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Nineteen species of anopheline and culicine mosquitoes are reported from larval collections made in northern Jordan and the Jordan Valley. Culex judaicus, Culiseta annulata, and Uranotaenia unguiculata are reported as new records for Jordan. The impact of agricultural development and man-made changes on the mosquito fauna of Jordan is discussed.
Autochthonous cases of urinary schistosomiasis are reported for the second time in Jordan. Eight Jordanian juveniles (seven males and one female) ranging in age from 10 to 15 years were diagnosed in 1995 as having the disease. Urine examination using the membrane filtration technique showed varying intensities of infection. The patients were treated with praziquantel and a follow-up showed the passage of dead eggs in the urine of five patients one month after treatment. All had egg-negative urine three months post-treatment. Epidemiologic investigation showed that the patients did not leave Jordan and that the seven males swam frequently in 1994 in an irrigation pool present in a farm at Ramah, in the southern Jordan Valley. The female patient had frequent contact with the pool water since she often went to the farm to obtain water for domestic animals. Bulinus truncatus snails were found in the pool and in pools on other farms in the area. Two hundred snails collected from the site did not shed cercariae after six months of observation. Several foreign workers in the area were found infected with Schistosoma haematobium, suggesting they were the source of infection.
The 1985 Jordan Husbands' Fertility Survey (JHFS) was designed to assess husbands' attitudes and behavior toward fertility and family planning. The 1985 JHFS was a follow-up survey to obtain data from husbands of women who were currently married in the 1983 Jordan Fertility and Family Health Survey (JFFHS). The results from the 1985 JHFS point to the usefulness of collecting fertility and family planning information from husbands. These findings showed that nearly 40 percent of the husbands do not believe in practicing contraception, and more than 50 percent of the husbands report that family size should be "up to God." How program officials address these issues will be important for the future success of the family planning program in Jordan.
A non-seasonal diarrhoeal episode in the Jordan Valley occurred over a 2-month period, during which no traditional enteropathogens were detected by the health authority laboratories. A total of 17 diarrhoeal stool specimens from infants, young children and adults were randomly collected and delivered to our laboratories to investigate the presence of unusual aetiological agents. Stools were examined for parasites, ova, viruses and cultured for bacterial pathogens. A multiplex polymerase chain reaction was developed to investigate the involvement of diarrhoeagenic Escherichia coli in this episode. Recognised pathogenic organisms were detected in 8 out of 17 of the diarrhoeatic patients, one patient of whom had a mixed infection with two agents. Rotavirus, enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), and enterotoxigenic E. coli (ETEC) were found to be associated with the diarrhoea. EIEC was the most common enteropathogen detected (4 out of 17) followed by rotavirus (3 out of 17). One of the EIEC isolates detected in one patient was associated with rotavirus. The clinical features of the diarrhoeatic patients were remarkably similar, regardless of aetiology. This study reveals the identity of pathogenic agents that are not detected by traditional methods employed by the health authority laboratories, which emphasise the urgent need for developing the current diagnostic techniques.
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Bulinus truncatus snails collected from water bodies of the South Shuna region, north of the Dead Sea, were found infected with a pharyngeal longifurcate distome cercaria. This new form of cercaria is named Cercaria bulini I. It has three pairs of penetration glands, 12 pairs of flame cells, and lacks the intestinal cecae. This cercaria is an active swimmer and develops within an elongated sporocyst. Other details on the morphology, behavior, and development of C. bulini I are presented.
