Publications by authors named "Joumana Hermez"
Background: Lebanon faces an HIV epidemic concentrated in key populations. The national AIDS programme [NAP] hosted by WHO since 1989 achieved substantial progress towards the 95-95-95 UNAIDS targets. In 2023, we reviewed the programme to guide its planned transition back into the structure of the Ministry of Health [MOH].
View Article and Find Full Text PDFBackground: The Middle East and North Africa (MENA) region is the most affected by hepatitis C virus (HCV) infection globally. This study aimed to estimate HCV incidence among people who inject drugs (PWID) in MENA and evaluate the impact of interventions.
Methods: A mathematical model was extended and applied to 13 countries with at least one data point on the population size of PWID and HCV antibody prevalence among PWID, generating estimates for the period 2024-2030.
Syphilis infection prevalence in the Middle East and North Africa: a systematic review and meta-analysis.
EClinicalMedicine
September 2024
Background: Syphilis is a sexually transmitted infection (STI) that can be prevented and effectively treated; yet it continues to be a cause of morbidity and mortality worldwide. There is a limited understanding of the epidemiology of syphilis in the Middle East and North Africa (MENA) region.
Methods: A systematic review conducted up to April 30, 2024 assessed the prevalence of syphilis and followed PRISMA guidelines, without language and date restrictions.
Background: The epidemiology of Neisseria gonorrhoeae (NG) infection in the Middle East and North Africa (MENA) region remains poorly understood, despite the global recognition of its disease burden and the growing concern regarding antimicrobial resistance. This study aimed to systematically review the evidence on NG prevalence in MENA, estimate the pooled mean prevalence across different populations, and explore population-level associations with prevalence as well as sources of between-study heterogeneity.
Methods: The study conducted a systematic review, risk of bias assessment, meta-analyses, and meta-regressions, utilizing both published and unpublished evidence sourced from international, regional, and national databases, in adherence to PRISMA guidelines.
Community-led interventions to re-engage people living with HIV into care in Pakistan.
East Mediterr Health J
October 2024
Background: By 2021, Pakistan had an estimated 210 000 people living with HIV (PLHIV), and 27% of those initiated into treatment in 2020 had disengaged from care within one year.
Aim: We assessed the effectiveness of an intervention to re-engage PLHIV lost to follow-up into care in Pakistan.
Methods: Between September 2020 and May 2021, the Association of People Living with HIV (APLHIV) implemented a search and rescue intervention for PLHIV lost to follow-up in 2 large treatment centres in Pakistan.
Emergence of mpox in the Eastern Mediterranean Region: Data assessment and implications for a public health response.
J Infect Public Health
November 2024
Article Synopsis
- Monkeypox (mpox), caused by the MPX virus, had a global outbreak in 2022-2023 due to a new variant, clade IIb, primarily affecting men who have sex with men (MSM) in the Eastern Mediterranean Region (EMR).
- A study analyzed mpox case reports submitted to the WHO from May 2022 to December 2023, revealing that most cases were adult males, predominantly MSM, with common symptoms including rash and fever.
- Concerns were raised about data completeness, as reported cases might be significantly lower than actual occurrences, affecting regional response strategies; however, collaborative efforts among EMR countries showed promise for future preparedness.
WHO global research priorities for sexually transmitted infections.
Lancet Glob Health
September 2024
Article Synopsis
- STIs are a major global health issue that adversely impacts sexual and reproductive health, especially in low-resource settings due to gaps in evidence and tools.
- In 2022, the WHO launched an initiative to prioritize STI research, identifying 40 key areas, with a focus on developing affordable diagnostic tests, new treatments, and enhanced epidemiologic data.
- The priorities also emphasize innovative approaches to STI communication and partner management, and include research related to mpox, highlighting the need for STI studies during disease outbreaks linked to sexual transmission.
Article Synopsis
- Trichomoniasis, caused by the parasite Trichomonas vaginalis, is an often overlooked STI in the Middle East and North Africa (MENA), prompting a study to better understand its prevalence and public health impact.
- The research involved a systematic review of 263 studies that reported 462 measures of TV prevalence; findings showed significant variation across different groups, with an overall mean prevalence of 4.7% in women but higher rates in specific populations like female sex workers (10.3%) and symptomatic women (13.9%).
- The study highlights that despite conservative sexual norms in MENA, the prevalence of this treatable infection is significant, influenced by factors like access to healthcare and a decline in prevalence over time
Objectives: Hepatitis C virus (HCV) infection poses a global health challenge. By the end of 2021, the WHO estimated that less than a quarter of global HCV infections had been diagnosed. There is a need for a public health tool that can facilitate the identification of people with HCV infection and link them to testing and treatment, and that can be customised for each country.
View Article and Find Full Text PDFBackground: Following reports of an outbreak of HIV infection among children in Larkana District, Pakistan, an international team investigated the extent and cause of the outbreak between April and June 2019.
Aims: To investigate the incidence of HIV among children in Larkana District, Pakistan and describe the distribution of cases by time, place and person.
Methods: Self-referred persons were tested for HIV using the national testing protocol.
Background: Pakistan has a high hepatitis burden for both hepatitis C virus (HCV) and hepatitis B virus (HBV). To achieve World Health Organization (WHO) 2030 targets for hepatitis elimination, there is a need to constitute progress in the country, find the barriers and strategies for HCV elimination, and take actions to address the gaps.
Methods: We collected data from (1) WHO estimates in 2020, (2) midterm review questionnaire of the WHO regional action plan, and (3) WHO estimates on immunization.
