1.  Peer Reviewed Title: Maternal mortality in Syria: causes, contributing factors and preventability. Author: Bashour H; Abdulsalam A; Jabr A; Cheikha S; Tabbaa M; Lahham M; Dihman R; Khadra M; Campbell OM Source: Tropical Medicine and International Health. 2009 Sep;14(9):1122-7. Abstract: OBJECTIVES: To describe the biomedical and other causes of maternal death in Syria and to assess their preventability. METHODS: A reproductive age mortality study (RAMOS) design was used to identify pregnancy related deaths. All deaths among women aged 15-49 reported to the national civil register for 2003 were investigated through home interviews. Verbal autopsies were used to ascertain the cause of death among pregnancy related maternal deaths, and causes and preventability of deaths were assessed by a panel of doctors. RESULTS: A total of 129 maternal deaths were identified and reviewed. Direct medical causes accounted for 88%, and haemorrhage was the main cause of death (65%). Sixty nine deaths (54%) occurred during labour or delivery. Poor clinical skills and lack of clinical competency were behind 54% of maternal deaths. Ninety one percent of maternal deaths were preventable. CONCLUSIONS: The causes of maternal death in Syria and their contributing factors reflect serious defects in the quality of maternal care that need to be urgently rectified. Language: English Keywords: SYRIA | RESEARCH REPORT | RECORDS | MATERNAL MORTALITY | CAUSES OF DEATH | PREGNANCY OUTCOMES | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | Developing Countries | Middle East | Information Processing | Information | Mortality | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 342964 |
| 2. Peer Reviewed Title: PREVALENCE OF CONSANGUINEOUS MARRIAGES IN SYRIA. Author: Othman H; Saadat M Source: Journal of Biosocial Science. 2009 May 12;:1-8. Abstract: SummaryConsanguineous marriage is the union of individuals having at least one common ancestor. The present cross-sectional study was done in order to illustrate the prevalence and types of consanguineous marriages in the Syrian Arab Republic. Data on consanguineous marriages were collected using a simple questionnaire. The total number of couples in this study was 67,958 (urban areas: 36,574 couples; rural areas: 31,384 couples) from the following provinces: Damascus, Hamah, Tartous, Latakia, Al Raqa, Homs, Edlep and Aleppo. In each province urban and rural areas were surveyed. Consanguineous marriage was classified by the degree of relationship between couples: double first cousins (F=1/8), first cousins (F=1/16), second cousins (F=1/64) and beyond second cousins (F<1/64). The coefficient of inbreeding (F) was calculated for each couple and the mean coefficient of inbreeding (alpha) estimated for the population of each province, stratified by rural and urban areas. The results showed that the overall frequency of consanguinity was 30.3% in urban and 39.8% in rural areas. Total rate of consanguinity was found to be 35.4%. The equivalent mean inbreeding coefficient (alpha) was 0.0203 and 0.0265 in urban and rural areas, respectively. The mean proportion of consanguineous marriages ranged from 67.5% in Al Raqa province to 22.1% in Latakia province. The alpha-value ranged from 0.0358 to 0.0127 in these two provinces, respectively. The western and north-western provinces (including Tartous, Lattakia and Edlep) recorded lower levels of inbreeding than the central, northern and southern provinces. The overall alpha-value was estimated to be about 0.0236 for the studied populations. First cousin marriages (with 20.9%) were the most common type of consanguineous marriages, followed by double first cousin (with 7.8%) and second cousin marriages (with 3.3%), and beyond second cousin was the least common type. Language: English Keywords: SYRIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HEALTH SURVEYS | COUPLES | MARRIAGE PATTERNS | CONSANGUINITY | PREVALENCE | HUMAN GEOGRAPHY | Developing Countries | Middle East | Research Methodology | Health | Family Characteristics | Family and Household | Sociocultural Factors | Marriage | Nuptiality | Demographic Factors | Population | Genetics | Biology | Measurement | Geography | Social Sciences | Science Document Number: 341478 |
3.  Title: Patterns and determinants of maternity care in Damascus. Author: Bashour H; Abdulsalam A; Al-Faisal W; Cheikha S Source: Eastern Mediterranean Health Journal. 2008 May-Jun;14(3):595-604. Abstract: This descriptive study was designed to describe the patterns and determinants of maternity care among Syrian women living in Damascus. All 39 birth registers in 2 large provinces were used to recruit 500 mothers of healthy newborns. Mothers were interviewed in their homes using a semistructured questionnaire. Multivariate analysis of the determinants of the frequency of use of antenatal care showed the following variables were significant: urban residence and visit to antenatal care in the 1st trimester. The significant variables for an early visit to antenatal care were the woman's level of education; being pregnant with the 1st baby; and number of visits to antenatal care. Being young (age less than 20 years) also correlated with early timing of the 1st antenatal visit. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | INTERVIEWS | QUESTIONNAIRES | MOTHERS | MATERNAL HEALTH | RESIDENCE CHARACTERISTICS | ANTENATAL CARE | PREGNANCY, FIRST TRIMESTER | EDUCATION | AGE FACTORS | Middle East | Developing Countries | Data Collection | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Health | Population Distribution | Geographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Pregnancy | Reproduction | Population Characteristics | Demographic Factors Document Number: 327175 |
| 4. Title: Effect of postnatal home visits on maternal / infant outcomes in Syria: A randomized controlled trial. Author: Bashour HN; Kharouf MH; Abdul Salam AA; El Asmar K; Tabbaa MA Source: Public Health Nursing. 2008 Mar-Apr;25(2):115-125. Abstract: Early postpartum home visiting is universal in many Western countries. Studies from developing countries on the effects of home visits are rare. In Syria, where the postpartum period is rather ignored, this study aimed to assess whether a community-based intervention of postnatal home visits has an effect on maternal postpartum morbidities; infant morbidity; uptake of postpartum care; use of contraceptive methods; and on selected neonatal health practices. A randomized controlled trial was carried out in Damascus. Three groups of new mothers were randomly allocated to receive either 4 postnatal home visits, one visit, or no visit. A total of 876 women were allocated and followed up. Registered midwives with special training made a one or a series of home visits providing information, educating, and supporting women. A significantly higher proportion of mothers in Groups A and B reported exclusively breastfeeding their infants (28.5% and 30%, respectively) as compared with Group C (20%), who received no visits. There were no reported differences between groups in other outcomes. While postpartum home visits significantly increased exclusive breastfeeding, other outcomes did not change. Further studies framed in a nonbiomedical context are needed. Other innovative approaches to improve postnatal care in Syria are needed. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | CLINICAL TRIALS | HOME VISITS | POSTPARTUM PROGRAMS | INTERVENTIONS | MATERNAL HEALTH | INFANT HEALTH | BREASTFEEDING, EXCLUSIVE | Middle East | Developing Countries | Clinical Research | Research Methodology | Communication | Family Planning Programs | Family Planning | Programs | Organization and Administration | Health | Child Health | Breastfeeding | Infant Nutrition | Nutrition Document Number: 324192 |
