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PubMed2006

Characterization of antimicrobial resistance and class 1 integrons found in Escherichia coli isolates from human stools and drinking water sources in Jordan.

This study demonstrates that Escherichia coli isolates from human stools showed mostly higher minimum inhibitory concentrations (MICs) and significant rates of resistance (32%-67%, P<0.05) than Escherichia coli water isolates in Jordan, as follows: ampicillin (67% vs 28%), trimethoprim/sulfamethoxazole (67% vs 28%) nalidixic acid (63% vs 20%), cefuroxime (32% vs 4%), gentamicin (32% vs 17%), norfloxacin (32% vs 12%) and tetracycline (33% vs 16%). The prevalence of integron integrase genes (Intl1) in these isolates was also significantly higher in patients' stools (67%, P <0.05) than in water (36%), but the distribution of Sul 1/Sul 2 or both in association with postive Intl1 and resistance to ampicillin and sulfamethoxazole was not significantly higher (74% versus 62%, P <0.05) in isolates from stool and water. Plasmid profiles of representative multiresistant E. coli isolates from both sources indicated the presence of two common plasmids (49,25 kb) in 11/12 (91.6%), and all E. coli transconjugants were positive for class 1 integron markers (Intl 1, Sul 1 and Sul2) and mostly associated with three transferable drug-resistant determinants to ampicillin, sulfamethoxazole and tetracycline. These results indicate that class 1 integrons with conjugative R-plasmids are common and transferable among commensal antimicrobial multiresistant E. coli isolated from human feces and drinking water sources in Jordan.

Anti-Bacterial Agents↗
PubMed2006

Childhood lead exposure in the palestinian authority, Israel, and Jordan: results from the Middle Eastern regional cooperation project, 1996-2000.

In the Middle East, the major sources of lead exposure have been leaded gasoline, lead-contaminated flour from traditional stone mills, focal exposures from small battery plants and smelters, and kohl (blue color) in cosmetics. In 1998-2000, we measured blood lead (PbB) levels in children 2-6 years of age in Israel, Jordan, and the Palestinian Authority (n = 1478), using a fingerstick method. Mean (peak; percentage > 10 microg/dL) PbB levels in Israel (n = 317) , the West Bank (n = 344), Jordan (n = 382) , and Gaza (n = 435) were 3.2 microg/dL (18.2 ; 2.2%) , 4.2 microg/dL (25.7; 5.2%), 3.2 microg/dL (39.3; < 1%) , and 8.6 microg/dL (> 80.0; 17.2%), respectively. High levels in Gaza were all among children living near a battery factory. The findings, taken together with data on time trends in lead emissions and in PbB in children in previous years, indicate the benefits from phasing out of leaded gasoline but state the case for further reductions and investigation of hot spots. The project demonstrated the benefits of regional cooperation in planning and carrying out a jointly designed project.

Child↗
PubMedDate not supplied

Advancing the development of human resources in nursing in Jordan.

BACKGROUND: This article describes a collaborative international health and development program between a Jordanian and a Canadian university. It presents a human resource development model in Jordan that has been the basis for a variety of developmental activities for practicing nurses and nurse educators in academic and clinical settings. METHOD: Reciprocal visits by leaders of the project, as well as continued collaboration between key members of the two universities were instrumental in ensuring success of this venture. RESULTS: The activities implemented in this project culminated in the development of a pragmatic human resource development model that is sensitive to issues particularly relevant to the Jordanian culture. CONCLUSION: The collaborative venture discussed in this article has enabled nurses and nurse educators to increase their academic and clinical skills and raised the profile of the nursing profession in Jordan.

Education, Nursing, Continuing↗
PubMed2005

Microbiological quality of sous and tamarind, traditional drinks consumed in Jordan.

