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Fulltext Self-medication practices against COVID-19 infection and awareness among residents of Mogadishu, Somalia: A cross-sectional analysis

Moussa AA, Omar FD, Fiidow OA, Ali FH, Babatunde SM

PLoS One, 2023;18(6):e0284854.
PMID: 37379300 DOI: 10.1371/journal.pone.0284854

The novel coronavirus disease (COVID-19) pandemic has affected several countries worldwide, resulting in a considerable strain on healthcare systems and increased trend of self-medication practices. This study aims to evaluate the awareness of COVID-19 and the prevalence of self-medication during the pandemic among residents in Mogadishu, Somalia. A cross-sectional study was conducted using a structured and pretested questionnaire between May 2020 and January 2021. Participants from various disciplines were randomly recruited within the study location and interviewed about their self-medication practices during the pandemic. Descriptive statistics were used to summarise the respondents' information and responses to the questionnaire items. Associations between participants' demographic characteristics and specific items relating to self-medication practices were analysed using the Chi-square test. A total of 350 residents participated in the study. Approximately 63% of the participants reported having practised COVID-19 related self-medication with the main reasons being pharmacists' advice (21.4%) and having an old prescription (13.1%), whereas 37.1% did not report their reasons for self-medication. Most participants (60.4%) engaged in self-medication despite not having any symptoms and 62.9% had taken antibiotics in the last three months. Most participants were aware that no medication has been approved for COVID-19 (81.1%), the negative effects of self-medication (66.6%), and the transmission routes of the virus. Meanwhile, more than 40% of the participants have not worn a mask while outside their homes, and do not follow the international COVID-19 guidelines. The most prevalent drug used by participants for self-medication against COVID-19 was paracetamol (81.1%) and antibiotics (78%). The factors associated with awareness of COVID-19 and self-medication practices included age, gender, educational qualification, and occupation. This study revealed considerable high self-medication practices among Mogadishu residents, thus highlighting the need to promote awareness regarding the adverse effects of self-medication and sanitisation guidelines in addressing COVID-19 at the community level.

Matched MeSH terms: Somalia/epidemiology
Fulltext Prevention and control of COVID-19 in pastoral community through One Health Approach

Yousuf A, Arifin SRM, Musa R, Isa MLM

One Health, 2020 Dec 20;11:100181.
PMID: 33072837 DOI: 10.1016/j.onehlt.2020.100181

The vast majority of its population being a pastoralist community, the Somali region in Ethiopia shares the longest border with its neighboring east African countries. These communities face a high risk for transmission of imported COVID-19 cases and remain vulnerable due to lack of access to health delivery and low utilisation of services. Valuable lessons from other countries, has placed the One Health Approach as an appropriate, feasible and applicable preventive and control measure for COVID-19. This paper discusses the epidemiological and social susceptibility of pastoral communities in the transmission of COVID-19 and the introduction of One Health Approach as an effective inter-disciplinary response and management.

Matched MeSH terms: Somalia
A probable case of poliomyelitis imported to Malaysia

Tay CG, Ong LC, Goh KJ, Rahmat K, Fong CY

J Clin Neurosci, 2015 Dec;22(12):1994-5.
PMID: 26254091 DOI: 10.1016/j.jocn.2015.07.001

We report a previously well 10-month-old Somalian girl who acquired asymmetric lower limb weakness in July 2013 in Mogadishu, Banadir, before arriving in Malaysia at 12 months of age. In May 2013, there was a wild poliomyelitis outbreak in that area, as reported by the World Health Organization. Laboratory investigation, including cerebrospinal fluid, was unremarkable, and electrophysiological studies showed active axonal denervation in the left lower limb. The whole spine T2-weighted MRI revealed non-enhancing hyperintensities of the bilateral anterior horn cells, predominantly on the left side at T11-12. The viral isolations from two stool specimens at her presentation to our centre, 2 months after the onset of illness and 2 weeks apart, were negative. Despite lacking the acute virological evidence of poliomyelitis, in view of the girl's clinical, electrophysiological and classical spinal neuroradiological features, together with her temporal relationship with a World Health Organization reported wild poliomyelitis outbreak, we believe these findings are consistent with a diagnosis of imported poliomyelitis. A review at 30 months of age showed persistent left lower limb monoplegia with little recovery. Our patient reiterates the importance of maintaining awareness of wild polio importation, and keeping abreast of the latest news of global poliomyelitis outbreaks when treating patients with flaccid paralysis, even if they arrive from non-endemic poliomyelitis areas.