| 5. Title: Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women. Author: Hubner U; Alwan A; Jouma M; Tabbaa M; Schorr H; Herrmann W Source: Clinical Chemistry and Laboratory Medicine. 2008;46(9):1265-9. Abstract: BACKGROUND: Hyperhomocysteinemia and B-vitamin deficiency are associated with recurrent abortion. Recent studies have not investigated functional markers of vitamin B12 deficiency, such as methylmalonic acid. METHODS: A total of 43 consecutive Syrian women with unexplained recurrent abortion and 32 pregnant controls were enrolled in the study. Serum folate, vitamin B12, methylmalonic acid and plasma homocysteine were determined. RESULTS: Vitamin B12 was significantly decreased in patients with recurrent abortion compared to controls (mean concentrations 197 vs. 300 pg/mL, p=0.004). The lowest mean serum vitamin B12 (172 pg/mL) was observed in primary aborters. Homocysteine was elevated in aborters in comparison to controls (8.3 vs. 7.1 micromol/L, p=0.093). Folate and methylmalonic acid did not differ significantly between the study groups. A highly significant correlation between homocysteine and methylmalonic acid and vitamin B12 was observed only in patients but not in controls (p<0.001 and p=0.002, respectively). In the logistic regression model, only serum vitamin B12 emerged with a significant odds ratio. CONCLUSIONS: The results confirm low serum vitamin B12 in recurrent abortion patients. However, methylmalonic acid did not support that functional vitamin B12 plays a role in this group. This unexpected result might be due to a decrease of the metabolically inert vitamin B12 fraction (holohaptocorrin) or confounding factors. Further studies are necessary to investigate the role of vitamin B12 deficiency in recurrent abortion. Language: English Keywords: SYRIA | RESEARCH REPORT | WOMEN | PREGNANT WOMEN | FETAL DEATH | VITAMINS AND MINERALS | ABORTION, SPONTANEOUS | Middle East | Developing Countries | Demographic Factors | Population | Population Characteristics | Mortality | Population Dynamics | Physiology | Biology | Pregnancy Complications | Diseases Document Number: 329297 |
| 6. Title: Case-finding tuberculosis patients: Diagnostic and treatment delays and their determinants. Author: Maamari F Source: Eastern Mediterranean Health Journal. 2008 May-Jun;14(3):531-545. Abstract: This study in the Syrian Arab Republic assessed the frequency and determinants of delays in diagnosis and treatment of new smear-positive tuberculosis cases at DOTS treatment centres. Among 800 patients, the mean delay due to patient care-seeking behaviour was 52.7 days (range 15-698) and the health system delay before diagnosis was 24.8 days; thus the mean total delay before diagnosis was 77.6 days. The mean delay from diagnosis to start of treatment was very short at 2.9 days. Significant risk factors for total delay were: living far from the health facility, feeling a high degree of stigma, seeking initial care at a non-health care provider and having more than 1 health care encounter before diagnosis. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | QUESTIONNAIRES | PROVIDERS WITH CLIENTS | DEMOGRAPHIC FACTORS | TUBERCULOSIS | EXAMINATIONS AND DIAGNOSES | TREATMENT | HEALTH SERVICES | BEHAVIOR | STIGMA | Middle East | Developing Countries | Research Methodology | Delivery of Health Care | Health | Population | Infections | Diseases | Medical Procedures | Medicine | Social Problems | Sociocultural Factors Document Number: 327172 |
| 7. Title: Findings from the Multiple Indicator Cluster Survey 3, Syrian Arab Republic, 2006. MICS. Monitoring the Situation of Children and Women. Preliminary report. Author: Syria. Central Bureau of Statistics; UNICEF; League of Arab States. Pan-Arab Project for Family Health Source: [Damascus], Syria, Central Bureau of Statistics, 2007 Apr. 34 p. (Monitoring the Situation of Children and Women) Abstract: The primary objectives of the 2006 Multiple Indicator Cluster Survey of the Syrian Arab Republic are as follows: to provide up-to-date information for assessing the situation of children and women in the Syrian Arab Republic. to furnish data needed for monitoring progress towards the goals established by the Millennium Development Goals and the goals of A World Fit for Children (WFFC) as a basis for future action; to contribute to the improvement of data and monitoring systems in the Syrian Arab Republic, and to strengthen technical expertise in the design implementation, and analysis of such systems. (excerpt) Language: English Keywords: SYRIA | EVALUATION REPORT | SURVEYS | NUTRITION | CHILD HEALTH | ENVIRONMENT | REPRODUCTIVE HEALTH | CHILD DEVELOPMENT | EDUCATION | SOCIAL PROTECTION | HIV INFECTIONS | AIDS | SEX BEHAVIOR | Middle East | Developing Countries | Evaluation | Sampling Studies | Studies | Research Methodology | Health | Biology | Political Factors | Sociocultural Factors | Viral Diseases | Diseases | Behavior Document Number: 326347 |
| 8. Title: Iraqi refugees in Syria. Author: al-Miqdad F Source: Forced Migration Review. 2007 Jun;:19-20. Abstract: Syria has offered Iraqi refugees care and assistance, and continues to do so, in spite of the limited nature of its material resources. At the start of 2007 UNHCR estimated that the number of Iraqi refugees in Syria exceeded 1.2 million, a huge influx to a country with a population of 18 million. This heavy number of arrivals has had an extreme effect on all facets of life in Syria, particularly on the services which the state offers to citizens. There has been a sharp increase in the cost of living and the unexpected weight of numbers has had dramatic impacts on the infrastructure and the economy. The sudden increase in the population has led to a rise in costs in all areas of life. The prices of foodstuffs and basic goods have gone up by 30%, property prices by 40% and rentals by 150%. Water consumption has increased by 21%. The additional cost to the Syrian government of supplying Iraqi refugees with drinking water and sanitation alone came to $6.8 million last year. There are so many Iraqi refugees that they have become a burden on the labour market. In 2006 Syria's unemployment rate was 18%. (excerpt) Language: English Keywords: IRAQ | SYRIA | PROGRESS REPORT | RECOMMENDATIONS | EVALUATION | REFUGEES | MIGRATION POLICY | INTERNATIONAL MIGRATION | ECONOMIC FACTORS | HEALTH SERVICES | EDUCATION | POLITICAL FACTORS | WAR | UNHCR | Developing Countries | Middle East | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Population Policy | Social Policy | Policy | Sociocultural Factors | Delivery of Health Care | Health | UN | International Agencies | Organizations Document Number: 317671 |
