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PubMed2002

Causes of infant mortality in Jordan.

OBJECTIVE: Jordan lacks accurate information on mortality and related indicators. Reporting of infant deaths is defective. Infant mortality rate based on registered deaths was 6/1000 live births, while estimates of this rate based on indirect methods varied between 29-70/1000 live births. Causes of death in general are grossly misrepresented in death certificates. The objective of this paper is to explore, in-depth, causes of infant mortality and related indicators. METHODS: An assessment of causes of death by verbal autopsy was carried out at the Department of Family and Community Medicine, University of Jordan, Amman, Jordan. This was applied between November 1995 through to October 1996, to a random sample of 200,000 persons living in 100 clusters representing the population and all geographic areas of Jordan. The verbal autopsy instrument was based on algorithms and filter questions to determine the underlying cause of death. In this sample there were 6028 infants among them 129 deaths were identified. Infant deaths were analyzed according to rates and causes of death were classified according to International Classification of Diseases (10th revision). RESULTS: Age-specific death rate was 21.4/1000 infants and gender specific death rates were 22.6/1000 male infants for males and 20.1/1000 female infants for females. The 3 leading causes of infant death were conditions originating in the perinatal period, congenital malformations and diseases of the respiratory system. The leading cause of death in the neonatal period was conditions originating in the perinatal period, while in the post-neonatal period, it was congenital malformations. Prematurity was the leading contributory cause of infant death. CONCLUSION: This study showed that causes of infant mortality in Jordan tend to be similar to those prevailing in developed countries.

Cause of Death↗
PubMed1993

Promoting WID in Jordan.

Founded in 1977, the Queen Alia Fund (QAF) has been promoting social development in Jordan for 15 years by providing social services, and educational and vocational training at the grassroots. The fund, which is the country's principal nongovernmental organization (NGO), operates a network of over 40 community development centers. Under its women's programs, the fund targets such areas as literacy, health, skill training, family planning (FP) and the environment. Princess Basma Bint Talal, chairperson, QAF, introduced the activities of the fund and expressed concern for population issues in Jordan during a meeting with JOICFP Deputy Executive Director Yasuo Kon on October 13 in Tokyo. "Jordan has a very high birthrate and rapid population expansion," she said. "This places very big burdens on services; so we are now very concerned with trying to relieve this situation." Noting that FP is a very sensitive issue in Jordan. Princess Basma said that a program for birth spacing had recently been adopted nationally. She added that both JOICFP and QAF shared many mutual priorities in their approaches including a shared emphasis on health education activities. "We'd very much like to see a fostering and promoting of relations between Japanese and Jordanian NGOs, particularly in this field, and we would be delighted if we could explore the possibility of further cooperation through some of the services we offer in Jordan in this regard," she said.

Asia↗
PubMed2004

Hodgkins lymphoma in North Jordan. Does it have a different pattern?

OBJECTIVE: To study the pattern of Hodgkin's lymphoma (HL) in North Jordan, identify the epidemiological features of this disease, and to see if these patterns are unique or follow the patterns seen in developed or developing countries. METHODS: All of the cases of HL diagnosed at the Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan between January 1996 and September 2002 were retrieved and reviewed histologically. Seventy-five confirmed HL cases were classified according to the WHO classification of hematological malignancies. Data on the age and gender of the patients were correlated with those of the histopathologic types of the disease. RESULTS: Patients range in age from 3-72 years with a median of 20 years. The young adult population (15-34 years) was the largest group in this study accounting for 45.9% of all cases followed by the childhood group (0-14 years), which accounted for 25.6% of the cases. The age distribution displayed only one peak between 11 and 20 years. Classic HL accounted for 91% of the cases, half of these cases belong to the mixed cellularity (MC) type and 46% belong to the nodular sclerosis (NS) type. The overall male to female ratio was 1.7:1; but the ratio was the highest (3.75:1) among children, and reversed among patients with NS type in the young adult group (0.78:1). CONCLUSION: The MC and NS types of HL accounted for the vast majority of HL in North Jordan. Similar to other developing countries the MC type of HL was the most common type followed by the NS type. The age distribution displayed a unimodal pattern with a peak between 11 and 20 years of age, which is a decade earlier than the first peak seen in the West. This pattern is also different from developing countries, where HL peaks in children less than 10 years of age. Hodgkin's lymphoma in Jordan appears to have an intermediate pattern between developing countries and the West.

