Public Health articles list

Background: Exhaust noise is known to be a major pollutant in the environment and workplaces due to the development of industry and transportation. Exhaust noise can be reduced to normal levels by mufflers or silencers. A reactive muffler efficiently dampens noise at low frequencies by reflecting sound waves. Therefore, muffler design is of great importance in exhaust noise reduction. Transmission loss (TL) is an essential characteristic of mufflers, demonstrating their acoustical properties. Any acoustical appliance is selected based on its damping performance and reliability. Predicting TL through experimentation is different from theoretical calculations. Methods: In the present study, a double-expansion chamber muffler was designed as a reflective muffler on a laboratory scale by equations. Next, TL was evaluated by an impedance tube applying a 4-microphone technique to determine the acoustical performance of the designed muffler. Results: Findings revealed that the TL of the muffler at 312 Hz frequency obtained 27.5 dB agreement with the required TL of the muffler of 25 dB. In addition, the TL of the muffler against frequency attenuates noise in broadband frequencies. Conclusions: These results indicated that the built muffler provides desired TL for exhaust chambers. Therefore, equations can be used as a precise method for muffler design. Furthermore, multi-expansion chamber mufflers are useful for reducing noise at a wide range of frequencies.

Niloofar

Purpose Noise pollution is a common health hazard worldwide which is emitted along with chemical air pollutants, simultaneously from many sources. Some studies have been conducted to control these pollutants, simultaneously with promising results being achieved. Dielectric beads have been used in air pollution control technologies, successfully and probable effectiveness of them in noise reduction can be promising in dual use of them in the exhausts emitting noise and air pollution, simultaneously. Methods In order to investigate the effectiveness of dielectric beads in noise reduction, two types of them; namely glass and ceramic beads, were placed separately inside the connecting tube of a double-expansion chamber muffler. Then the transmission loss (TL) of muffler was examined using impedance tube. A factorial design was used to evaluate and optimize the effect of noise related parameters on TL of such a system. Results Results show that the presence of dielectric beads has significant effect on TL of muffler. The maximum TL was obtained as 74.76 dB for muffler with ceramic beads, under the optimal condition of 5250 Hz and 120 dB. Measurement of TL and sound absorption coefficient (SAC) of glass and ceramic beads showed that the noise reduction in muffler with ceramic and glass beads is probably due to SAC in ceramic beads and noise reflections in glass beads, respectively. Conclusion These results promise the dual use of dielectric beads in the exhausts emitting noise and air pollution simultaneously.

Niloofar

Sulfur dioxide, a noxious air pollutant, can cause health and environmental effects, and its emissions should be controlled. Nonthermal plasma is one of the most effective technologies in this area. This study evaluated the efficiency of a packed-bed plasma reactor (PBR) and in-plasma catalysis (IPC) in SO2 removal process which were finally optimized and modeled by the use of the central composite design (CCD) approach. In this study, SO2 was diluted in zero air, and the NiCeMgAl catalyst was selected as the catalyst part of the IPC. The effect of three main factors and their interaction were studied. ANOVA results revealed that the best models for SO2 removal efficiency and energy yielding were the reduced cubic models. According to the results, both PBR and IPC reactors were significantly energy efficient compared with the nonpacked plasma reactor and had high SO2 removal efficiency which was at least twice larger than that of the nonpacked one. Based on the results, the efficiency of IPC was better than in PBR, but its performance decreased over time. However, the PBR had relatively high SO2 removal efficiency and energy efficiency compared to the nonpacked reactor, and its performance remained constant over the studied time. In optimization, the maximum SO2 removal efficiency and energy efficiency were 80.69% and 1.04 gr/kWh, respectively (at 1250 ppm, 2.5 L/min, and 18 kV as the optimum condition) obtained by the IPC system which were 1.5 and 1.24 times greater than PBR, respectively. Finally, the model’s predictions showed good agreement with the experiments.