| 9. Title: Iraq: Growing needs amid continuing displacement. Author: Harper A Source: Forced Migration Review. 2007 Dec;(29):51-53. Abstract: Seven months after over 100 country representatives gathered in Geneva to address the Iraq displacement crisis, the humanitarian situation has markedly deteriorated. Expectations that highlighting the burdens of Iraq's neighbours would result in financial and political support have been dashed. Support provided - relative to humanitarian needs - has been negligible. Every hour, around 50 to 100 Iraqis are being forced to leave their homes. UNHCR believes that some 4.5 million Iraqis - one in six of the population - have now left their homes, up to half a million of them since the Geneva meeting. Regional asylum states, particularly Syria which hosts some 1.6 million Iraqis, have become disenchanted with unfulfilled assurances. Following a number of threats, Syria introduced a visa regime for Iraqis in October. This decision, the first time that Syria has taken such an action against a fellow Arab state, has effectively closed the last remaining avenue of escape for desperate Iraqis. (excerpt) Language: English Keywords: IRAQ | SYRIA | CRITIQUE | REFUGEES | INTERNALLY DISPLACED PERSONS | WAR | MIGRATION POLICY | SOCIAL ADJUSTMENT | RELIGIOUS ASPECTS | SETTLEMENT AND RESETTLEMENT | UNHCR | INTERNATIONAL COOPERATION | Middle East | Developing Countries | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Political Factors | Sociocultural Factors | Population Policy | Social Policy | Policy | Social Behavior | Behavior | Religion | UN | International Agencies | Organizations Document Number: 323544 |
| 10. Title: Prevalence of factor V Leiden mutation and its relation with recurrent spontaneous pregnancy loss in a group of Syrian women. Author: Mohammad MM; Al-Halabi MG; Monem FM Source: Middle East Fertility Society Journal. 2007;12(3):179-183. Abstract: The aim of our study was to investigate the prevalence of factor V Leiden and its relation with RPL in a group of Syrian women. The study group included 35 women with a history of recurrent pregnancy loss (two or more abortions before 20th week of gestation) were referred to Orient hospital for obstetrics, gynecology and assisted reproduction, Damascus, Syria, for investigation between December 2005 and July 2006. All women with known causes of pregnancy loss after convenient investigations were excluded. The control group included 45 healthy women from the same ethnic background, who had at least one successful pregnancy, and none of them had a history of fetal loss or complicated pregnancy. FVL mutation was screened by Real-time PCR method. The results show that 10 women out of 35 with RPL and 4 women out of 45 controls had FVL mutation (28.6 versus 8.9 %, P=0.022, Odds ratio 4.1, 95% CI: 1.16-14.4). From the 25 women who were primary RPL, eight patients had the factor V Leiden (32 versus 8.9%, P=0.014, OR: 4.8, 95%CI: 1.2, 18.17). From the 10 women who were secondary RPL, two patients had the factor V Leiden (20 versus 8.9%, P=0.30, OR: 2.5, 95% CI: 0.4-16.4). All patients and controls carrying the factor V Leiden were heterozygote. Our results revealed that the prevalence of FVL was significantly higher in women with RPL in comparison with controls, particularly in the subgroup with primary RPL, and there is an association between factor V Leiden mutation and recurrent pregnancy loss. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | GENETIC TECHNIQUES | CASE CONTROL STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREVALENCE | CHROMOSOME ABNORMALITIES | ABORTION, SPONTANEOUS | Middle East | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Measurement | Neonatal Diseases and Abnormalities | Diseases | Pregnancy Complications Document Number: 324440 |
| 11. Title: State party examination of the Syria Arab Republic's initial report on the Optional Protocol on the Sale of Children, Child Prostitution and Child Pornography (OPSC). Session 43 of the Committee on the Rights of the Child. Author: NGO Group for the Convention on the Rights of the Child Source: [Unpublished] 2006. 5 p. Abstract: The Syrian Arab Republic acceded to the OPSC on 15 May 2003. On 19 September 2006, the Committee on the Rights of the Child (the Committee) examined Syria's Initial Report on the OPSC. The Head of Delegation and Chief of the Syrian Commission for Family Affairs (SCFA), Ms. Ghanem, described how the application and follow-up of the OPSC was being carried by competent ministries and institutions of civil society. The measures taken and planned included the review of the penal code, family law, and constitution of Syria, the imposition of aggravated penalties for crimes listed in the OPSC, and the granting of full medical care to victims. In terms of monitoring, the issue of child protection was raised at national level in 2003. The SCFA submitted a draft plan for the protection of children from abuse, a framework to implement both the CRC and OPSC backed by a budget of one million US dollars. At the time of meeting, this first draft on child protection was ready to be discussed. The SCFA formed a committee to follow up on the implementation of this national plan. Other measures included two centres for delinquent girls, the creation of a gender-sensitive database for child protection, and the integration of children's rights education in the school curricula. Several national campaigns promoting children's rights were conducted and planned. (excerpt) Language: English Keywords: SYRIA | CONFERENCES AND CONGRESSES | EVALUATION | SEX WORKERS | CHILDREN | HOMELESS PERSONS | SEXUAL TRAFFICKING | SEXUAL ABUSE | CHILD ABUSE | LEGISLATION | COORDINATION | PREVENTION AND CONTROL | ADOPTION | CHILD LABOR | Developing Countries | Middle East | Sex Behavior | Behavior | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Crime | Social Problems | Sociocultural Factors | Political Factors | Organization and Administration | Diseases | Child Rearing | Labor Force | Human Resources | Economic Factors Document Number: 309909 |