Matched MeSH terms: Somalia/epidemiology
Fulltext Undernutrition prevalence and its determinants among children below five years of age in shabelle zone, Somali Region, Eastern Ethiopia

Abdi Guled, Rashid, Nik Mazlan Mamat, Wan Azdie Mohd Abu Bakar, Belachew, Tefera, Assefa, Nega

International Journal of Allied Health Sciences, 2017;1(2):72-91.
MyJurnal

Malnutrition is a major public health problem worldwide. More than half of under-five child deaths are due to undernutrition, mainly in developing countries. Ethiopia is among the highestin Sub-Saharan Africa. While,Somali regionis the worstin Ethiopia.

Matched MeSH terms: Somalia
Fulltext Knowledge, attitudes, and practices of female health care service providers on female genital mutilation in Somalia: A cross-sectional study

Mehriban N, Zafar Ullah AN, Haque MI, Harun MGD, Isse DM, Muhammad F, et al.

Womens Health (Lond), 2023;19:17455057231199032.
PMID: 37732458 DOI: 10.1177/17455057231199032

BACKGROUND: Despite a strong international standpoint against female genital mutilation, the prevalence of female genital mutilation in Somalia is extremely high.
OBJECTIVES: This study assessed the knowledge, attitude, and practice of female genital mutilation among female health care service providers in order to formulate appropriate policies and programs to eliminate this harmful practice.
DESIGN: Facility-based cross-sectional survey conducted in 2019 among female doctors and nurses working in Banadir Hospital, Mogadishu, Somalia.
METHODS: A total of 144 female health care service providers were randomly selected, and data were collected through a pre-tested, semi-structured questionnaire. Quantitative data were analyzed by using the statistical software SPSS (Version 21), and qualitative data were analyzed thematically in accordance with the objectives of the study.
RESULTS: The study found that about three-fifths of the respondents had undergone some forms of female genital mutilation during their life. An overwhelming majority believed that female genital mutilation practices were medically harmful, and a majority of them expressed their opinion against the medicalization of the practice of female genital mutilation. The study also observed a significant association between participants' age and their negative attitudes regarding the legalization of female genital mutilation.
CONCLUSION: Health care service providers' effort is critical to eliminating this harmful practice from the Somalian society. Strong policy commitment and a comprehensive health-promotion effort targeting the parents and community leaders are essential to avert the negative impact of female genital mutilation.

Matched MeSH terms: Somalia
Examining the effects of climate change and political instability on maize production in Somalia

Warsame AA, Sheik-Ali IA, Barre GM, Ahmed A

Environ Sci Pollut Res Int, 2023 Jan;30(2):3293-3306.
PMID: 35945318 DOI: 10.1007/s11356-022-22227-1

Agricultural production is sensitive to climate variability, so climate change-agriculture sector nexus is topical in developing countries. To this end, this study examines the impact of climate change variables-rainfall and temperature-and non-climatic factors on maize production in Somalia for the period between 1980 and 2018 using the autoregressive distributed lag (ARDL) bound test, dynamic ordinary least square (DOLS), variance decomposition(VD), and impulse response function (IRF). The empirical results of the ARDL bound test confirmed the presence of long-run cointegration between the dependent variable and the explanatory variables. Furthermore, the long-run results revealed that average temperature, average rainfall, and political instability significantly inhibit maize production in the long and short runs, but rainfall has a favorable effect on maize production in the short run. Furthermore, rural population and land area under maize cultivation have negative and positive effects on maize production in the long run, respectively-albeit they are statistically insignificant. The empirical results of the study are robust to different econometric methods. Based on these findings, the study emphasizes the importance of the de-escalation of conflicts and the implementation of irrigation facilities which will enhance the productivity of maize crop production.

