1039 cultured specimens, 896/1039 (86%) showed no growth. The most commonly isolated organisms were Klebsiella pneumoniae 19/128 (15%), Staphylococcus epidermidis (13%, 17/128), and Enterococcus faecium (13%, 16/128). Notably, K. pneumoniae showed 100% resistance to third-generation cephalosporins, suggestive of ESBL production. Among the tested samples, 92/128 (72%) had MDROs, and 26/92 (28%) were extensively drug-resistant (XDR). Among the patients tested, 84/111 (76%) had MDROs, of which 25/84 (30%) were XDR. Children under 5 years had higher odds (OR = 5.84, 95% CI: 1.17-38.21) of having MDRO infections, as well as those with multiple admissions (OR = 3.77, 95% CI: 1.06–20.34). Further, increasing age was inversely associated with MDRO presence. The odds of MDRO infection decreased by 24% for every year increase in age (aOR = 0.76; 95% CI: 0.60–0.93; p = 0.006). Conclusions: The findings highlight the limited diagnostic use and a high burden of MDROs and XDR infections in hospitalized children. Strengthening diagnostic capacity and pediatric antimicrobial stewardship is urgently needed in such settings. Full article

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by protozoa of the Leishmania genus. Once confined to endemic regions such as the Middle East, Americas, North Africa, and Central Asia, CL is increasingly emerging in non-endemic areas due to a multitude of drivers, including population displacement, environmental disruption, and political instability. These overlapping drivers contribute to expanding sand fly habitats, degrading living conditions, and weakening health systems, increasing transmission. Rising global temperatures further facilitate vector expansion into new regions, where clinical unfamiliarity often leads to misdiagnosis, delayed treatment, increased morbidity, and greater financial burden. Despite its rising incidence and global spread, CL remains a neglected tropical disease since it is seldom fatal, with scant interest by public health authorities and financial donors, limiting activities that further research and prevent spread of the disease. This review synthesizes current evidence on how geopolitical instability, forced migration, and climate-driven ecological changes collectively reshape CL epidemiology and complicate diagnosis, treatment, and surveillance. As CL extends beyond traditional geographic boundaries, it requires integrated strategies that address its multifaceted drivers through strengthened cross-border surveillance, provider education, and international coordination—focusing on prevention, diagnosis, and equitable access to diagnostics and therapeutics, especially among displaced and underserved populations. Full article

Background/Objectives: To evaluate the impact of the European–Mediterranean Postgraduate Program on Organ Donation and Transplantation (EMPODaT) on organ donation and transplantation (ODT) at 6 years. Methods: EMPODaT is a Trans-European Mobility Programme for University Studies (TEMPUS) project founded by the European Commission to address ODT professionals’ shortage in Middle East/North Africa (MENA) countries through structured postgraduate education. Leading universities from Spain, Germany, Sweden, and France, and key institutions in Egypt, Lebanon, and Morocco, developed a one-year blended training program incorporating e-learning, in-person courses, and hospital traineeships. The effect of the program at 6 years was analyzed by surveying the 90 healthcare participants. Results: A total of 73.9% of respondents remained actively engaged in the field, and some assumed leadership roles (local directors 14.4%, donor coordinators 13%). Also, 65.2% of participants reported improvements in policies and practices, with notable progress in donor screening (39.1%), brain death diagnosis (30.4%), and hospital policy reforms (69.7%). The study identified barriers, such as legal (34.4%), financial (34.8%), and public/social resistance (39.1%). Training alone, without strong hospital policies, support, and government involvement, was insufficient for introducing meaningful changes in ODT. Conclusions: Key aspects for successful implementation of training programs on ODT in MENA countries should consider hospital leadership engagement, strengthen institutional collaborations, and incorporate national health authorities to enhance sustainability and drive systemic changes. Prioritizing individuals in key decision-making positions could further enhance program effectiveness. Full article