Niloofar

Air pollution is a major health problem in developing countries and has adverse effects on human health and the environment. Non-thermal plasma is an effective air pollution treatment technology. In this research, the performance of a dielectric barrier discharge (DBD) plasma reactor packed with glass and ceramic pellets was evaluated in the removal of SO2 as a major air pollutant from air in ambient temperature. The response surface methodology was used to evaluate the effect of three key parameters (concentration of gas, gas flow rate, and voltage) as well as their simultaneous effects and interactions on the SO2 removal process. Reduced cubic models were derived to predict the SO2 removal efficiency (RE) and energy yield (EY). Analysis of variance results showed that the packed-bed reactors (PBRs) studied were more energy efficient and had a high SO2 RE which was at least four times more than that of the non-packed reactor. Moreover, the results showed that the performance of ceramic pellets was better than that of glass pellets in PBRs. This may be due to the porous surface of ceramic pellets which allows the formation of microdischarges in the fine cavities of a porous surface when placed in a plasma discharge zone. The maximum SO2 RE and EY were obtained at 94% and 0.81 g kWh−1, respectively under the optimal conditions of a concentration of gas of 750 ppm, a gas flow rate of 2 l min−1, and a voltage of 18 kV, which were achieved by the DBD plasma packed with ceramic pellets. Finally, the results of the model's predictions and the experiments showed good agreement.

Niloofar

Poor water quality and lack of access to improved sanitation continue to pose a significant threat to human health. The burden of disease analysis suggests that lack of access to safe water supply, sanitation and hygiene is the third most significant risk factor for poor health in developing countries with high mortality rates. Diarrhoea is the leading disease associated with unsafe water supply, sanitation and hygiene and is responsible for the deaths. The study observed that out of the 150 respondents, 37% are 31-40 years, followed by 20-30 years with 32%. 130 (86.7%) respondents have got married, and 61% of the respondents are female. 85% adopted the nuclear family system, and 50% of respondents are illiterates in the study areas. 85% of respondents are daily wage earners, 37%are earnings rupees between 2000-2500 per month. 27% of respondents are landless labours, and 37% of households possess below 2 acres of land. 40% of respondents suffer from health problems, and 44% consume rice as their staple food. 62% of respondents have debts, and 33% got from money lenders. 62% of respondents do not have toilet facilities and go open defecation. 92% of respondents stated that toilet makes dignity, saves time and energy, saves their children school days, makes adolescent girls privacy, save wage loss, and toilet makes quality life.

B Suresh Lal

Background: Ending open defecation has been identified as a top priority for reducing global inequalities in water and sanitation (WASH). It is explicitly referenced in sustainable development goals (SDGs) target 6.2 and closely associated with more comprehensive efforts to end extreme poverty by 2030. Since 2000, the global rate of open defecation has decreased from 21% to 9% (0.7 percentage points per year). However, the 673 million people still practicing open defecation in 2017 were increasingly concentrated in a small number of countries, and these will need to be the primary focus of efforts to end open defecation by 2030. Objectives: To study the socio-economic background of Adivasis, to study the status of sanitation in rural areas, to examine whether economic conditions affect open defecation, to examine whether better sanitation facilities improve health conditions and to examine whether improved sanitation facilities impact the quality of life and thereby dignity of tribal women. Methods: Essentially it is an empirical study and a multi-stage random sample design was adopted. Data were collected from 120 sample households from two villages, i.e., Bandarigudem and Nadikudi of Khammam districts in Telangana State through a structured questionnaire. Statistical tools like frequency distribution, percentages, cross-tabulation with Chi-Square test, and a case study method were used. Results & Discussion: This paper found that 35% of Adivasis have health problems, and 73% said that they are getting treatment with RMP. 87% have toilet facility and more than 12% still defecate openly. 18.3% said that they faced different problems at open defecation, and 50% of women not using sanitary napkins. Nearly 90% of respondents wash their hands after toilets and coming from outside of the home. Ten per cent of respondents said that they do not have an awareness of sanitation. Therefore, the study confirmed that the sanitation facilities considerably made the women's dignity and quality of life better in the study area. Moreover, four case studies also focused on open defecation problems in the study area.

B Suresh Lal

Effective communication between patients and doctors is fundamental to high-quality healthcare, patient safety, and overall satisfaction. However, the onset of COVID-19 has prompted significant shifts in communication from in-room and face-to-face interactions to virtual consults. The impact of this pandemic related change on patient-doctor communication goals, processes, attributes, and environment remains unclear. We undertook a scoping review involving the systematic search of seven academic databases for relevant articles published up to and including June 2021. In total, 47 articles were identified that met the inclusion criteria. We applied the patient-doctor communication framework to guide our deductive thematic analysis of articles included, sorting results from reported studies and position papers into themes and sub-themes. The theme of communication goals highlighted sub-themes related to patient safety, convenience, affordability, and satisfaction; preparation included sub-themes on technology interventions, workforce training, and digital literacy; participant attributes included compassion for doctors and rebuilding trust among patients; and communication process included issues related to telemedicine or video conferencing, challenges with diminished patient privacy, and distractions in the patient's home setting. Finally, the environment theme included insights into doctors' workload, isolation, and anxiety and how changes requiring increases in virtual consults iteratively altered confidence in care provision and communication with patients. Results of the scoping review provide important insights for strengthening virtual patient-doctor interactions, including target areas for training and professional development during and beyond the current pandemic.