| 12. Title: Intimate-partner violence [letter] Author: Mihas C; Alevizos A; Mariolis A Source: Lancet. 2006 Nov 18;368(9549):1765-1766. Abstract: Although Claudia Garcia-Moreno and colleagues acknowledge that intimate-partner violence is a global health-care problem, they report that educational status does not explain differences in the prevalence of intimate-partner violence between the countries the research team visited. However, other studies suggest conflicting results. Thompson and colleagues studied 3568 women aged 18--64 years in the USA and showed that the rates of intimatepartner violence were higher for women with less education. In another study, Maziak reported that poor education was one important correlate of physical abuse in 412 Syrian women. The association between female educational status and intimate-partner violence is also documented in a review article by Jewkes. According to this study, high educational status of women was associated with low levels of violence in some countries, whereas in others the aforementioned relation followed an inverted U-shape pattern, with low violence rates at the lowest and highest educational levels. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | SYRIA | CRITIQUE | WOMEN | SEXUAL PARTNERS | DOMESTIC VIOLENCE | PREVALENCE | EDUCATIONAL STATUS | INCOME | PHYSICAL ABUSE | North America | Americas | Developed Countries | Developing Countries | Middle East | Demographic Factors | Population | Sex Behavior | Behavior | Crime | Social Problems | Sociocultural Factors | Measurement | Research Methodology | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Violence Document Number: 309662 |
| 13. Peer Reviewed Title: Routines in facility-based maternity care: evidence from the Arab world. Source: BJOG: An International Journal of Obstetrics and Gynaecology. 2005 Sep;112:1270-1276. Abstract: Objectives To document facility-based practices for normal and delivery in Egypt, Lebanon, the West Bank (part of the Occupied Palestinian Territory) and Syria and to categorise common findings according to evidence-based obstetrics. Design Three studies (Lebanon, West Bank and Syria) interviewed a key informant (providers) in maternity facilities. The study in Egypt directly observed individual labouring women. Setting Maternity wards. Sample Nationally representative sample of hospitals drawn in Lebanon and Syria. In the West Bank, a convenience sample of hospitals was used. In Egypt, the largest teaching hospital’s maternity ward was observed. Methods Shared practices were categorised by adapting the World Health Organization’s (WHO) 2004 classification of practices for normal birth into the following: practices known to be beneficial, practices likely to be beneficial, practices unlikely to be beneficial and practices likely to be ineffective or harmful. Main outcome measures Routine hospital practices for normal labor and delivery. Results There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately and practices of unproven benefit were also documented. Some documented childbirth practices are potentially harmful to mothers and their babies. Conclusion Facility practices for normal labour were largely not in accordance with the WHO evidence-based classification of practices for normal birth. The findings are worrying given the increasing proportion of facility-based births in the region and the improved but relatively high maternal and neonatal mortality ratios in these countries. Obstacles to following evidence-based protocols for normal labour require examination. (author's) Language: English Keywords: EGYPT | LEBANON | GAZA | SYRIA | RESEARCH REPORT | PREGNANT WOMEN | CHILDBIRTH | PREOPERATIVE PROCEDURES | POSTOPERATIVE PROCEDURES | SAFETY | MATERNAL HEALTH SERVICES | DELIVERY OF HEALTH CARE | Developing Countries | Africa, Northern | Africa | Middle East | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Surgery | Treatment | Public Health | Health | Maternal-Child Health Services | Primary Health Care | Health Services Document Number: 290169 |
| 14. Peer Reviewed Title: Syrian women's perceptions and experiences of ultrasound screening in pregnancy: implications for antenatal policy. Author: Bashour H; Hafez R; Abdulsalam A Source: Reproductive Health Matters. 2005;13(25):147-154. Abstract: Ultrasound scanning is firmly embedded in antenatal maternity care around the world. This paper reports on a qualitative study carried out in 2003 of 30 Syrian women’s perceptions and experiences of routine ultrasound in pregnancy. It was part of a larger study of the experiences of pregnancy and childbirth of 500 women from Damascus and its suburbs who had recently given birth to healthy newborns. The women had had multiple scans during pregnancy and accepted its use uncritically nearly all the time. The scans gave them reassurance that the baby was healthy, the pregnancy was progressing well and allowed them to learn the sex of the baby. The women also reacted positively to the antenatal educational messages that were conveyed using scans. However, we found the excessive use of this technology worrying. We believe private doctors, who attend 80% of pregnant women, use ultrasound primarily to attract women to their clinics and increase their income. We recommend that maternity care in Syria should be better regulated; that women and their doctors should be made aware of the essential components of antenatal care; that national guidelines for antenatal care should be developed and that Syrian women should be empowered to ask questions about pregnancy and childbirth and the care they receive. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | QUALITATIVE RESEARCH | PREGNANT WOMEN | PROVIDERS WITH CLIENTS | PHYSICIANS | ANTENATAL CARE | CLINICS | PRIVATE SECTOR | ULTRASONICS | PERCEPTION | PHYSICIAN-PATIENT RELATIONS | Middle East | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Health Personnel | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Facilities | Macroeconomic Factors | Economic Factors | Psychological Factors | Behavior | Interpersonal Relations Document Number: 286959 |
| 15. Title: Syrian women's preferences for birth attendant and birth place. Author: Bashour H; Abdulsalam A Source: Birth. 2005 Mar;32(1):20-26. Abstract: Women’s preferences for type of maternity caregiver and birth place have gained importance and have been documented in studies reported from the developed world. The purpose of our study was to identify Syrian women’s preferences for birth attendant and place of delivery. Interviews with 500 women living in Damascus and its suburbs were conducted using a pretested structured questionnaire. Women were asked about their preferences for the birth attendant and place of delivery, and an open-ended question asked them to give an explanation for their preferences. We analyzed preferences and their determinants, and also agreement between actual and preferred place of delivery and birth attendant. Only a small minority of women (5–10%) had no preference. Most (65.8%) preferred to give birth at the hospital, and 60.4 percent preferred to be attended by doctors compared with midwives (21.2%). More than 85 percent of women preferred the obstetrician to be a female. The actual place of delivery and type of birth attendant did not match the preferred place of delivery and type of birth attendant. Women’s reasons for preferences were a perception of safety and competence, and communication style of caregiver. Most women preferred to be delivered by female doctors at a hospital in this population sample in Syria. The findings suggest that proper understanding of women’s preferences is needed, and steps should be taken to enable women to make good choices. Policies about maternity education and services should take into account women’s preferences. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | SAMPLING STUDIES | POSTPARTUM WOMEN | MIDWIVES AND MIDWIFERY | CHILDBIRTH | MATERNAL HEALTH SERVICES | PHYSICIAN-PATIENT RELATIONS | GENDER ISSUES | SATISFACTION | Developing Countries | Middle East | Studies | Research Methodology | Puerperium | Reproduction | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Maternal-Child Health Services | Primary Health Care | Health Services | Interpersonal Relations | Behavior | Psychological Factors Document Number: 282055 |