As the world’s population of older adults continues to grow rapidly, combating loneliness and social isolation has become an emerging health concern for this group. Though there has been increasing interest within the scientific community in exploring digital games as an intervention for loneliness, research on gaming as an intervention is a relatively new field of study. This scoping review examines the current state of research on the impact of digital gaming on loneliness in the older adult population and was conducted in accordance with the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A total of 317 potentially relevant studies were identified through database searches, and of these, 278 studies were excluded due to failure to meet inclusion criteria. The full texts of 39 articles were assessed for eligibility, resulting in 9 articles being included in this scoping review. Some important findings from our study include the central role of social interaction in addressing loneliness and the potential for interventions targeting both physical and mental well-being to have a more significant impact on alleviating loneliness. We also found that while many studies reported positive effects of gaming interventions, some findings were contradictory, suggesting that the relationship between gaming and loneliness is complex and moderated by multiple factors. Recommendations for future research include expanding investigations to outside of East Asia (where the majority of existing studies were conducted) to the United States, Africa, India, or Europe. Full article

We employed a global high-resolution inverse model to estimate sectoral methane emissions, integrating observations from the GOSAT-2 satellite for the first time, along with observations from the surface observation network. A similar set of inversions using GOSAT observations was carried out to evaluate the consistency between emissions estimates derived from these two satellites and to ensure that GOSAT-2 data could seamlessly integrate with the existing data series without disrupting the continuity of flux estimates. This analysis, covering the period from 2019 to 2022, utilized prior anthropogenic emissions data mainly from EDGAR v6 and incorporated additional natural sources and sinks as outlined by global methane budget, 2020. Our analysis reveals a general agreement between total methane emissions estimates from GOSAT and GOSAT-2. However, on a sectoral basis, we found notable regional differences in the flux estimates. While GOSAT inversion estimates ~8 Tg a⁻¹ more anthropogenic emissions for China and around 4 Tg a⁻¹ more wetland emissions for Brazil and Indonesia, the posterior error distribution suggests that GOSAT-2 inversion is closer to surface observations over Asia. These discrepancies are found in regions with significant differences in XCH₄ data from the two satellites, such as East Asia and North America, tropical South America, and tropical Africa. These regional biases persist due to limited representative surface reference sites for Level 2 bias correction. The relatively lower data volume from GOSAT also introduces seasonal biases in the flux estimates when the quality filtering of Level 2 data persistently reduces usable observations during certain seasons, resulting in inadequate representation of the seasonal cycle in regions such as East Asia. Similarly, in tropical South America, where the model is relatively under-constrained by the limited surface observations, the lower data volume of GOSAT-2 suffers. While the two inversions exhibit consistent overall performance across North America and Europe, the GOSAT-2-based inversion demonstrates a better performance over East Asia. Therefore, while the two satellite datasets are broadly consistent, considering the fact that the biases in the XCH₄ data overlap with regions under-constrained by surface observations, establishing additional surface reference measurement sites is desirable to ensure consistent inversion results. Full article

This paper examines a prospect scenario of adopting Child Development Accounts (CDAs) as a social welfare innovation in Jordan. CDAs are considered as an asset-building policy aimed at enhancing financial inclusion and socio-economic well-being. This paper discovers the feasibility of CDAs that have proven successful in several countries, as their potential in Middle Eastern countries, particularly in Jordan, remains unexplored. The application of CDAs in the social welfare system aims to support sustainable asset accumulation and improve the living standards of diverse segments in Jordan by integrating CDAs within the efforts made by Jordan to achieve financial inclusion, alleviate poverty, and supplement household income through asset development. There are opportunities to implement the program in Jordan, including expanding the scope of microfinance, public–private partnerships, and targeted programs for women, youth, and refugees. However, several challenges may hinder its application, including limited financial literacy, high unemployment rates, income inequality, regulatory obstacles, and difficulties in implementing social reforms. The paper contributes to the debate on social welfare policies adopted in developing countries by providing solutions based on global practices in CDA execution and has implications and recommendations for decision makers to achieve economic development. Future research in Middle East and North Africa (MENA) countries should target pilot projects and comparative studies to refine CDA strategies. Full article