This study was conducted to evaluate the microbiological quality of sous (a drink prepared by extracting dried roots of Glycyrrhiza glabra) and tamarind (a drink prepared by infusing Tamarindus indica dried pulp), traditional drinks consumed in Jordan. Twenty-one samples of sous and 44 samples of tamarind were collected from the local market in Amman, Jordan. Water is the major component of the drinks. Sous drink is characterized by having an alkaline pH (range, 6.6 to 9.9; mean, 8.6), whereas tamarind drink has an acidic pH (range, 1.8 to 3.7; mean, 2.8). The drinks are not processed for safety before serving, and at some vendors drinks are not properly refrigerated. The mean counts for aerobic bacteria, lactic acid bacteria, and yeasts in sous drink samples were 5.9, 5.0, and 3.8 log CFU/ml, respectively; those in tamarind drink samples were 4.0, <1, and 5.8 log CFU/ml, respectively. The lactic acid bacteria isolated were Enterococcus raffinosus, Enterococcus hirae, Enterococcus durans, Lactobacillus acidophilus, and Lactobacillus buchneri. The yeast isolates in sous drink were from the genera Candida, Filobasidium, Hanseniaspora, Lodderomyces, Pichia, and Williopsis, and those in tamarind drink were from Arthroascus, Brettanomyces, Candida, Debaromyces, Filobasidiella, Hanseniaspora, Klavispora, Lodderomyces, Pichia, Saccharomycodes, Trichosporon, and Zygosaccharomyces. Enterobacteriaceae were detected in two sous samples and were identified as Enterobacter sakazakii and Erwinia sp., and in two tamarind samples and were identified as Citrobacter freundii and Klebsiella pneumoniae. Salmonella was detected in one sous and one tamarind sample. Pseudomonas aeruginosa was detected in only one sous sample. These findings highlight the importance of application of hygienic practices throughout preparation and vending of drinks, starting with raw ingredients and continuing through preparation, storage, display, and serving.

Bacteria↗
PubMedDate not supplied

Malignant lymphoma in Jordan: a retrospective analysis of 347 cases according to the World Health Organization classification.

BACKGROUND: Most studies describing the subtypes of lymphoma in Jordan were carried out in the 1980s at a time when immunohistochemical facilities were unavailable. Using a database established after immunohistochemical studies were introduced, we determined the frequency of the various types of nodal and extranodal lymphomas in the adult and paediatric Jordanian population. We also assessed the incidence of bone marrow involvement at the initial presentation for each lymphoma type. METHODS: A retrospective analysis of the histopathological subtypes of various lymphomas was conducted on all primary lymphoma cases diagnosed during a 3-year period between January 2001 and December 2003. RESULTS: Of 347 patients included in the study, 78.4% had non-Hodgkin's lymphoma (NHL) and 21.6% had Hodgkin's lymphoma (HL). In the NHL group, diffuse large B-cell lymphoma was the most common (28.2%) followed by follicular lymphoma (15.6%). In the HL group, the nodular sclerosis variant was the most frequent (7.8%) followed by the mixed cellularity type (5.5%). Of all the lymphoma cases, the highest incidence of marrow involvement was seen in patients with lymphoplasmacytic lymphoma. Forty-nine patients were children (age <15 years) in whom Burkitt's lymphoma (15 cases) and HL (14 cases) were the commonest subtypes. One-hundred six patients with primary extranodal lymphomas (ENL) accounted for 30.5% of all lymphomas. CONCLUSIONS: There is a higher incidence of NHL in Jordan compared with other series in the Middle East. Among the various lymphomas, diffuse large B-cell lymphoma is the most commonly encountered lymphoma in adults. Burkitt's lymphoma and Hodgkin's disease are the most frequent childhood lymphomas, followed closely by lymphoblastic lymphoma.

Adolescent↗
PubMedDate not supplied

Jordan's vulnerability: a population at risk of HIV/AIDS.