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OBJECTIVE: Non-Hodgkin lymphoma (NHL) is one of the most frequent malignancies in Jordan. The aims of this study are: 1. To classify NHL cases in Jordan, using the new World Health Organization (WHO) classification system, 2. To identify the most common types of NHL in Jordan, and 3. To compare lymphoma types and patterns in Jordan with those in surrounding countries and the West. METHODS: We studied all NHL cases, diagnosed during 1996 through to 1999 inclusive, at 2 major medical centers in Jordan, in order to identify their main types and patterns. One hundred and eleven cases of confirmed NHLs were reexamined and immunophenotyped in the year 2000, at the Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan, using an immunohistochemical panel of antibodies, including CD3, CD15, CD20, CD30, CD43, CD45 and CD45RO. Confirmed NHL cases were reclassified according to the recently proposed WHO system of Hematological Malignancies. RESULTS: The median age of NHL cases was 44-years (range 2-85). The vast majority of cases were of B-cell phenotype; only 14% of the cases were T-cell lymphomas. Most of the cases were of the aggressive intermediate to high-grade large cell type. Diffuse large B-cell lymphoma (DLBCL) comprised 53% of NHLs and 62% of B-cell NHLs. Indolent lymphomas were uncommon, comprising 14% of all NHL cases. Twenty-nine cases were seen among patients less than 20-years. Burkitt lymphoma represented the largest group (55%) of the childhood NHLs followed by diffuse large cell and lymphoblastic types. CONCLUSION: Indolent lymphomas are rare in Jordan and account for less than 15% of all NHLs. Aggressive lymphomas; on the other hand, account for the majority of NHLs in Jordan. Burkitt lymphoma affected children less than 10-years of age with a median of 4.5-years. These observations indicate that NHLs in Jordan have different type distribution and patterns from those seen in the West.
The Lower Jordan River is located in the semiarid area of the Jordan Valley, along the border between Israel and Jordan. The implementation of the water sections of the peace treaty between Israel and Jordan and the countries' commitment to improve the ecological sustainability of the river system require a better understanding of the riverine environment. This paper investigates the sources and transformations of nitrogen compounds in the Lower Jordan River by applying a combination of physical, chemical, isotopic, and mathematical techniques. The source waters of the Lower Jordan River contain sewage, which contributes high ammonium loads to the river. Ammonium concentrations decrease from 20 to 0-5 mg N L(-1) along the first 20 km of the Lower Jordan River, while nitrate concentrations increase from nearly zero to 10-15 mg N L(-1), and delta(15)N (NO(3)) values increase from less than 5 per thousand to 15-20 per thousand. Our data analysis indicates that intensive nitrification occurs along the river, between 5 and 12 km from the Sea of Galilee, while further downstream nitrate concentration increases mostly due to an external subsurface water source that enters the river.
OBJECTIVE: To investigate the prevalence of antibodies to Bartonella henselae (B.henselae) and Bartonella quintana (B.quintana) among children from central and northern Jordan. METHODS: Sera from 482 children were randomly collected from referenced governmental hospitals in the central and northern parts of Jordan during the period between January 2001 to March 2003. An indirect immunofluorescent assay was used to determine serum antibody titers to B.henselae and B.quintana. Sera that were reactive at a dilution >/-1:64 were considered positive. In addition, blood from 20 cats belonged to children with high B.henselae titers were tested using polymerase chain reaction. RESULTS: Out of the 482 serum samples examined, 53 (11%) and 20 (4.1%) had positive antibody titers for B. henselae and B.quintana. Bartonella henselae was isolated from 4 cats that belonged to 3 children with high antibody titers to B.henselae-IgG. The seroprevalence of IgG antibodies to B.henselae was significantly higher (P<0.05) in children aged 7-10-years than in younger or older ones. Having a cat in the household and having a history of cat scratches or bites were strongly associated (P<0.01) with seropositivity to B.henselae-specific IgG. Cats ownership and history of cat scratches or bites had no impact on the prevalence of B.quintana. Seropositivity to B.henselae-specific IgG was significantly higher (P<0.01) in children from northern Jordan than in children from central Jordan. CONCLUSION: This study substantiates the presence of B.henselae in Jordan, documents the seroreactivity to 2 Bartonella antigens, and suggests that cat ownership and history of cat scratches or bites are important epidemiological risk factors for B.henselae infection in Jordan.