Matched MeSH terms: Somalia
Fulltext Seroprevalence of varicella-zoster virus in five US-bound refugee populations

Leung J, Lopez A, Mitchell T, Weinberg M, Lee D, Thieme M, et al.

J Immigr Minor Health, 2015 Feb;17(1):310-3.
PMID: 24271111 DOI: 10.1007/s10903-013-9946-x

Little is known about varicella-zoster virus (VZV) susceptibility in US-bound refugee populations, although published data suggest that VZV seroprevalence in these refugee populations may be lower than US populations. We describe VZV seroprevalence in five US-bound refugee groups: (1) Bhutanese in Nepal, (2) Burmese on the Thailand-Burma (Myanmar) border, (3) Burmese in Malaysia, (4) Iraqi in Jordan, and (5) Somali in Kenya. Sera were tested for presence of VZV IgG antibodies among adults aged 18-45 years. Overall VZV seroprevalence was 97% across all refugee groups. VZV seroprevalence was also high across all age groups, with seroprevalence ranging from 92-100% for 18-26 year-olds depending on refugee group and 93-100% for 27-45 year-olds. VZV seroprevalence was unexpectedly high in these five US-bound refugee groups, though may not reflect seroprevalence in other refugee groups. Additional studies are needed to better understand VZV seroprevalence in refugee populations over time and by region.

Matched MeSH terms: Somalia/ethnology
The development and comprehensibility of a pictorial asthma action plan

Roberts NJ, Mohamed Z, Wong PS, Johnson M, Loh LC, Partridge MR

Patient Educ Couns, 2009 Jan;74(1):12-8.
PMID: 18789626 DOI: 10.1016/j.pec.2008.07.049

OBJECTIVE: Written action plans are regarded as an important part of asthma self-management education and yet they may not be understood by those with limited literacy skills. This study was designed to produce an understandable pictorial asthma action plan.
METHODS: With advice from a group of doctors and nurses a "standard" written action plan was translated by a medical artist into a series of pictorial images. These were assessed using the techniques of guessability and translucency by a series of adults attending a specialist asthma clinic in London and the same process was subsequently used to assess comprehensibility of the images and plans amongst a group of Somalis living in Manchester, UK and Malaysians in Seremban, Malaysia.
RESULTS: Guessability testing showed that the majority of pictograms were well understood by each of the study groups. Translucency testing revealed close agreement with intended meaning for the majority of the images. One image, depicting extra use of reliever medication scored less well in all populations; two other images scored less well in the Somali and Malaysian groups and reflect less use of certain inhaler devices in other countries. The overall plan was well understood by all patients who were able to adequately recount the appropriate actions to take in different clinical scenarios.
CONCLUSION: We have developed a pictorial asthma action plan understandable by 3 different populations of patients with asthma.
PRACTICE IMPLICATIONS: Pictorial representations have been shown by other studies in other situations to be an effective method of reinforcing the spoken word. The pictorial asthma action plan developed for this study has been shown to be comprehensible, personalised to the individual in the usual fashion. It is now suitable for further evaluation in clinical practice.
Study site in Malaysia: Asthma clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia

Matched MeSH terms: Somalia/ethnology
Fulltext Knowledge, attitude and practice of female genital mutilations among males and females attending Out Patients and MCH Clinic of Elder District Rural Hospital Galgadud Region Somalia

Shamsul, A.S., Abdi Nur, S.A., Halim, I., Rahmah, M.A.