Time to scale up testing and treatment for HBV and HCV in the WHO Eastern Mediterranean Region.
Lancet Gastroenterol Hepatol
October 2023
Background: Measuring the incidence of HIV and hepatitis C virus (HCV) infection among people who inject drugs (PWID) is key to track progress towards elimination. We aimed to summarise global data on HIV and primary HCV incidence among PWID and associations with age and sex or gender.
Methods: In this systematic review and meta-analysis, we updated an existing database of HIV and HCV incidence studies among PWID by searching MEDLINE, Embase, and PsycINFO, capturing studies published between Jan 1, 2000, and Dec 12, 2022, with no language or study design restrictions.
Article Synopsis
- * The study found that the overall pooled HSV-2 seroprevalence is around 5.1% in the general population, with higher rates of 13.3% in intermediate-risk groups and 20.6% in female sex workers, indicating significant variability across different demographics.
- * Compared to other global regions, MENA shows lower HSV-2 seroprevalence rates, but there is a trend suggesting an increase
This study characterized population-level trends and associations with hepatitis C virus (HCV) antibody (Ab) prevalence in the Middle East and North Africa (MENA). Data source was the standardized and systematically gathered MENA HCV Epidemiology Synthesis Project Database. Random-effects univariable and multivariable meta-regressions were conducted.
View Article and Find Full Text PDFProgress towards elimination of viral hepatitis by 2030 in the WHO Eastern Mediterranean Region, 2019.
Lancet Gastroenterol Hepatol
September 2022
The WHO Global Health Sector Strategy and hepatitis regional action plan for the WHO Eastern Mediterranean Region (EMR) proposed strategic directions for countries to progress towards the elimination of viral hepatitis by 2030. In 2019, we reviewed progress to gain a picture of current pressures and identify priority actions for member states to reach this goal. We collected data from country, regional, and global reports published in 2015-19, questionnaires completed by countries, and convened a regional consultation with programme managers and partners.
View Article and Find Full Text PDFBackground: The incidence of HIV infection among female sex workers and their clients in the Middle East and north Africa is not well known. We aimed to assess HIV incidence, the contribution of heterosexual sex work networks to these numbers, and the effect of interventions by use of mathematical modelling.
Methods: In this modelling study, we developed a novel, individual-based model to simulate HIV epidemic dynamics in heterosexual sex work networks.
Objectives: To present an assessment of key components and results of HIV surveillance activities relevant for understanding HIV epidemics in the countries of the World Health Organization (WHO) Eastern Mediterranean Region among key populations (KPs), which include men who have sex with men (MSM), sex workers, people who inject drugs and transgender people.
Methods: We examined HIV surveillance data submitted by the National AIDS Programmes of all 22 countries of the WHO Eastern Mediterranean Region via an online database hosted by the WHO since 2011. We also examined journal articles available on PubMed and technical reports on surveillance activities.
Background: In 2016, WHO launched the Global Health Sector Strategy on STIs, 2016-2021 (GHSS) to provide guidance and benchmarks for country achievement by 2020 and four global targets for achievement by 2030.
Methods: A country survey jointly developed by experienced technical personnel at WHO Headquarters (HQ) and WHO regional offices was reviewed and distributed by WHO regional advisors to 194 WHO Member States in September-March 2020. The survey sought to assess implementation and prioritization of STI policy, surveillance, service delivery, commodity availability, and surveillance based on targets of the GHSS.
HIV epidemiology in the WHO Eastern Mediterranean region: a multicountry programme review.
Lancet HIV
February 2022
Background: Worldwide, HIV incidence, and mortality has decreased since 2010; however, in the WHO Eastern Mediterranean region, trends continue to increase. We reviewed the regional progress to understand determinants of this situation and inform strategies to accelerate the response.
Methods: We conducted a multicountry programme review of 22 countries in the WHO Eastern Mediterranean region from Jan 1, 2010 to Dec 31, 2020.
Article Synopsis
- - From 2016 to 2019, the adoption of WHO PrEP guidelines saw significant growth, with 67% of surveyed countries implementing these recommendations, increasing the number of PrEP users from around 370,000 to 626,000 in just one year.
- - By analyzing data from various regions, it was forecasted that global PrEP users could reach between 2.4 million and 5.3 million by the end of 2023, although potential disruptions from COVID-19 could lower this estimate to between 2.1 million and 3 million.
- - The findings highlight the successful uptake of PrEP in many countries but also underline the uncertainty introduced by the pandemic, emphasizing the need for
Background And Aims: People who inject drugs (PWID) are a key population at high risk of hepatitis C virus (HCV) infection. The aim of this study was to delineate the epidemiology of HCV in PWID in the Middle East and North Africa (MENA).
Methods: Syntheses of data were conducted on the standardized and systematically assembled databases of the MENA HCV Epidemiology Synthesis Project, 1989-2018.
Partner notification in the Eastern Mediterranean Region: is there a way?
East Mediterr Health J
October 2019
Article Synopsis
- The study aimed to assess the prevalence of Chlamydia trachomatis infection in the Middle East and North Africa due to limited understanding in the region.
- Researchers conducted a systematic review and meta-analysis, analyzing 552 prevalence measures from 255 reports across 20 countries to identify infection rates.
- The findings revealed a pooled prevalence of 3.0% for current genital infections in general populations, with higher rates in specific groups such as female sex workers (13.2%) and symptomatic individuals (17.4% in men and 12.4% in women).