The Middle East and North Africa region has not played a major role in climate action so far, and several countries depend economically on fossil fuel exports. However, this is a region with vast solar energy resources, which can be exploited affordably for power generation and hydrogen production at scale to eventually reach carbon neutrality. In this paper, we elaborate on the case of the United Arab Emirates and explore the aspirations and feasibility of its net-zero by 2050 target. While we affirm the concept per se, we also highlight the technological complexity and economic dimensions that accompany such transformation. We expect the UAE’s electricity demand to triple between today and 2050, and the annual green hydrogen production is expected to reach 3.5 Mt, accounting for over 40% of the electricity consumption. Green hydrogen will provide power-to-fuel solutions for aviation, maritime transport and hard-to-abate industries. At the same time, electrification will intensify—most importantly in road transport and low-temperature heat demands. The UAE can meet its future electricity demands primarily with solar power, followed by natural gas power plants with carbon capture, utilization and storage, while the role of nuclear power in the long term is unclear at this stage. Full article

This article examines the production costs of cocoa farming in Côte d’Ivoire, West Africa, taking into account the opportunity cost approach. To this end, surveys were conducted among 228 farmers in three regions, Bonon, Soubré and Biankouma, following an east–west gradient. The estimated costs of using family labor and land were based on the opportunity cost approach. The financial costs associated with production were also taken into account. Comparative analyses between different localities and cropping systems highlighted specific workload characteristics. Finally, a principal component analysis (PCA) was used to profile producers according to their income levels and profits. The findings showed that family labor was the main component of cocoa production costs. Prices paid to farmers did not always cover all production costs, with 38% of farmers producing at a loss, and this was contingent on the agro-ecological zone. Furthermore, the agroforestry system proved to be more economical in terms of labor than the full-sun system. These results underline the relevance of the opportunity cost approach in assessing production costs and setting cocoa selling prices. This should lead to a review of public price-setting mechanisms to ensure fair remuneration for family labor. Full article

Lumpy skin disease virus (LSDV), a transboundary pathogen threatening cattle health in South and Southeast Asia, presents growing challenges for disease control. This study combined serological, molecular, and genomic approaches to investigate LSDV in Barura Upazila, Bangladesh. Serological screening of 424 cattle using a commercial ELISA revealed a high seroprevalence of 55.5% (95% CI: 50.7–60.3), indicating widespread exposure. Although differences were observed by age and breed, no significant associations were found with seropositivity, suggesting broad regional circulation. Real-time PCR confirmed LSDV DNA in all 20 clinically infected animals, with consistent P32 gene amplification. Two samples with low Cq values underwent whole-genome sequencing. The complete genomes of LSDV-L2/2024 and LSDV-L3/2024 showed >99.6% identity with the reference strain LSDV-29, yet carried unique genomic features, including truncated or variant ORFs and immune-related gene differences. Phylogenetic analysis of the DNA polymerase gene revealed distinct clustering: L2/2024 aligned with South Asian isolates, while L3/2024 grouped with strains from Africa, the Middle East, and Europe. These results highlight co-circulation of genetically diverse strains and possible cross-regional introductions. Overall, our findings underscore the evolutionary plasticity of LSDV and the critical need for ongoing genomic surveillance to guide targeted vaccine development and disease control strategies. Full article