Malaysian Journal of Community Health, 2008;14(1):45-51.
MyJurnal

Background: Somalia is a country that still practices Female Genital Mutilation (FGM). Female genital mutilation (FGM) constitutes all procedures, which involve partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or any other nontherapeutic reasons.
Methodology: A cross-sectional community based study was conducted among males and females above 18 years of age attending the Out Patient Clinic and Mother & Child Clinic of Elder District, Rural Hospital Galgadud Region, Somalia in June 2006 using a structured questionnaire to access the respondents’ knowledge, attitude and practice.
Results: Four hundred respondents were interviewed and male respondents were noted to be more knowledgeable than their female counterparts (p 0.004) and so does respondents with formal education (p <0.001) and had occupation (p <0.001). Majority of the female respondents (97.1%) favors the practices of FGM and reasons such as to protect virginity (p <0.001), increase marital opportunity (p <0.001) and religious recommendations (p <0.001) were noted to be the important
factors in the continuation of FGM. All of the female respondents have had some form of FGM, giving the prevalence rate of 100% with 64.1% underwent the procedure at between the age of 5-10 years old and the commonest form of FGM were infibulations. Mother (69.4%) was the important decision maker for these women.
Conclusion: Aggressive education programme should be introduced targeting the women in this community. They should be well informed on the complication of FGM and its health effects. Providing clinics will help to alleviate some of the complications related to FGM. Law on protecting women from these practices should be introduced and enforced.
Key Words: female genital mutilation, knowledge, attitude, practice
Study site: Clinic of Elder District, Rural Hospital Galgadud Region, Somalia

Matched MeSH terms: Somalia
Fulltext Patterns of health ailments and other health problems among children at a relief camp, Aceh, Indonesia; a two months post tsunami study

Adlina, S., Soe, Soe Aye, Narimah, A.H.H., Nuraliza, A.S.

Malaysian Journal of Public Health Medicine, 2005;5(1):31-37.
MyJurnal

On December 26, 2004, an earthquake triggered a devastating tsunami that caused death and destruction in twelve countries including India, Indonesia, Malaysia, Maldives, Seychelles, Somalia, Sri Lanka and Thailand. One of the authors was a volunteer with FELDA WAJA AMAN MALAYSIA medical relief team that served the Aceh victims from 16th February to 24th February 2005 (8 weeks post tsunami). A study to determine the pattern of health ailments was conducted among children aged 18 years and below based at Seuneubok Camp, 30 km from Banda Aceh. All respondents were from Pulau Aceh and the total number of children seen and examined was 60. About 18% had lost their fathers, 10 % had lost their mothers and 27% had lost one or more of their siblings. 77% suffered some form of health ailments. The common health ailments were diarrhea (61%), respiratory complaints (59%) and fever (20%). About 38 % of preschoolers had loss of appetite and 28% had sleep disturbances. About 35% of the elementary school children suffered from sleep disturbances, 29% of the young adolescents suffered from headaches and 24% had sleep disturbances. Nearly a quarter (24%) of all the children felt fearful and anxious about the disaster. Nevertheless, 56% of the respondents wanted to return back to Pulau Aceh, although 14 % did not want to go back. Interestingly, 73% of the children voiced their gratitude to God for having been saved from death.

Matched MeSH terms: Somalia
Fulltext The right to health as the basis for universal health coverage: A cross-national analysis of national medicines policies of 71 countries