Adolescent↗
PubMed1993

Jordan, an active Volvox transposable element similar to higher plant transposons.

We have isolated a 1595-bp transposable element from the multicellular green alga Volvox carteri following its insertion into the nitrate reductase (nitA) locus. This element, which we have named Jordan, has short (12-bp) terminal inverted repeats and creates a 3-bp target site duplication, like some higher plant transposons of the classic type. Contained within the first 200 bp of one end of the element are 55-bp inverted repeats, one of which begins with the terminal inverted repeat. Revertants of the transposon insertion into the nitA locus were obtained at a rate of approximately 10(-4) per Volvox embryo per generation. In each revertant examined, all transposon sequences were completely excised, but footprints containing both sets of duplicated bases, in addition to three to nine extra bases, were left behind. Jordan contains no significant open reading frames and so appears to be nonautonomous. DNA gel blot analysis indicates that Jordan is a member of a large family of homologous elements in the Volvox genome. We have isolated and characterized several of these homologs and found that they contain terminal very similar to those of Jordan. Efforts to utilize Jordan and its homologs as tools to tag and clone developmentally interesting genes of Volvox are discussed.

Base Sequence↗
PubMed1993

Laboratory and clinical evaluations of the Jordan Exact toothbrush.

A new toothbrush, the Jordan Exact, has been compared with a flat multitufted toothbrush, the Oral-B 35 toothbrush. In a laboratory study the Jordan Exact toothbrush had significantly higher interproximal access, compared to the Oral-B 35, combining all toothbrushing pressures tested, using either vertical or horizontal brushing motions on simulated molar teeth. Clinical safety and efficacy were evaluated in a 30-day single blind study. Evaluations of plaque mean scores were recorded before and after a one minute brushing at baseline, day 15 and day 30. At the same time periods, assessments of irritation, gingivitis and bleeding on probing were conducted. No oral irritation from either toothbrush was observed or reported throughout the test period. At all examinations there were no significant differences in overnight plaque scores. After brushing, an analysis of covariance on plaque area scores revealed that the Jordan Exact toothbrush removed significantly more plaque than the Oral-B 35 toothbrush. By day 30, the Jordan Exact toothbrush significantly reduced gingivitis on buccal surfaces but no significant change was observed in the Oral-B 35 group. Subjects using the Jordan Exact toothbrush had a significant decline in bleeding on probing; subjects in the Oral-B 35 toothbrush group had no significant change over the 30 days of the study.

Adolescent↗
PubMed2002

Ecological-genomic diversity of microsatellites in wild barley, Hordeum spontaneum, populations in Jordan.

We analyzed the ecological-genomic diversity of microsatellites of wild barley, Hordeum spontaneum (C. Koch) Thell., at 18 loci in 306 individuals of 16 populations from Jordan across a southward transect of increasing aridity. The 18 microsatellites revealed a total of 249 alleles, with an average of 13.8 alleles per locus (range 3-29), with nonrandom distribution. The proportion of polymorphic loci per population averaged 0.91 (range 0.83-1.00); gene diversity, He, averaged 0.512 (range 0.38-0.651). We compared the number of alleles of the 18 loci to those found in Israel populations by Turpeinen et al. Out of the 280 alleles, 138 (49.3%) were unique (i.e. occurred in only one of the countries). The percentage of unique alleles in Jordan and Israel populations was 43.0% and 17.9%, respectively, suggesting that Jordan is an important center of origin and diversity of wild barley. Estimates of mean gene diversity were highest in the populations collected near the Golan Heights, such as Shuni North, Shuni South and Jarash. Sixty nine percent of the microsatellite variation was partitioned within populations and 31% between populations. Associations between ecogeographical values and gene diversity were established for eight microsatellite loci. The cluster produced by simple sequence repeat (SSR) data is mostly coincidence with the result of the dendrogram of the Spalax ehrenbergi superspecies of subterranean mole rats in Jordan based on allozyme gene loci. The major soil type in the wild barley habitat of each ecological group was different. Stepwise multiple regression analysis indicated that the variance of gene diversity was explained by altitude (R(2) = 0.362**). These observations suggest that microsatellites are at least partly adaptive and subject to natural selection.