Mahuapatra1@gmail.com

The anti-emetic activity of the leaves methanolic extracts of Cassia angustifolia Vahl., Cassia holosericea Fresen., Cassia italica Miller. Lam. ex F.W. Ander and Cassia purpurea Roxb., was evaluated in young chicks. Emesis was induced by copper sulfate (50 mg/kg), and the extracts were tested orally at a dose of 150 mg/kg. All the extracts significantly decreased the number of retching (p < 0.05 and p < 0.01) compared with standard chlorpromazine.

Dr. Salman Ahmed

The current study was designed to explore the analgesic effects of methanol extracts from the leaves of Samanea saman Merr. and Prosopis cineraria Druce., using tail immersion test. Thermal stimuli produced painful reactions in mice by dipping the tail tips of the mice into hot water. Methanol extracts of the leaves of Samanea saman Merr. and Prosopis cineraria Druce. were administered intraperitoneally at the dose of 100mg /kg body weight. Pethidine 50mg/Kg intraperitoneally was used as a standard analgesic drug. The tail-flick latency delay was measured at 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 hours after the intraperitoneal administration. Both extracts produce analgesic effects when compared with pethidine.

Dr. Salman Ahmed

Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes (T2D) are interconnected metabolic disorders with significant health implications. However, a comprehensive understanding of the extent of their co-occurrence in Africa is lacking. The aim of this review was to determine the prevalence of MAFLD and its association with glycemic control (HbA1c) in persons with T2D in Africa. A systematic search was conducted on PubMed, Medline, Embase, Scopus, Global Health, and Web of Science from their inception to December 6, 2023. Data on MAFLD prevalence and correlation coefficients regarding its association with glycemic control were pooled through random effect meta-analyses. Potential sources of heterogeneity were investigated using subgroup analysis and meta-regression. A total of 10 studies were included in the meta-analysis of MAFLD prevalence, while 2 were incorporated in the analysis of the association between MAFLD and glycemic control. The pooled prevalence of MAFLD in persons with T2D was 48.1% (95% CI: 36.1–60.3). The subgroup analysis revealed regional variations in MAFLD prevalence, with rates of 44.7% (95% CI: 28.7–62.0) in sub-Saharan Africa and 55.3% (95% CI: 36.2–73.0) in Northern Africa. Additionally, we observed an increasing trend in MAFLD prevalence, recording 55.1% (95% CI: 43.6–66.1) in the recent five years. There was a weak positive correlation between MAFLD and HbA1c (r = 0.33, 95% CI: 0.18–0.47). The findings of this study highlight a high prevalence of MAFLD in persons with T2D in Africa, with a suggested link between MAFLD and suboptimal glycemic control. Therefore, healthcare providers should prioritize the screening and management of MAFLD in individuals with T2D to enhance their metabolic health.

Emmanuel Ekpor

Context: Menstruation is one of the most basic characteristic features of girls and inadequate knowledge of adolescent girls about menstruation can result in faulty menstrual hygiene management (MHM) and inappropriate dietary management both of these can causes diseases which is a major threat for adolescent health in developing countries like Bangladesh. Aim: To identify current knowledge, attitudes, and practices related to menstruation and menstrual hygiene management (MHM) among adolescent girls. Settings and Design: It is a descriptive cross-sectional study conducted in Jashore, Bangladesh. Methods and Materials: A pre-formed, pre-tested questionnaire was used. The questionnaire-based survey was conducted among randomly selected 250 adolescent girls between 10 and 19 years. Statistical analysis used: Data were analyzed statistically by Microsoft office excels and SPSS windows version 16 software programs. Results: Among 250 adolescent girls majority had their menarche between 12 and 15 years of age, 70% of adolescent girls of this study belonged to lower class families. This study revealed that 85% of the respondents had regular menstruation whereas 15% had irregular menstruations also. Most of them faced different types of Premenstrual syndrome including 76% from headache, 80% from lower abdominal pain, and 62.5% from fatigue and weakness. Only 56% had previous knowledge about puberty before attaining menarche. There was a statistically significant correlation between the mother’s education and the knowledge of participants about menstruation at puberty. All the participants used to bath and wash hand after changing pads whereas 80.8% used to avoid all types of exercises. Almost 94% of respondents used to dispose of their napkins properly. The micro-nutrient deficiency was also common; especially 49.2% were suffering from Iron deficiency and 69.6% from folic acids deficiency. Conclusion: Awareness programs regarding both menstrual hygiene and dietary management can aid to alleviate some complications during puberty and ensure better health for adolescent girls.