Perehudoff SK, Alexandrov NV, Hogerzeil HV

PLoS One, 2019;14(6):e0215577.
PMID: 31251737 DOI: 10.1371/journal.pone.0215577

Persistent barriers to universal access to medicines are limited social protection in the event of illness, inadequate financing for essential medicines, frequent stock-outs in the public sector, and high prices in the private sector. We argue that greater coherence between human rights law, national medicines policies, and universal health coverage schemes can address these barriers. We present a cross-national content analysis of national medicines policies from 71 countries published between 1990-2016. The World Health Organization's (WHO) 2001 guidelines for developing and implementing a national medicines policy and all 71 national medicines policies were assessed on 12 principles, linking a health systems approach to essential medicines with international human rights law for medicines affordability and financing for vulnerable groups. National medicines policies most frequently contain measures for medicines selection and efficient spending/cost-effectiveness. Four principles (legal right to health; government financing; efficient spending; and financial protection of vulnerable populations) are significantly stronger in national medicines policies published after 2004 than before. Six principles have remained weak or absent: pooling user contributions, international cooperation, and four principles for good governance. Overall, South Africa (1996), Indonesia and South Sudan (2006), Philippines (2011-2016), Malaysia (2012), Somalia (2013), Afghanistan (2014), and Uganda (2015) include the most relevant texts and can be used as models for other settings. We conclude that WHO's 2001 guidelines have guided the content and language of many subsequent national medicines policies. WHO and national policy makers can use these principles and the practical examples identified in our study to further align national medicines policies with human rights law and with Target 3.8 for universal access to essential medicines in the Sustainable Development Goals.

Matched MeSH terms: Somalia
Fulltext Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective

Epping-Jordan JE, van Ommeren M, Ashour HN, Maramis A, Marini A, Mohanraj A, et al.

Int J Ment Health Syst, 2015;9:15.
PMID: 25904981 DOI: 10.1186/s13033-015-0007-9

BACKGROUND: Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development.
CASE DESCRIPTION: Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste.
DISCUSSION AND EVALUATION: These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders.
CONCLUSIONS: Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

Matched MeSH terms: Somalia
Fulltext Association between the spread of COVID-19 and weather-climatic parameters

Carta MG, Scano A, Lindert J, Bonanno S, Rinaldi L, Fais S, et al.

Eur Rev Med Pharmacol Sci, 2020 08;24(15):8226-8231.
PMID: 32767354 DOI: 10.26355/eurrev_202008_22512

OBJECTIVE: To explore whether the climate has played a role in the COVID-19 outbreak, we compared virus lethality in countries closer to the Equator with others. Lethality in European territories and in territories of some nations with a non-temperate climate was also compared.
MATERIALS AND METHODS: Lethality was calculated as the rate of deaths in a determinate moment from the outbreak of the pandemic out of the total of identified positives for COVID-19 in a given area/nation, based on the COVID-John Hopkins University website. Lethality of countries located within the 5th parallels North/South on 6 April and 6 May 2020, was compared with that of all the other countries. Lethality in the European areas of The Netherlands, France and the United Kingdom was also compared to the territories of the same nations in areas with a non-temperate climate.
RESULTS: A lower lethality rate of COVID-19 was found in Equatorial countries both on April 6 (OR=0.72 CI 95% 0.66-0.80) and on May 6 (OR=0.48, CI 95% 0.47-0.51), with a strengthening over time of the protective effect. A trend of higher risk in European vs. non-temperate areas was found on April 6, but a clear difference was evident one month later: France (OR=0.13, CI 95% 0.10-0.18), The Netherlands (OR=0.5, CI 95% 0.3-0.9) and the UK (OR=0.2, CI 95% 0.01-0.51). This result does not seem to be totally related to the differences in age distribution of different sites.
CONCLUSIONS: The study does not seem to exclude that the lethality of COVID-19 may be climate sensitive. Future studies will have to confirm these clues, due to potential confounding factors, such as pollution, population age, and exposure to malaria.

Matched MeSH terms: Somalia/epidemiology
Development and human resources in the Islamic world: a study of selected countries

Duza MB

Popul Sci, 1987;7:1-30.
PMID: 12315536

"The present paper attempts to provide an analytical profile of development and human resources in [12] selected [Islamic] countries." The countries--Bangladesh, Somalia, Pakistan, Indonesia, Egypt, Turkey, Malaysia, Algeria, Iraq, Saudi Arabia, Kuwait, and United Arab Emirates--vary in income levels from low to high and in population size from 1 million to 159 million. Using data from the World Bank and the Population Council, comparisons are made on the basis of mortality and fertility levels, family size, income, urbanization, labor force size and growth, education, nutrition, and health. Governmental policy changes and future directions are discussed.

Matched MeSH terms: Somalia

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