Adaptation, Physiological↗
PubMed2006

Multiple sclerosis in Jordan: A clinical and epidemiological study.

OBJECTIVES: To characterize the clinical, demographic and epidemiological features of multiple sclerosis (MS) in Jordan. METHODS: Data for consecutive Jordanian patients, fulfilling the McDonald criteria for clinically definite and clinically probable MS, during the time period 2004-2005 were collected and analyzed in the three major referral centers for MS in Jordan. RESULTS: We identified a total of 224 patients (165 females, 87%; 59 males, 13%). The mean (+/-SD) age of onset was 29.3 (+/-9.6) years, and mean (+/-SD) duration of illness was 3.9 (+/-9.3) years. The prevalence of MS in the city of Amman was 39/100,000. The prevalence of MS in Irbid, north Jordan, was 38/100,000. The most frequent presentation was weakness (30.8%), followed by optic neuritis (20.1%), sensory impairment (19.6%), and ataxia (14.3%). A relapsing remitting pattern was identified in 90.2% of patients, the rest being primary and secondary progressive, and one patient had a progressive relapsing course. Family history of MS was found in 9.4% of the cases. About 60% of the patients were using interferon beta. The degree of physical disability was determined using the Expanded Disability Status Scale (EDSS). Younger age of onset, shorter duration of illness, a relapsing remitting pattern, and use of interferon were identified as statistically significant predictors of less disability. CONCLUSION: Jordan is a medium-high risk country for MS, with prevalence higher than what has previously been reported, possibly representing an increase in incidence. Clinical and demographic characteristics are similar to most reports worldwide.

Adolescent↗
PubMed2003

Risk factors for childhood epilepsy: a case-control study from Irbid, Jordan.

OBJECTIVE: The goal of this case-control study is to identify the significance of certain risk factors for epilepsy in a population of epileptic children in Northern Jordan. The risk factors examined are febrile convulsions, head trauma, central nervous system infections, abnormal perinatal history, family history and parental consanguinity. METHODOLOGY: We designed a case-control study for patients attending the outpatient neurology clinic of Princess Rahma Teaching Hospital in Irbid, Jordan during a 7-month period. Controls were selected, matched for age and sex, from a group of non-epileptic patients attending the general paediatrics outpatient clinic in the same hospital and during the same period. Data about the investigated risk factors were obtained by personal interview and review of the medical records and were analysed statistically for significance. RESULTS: The total number of participants was 200 patients and controls each. History of febrile convulsions, head trauma, abnormal perinatal history and family history showed a statistically significant increase risk for developing epilepsy. Central nervous system infections and parental consanguinity did not add to the risk of developing epilepsy. CONCLUSION: Positive family history for epilepsy, head trauma, febrile convulsions and abnormal perinatal history were shown to have a statistically significant association with epilepsy in patients attending Princess Rahma Teaching Hospital in Northern Jordan. Although consanguinity is widely practised in Jordan, it appears that it does not increase the risk of epilepsy probably due to the small contribution of monogenic recessive epilepsies to the population with epilepsy.

Case-Control Studies↗
PubMed2000

Methane emissions from domestic waste management facilities in Jordan--applicability of IPCC methodology.

In this paper, methane emissions from municipal wastewater treatment plants and municipal solid waste (MSW) landfills in Jordan for 1994 have been estimated using the methodology developed by the Intergovernmental Panel on Climate Change (IPCC). For this purpose, the 14 domestic wastewater treatment plants in the country were surveyed. Generation rates and characterization of MSW components as well as dumping and landfilling practices were surveyed in order to estimate 1994 CH4 emissions from these sites. Locally available waste statistics were used in cases where those of the IPCC guidelines were not representative of Jordan's statistics. Methane emissions from domestic wastewater in Jordan were estimated at 4.66 gigagrams (Gg). Total 1994 CH4 emissions from MSW management facilities in Jordan are estimated at 371.76 Gg--351.12 Gg (94.45%) from sanitary landfills, 19.83 Gg (5.33%) from MSW open dumps, and 0.81 Gg (0.22%) from raw sewage-water dumping ponds. Uncertainties associated with these estimations are presented.

Greenhouse Effect↗
PubMed2005

Distribution of blood pressure and heart rate among adults in Jordan: a national survey.