| 16. Title: Challenges of temporary protection in Syria. Author: Maymann A Source: Forced Migration Review. 2005 May;(23):42-43. Abstract: Aware of US preparations for an attack on Iraq, the humanitarian community was ready to receive thousands of Iraqis expected to pour into Syria and Jordan at the end of March 2003. However, instead of arriving as expected en masse,1 Iraqi refugees have arrived in dribs and drabs – threatened both by bullets and loss of livelihoods – as the situation in Iraq has continued to deteriorate. The number of Iraqis in Syria is widely contested. The Syrian authorities estimate the number at around 400,000, other sources quote one million and Syrian taxi drivers say two million. Many are financially self-sufficient or have family connections in Syria and the majority have never approached UNHCR. As of February 2005, UNHCR has registered approximately 15,000 Iraqis since the outbreak of the war. During 2004, an average of 250 Iraqis approached UNHCR every week for registration and documentation. Christians constitute some 35% of registered Iraqis in Syria, despite the fact that in Iraq Christians constitute only around 5% of the total population. (excerpt) Language: English Keywords: SYRIA | IRAQ | CRITIQUE | REFUGEES | NONGOVERNMENTAL ORGANIZATIONS | SETTLEMENT AND RESETTLEMENT | UNHCR | WAR | POLITICAL FACTORS | Middle East | Developing Countries | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Organizations | UN | International Agencies Document Number: 288099 |
| 17. Title: Mapping the health and environmental situation in informal zones in Aleppo, Syria: report from the Aleppo household survey. Author: Maziak W; Ward KD; Mzayek F; Rastam S; Bachir ME Source: International Archives of Occupational and Environmental Health. 2005 Aug;78(7):547-558. Abstract: Despite large communities living in informal zones around major cities in Syria, there is currently no information on the health and environmental situations in these areas. From May to August 2004, the Syrian Center for Tobacco Studies (SCTS) conducted the first household survey aiming to provide a baseline map of main health problems and exposures affecting these communities in Aleppo, the second largest city in Syria (2,500,000 inhabitants). Information on 1,021 participants randomly selected using stratified cluster sampling were available (46% males, mean age 34±11.7, age range 18-65 years, response rate 86%), including self-reported health/disability, exposures, and saliva cotinine measurement. Some positive findings include better than expected access to electricity, piped water, city sewage, and the use of propane for cooking. Particular areas of concern include high fertility rates, overcrowded housing conditions, and gender inequality in education and work. Household features likely to reflect negatively on residents' health include the use of diesel chimneys for heating and lack of smoking restrictions. Overall, residents of informal zones suffer from substantial physical and mental health problems and are exposed to high levels of indoor air pollution. All seem to affect women and the elderly disproportionately, while men are more affected by smoking, occupational respiratory exposures, and injuries. Both infectious and non-infectious respiratory outcomes were very common among study participants. Chronic and degenerative disease, including CVD and joint problems, were a source of substantial morbidity among the studied communities. This study highlights major health and environmental specificities of marginalized populations living in Aleppo, where women seem to bear a disproportionate burden of poor health and disability. Smoking and exposure to tobacco smoke seem among the major exposures facing these populations. (author's) Language: English Keywords: SYRIA | SUMMARY REPORT | HEALTH SURVEYS | HOUSEHOLDS | ENVIRONMENTAL POLLUTION | RESPIRATORY INFECTIONS | RISK FACTORS | TOBACCO USE | EXPOSURE | Middle East | Developing Countries | Health | Family and Household | Sociocultural Factors | Environmental Degradation | Environment | Infections | Diseases | Biology | Behavior Document Number: 297085 |
| 18. Peer Reviewed Title: Smoking among adults in Syria: proxy reporting by 13-14 year olds. Author: Maziak W; Tabbah K Source: Public Health. 2005 Jul;119(7):578-581. Abstract: Despite active epidemiological research related to smoking in Syria in the past few years, there is currently no population-based prevalence data for adult smoking in this country. This study presents the first such figures based on information about the smoking habits of 3066 couples in Aleppo, Syria collected during a survey on respiratory morbidity among 13-14-year-old youths. Reports from the young people indicated levels of parental smoking to be 54% for men and 18% for women. This figure for women is twice that reported previously. The mean number of smokers within the studied households was one smoker per household. Smoking among women was found to be strongly associated with their educational status and their spouse's smoking status. This information is of major importance for public health efforts to deal with the smoking epidemic in Syria, as it indicates a hidden epidemic of smoking among women, most likely due to under-reporting. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | HEALTH SURVEYS | PUBLIC HEALTH | PREVALENCE | WOMEN | PARENTS | ADOLESCENTS | TOBACCO USE | Developing Countries | Middle East | Health | Measurement | Research Methodology | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Behavior Document Number: 297348 |