This paper describes the findings of an ethnographic study that sought to explore the influence of HIV/AIDS on the practice of primary care nurses in Jordan. The study was undertaken in three (3) rural and three (3) urban comprehensive primary health care centres. Data collection included participant observation, key informant interviews, field notation and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of nurses. The findings indicate that the ability of the nurses to raise awareness and therefore reduce the spread of HIV/AIDS is unrealistic. Data shows that the population is at risk because the nurses' knowledge and skill base is inadequate and the health care facilities are crippled by limited human and physical resources. Poor management and the lack of localised leadership are also factors identified as contributing to the vulnerability of Jordanians. Enhanced commitment from the Ministry of Health and the senior nursing administration in Jordan is required if the comprehensive primary health care centres are to meet expectations and improve health outcomes of the population. Funding must be directed to improve the infrastructure of the comprehensive primary health care centres and adequate concurrent funds provided for the purchase of non-capital items. It is crucial that support be made available to up-skill the nursing staff and superior recruitment and retention initiatives implemented to address the current nursing shortages.

Anthropology, Cultural↗
PubMed1999

Mortality and causes of death in Jordan 1995-96: assessment by verbal autopsy.

Mortality indicators and causes of death in Jordan were assessed by verbal autopsy. A random sample of 100 clusters of ca. 300 households each were monitored for one year by notification assistants selected from the study area itself. Registered deaths were reported to research assistants who visited the family to complete the verbal autopsy form, which was structured and contained about 100 questions. Causes of death were determined by two physicians according to preset algorithms. A total of 965 deaths were reported among 198,989 persons, giving a crude death rate of 5 per 1000 population per year. The three leading causes of death were diseases of the circulatory system, malignancies and accidents. In the absence of a health information system, verbal autopsy as implemented in Jordan can serve as a reliable substitute.

Adolescent↗
PubMed1999

Salivary gland tumors in Jordan: a retrospective study of 221 patients.

AIM: To evaluate the types and clinical outcome of salivary gland tumors in Jordan. METHODS: Hospital records of 221 patients (85 women and 136 men) with salivary gland tumors, diagnosed from January 1988 to December 1997 were reviewed. The patients were analyzed according to sex, age, histopathological type and site of the tumor. Survival curves for patients with malignant tumors were constructed using Kaplan-Meier's method. RESULTS: Of the total 221 salivary gland tumors, 155 (70.2%) were parotid tumors, 42 (19%) minor salivary gland tumors, 23 (10.4%) submandibular gland tumors, and a single (0.4%) sublingual gland tumor. Most of the tumors (151, or 68.4%) were classified as benign and 70 (31.6%) were malignant. Men to women ratio was 1.6:1, and the age of the patients ranged from 2 to 81 years. The overall 5 and 10 year-survival rates for the 70 malignant tumors were 67% and 53%, respectively, for all tumor stages. Mucoepidermoid carcinoma had the best, and squamous cell carcinoma the worst 10-year survival rate. Patients treated with surgery and subsequent radiation therapy had better survival rates than those treated with surgery or radiation therapy alone. CONCLUSION: The principal site for salivary gland tumors in Jordan population was the parotid, and the pleo- morphic adenoma the most common pathological finding. Tumor characteristics and survival data for the Jordanian population are comparable to those from western countries.

Adenoma, Pleomorphic↗
PubMed2000

Consanguinity, fertility, reproductive wastage, infant mortality and congenital malformations in Jordan.

OBJECTIVES: Consanguinity is a wide spread practice in Jordan. The objective of this study is to explore the health effects of consanguinity, in particular fertility, reproductive wastage, infant mortality and congenital malformations. METHODS: A stratified 2 stage cluster sample of 1867 married couples, representative of all population groups and all geographic locations of Jordan were randomly selected. A questionnaire was specially designed to explore each of the objectives set for the study and was field tested. A group of field workers were thoroughly trained on the implementation of this instrument. All 1867 couples were interviewed by these field workers and completed questionnaires were reviewed before data entry. Data analysis was carried out using SPSSX statistical package. Significance tests were performed wherever appropriate. RESULTS: The study showed that fertility, as measured by the number of pregnancies, taking into consideration marriage duration, was not affected by consanguinity. Twin pregnancies and abortions did not show any significant difference between consanguineous and non-consanguineous marriages. Consanguineous marriages showed significantly higher rates of still births and infant mortality in general. Within the consanguineous group, female infant mortality rates were significantly higher than those of males. Congenital malformations as reported by mothers of consanguineous marriages were significantly higher than those reported by mothers of non-consanguineous marriages. CONCLUSION: This study showed that consanguinity has a detrimental effect on many aspects of reproductive health.