Knowledge of population distribution of blood pressure is useful for predicting blood pressure related health burden as well as for planning prevention strategy. The aim of this investigation is to determine the distribution of systolic blood pressure (SBP), diastolic blood pressure (DBP), arterial blood pressure (ABP), and heart rate among normotensive adults resident from all regions of Jordan. This study is the first detailed description of these parameters in Jordan at a national level. A total of 14,310 adult males (7,400) and females (6,910) were selected randomly in various regions of Jordan. For each individual, the SBP, DBP, and heart rate were measured three times with 10-15-minute intervals in the sitting position and at the resting state. The ABP was calculated from the measured SBP and DBP. The mean values were distributed according to age and sex. Student's t-test was used for statistical analysis. Males had significantly higher SBP, DBP, ABP, and heart rate values than females. There also was an increase of these values with advancing age. Moreover, cases of hypotension and bradycardia were higher in the female population than in males, whereas cases of hypertension and tachycardia were higher in males. Distribution of blood pressure and heart rate among adults in Jordan was determined. Cases of undiagnosed hypertension, hypotension, and an increase or a decrease in heart rate were detected through our random screening in the target population. Individuals with these abnormalities require further clinical investigations to confirm or exclude these findings.

Adolescent↗
PubMed1996

Seroprevalence of brucellosis among high risk people in northern Jordan.

BACKGROUND: Brucellosis is considered the most important zoonosis in Jordan with high prevalence among man and livestock. METHODS: This study was carried out on high risk people in 1992 in order to assess the seroprevalence of brucellosis in northern Jordan. The sera of 1236 individuals (636 at high risk and 600 controls) were evaluated using the Rose Bengal plate agglutination test (RBPT) and enzyme-linked immunosorbent assay (ELISA-IgG) tests. RESULTS: A significantly (P < 0.05) higher seroprevalence of brucellosis among high risk people (8.2 percent) compared to the control sample (0.5 percent) was found. The overall seroprevalence was significantly higher among sheep farmers and meat handlers than in other occupations tested. The seroprevalence increased with age and years at work, but was not influenced by sex or locality. The results indicated a higher seroprevalence among veterinarians in northern Jordan, compared to central Jordan but the difference was not significant. Seroprevalence was present only among veterinarians working in clinics especially in the working age group (34-43 years). CONCLUSION: The results of this study emphasized the importance of contact infections, namely contact with infected animals and their products, as a method of transmission of brucellosis compared to ingestion of contaminated animal products.

Adult↗
PubMed2001

Work, family socioeconomic status, and growth among working boys in Jordan.

AIMS: To describe the work, family socioeconomic characteristics, and growth of a representative sample of working children in Jordan. METHODS: In a cross sectional survey of growth and health, 135 working children (aged 10-16 years) were studied in the areas of Irbid, Jarash, and North Jordan Valley. The children and their parents were interviewed and data collected on length of working week, income earned by the child, duration of work in years, age of starting work, type of work, child's smoking status, and family socioeconomic status. RESULTS: The mean age of the children was 13.3 years; 14.8% had started work before the age of 10 and 12.6% had been working for more than four years. Mean income was 34 Jordanian Dinars but 6.7% were unwaged; 34% were working more than 60 hours per week, and 85.9% more than 40 hours. Monthly income and working hours were positively correlated with the age of the child. There was no correlation between age and smoking status; 37.8% smoked more than five cigarettes per day. Mean height and weight z scores were -0.365 and -0.081 of the UK standard respectively. Packed cell volume was within the anaemic range in 34.1% of children. CONCLUSIONS: In Jordan many children start work at an early age and work long hours for little or no income. Stunting and anaemia are common and many are established smokers. Relevance of these findings for social policy and health care of working children in Jordan and elsewhere is discussed.

Adolescent↗
PubMed2007

Jordan: communities and community genetics.