| 19. Title: Gendering the chain migration thesis: women and Syrian transatlantic migration, 1878-1924. Author: Gualtieri S Source: Comparative Studies of South Asia, Africa and the Middle East. 2004;24(1):67-78. Abstract: One wonders what went through Kamila Jubran's mind as she realized that death had come to claim her. She had traveled so far in the hopes of securing a better life for herself and for her children. Instead, she had watched her oldest and youngest succumb to the ravages of consumption while another toiled nightly to help make ends meet. Only her precocious son, Kahlil, having already caught the eye of a Boston patron, seemed to have a hopeful future ahead of him. And so, Kamila's last breath on the afternoon of 28 June 1903 might have been one of resignation. She had left a life of punishing debt in Mount Lebanon, survived the long, fetid journey in steerage class, and made it past the inspectors at Ellis Island. In the end, the difficulties and obstacles in the "new world" had been ones she had always confronted in the "old": sickness, poverty, and death. It is impossible to know for certain what Kamila's dying thoughts really were, although Kahlil (future literary innovator and celebrated author of The Prophet) would later portray her as a heroic figure of self- sacrifice and suggest that she embraced death with serenity. Kamila's daughter, Marianna, noted only that her mother was drugged and unconscious before she died. Amid the uncertainties over how Kamila interpreted her experience of migration in the final hours as the long journey from Bsharri to America ended in a crowded Boston tenement building, one point is clear: she does not fit the image that dominates the historiography of Syrian migration to the United States, that of the bachelor, blazing a trail for subsequent migrants to follow. Kamila had left behind her drink-prone, debt-ridden husband and traveled to Boston in the company of her children. The only thing she appears to have followed to America was a desire to improve her family's condition. (excerpt) Language: English Keywords: SYRIA | UNITED STATES OF AMERICA | LITERATURE REVIEW | WOMEN | IMMIGRANTS | INTERNATIONAL MIGRATION | OCCUPATIONAL STATUS | PATRIARCHY | MARITAL STATUS | Developing Countries | Middle East | North America | Americas | Developed Countries | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Employment Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Family Characteristics | Family and Household | Nuptiality Document Number: 289080 |
| 20. Title: Gender and smoking status-based analysis of views regarding waterpipe and cigarette smoking in Aleppo, Syria. Author: Maziak W; Rastam S; Eissenberg T; Asfar T; Hammal F Source: Preventive Medicine. 2004 Apr;38(4):479-484. Abstract: Narghile (waterpipe) smoking is increasing across the Eastern Mediterranean region (EMR), though little is known about the social attitudes and perceptions related to this method of tobacco use, and how those attitudes and perceptions are influenced by gender. Data from two cross-sectional surveys conducted in 2003 in Aleppo, Syria, were used to examine these issues. Overall, 855 participants were included (439 men, 416 women; mean age, 24.4 ± 7.1 years; response rate, 97%). The current analysis focuses on responses to four similar nine-item questions tapping perceptions related to narghile smoking by women or men, and cigarette smoking by women or men. Scores on the nine items were summed to yield a total score to gauge participants' perceptions about narghile and cigarette. Generally, participants were less positive about women smoking relative to men smoking, and cigarette smoking relative to narghile smoking. Cigarette smoking by women was the behavior least associated with positive perceptions. Individuals who resided in the city, were economically better-off, and were Christian, had higher perception scores (i.e., more positive attitudes) toward all forms of smoking, whereas older and married participants had higher perception scores for narghile only. Smoking status of participants, especially narghile smoking, was also associated with more positive perceptions toward smoking in general. We conclude that preliminary analysis shows that views on different forms of smoking in Syria differ by gender and smoking status. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | MEN | WOMEN | TOBACCO USE | ATTITUDES | PERCEPTION | GENDER RELATIONS | Developing Countries | Middle East | Research Methodology | Demographic Factors | Population | Behavior | Psychological Factors | Gender Issues | Sociocultural Factors Document Number: 297346 |
| 21. Title: Completing the fertility transition: Jordan, Lebanon and Syria. Author: Tabbarah R Source: In: Expert Group Meeting on Completing the Fertility Transition, New York, 11-14 March 2002, [compiled by] United Nations. Department of Economic and Social Affairs. Population Division. New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2004. :448-456. Abstract: The demographic transition in the Arab countries of Western Asia in general has been somewhat peculiar. Total fertility rose substantially before it began its historical decline. Life expectancy rose at a very fast pace. The very high fertility rates, resulted in an extremely youthful populations which, combined with low mortality schedules, resulted in crude death rates (CDRs) of 3 to 4 per thousand population, that is, lower than rates ever achieved in developed and most developing countries. The maximum range between crude birth rates (CBRs) and crude death rates, therefore, reached, in some countries, particularly in the Gulf, the unprecedented levels of 4.5 to 5 per cent a year. Looking to the near future, as the ageing process advances with the expected fall in fertility, the further gains in life expectancy will be accompanied by an increase in crude death rates. (excerpt) Language: English Keywords: JORDAN | LEBANON | SYRIA | CRITIQUE | DEMOGRAPHIC TRANSITION | FERTILITY | INCOME | EDUCATION | Middle East | Developing Countries | Population Dynamics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors Document Number: 281143 |
| 22. Peer Reviewed Title: Quinacrine sterilization (QS) in Syria: a preliminary report on 297 cases. Author: Garabedian V Source: International Journal of Gynecology and Obstetrics. 2003 Oct;83 Suppl 2:S133-S135. Abstract: The objectives were to evaluate the safety, efficacy and acceptability of quinacrine sterilization (QS) in Syria. From July 2001 to December 2002, 297 women who requested permanent sterilization volunteered for QS either in my private practice or my local family planning center in Aleppo, Syria. The standard protocol was used: 252 mg of quinacrine in the form of 7 pellets are deposited at the uterine fundus with a modified CuT IUD inserter during the proliferative phase of the menstrual cycle. This procedure is repeated 4 weeks later. DMPA was injected at the time of the first insertion for temporary contraception. Every sterilized woman has had a monthly checkup visit until the cut-off date for this report, including a beta HCG pregnancy test. All procedures were performed by the author. The cut-off date for this report was June 11, 2003. The single pregnancy was ectopic. Four women (1.3%) complained of severe pain. Moderate pain was experienced by 13.1% while the remaining women felt mild pain, all easily treated. The remaining side effects were minor and also easily treated. Oligomenorrhea and amenorrhea affected 29% of the women and lasted for several months. Immediate side effects are similar to reports from other researchers. Results thus far regarding efficacy are encouraging. QS has proven to be acceptable. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | RISK ASSESSMENT | CONTRACEPTIVE METHOD ACCEPTABILITY | WOMEN | QUINACRINE STERILIZATION | FEMALE STERILIZATION | Developing Countries | Middle East | Evaluation | Contraceptive Usage | Contraception | Family Planning | Demographic Factors | Population | Sterilization, Sexual Document Number: 305228 |