Abortion, Spontaneous↗
PubMed1992

Features of the population situation and policies in Jordan.

"This study reviews the demographic situation in Jordan from both Arab and international perspectives and provides an introduction to the nature and characteristics of Jordanian demographic policy and [implementation]. The study seeks to highlight government and private efforts pertaining to family planning. [It reviews] the more important demographic changes in Jordan in addition to providing official and international statistics for the second half of the 1980s."

Asia↗
PubMed2003

Eye diseases in children in Southern Jordan.

OBJECTIVE: To study the prevalence of refractive errors and certain eye diseases in children in southern Jordan. METHODS: In the period between May 2001 and April 2002, 1725 patients (6-14 years of age) visiting the Pediatric Clinics in Prince Ali Hospital, Jordan for non ophthalmologic complaints were tested by a pediatrician for their visual acuity (VA) using a Snellen's E-chart. Patients with suspected eye abnormalities and those with VA of < 6/12 were referred for further detailed eye examination. RESULTS: Twelve patients had bilateral VA of < 6/12, and an additional 5 patients had unilateral VA of < 6/12. Strabismus was seen in 9 patients (0.5%), and amblyopia in 5 patients (0.3%). Vernal keratoconjunctivitis was seen in 26 patients (1.5%). CONCLUSION: It is important to conduct a large study, perhaps a multicenter study to evaluate the eye diseases in developing countries.

Adolescent↗
PubMed2003

Blood lead levels and gamma-glutamyl transferase activity in battery factory workers in Jordan.

OBJECTIVE: The aim of this study is to investigate blood lead levels in workers of lead acid battery factories and the relationship between those levels and the activity of y-glutamyl transferase (y-GT). METHODS: Samples of blood were collected during the period from July 2001 to August 2001 from 95 workers of the 2 lead-acid battery factories in Amman, Jordan. They were categorized into 2 groups based on the nature of their work: direct (high exposure) and indirect contact (low exposure) groups. Lead concentration in whole venous blood and y-GT activity was measured. RESULTS: Mean blood lead levels were 51.4 +/- 1.8 and 23.9 +/- 3.8 ug/dl for both direct and indirect groups. y-Glutamyl transferase mean activity was found to be 29.2 +/- 2.6 U/L for direct and 23 +/- 5.7 U/L for indirect contact groups. Fifty healthy individuals were selected as controls. Their mean blood lead levels and y-GT mean activity were 12.3 +/- 0.5 ug/dl and 25.6 +/- 1.2 U/L. As results indicated, no significant relation was found between lead blood levels and y-GT activity (p=0.303) or between lead blood levels and duration of exposure in both direct and indirect groups (p=0.61). However, significant relation was found between lead blood levels and type of work (p value approached zero) and between lead blood levels and duration of exposure in those workers with lead blood levels exceeding 20 ug/dl and employed for more than one year (p value approached zero). CONCLUSION: Lead blood levels among workers in lead acid battery factories in Jordan are high. In most cases, they are higher than the limit permitted by the World Health Organization. Therefore, good protection measures should be taken in such factories to avoid the negative impact of high lead blood levels on the health of workers.

Humans↗
PubMed1954

Ineffectiveness of DDT residual spraying in stopping malaria transmission in the Jordan Valley.

The malaria-control campaign in the Jordan Valley-undertaken by the United Nations Relief and Works Agency for Palestine Refugees in the Near East in 1949-has been based solely on DDT residual spraying in the northeastern areas, but in certain southern districts some larvicidal and drainage work has been done.Observations made in the north-east showed that active malaria transmission had occurred in 4 of the 12 villages surveyed in 1951, and in 8 of the 9 villages surveyed in 1952. That the insecticide was effective was demonstrated by the fact that sprayed structures were almost entirely free from anophelines four months after the last spraying, but entomological surveys showed that Anopheles sergenti and A. superpictus (the main malaria vectors) were successfully evading contact with sprayed surfaces by using caves and fissures in hills as daytime resting-places.The author discusses the bearing that the topography of the area and the habits of the population have on the transmission of the disease, and stresses the importance of surveys. He recommends the resumption of antilarval measures in the Jordan Valley.