The population in Jordan mounted from half a million in 1952 to 5.3 millions in 2004 and is composed of a variety of ethnic groups, the majority being Arabs. Couples nowadays tend to have fewer children, with the total fertility rate falling from 7.4 in 1976 to 3.7 in 2004. Consanguineous marriages are traditionally favored, with the preferred marriage partner being the offspring of the father's brother. First-cousin marriages declined from 28.5% for marriages contracted between 1950 and 1979 to 19.5% for marriages contracted after 1980. In the overall population, carrier rates for beta-thalassemia, alpha-thalassemia and sickle cell anemia are in the range of 2-4%, 3.2-12% of males have glucose-6-phosphate dehydrogenase deficiency, and the prevalences for familial Mediterranean fever and cystic fibrosis were estimated at around 0.04% each. A mandatory premarital screening program for beta-thalassemia carriers commenced in June 2004. The high consanguinity rate and the large family size in Jordan have contributed to the description of a number of rare and new autosomal recessive conditions. Genetic services in Jordan are still scarce and do not cover all the country due to the major impediments of a paucity of resources and trained health professionals in the area of medical genetics. The demographic data suggest that the health system in Jordan is capable of introducing some basic community genetic services into the primary health care program through comprehensive and cost-effective programs.

Community Health Services↗
PubMed2004

Gastric malignancies in Northern Jordan with special emphasis on descriptive epidemiology.

AIM: To study the epidemiology of gastric malignancies in Jordan as a model for Middle East countries where such data is scarce. METHODS: Pertinent epidemiological and clinicopathological data for 201 patients with gastric malignancy in north of Jordan between 1991 and 2001 were analyzed. RESULTS: Male: female ratio was 1.8:1. The mean age was 61.2 years, and 8.5% of the patients were younger than 40 years of age. The overall age-adjusted incidence was 5.82/100 000 population/year. The age specific incidence for males raised from 1.48 in those aged 30-39 years to 72.4 in those aged 70-79 years. Adenocarcinomas, gastric lymphomas, malignant stromal tumors, and carcinoids were found in 87.5%, 8%, 2.5%, and 2% respectively. There was an average of 10.1-month delay between the initial symptoms and the diagnosis. Only 82 patients underwent curative gastrectomy. Among adenocarcinoma groups, Lauren intestinal type was the commonest (72.2%) and the distal third was the most common localization (48.9%). The mean follow up for patients with gastric adenocarcinoma was 25.1 mo (range 1-132 mo). The 5-year survival rates for stages I (n=15), II (n=41), III (n=59), and IV (n=53) were 67.3%, 41.3%, 5.7%, and 0% respectively (P=0.0001). The overall 5 year survival was 21.1%. CONCLUSION: Despite low incidence, some epidemiological features of gastric cancer in Jordan mimic those of high-risk areas. Patients are detected and treated after a relatively long delay. No justification in favor of a possible gastric cancer screening effort in Jordan is supported by our study; rather, the need of an earlier diagnosis and subsequent better care.

Adolescent↗
PubMed2000

Ankylosing spondylitis in Northern Jordan.

OBJECTIVE: This study describes the profile of ankylosing spondylitis as seen in the Rheumatology Practice at Prince Rashid Ben Al-Hassan Hospital, lrbid, Jordan over a period of 14 months. METHODS: Fifty-two cases that met the modified New York clinical criteria for ankylosing spondylitis were accumulated. A standardized method that included patients' interview, physical examination including measurements of spinal mobility, medical record review, radiographic and laboratory examination was applied. RESULTS: Forty-two cases (85%) of the 52 accumulated cases were males and 10 cases (15%) were females (male:female ratio of 4.2:1). Their mean age of onset was 26 years (range 16-40 years) and the mean duration of the disease was 8.7 years (range 2-25 years). Symmetrical radiographic sacroiliitis was present in all cases, while radiographic spondylitis was present in 32 cases (62%) and radiographic cervical spine involvement was present in 16 cases (31%). Peripheral arthritis was present in 10 cases (19%), while enthesitis was present in 34 cases (65%). Conjunctivitis was seen in 28 cases (54%) and uveitis was seen in 2 cases (4%). A positive family history was elicited in 8 cases (15%), and Human Leukocyte Antigen type B27 was positive in 42 cases (81%). All patients were rheumatoid factor negative. CONCLUSION: Although several limitations to this study were recognized, these were a restraint to an accurate estimate of the incidence of ankylosing spondylitis in northern Jordan. However, the study has provided epidemiological data on ankylosing spondylitis and could be of help for further studies. Further comprehensive-cooperative research including the 3 health sectors (Private, Ministry of Health and Military Hospitals) would be very helpful in establishing a more accurate estimate of the size of the problem in Jordan and providing an accurate profile of ankylosing spondylitis in Jordan.