Nitrogen dioxide (NO₂) plays a crucial role in environmental processes and public health. In recent years, NO₂ pollution has been monitored using a combination of in situ measurements and satellite remote sensing, supported by the development of advanced retrieval algorithms. With advancements in satellite technology, large-scale NO₂ monitoring is now feasible through instruments such as GOME-2C and TROPOMI. However, the fixed local overpass times of polar-orbiting satellites limit their ability to capture the complete diurnal cycle of NO₂, introducing uncertainties in emission estimation and pollution trend analysis. In this study, we evaluated differences in NO₂ observations between GOME-2C (morning overpass at ~09:30 LT) and TROPOMI (afternoon overpass at ~13:30 LT) across three representative regions—East Asia, Central Africa, and Europe—that exhibit distinct emission sources and atmospheric conditions. By comparing satellite-derived tropospheric NO₂ column densities with ground-based measurements from the Pandora network, we analyzed spatial distribution patterns and seasonal variability in NO₂ concentrations. Our results show that East Asia experiences the highest NO₂ concentrations in densely populated urban and industrial areas. During winter, lower boundary layer heights and weakened photolysis processes lead to stronger accumulation of NO₂ in the morning. In Central Africa, where biomass burning is the dominant emission source, afternoon fire activity is significantly higher, resulting in a substantial difference (1.01 × 10¹⁶ molecules/cm²) between GOME-2C and TROPOMI observations. Over Europe, NO₂ pollution is primarily concentrated in Western Europe and along the Mediterranean coast, with seasonal peaks in winter. In high-latitude regions, weaker solar radiation limits the photochemical removal of NO₂, causing concentrations to continue rising into the afternoon. These findings demonstrate that differences in polar-orbiting satellite overpass times can significantly affect the interpretation of daily NO₂ variability, especially in regions with strong diurnal emissions or meteorological patterns. This study highlights the observational limitations of fixed-time satellites and offers an important reference for the future development of geostationary satellite missions, contributing to improved strategies for NO₂ pollution monitoring and control. Full article

Climate change is a global crisis that disproportionately affects vulnerable agrarian communities, exacerbating food insecurity and health risks. This qualitative study explored the relationship between climate change and health in the following two rural sub-counties of Kilifi County, Kenya: Ganze and Magarini. In fall 2023, we conducted 16 focus group discussions with adolescent girls (14–17), young adults (18–30), and older adults (31+). Thematic analysis revealed that climate change adversely affects health through key social determinants, including economic instability, environmental degradation, limited healthcare access, food insecurity, and disrupted education. Participants reported increased food scarcity, disease outbreaks, and reduced access to medical care due to droughts and floods. Economic hardship contributed to harmful survival strategies, including transactional sex and school dropout among adolescent girls. Mental health concerns, such as stress, substance use, and suicidal ideation, were prevalent. These findings highlight the wide-ranging health impacts of climate change in agrarian settings and the urgent need for comprehensive, community-informed interventions. Priorities should include improving nutrition, reproductive and mental health services, infectious disease prevention, and healthcare access. Full article

Understanding the spatio-temporal dynamics of religion is crucial for explaining cultural and geopolitical transformations. Based on multi-source religious demographic data, this study analyzes the spatio-temporal dynamics of global Catholicism after WWII using gravity migration and standard deviational ellipse models, revealing spatial heterogeneity and tracing the migration of its developmental center. Spatial typology techniques are further employed to classify patterns of Catholic growth efficiency. Our findings reveal that: (1) The absolute number of global Catholics has steadily increased, exhibiting a west-heavy, east-light pattern, with particularly notable growth in the Americas and Sub-Saharan Africa. The proportion of Catholics has declined—especially in traditional strongholds such as Europe and the Americas—while rising in emerging missionary regions, notably in Africa. (2) The macro-trend of Catholic development demonstrates a continuous southward shift in its global center of gravity, transitioning from Europe to the Global South—particularly regions like Africa, Asia, and Latin America. The standard deviational ellipse reveals pronounced oscillation, with an increasing rotation angle and a southward tilt, suggesting an accelerating pace of change in the global distribution of Catholicism. (3) Post-WWII, Catholic growth outpaced population in 75.57% of countries, though modestly. Developmental efficiency temporally followed a trajectory of “broad weak positive—drastic polarization—weak equilibrium”, while spatially reflecting pronounced regional heterogeneity shaped by the combined effects of colonial legacies, social demands, political dynamics, and modernity shocks. Overall, our study provides empirical support for understanding the links between religious spatial patterns and social transformation. Full article