Arafat Hassan Razon

Background: Irritable bowel syndrome (IBS) is a very common gastrointestinal dis-order worldwide, but research regarding this disease is rare in Bangladesh. This studyaimed to assess the prevalence of IBS and its associated risk factors among universitystudents in Bangladesh.Methods: This is a cross-sectional study. A total of 300 randomly selected partici-pants were included in this study. By using a structured questionnaire and anthropo-metric methods, we collected all the required data for our study. The diagnosis of IBSwas based on Rome III criteria.Results: The overall prevalence of IBS was 39.3%, but the majority (77.3%) had nobasic awareness of IBS. In our study, anxiety and depression (χ2 = 6.817; odds ratio[OR] = 1.910; 95% confidence interval [CI] = 1.172, 3.113; P = 0.011) had a signif-icant relationship with IBS and IBS had a significant (P < 0.001) relationship withfood intolerance (χ2 = 8.737; OR = 2.130; 95% CI = 1.284, 3.531), chest pain(χ2 = 7.482; OR = 2.035; 95% CI = 1.218, 3.401), and insomnia (χ2 = 19.320;OR = 2.907; 95% CI = 1.794, 4.709). In our dietary data, the intake patterns of vege-tables (P = 0.000), fast food (P = 0.000), and tea–coffee (P = 0.003) showed astrong significant association with IBS. On the other hand, monthly household income(P = 0.154) and body mass index (BMI) (P = 0.138) showed no significant associa-tion with IBS. Among our study subjects, IBS-constipation (54.2%) was more com-mon than IBS-diarrhea (27.1%) and IBS-mixed (18.6%). Moreover, among the 118IBS respondents, 67.8% had a headache with increased flatulence (95.8%) as the mostcommon IBS-related complication.Conclusion: IBS is common in university students of Bangladesh and is associatedwith anxiety, depression, and particular dietary patterns.

Arafat Hassan Razon

Background: Hypertension (HTN) has emerged as a significant public health challenge and a leading cause of mortality and morbidity in developing countries like Bangladesh. Objective: This study aimed to assess the prevalence of hypertension and its associated risk factors among resi dents of Dhaka, the capital of Bangladesh, during the COVID-19 pandemic. Methods: A cross-sectional study was conducted using a multistage random sampling technique to select 305 individuals from Khilkhet Thana in Dhaka North City Corporation. Data were collected through direct surveys using a modified version of the WHO STEPS questionnaire and analyzed using SPSS version 22 software. Findings: The study identified a 34.4 % prevalence of HTN among the participants, with 46.2 % of hypertensive individuals being under 40 years of age. Of the 105 hypertensive individuals, 65 % were newly diagnosed during the study, and 11 previously diagnosed individuals were not on any medication. A significant association (P < 0.001) was observed between the prevalence of HTN and inadequate intake of fruits (OR = 3.129, 95 % CI = 1.912–5.122, χ2 = 21.328), insufficient vegetables consumption (OR = 2.199, 95 % CI = 1.356–3.565, χ2 = 10.373), high intake of fatty foods (OR = 2.387, 95 % CI = 1.465–3.890, χ2 = 12.454), and excessive salt consumption (OR = 2.771, 95 % CI = 1.677–4.579, χ2 = 16.310). Additionally, the prevalence of HTN was notably higher among overweight (46.70 %) and at-risk (22.90 %) individuals, based on Body Mass Index (BMI) and waist-to-hip ratio (WHR), respectively. The study also found significant correlations (P < 0.001) between HTN and factors such as smoking (OR = 2.824, 95 % CI = 1.601–4.980, χ2 = 13.432), kidney disease (OR = 7.534, 95 % CI = 2.694–21.070, χ2 = 19.282), general stress (OR = 3.692, 95 % CI = 2.179–6.255, χ2 = 24.896), COVID-19 related stress (OR = 3.511, 95 % CI = 2.116–5.826, χ2 = 24.712) and sleeping pattern (OR = 5.798, 95 % CI = 3.404–9.875, χ2 = 45.724). Conclusions: The high prevalence of HTN, particularly among younger individuals during the COVID-19 pandemic, highlights the urgent need for nationwide surveys, surveillance, and clinical research to accurately depict the true burden of HTN in Bangladesh.