Animals↗
PubMed1957

Relapsing fever in Jordan.

The author reports on a survey carried out by him in 1954 on relapsing fever in Jordan. In that country the disease is largely tick-borne, the main vector being Ornithodoros tholozani. Some of the frequent cases in the town of Nablus and the village of Marda in West Jordan may, however, be caused by O. coniceps. The centres of infection are some of the numerous caves scattered throughout the hilly areas and certain houses in which chickens are kept.It is believed that the vector ticks could be successfully exterminated by the use of insecticides and by the adoption of certain procedures outlined by the author.Arsenobenzol compounds and penicillin have been shown not to be very effective for the treatment of relapsing fever, but good results have been obtained with Aureomycin and Terramycin.

Animals↗
PubMed2003

Occurrence of Salmonella typhi and Salmonella paratyphi in Jordan.

In order to justify the surveillance control system and hygiene policy in Jordan, this study evaluated the occurrence of diarrhoea during the period 1988-2000, focusing on cases caused by Salmonella typhi and Salmonella paratyphi. From January 1988 to December 2000, the number of notified diarrhoeal cases by the Ministry of Health in Jordan was 1,399,563 million. Other groups of patients confined to the Governorate of Amman was diagnosed at Al-Battikhi Medical Laboratories. One-way ANOVA and Least Significant Difference (LSD) were carried out for statistical analysis. The number of reported diarrhea cases was 1,399,563, 53.0% were males, and 47.0% were females, among them, 80.3% were < 20 years and 19.7%, were > 20 years. Out of 245,255 patients tested for S. typhi and S. pararyphi, positive stool culture were 1992 (0.6%). Out of these, 960 (48.2%) were males and 1,032 (51.8%) were females (P = 0.028). The highest incidence rate (10.8) was observed in the year 1993, while the lowest incidence rate (0.9) was found in year 2000. A significant difference (P < 0.001) was found between the number of S. typhi and S. Paratyphi cases and year. The seasonal variation was also found to be significant (P < 0.0001), with the summer period showing the highest incident rate. A significant difference (P < 0.001) was observed between number of typhoid and paratyphoid cases and districts. A significance difference between number of typhoid and paratyphoid cases with age and sex. The group most affected was school age and adolescence. The demographic situation plays an important role in reporting typhoid and paratyphoid cases, where there might be an urgent indication for a better surveillance control system on water resources and disposal systems. S. typhi and S. paratyphi antibiotics resistance pattern showed they were resistant to tetracycline (56.0%, 58.0%), ampicillin (45.0%, 48.0%), trimethoprim (43.0%, 47.0%), cephtazidime (12.0%, 13.5%) chloramphenicol (6.8%, 7.2%), gentamycin (3.0%, 4.0%) neomycin (2.1. 1.8%), calvulanic acid (augmentin (1.4%, 2.2%) and norofloxacin (0.92%, 1.1%). Susceptibility to amikacin, ciprofloxacin, cetfriaxone, ofloxacine, imepenim, cefixime and cefotaxime was 100.0%. The increase in percentage of antibiotic resistant strain might indicate a need for a further prescribing policy for treatment.

Adolescent↗
PubMed2004

Comparison of some risk factors between non-familial and familial breast cancer females in Jordan.