Adolescent↗
PubMed2001

Prevalence of Helicobacter pylori in Northern Jordan. Endoscopy based study.

OBJECTIVE: Helicobacter pylori infection is considered the most common infection worldwide and is associated with many other disorders. The aim of this study is to determine the prevalence of this infection among patients undergoing endoscopy in Northern Jordan. METHODS: Between November 1998 and September 2000, all patients referred from the Gastro-esophageal Clinic to the Endoscopy Unit at Princess Basma Teaching Hospital, Irbid, Northern Jordan were enrolled in this prospective study. For each patient clinical and epidemiological data was collected and endoscopy was performed. At least 3 antral biopsies were obtained from each patient, and these were examined histologically for the presence of gastritis and stained for Helicobacter pylori using modified Giemsa stain. RESULTS: A total of 197 consecutive patients (113 females) with a mean age of 40.2 years (range 15-91 years) were studied. Abdominal pain was the highest presenting symptom. Gastritis 91% and esophagitis 42% were the most frequent endoscopic findings. Gastritis was documented histologically in 183 (93%) of patients. Helicobacter pylori was found in 161 patients (82%), with all of these having histological gastritis. The 11 patients with gastric ulcer, compared to the 51 out of the 59 (86%) patients with duodenal ulcer, showed Helicobacter pylori in their biopsies. CONCLUSION: The prevalence of Helicobacter pylori infection in patients subjected to an upper gastrointestinal endoscopy in Jordan is high. This study confirms that Helicobacter pylori is significantly associated with gastritis and peptic ulcer. Further studies are needed to determine the types of Helicobacter pylori strains present in Jordan.

Adolescent↗
PubMed1991

Survey report: Jordan.

Preliminary results from the 1990 Jordan Population and Family Health Survey show a 20% decline in fertility since the early 1970s. The total fertility rate (TFR, or average lifetime births/woman) declined from 7.7 births in the 1971-1975 period, to 6.6 in 1980-1983, to 5.6 in 1987-1990. A national sample of 6462 evermarried women of childbearing ages were interviewed. More than 1/2 (58%) of respondents had ever used a method of contraception. 35% of married women reported currently using some method of contraception, up from 26% in 1983. The IUD was the most popular modern method--used by 15% of women. Female sterilization (6% of respondents) edged out the pill (5%). These findings show a shift in contraceptive use from the pill to the IUD and female sterilization compared with 1983. In general, older women, those living in big cities, women with a formal education, and those who have children are more likely to use contraception. Compared with other countries, the level of fertility in Jordan is high for the level of contraceptive use. Reliance on traditional methods may account for this difference: 27% were currently using modern methods and 8% traditional. Knowledge of contraceptive methods is high. Almost all women knew of at least 1 method of family planning, either modern or traditional. The pill and IUD were the best-known methods; 98% of the women knew at least 1 of these. The next best-known were traditional methods: periodic abstinence (77%) and withdrawal (69%). Most women who knew a family planning method also knew where to obtain it. For example, more than 94% of those surveyed knew about female sterilization, of whom 85% knew where to go to have it done. The survey showed infant mortality in Jordan had declined to 27/1000 livebirths. Almost all children under 2 had received some vaccinations, and almost all are breastfed for at least some time. There seems to be a strong program prompting diphtheria/pertussis/typhoid, polio, and measles vaccination in Jordan, according to the report. Of all children 12-23 months, 88% had received these vaccinations, although coverage declined with successive doses.

Asia↗
PubMed1995

The impact of this involuntary mass "return" to Jordan in the wake of the Gulf crisis.

"This article investigates the impact of the involuntary movement to Jordan of about 300,000 Palestinians in the wake of the Gulf crisis of 1990-91. It explores the character of the population that arrived en masse in Jordan and whether their arrival burdened or benefitted that country.... The involuntary migration compounded other effects of the Gulf crisis on Jordan and exacerbated the country's already serious economic problems. Integration of the returnees was painful. But contrary to initial expectations, the mass arrival did not result in unmitigated disaster and may have contributed to an economic recovery in Jordan, suggesting that there may be potentially beneficial windfall effects of sudden population influxes, even when they are involuntary and disorderly."

Acculturation↗