BACKGROUND: The most prevalent disease in Jordan is hypertension. Jordan is a small, middle-income developing country in the Middle East. It has a population of 5611202 people. Few studies have examined the associated cardiovascular risk factors in Jordan. DESIGN: The aim of this investigation was to explore specific lifestyles in Jordan, measuring blood pressure and heart rate through a randomized cross-sectional population study. METHODS: A total of 14310 adult males (7400) and females (6910) were selected in various regions of Jordan. Selected participants were interviewed by trained senior pharmacy students. They were asked whether they had hypertension or other cardiovascular disorders and if the answer was negative further questions were asked. This was followed by measurement of blood pressure and heart rate. Demographic data such as age, sex and nationality were also recorded, as was family history of hypertension. For each individual of the sample, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were measured three times with 10-15min intervals in a sitting position and resting state. The Student's unpaired t-test was used for statistical analysis. Results were considered statistically significant when the P value was less than 0.05. RESULTS: A general trend in all the results tables was a lower blood pressure among those without a family history of cardiovascular disease and higher values among those with a family history of cardiovascular disease. CONCLUSION: This study demonstrates that SBP and DBP increase with all associated risk factors if a family history of hypertension is positive. This cross-sectional study revealed the presence of a consistent and strong relationship between certain lifestyle risk factors with an elevation in blood pressure concurrent with a positive family history of hypertension.
Mismanagement of solid waste leads to public health risks, adverse environmental impacts and other socio-economic problems. This is obvious in many developing countries around the world. Currently, several countries have realized that the way they manage their solid wastes does not satisfy the objectives of sustainable development. Therefore, these countries, including Jordan, which forms the case study presented here, have decided to move away from traditional solid waste management (SWM) options to more integrated solid waste management approaches. Unfortunately, in many developing countries like Jordan, the lack of adequate resources to implement the necessary changes is posing a serious obstacle. The present paper discusses the various practices and challenges of solid waste management in Jordan from both a technical and economic perspective. An overview of the current practices and their environmental implications in three major cities of the country, which generate more than 70% of the country's solid waste, is presented. Recent literature on solid waste management in Jordan has been reviewed; and data on the total amount of municipal solid waste generated, compositional variations over the last two decades, and future projections are presented. The necessity, importance and needs of solid waste recovery and reuse are identified. The review of the legal frameworks indicated that there is a need for detailed and clear regulations dealing specifically with solid waste. The service cost analysis revealed that none of the municipalities in Jordan sufficiently recover the cost of the services, with more than 50% being subsidized from the municipalities' budgets. The allocation of the available resources was analyzed and service performance indicators assessed. Factors that should be taken into consideration when making the decision to move from a traditional SWM approach to a more integrated approach are highlighted and suggestions for a more smooth transition are recommended.
The chemical and mineralogical composition of dry deposition in the western highlands of central and south Jordan at the end of the summer season 2000, reflect the composition of soils in addition to anthropogenic activities at these areas. Calcite predominated in the central region whereas calcite and quartz are the dominant minerals in south Jordan. The concentrations of Hg, Cr, Ni, Cu, Pb and Zn were higher in central Jordan, which might be attributed to higher anthropogenic activities than south. On the other hand, Fe, Mn, Ti, Ba, Sr, Y and Rb were higher in the south of Jordan reflecting the composition of soil at these sites. At Aqaba city, the only port of Jordan, where Cr, Cd, As and S were higher than other areas. This variation might be attributed to the contribution of phosphate dust in the atmosphere through handling processes.