Arafat Hassan Razon

Background: Dyslipidemia is an established cardiovascular risk factor in persons with type 2 diabetes (T2D), yet the extent to which these conditions co-occur in Africa is unknown. This systematic review and meta-analysis aimed to determine the prevalence of dyslipidemia among persons with T2D in Africa. Methods: Medline, Embase, Global Health, Scopus, and Web of Science were searched on 5 December 2023. This review adhered to the PRISMA guidelines and was prospectively registered on PROSPERO. The prevalence data for dyslipidemia was pooled through a random-effects meta-analysis. The authors assessed heterogeneity and publication bias using I2 statistics and Egger’s test, respectively. Results: Our search identified 8035 records, of which 60 articles involving 20 034 individuals with T2D were included in this review. The pooled prevalence of dyslipidemia recorded 38.6% (95% CI: 34.1–43.4) for high TC (≥ 5.2 mmol/l), 52.7% (95% CI: 44.2–61.1) for high low-density lipoprotein cholesterol (LDL-C) (≥ 2.6 mmol/l), 43.5% (95% CI: 37.1–50.0) for low high-density lipoprotein cholesterol (HDL-C) (< 1.0 mmol/l in men and less than 1.3 mmol/l in women), and 37.4% (95% CI: 32.2–42.9) for high triglycerides (TG) (≥ 1.7 mmol/l). Subgroup analysis based on gender indicated a notably higher prevalence of dyslipidemia among females compared to males. Conclusion: Dyslipidemia is prevalent among persons with T2D in Africa. This highlights the need for early screening, diagnosis, and management of dyslipidemia to mitigate the risk of cardiovascular complications in this population.

Emmanuel Ekpor

Background The prevalence of diabetes is escalating globally, underscoring the need for comprehensive evidence to inform health systems in effectively addressing this epidemic. The purpose of this study was to examine the patterns of countries’ capacity to manage diabetes using latent class analysis (LCA) and to determine whether the patterns are associated with diabetes-related deaths and healthcare costs. Methods Eight indicators of country-level capacity were drawn from the World Health Organization Global Health Observatory dataset: the widespread availability of hemoglobin A1C (HbA1c) testing, existence of diabetes registry, national diabetes management guidelines, national strategy for diabetes care, blood glucose testing, diabetic retinopathy screening, sulfonylureas, and metformin in the public health sector. We performed LCA of these indicators, testing 1–5 class solutions, and selecting the best model based on Bayesian Information Criteria (BIC), entropy, corrected Akaike Information Criteria (cAIC), as well as theoretical interpretability. Multivariable linear regression was used to assess the association between capacity to manage diabetes (based on the latent class a country belongs) and diabetes-related deaths and healthcare costs. Results We included 194 countries in this secondary analysis. Countries were classified into “high capacity” (88.7%) and “limited capacity” (11.3%) countries based on the two-class solution of the LCA (entropy = 0.91, cAIC = 1895.93, BIC = 1862.93). Limited capacity countries were mostly in Africa. Limited capacity countries had significantly higher percentage of their deaths attributable to diabetes (adjusted beta = 1.34; 95% CI: 0.15, 2.53; p = 0.027) compared to high capacity countries even after adjusting for income status and diabetes prevalence. Conclusions Our findings support the report by the Lancet commission on diabetes, which suggests that differences in diabetes outcomes among countries may be explained by variations in the capacity of and investments made in their health systems. Future studies should evaluate initiatives such as the WHO Global Diabetes Compact that are currently underway to improve the capacity of resource-limited countries.

Emmanuel Ekpor

The city that never sleeps, a vibrant tapestry of dense neighborhoods and relentless energy, has long grappled with the pervasive challenge of air pollution. The very dynamism that defines the city – its traffic, buildings, and industry – contributes to ambient concentrations of fine particulate matter (PM2.5) and ground-level ozone (O3), pollutants known to exact a heavy toll on public health. [1-3] An extended analysis of environmental health data from 2005 to 2019, meticulously compiled by the town Department of Health and Mental Hygiene (DOHMH), offers a crucial lens through which to view the city's journey: a narrative marked by significant public health victories interwoven with stark, persistent environmental injustices. [4] This fifteen-year period reveals not just the efficacy of targeted interventions but also the deeply entrenched disparities that continue to leave vulnerable communities uneasy. Thus, the aforementioned challenge provides a very important lesson to address similar problems around the globe, especially in the crowded urban areas.