| 23. Title: Physical abuse in low-income women in Aleppo, Syria. Author: Maziak W; Asfar T Source: Health Care for Women International. 2003;24(4):313-326. Abstract: Violence against women is a vicious practice present in all societies. Yet data about its occurrence and associated factors are scarce in the Arab world. In this study, we attempt to determine the spread of physical abuse and its sociodemographic correlates among low income women in Aleppo, Syria. A sample of 411 women was recruited from 8 randomly selected primary care centers in Aleppo. Response rate was 97%, mean age of participants 28 ± 8 years, and most women (88%) were married. A special questionnaire was used including questions about physical abuse, the self-reporting questionnaire (SRQ-20), and questions about relevant sociodemographic information. Current physical abuse (battering at least 3 times during the previous year) was found in 23% of the investigated and among 26% of married women, while regular abuse (battering at least once weekly) was found in 3.3% of married women. Correlates of physical abuse were women’s education, religion, age, marital status, economic status, mental distress, smoking, and residence. Our data show that physical abuse is prevalent in this population and that women’s education is the most important modifiable factor. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | SURVEYS | SAMPLING STUDIES | INTERVIEWS | STATISTICAL STUDIES | CORRELATION OF DATA | LOW INCOME POPULATION | WOMEN | PHYSICAL ABUSE | DOMESTIC VIOLENCE | SOCIOECONOMIC FACTORS | Middle East | Developing Countries | Studies | Research Methodology | Data Collection | Correlation Studies | Social Class | Socioeconomic Status | Economic Factors | Demographic Factors | Population | Violence | Behavior | Crime | Social Problems Document Number: 178931 |
| 24. Peer Reviewed Title: Why most women in Syria do not smoke: Can the passive barrier of traditions be replaced with an information-based one? Author: Maziak W; Asfar T; Mock J Source: Public Health. 2003 Jul;117(4):237-241. Abstract: To explore the subjective motivations why most Syrian women do not smoke, we performed a cross-sectional survey among primary healthcare patients in Aleppo using an interviewer-administered questionnaire with motivations categorized as traditions and norms, family values, health concerns, personal conviction, economic, religious and other. Study participants (n = 240) had a mean age of 29 years. Among non-smokers, traditions and norms, and health concerns were the main reasons for not smoking, followed by family values, husband's views about smoking, personal conviction, economic reasons and religious reasons. Motivations differed according to the participants' previous smoking, marital and educational status. Better-educated women tended to have their own motives based on a more complete awareness of the smoking problem. Tobacco control efforts should aim at replacing the passive barrier of traditions with a well-informed positive one. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | SAMPLING STUDIES | WOMEN | LOW INCOME POPULATION | TOBACCO USE | MOTIVATION | CULTURAL BACKGROUND | EDUCATIONAL STATUS | MARITAL STATUS | Developing Countries | Middle East | Studies | Research Methodology | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior | Psychological Factors | Population Characteristics | Nuptiality Document Number: 180877 |
| 25. Title: Director's annual report 2001. Author: Howard Karagheusian Commemorative Corporation Source: Beirut, Lebanon, Howard Karagheusian Commemorative Corporation, [2002]. 72, [58] p. Abstract: This report describes the 80th Anniversary of Howard Karagheusian Commemorative Corporation (HKCC). It specifically evaluates all the services of HKCC regrouped in the three main departments: medical and services; social assistance programs; and social center activities. It also presents the work in Syria according to the reports of Dr. Bedros Darakjian and summarizes the relations and cooperation with other social agencies. Language: English Keywords: LEBANON | SYRIA | ANNUAL REPORT | CHILD | PUBLIC HEALTH | OBSTETRICS | EYESIGHT | DENTAL HEALTH | MATERNAL-CHILD HEALTH SERVICES | SOCIAL DEVELOPMENT | PROGRAM ACTIVITIES | Middle East | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Medicine | Health Services | Delivery of Health Care | Physiology | Biology | Primary Health Care | Economic Factors | Programs | Organization and Administration Document Number: 170175 |
| 26. Title: Smoking in Syria: profile of a developing Arab country. Author: Maziak W Source: International Journal of Tuberculosis and Lung Disease. 2002 Mar;6(3):183-191. Abstract: One of the main obstacles to tobacco control in the Middle East lies in the shortage of reliable, standardised data on the spread and patterns of tobacco use in society. In Syria, a project aiming at drawing an epidemiological map of the tobacco epidemic in this country was started 4 years ago. Overall, nine studies have resulted, with a total of 6780 participants. The crude prevalence of current smoking among adults in Syria, based on combined information from all studies, is 48% and 9% for males and females, respectively. The prevalence of current smoking among high school adolescents is 16% and 7% for boys and girls, respectively, and was strongly associated with parental and sibling smoking. High school students from families with parents and/or siblings who smoked were 4.4 times more likely to be current smokers than those from non-smoking families. The biggest influx of new smokers among males in Syria is occurring in the early twenties, but an earlier pattern can occur among youths with low academic performance or socioeconomic status. Smoking in women, evaluated by data from physicians, tends to start later than in men and continues to increase with age. Women's smoking in Syria is related to their level of social liberalisation. Data show that active smoking is associated with an increased risk of respiratory diseases among smokers, and that exposure to environmental tobacco smoke (ETS) is associated with an increased risk of respiratory symptoms in children. Knowledge about the harmful effects of smoking and the desire to quit are disproportionate to the rate of successful cessation. The evidence collected indicates possible avenues for tobacco control in Syria, including price increases, smoking cessation programmes, restriction of adolescents' access to cigarettes, and intensive prevention work among women. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | EPIDEMIOLOGY | PREVALENCE | ADULTS | ADOLESCENTS | TOBACCO USE | RISK FACTORS | Middle East | Developing Countries | Public Health | Health | Measurement | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Youth | Behavior | Biology Document Number: 297083 |