OBJECTIVE: To compare the risk factors such as age, menopause, menarche, age at the first pregnancy, number of pregnancies and breast feeding period between the familial and non-familial breast cancer females in Jordan. METHODS: This study was carried out in Al-Basheer Hospital, Amman, Jordan during the period 2000 and 2002. A questionnaire was used to collect information from 99 females who were histologically and pathologically diagnosed with breast cancer. Data of the questionnaire were entered and analyzed using statistical package for social sciences. RESULTS: The highest percentage of non-familial and familial breast cancer occurrence was among age group 51-60 years. The age of the first pregnancy is another risk factor of which the highest percentage of breast cancer was reported for both familial (57.1%) and non-familial (65.4) breast cancer females who have their first pregnancy while they were 20-years-old and above. More than 4 pregnancies also represents a risk factor for both non-familial (67.9%) and familial (68.6%) breast cancer patients. In this study, there are no statistical differences between menopause and menarche age among the breast cancer females. Finally, an inverse relationship was shown between breast feeding period (equal or more than 24 months) and the occurrence of breast cancer in both non-familial (2%) and familial (0%) breast cancer. CONCLUSION: This study found that age 51-60 years and the increase number of pregnancies (more than 4) in the age of 20 years or more are risk factors for both types of breast cancer. On the other hand, longer period of breast feeding (more than 24 months) decreases the risk of breast cancer in both types.

Adult↗
PubMed2004

Evaluation of dizziness at Jordan University Hospital.

OBJECTIVE: This study was performed prospectively to evaluate the dizzy patients in the Neurotology Outpatient clinic at Jordan University Hospital, Amman, Jordan during the period 1993-2000 and to discuss the prevalence and etiology of dizziness. METHODS: Data were collected from 108 patients (52 males and 56 females) with a mean age of 45.6-years. Diagnosis was made on the basis of history, physical, otolaryngological and neurological examination and confirmed by relevant investigation including laboratory, radiological and audio vestibular tests. RESULTS: Secure diagnosis were made in 98% of patients (14% had one cause alone and 84% had multiple causes). Cardiovascular disorders accounted for 31.5% of primary and 49% of secondary causes, peripheral vestibular disorders, 25% of primary and 3% of secondary causes, central vestibular disorders 17% of primary and 9% of secondary causes, metabolic endocrine 13% of primary and 38% of secondary causes, cervical osteoarthritis 5.5% of primary and 28% of secondary causes and psychogenic 4.6% of primary and 6.5% of secondary causes. CONCLUSION: Our findings demonstrate that vertigo is the most common subtype of dizziness (50%). Multiple causes are more prevalent in older age and the single cause is more prevalent in younger age. Cardiovascular was the most common cause of dizziness followed by vestibular disorders, metabolic and cervical osteoarthritis. Vestibular disorders are primary causes and non vestibular are predominantly secondary causes of dizziness. Hyperlipidemia, diabetes and cervical causes are major secondary contributors to dizziness. We recommend a multi disciplinary setting and application of a comprehensive diagnostic and treatment approach without unnecessary protracted investigative scheme and installment of rehabilitation facilities.

Adolescent↗
PubMedDate not supplied

Effect of fasting during the month of Ramadan on serum levels of luteinizing hormone and testosterone in people living in the below sea level environment in the Jordan Valley.

OBJECTIVES: To study a possible effect of Ramadan fasting on luteinizing hormone and testosterone in people of the Jordan Valley. METHODS: A comparative study (n=40) of serum levels of luteinizing hormone (LH) and testosterone (T) between people living in the Jordan Valley (JV), n=20, 360 meters below sea level, and those living in Ramtha City (RC), n=20, 600 meters above sea level, was conducted in December, 1998. A similar study (n=40) was also done during January 1999 in fasting people during the month of Ramadan. RESULTS: Serum levels of LH in non-fasting people of the JV were statistically similar to those in people of RC. There was also no difference in serum levels of T between non-fasting people of the JV and those in RC. Serum levels of LH in fasting people of the JV were statistically indifferent from those fasting in RC. Serum T levels in fasting people of the JV, on the other hand, were higher than those in fasting people of RC (76+/-18.3 ng/ml compared to 62.7+/-24.2 ng/ml). CONCLUSIONS: It is probably the environmental factors such as the higher barometric pressure of the JV compared to that at above sea level that play a role in higher serum levels of T in people of the JV. Other factors, such as genetic background and/or the cultural and nutritional characteristics of the people of the JV, may also contribute to this difference in serum T levels.

Adaptation, Physiological↗