In order to study the aetiology of vesico-vaginal fistula in Jordan, and assess the outcome of surgical treatment, 132 cases of acquired vesico-vaginal fistulae treated at Al-Bashir Hospital, and Jordan University Hospital, Amman, Jordan, during the period between 1972 and 1996 were reviewed. Forty-five cases (30%) had one or more previous failed repair outside these hospitals. Successful repair of 108 cases was achieved (82%), 60 cases of them from the first attempt (45%) and, 48 other cases after repeated attempts (36%). In 24 cases, a total of 72 repeated operations failed. Obstetric fistulae in Jordan are decreasing due to improvement and expansion of maternity care. Although a patient with neglected fistula is a social problem, this is not the case in Jordan because of the strong family ties. Nevertheless, they present a great challenge to the gynaecologist. Referral to a centre experienced in this type of surgery certainly improves the success rate, and diminish the suffering of these patients.
Differences were observed in hormonal levels between in both sexes of people living in Irbid City (620 meters above sea level) and in the Jordan Valley (360 meters below sea level). In addition, exercise was shown to differentially affect hormonal levels of both sexes at the above and below sea level locations. Serum levels of leutinizing hormone (LH) and testosterone (T) in adult male and serum levels of follicle-stimulating hormone (FSH) and progesterone (P) in adult female people were investigated in Irbid City and in the Jordan Valley during the years 1997 and 1998. The levels of these hormones were followed each month during this period. In males living in Irbid City, LH and T peaked from March through June, and in females at the same site, FSH and P also peaked from March through June. These data confirm the seasonal variation in sex hormones reported elsewhere in (wo)man and in other species. In males and females of the Jordan Valley, serum levels of LH, FSH, T and P were all higher than those of Irbid City throughout the year. Additionally, peaks of LH and T in male and FSH and P in female subjects in the Jordan Valley were observed from March through September. The high levels of these hormones and the extension of their peaks are suggested to be due to effects of the environmental factors of the Jordan Valley (high temperature, high barometric pressure) compared to those in Irbid City and other areas located at above sea level altitude.
Between November 1991 and March 1992, 37 cases of paralytic poliomyelitis occurred in Jordan, where none had been reported since 1988. Of these, 17 (50%) of 34 patients had received at least three doses of oral poliovirus vaccine (OPV3). The first and 2 subsequent case-patients were children of Pakistani migrant workers, and the first 8 and a total of 27 (75%) case-patients resided in or near the Jordan Valley. A seroepidemiologic study of 987 children in all regions of Jordan was performed to assess OPV3 coverage and immune response to OPV. Although OPV3 coverage by 12 months of age was high (96%) in the general population, coverage was lower among Pakistani (21%), Bedouin (63%), and Gypsy (9%) children (P < .001). Seroprevalences for poliovirus type 3 were 71% in the Jordan Valley versus 81% in other regions after 3 doses of OPV (P < .06) and 77% in the Jordan Valley versus 98% in other regions after 5 doses of OPV (P < .001). This outbreak demonstrates the importance of achieving high seroimmunity to infection in all geographic areas to prevent the reintroduction and spread of imported strains of wild poliovirus.
The practice of pharmacy, as well as pharmacy education, varies significantly throughout the world. In Jordan, Kuwait, and Saudi Arabia, the profession of pharmacy appears to be on the ascendance. This is demonstrated by an increase in the number of pharmacy schools and the number of pharmacy graduates from pharmacy programs. One of the reasons pharmacy is on the ascendance in these countries is government commitment to fund and support competitive, well-run pharmacy programs. In this report we describe pharmacy education in 3 Middle East countries: Jordan, Kuwait, and Saudi Arabia. All 3 countries offer bachelor of pharmacy (BPharm) degrees. In addition, 2 universities in Jordan and 1 in Saudi Arabia offer PharmD degree programs. The teaching methods in all 3 countries combine traditional didactic lecturing and problem-based learning. Faculties of pharmacy in all 3 countries are well staffed and offer competitive remuneration. All 3 countries have a policy of providing scholarships to local students for postgraduate training abroad. The majority of students in Jordan and Kuwait are female, while the ratio of male to female students in Saudi Arabia is even. Students' attitudes towards learning are generally positive in all 3 countries. In Saudi Arabia and Kuwait, most pharmacy graduates work in the public sector, while in Jordan, the majority work in the private sector.