Karishma

The unprecedented global effort to develop and distribute COVID-19 vaccines has highlighted remarkable scientific achievements and persistent inequities in access across populations. Analyzing of regional vaccine deployment patterns reveals critical insights into pandemic response dynamics, shaped by manufacturing capacity, regulatory frameworks, procurement strategies, and regional health priorities. Data from WHO regions (Africa, the Americas, Eastern Mediterranean, Europe, and Western Pacific) demonstrate significant disparities in vaccine types and suppliers, underscoring the complexity of global vaccination efforts. (Figure 1) illustrates this regional vaccine distribution by WHO regions.

Karishma

The global endeavor to develop and deploy COVID-19 vaccines has underscored both significant scientific progress and enduring disparities in worldwide access. This analysis examines regional vaccine distribution patterns across World Health Organization (WHO) regions—Africa, the Americas, Eastern Mediterranean, Europe, and Western Pacific—revealing substantial variations in vaccine types and manufacturer contributions. Data indicate that the Americas and Europe demonstrate a broad vaccine portfolio, with prominent contributions from major international pharmaceutical companies alongside regionally developed vaccines. Conversely, African, Eastern Mediterranean, and Western Pacific regions show considerable reliance on vaccines from Asian (notably China and India) and Russian manufacturers, in addition to Western products. This distribution highlights the influence of geographical proximity to manufacturing centers, regional alliances, and local production capabilities (e.g., CIGB and Finlay in the Americas, COVIran Barakat in the Eastern Mediterranean, and various Chinese products in the Western Pacific) on vaccine availability. Predominant vaccines by country count include Pfizer-BioNTech's Comirnaty, AstraZeneca's Vaxzevria, Janssen's Ad26.COV2-S, Moderna's Spikevax, Beijing CNBG's BBIBP-CorV, and SII's Covishield. The observed regional variations in vaccine types and supply chains carry implications for comparative effectiveness research, the understanding of differential immune responses, and the evaluation of pandemic control strategies. Furthermore, inconsistencies in global data reporting and product nomenclature present challenges for comprehensive analysis. The findings emphasize the importance of diversified supply chains, the growing role of regional manufacturing in enhancing global health security, and the need for standardized global data for a more profound understanding of vaccine equity and efficacy to inform future pandemic responses.

Mostafa Eissa

Background: Malnutrition is a deficiency of nutrients due to inadequate energy intake. Picky eating behavior in children could be a cause of malnutrition, but previous studies’ results were still inconsistent. This study aimed to determine the relationship between picky eating behavior and malnutrition among children aged 2-5 years. Methods: This case-control study involved 70 children aged 2-5 years in Kutukan Village, Randublatung District, Blora Regency. Malnutrition was defined as a weight-for-age Z score <-2.0 SD based on the WHO classification. Child eating behavior was evaluated using the Child’s Eating Behavior Questionnaire (CEBQ), identifying picky eaters if the food avoidance score surpassed the food approach score. Data analysis employed the Chi-Square test. Results: Boys experienced more malnutrition, with 20 (57.1%) affected, and the most affected age group was 24-35 months, with 19 (54.3%). Questionnaire processing revealed that the number of picky-eater children in the malnutrition group was 33 (94.3%), while in the non-malnutrition group, there were 31 (88.6%). Bivariate analysis showed no relationship between picky eating behavior and malnutrition in children aged 2-5 years (p=0.673; CI 95%=0.364-12.459). Conclusion: This study found no significant relationship between picky eating and malnutrition in children aged 2-5 years.

Minidian Fasitasari

Since the WHO declared COVID-19 a pandemic on March 11, 2020, all countries worldwide have taken precautions to combat this pandemic, except for Yemen. The civil war and resulting humanitarian crises have diverted the attention of the Yemeni people and authorities away from COVID-19, potentially leading to the escalation of the pandemic. Following the initial denial, the internationally recognized government and the de facto authority of the Houthis acknowledged the first COVID-19 cases on March 11, 2020 and May 13, 2020, respectively. With only half of the Yemeni hospitals and medical facilities being fully operational, the authorities and humanitarian groups are working together to end the crisis. Due to paucity of information on the real number of cases in the country attributed to various reasons, no one can predict the future in this country, which will be most likely worse unless the civil war stops, and the humanitarian groups with the authorities need to work hard to strengthen the health system to prepare it for the current and all upcoming health crisis and pandemics.

Karishma