| 27. Peer Reviewed Title: Socio-demographic correlates of psychiatric morbidity among low-income women in Aleppo, Syria. Author: Maziak W; Asfar T; Mzayek F; Fouad FM; Kilzieh N Source: Social Science and Medicine. 2002 May;54(9):1419-27. Abstract: Interest in mental morbidity as an important component of health is increasing worldwide. Women generally suffer more than men from common mental disorders, and discrimination against women adds to their mental sufferings. Studies looking into the sociodemographic correlates of women's mental morbidity are lacking in most Arab countries. In this study, the authors wanted to determine the spread and sociodemographic correlates of mental distress among low -income women in Aleppo, Syria. A sample of 412 women was recruited from 8 randomly selected primary care centers in Aleppo. Response rate was 97.2%, mean age of participants 28+8.4 years, where married women constituted 87.9%. A special questionnaire was prepared for the study purpose, utilizing the SRQ-20 non-psychotic items and questions about background information considered relevant to the mental health of women in the studied population. Interviews were conducted in anonymous one-to-one fashion. The prevalence of psychiatric distress in the authors' sample was 55.6%. Predictors of women's mental health in the logistic regression analysis were; physical abuse, women's education, polygamy, residence, age, and age of marriage. Among these predictors, women's illiteracy, polygamy, and physical abuse were the strongest determinants of mental distress leading to the worse outcomes. The authors' data show that mental distress is common in the studied population and that it is strongly associated with few, possibly modifiable, factors. (author's) Language: English Keywords: SYRIA | LITERATURE REVIEW | INTERVIEWS | STATISTICAL REGRESSION | LOW INCOME POPULATION | WOMEN | MORBIDITY | PSYCHOLOGICAL FACTORS | MENTAL DISORDERS | SOCIOECONOMIC FACTORS | DEMOGRAPHIC FACTORS | Middle East | Developing Countries | Data Collection | Research Methodology | Data Analysis | Social Class | Socioeconomic Status | Economic Factors | Population | Diseases | Behavior Document Number: 167606 |
| 28. Title: Violence against women [letter] Author: Maziak W Source: Lancet. 2002 Jul 27;360:343-344. Abstract: In this letter to the editor, Wasim Maziak commends the publishing of articles on violence against women, given this issue of The Lancet on the serious implications of women's health and well- being. Maziak also details findings of a study on 412 Syrian women. Depression and post-traumatic stress disorder are mentioned as the most frequent mental health sequelae of intimate- partner violence. Language: English Keywords: SYRIA | DOMESTIC VIOLENCE | WOMEN | PHYSICAL ABUSE | GENDER ISSUES | PSYCHOLOGICAL FACTORS | Middle East | Developing Countries | Crime | Social Problems | Demographic Factors | Population | Violence | Behavior Document Number: 169464 |
| 29. Title: Cost-effectiveness of different treatment strategies for tuberculosis in Egypt and Syria. Author: Vassall A; Bagdadi S; Bashour H; Zaher H; Maaren PV Source: International Journal of Tuberculosis and Lung Disease. 2002;6(12):1083-1090. Abstract: The setting was The National Tuberculosis Programmes in Egypt and Syria and the objectives were to calculate the costs and effectiveness of alternative ways of implementing TB control in Egypt and Syria, in order to illustrate the factors influencing the cost-effectiveness of TB treatment in middle-income countries. We compared the costs and cure rates in Egypt and Syria of the World Health Organization recommended directly observed treatment, short-course (DOTS) strategy and alternative strategies. The study included costs both to the health services and to the patient. In Egypt and Syria, the cost-effectiveness of DOTS implemented through the primary health care (PHC) system was respectively $258 and $243 per patient cured. This compares to a cost per patient cured of $297 (Egypt) and $693 (Syria) for alternative strategies implemented through specialist clinics. In Egypt, when DOTS is implemented through specialist chest clinics it costs $585 per patient cured. Hospitalisation costs either $1490, $1621 or $1699 per patient cured, depending on treatment delivery in the continuation phase. This study demonstrates that the move towards DOTS integrated at the PHC level has substantially improved the effectiveness of TB treatment in Egypt and Syria, without substantially increasing costs. An analysis of the different costs and effectiveness of the variety of TB treatment strategies has enabled both National Tuberculosis Programmes to expand DOTS and implement it in a way that takes into account limited resources and local health systems. (author's) Language: English Keywords: EGYPT | SYRIA | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | TUBERCULOSIS | TREATMENT | COST EFFECTIVENESS | Africa, Northern | Africa | Developing Countries | Middle East | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Infections | Diseases | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 278464 |
| 30. Title: Socio-demographic determinants of smoking among low-income women in Aleppo, Syria. Author: Maziak W; Asfar T; Mzayek F Source: International Journal of Tuberculosis and Lung Disease. 2001 Apr;5(4):307-312. Abstract: The objectives were to determine the spread and sociodemographic correlates of smoking among low-income women in Aleppo, Syria. A sample of 412 women was recruited from eight randomly selected primary care centres (total number 22) in Aleppo. The response rate was 97.2%, the mean age of participants was 28 (± 8.4) years, and married women constituted 88.3% of those studied. A special questionnaire was prepared for study purposes, and interviews were conducted in an anonymous, one-to-one fashion. Current smoking and daily smoking were found among respectively 16.5% and 7.5% of those investigated. Smokers were older, economically better off and came from smaller households (P < 0.05 for all) than non-smokers. They also were more likely to be non-Arabs, Christians, and city residents than nonsmokers P < 0.05 for all). Mental morbidity and physical abuse were both associated with smoking among those investigated (P = 0.05). Smokers among married women were more likely to marry later, to marry a nonrelative, to be older at the birth of their first child, and were less likely to live with members of their husband's family (P < 0.05 for all). Multivariate predictors of smoking status among married women were race, residence, household, consanguinity, working, mental morbidity and physical abuse. Our data show that the level of smoking among poor women in this society is still low compared to that of men, but it is higher than that of women in other social strata studied. Women's smoking is found to be associated with a less tradition-oriented social profile. (author's) Language: English Keywords: SYRIA | RESEARCH REPORT | MULTIVARIATE ANALYSIS | WOMEN | LOW INCOME POPULATION | TOBACCO USE | SOCIOECONOMIC FACTORS | WOMEN'S HEALTH | Middle East | Developing Countries | Data Analysis | Research Methodology | Demographic Factors | Population | Social Class | Socioeconomic Status | Economic Factors | Behavior | Health Document Number: 297082 |
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